Sunday, February 17, 2008

I said no, no, no.....

Not to going to rehab, but to an endometrial biopsy. Here's how it went down:

Nurse called last week, I thought to start scheduling our next cycle. She was actually calling to relay the advice of a new doctor who has apparently joined the practice. This doctor decided that what we really needed was to do a mock cycle and then an endometrial biopsy to see whether or not I needed to add any additional progesterone to our routine. That means, go through an entire cycle, including weeks of PIO injections, ending not in a transfer, but in this new doc taking a swab of my uterine lining. Based on the results of those weeks of hormones, headaches, shots and that swab we would either: a.) know that the protocol was just fine and start a new cycle or b.) add a little more progesterone to it.

I hung up with nurse, slightly stunned. Thinking first of all, "Who the F*ck is Dr. ____ and what does he/she know about me?" Second thought was, "Yes, my lining was slightly under 8 this time around but THEY CHOSE not to increase my estrace. It was less than 8 the first cancelled cycle and we upped the estrace, which seemed the do the trick. It was less than 8 the second cancelled cycle because I was only on estrace for a few days before the first stripe test...."

The more I thought about things, the angrier I got. I turned to hubby for some reason and rational thought. Perhaps I was overreacting or still upset from the BFN. His anger and indignity only added to mine. He broke it down like this: If an endometrial biopsy was what they wanted to do, they had 2 cancelled cycles which they could have continued to that end, AND the several months we were sitting around doing nothing while we were waiting for our donor to be available. Now, they want to waste our time, money, emotions? Now??

I felt slightly better knowing we were on the same page. From my perspective, I simply couldn't imagine going through the stress of a cycle knowing it was a mock one. Shooting up is hard for me as it is. Would I really go forward with that day after day knowing that all I had to look forward to was a cotton swab up my noonie? It would be different if I or they suspected some serious abnormality. It would be different if increasing estrace hadn't already been proven to work. It would be different if we only had 1 or 2 embies left. It would be different if we had a few thousand dollars to throw around on meds and medical tests that serve our clinic's purposes and stats more so than ours. It would be different if Dr. ___ was the person who had taken us through the process up to this point. It would be different if there weren't ample time and opportunity to address this perceived issues without the pain of additional and fake cycle.

But none of this is the case.

So, confident that hubby had my back, I called nurse the next morning. And we talked about all of this. And much more. We talked about how bothered we were that of the 4 people present for our transfer, we knew none of them (nurse had CPR training and had already told us she couldn't be present). We talked about how upset we were that this new and unknown person (Dr. ___) seemed to be calling the shots on our cycles. We talked about how it felt when we felt the (well-respected and university-affiliated) clinic was more interested in keeping their stats above the national average than they were with us as patients. It was a long and hard conversation.

And it was so worth it.

She totally understood and sympathized and made it seem like she, too, was bothered by the message she had to relay. She explained that the clinic was expanding and that a number of doctors had joined the team, hence Dr. ___, hence the unknown faces between my legs at transfer. She explained who the new docs were and which aspects of the clinic they would be in charge of. We told her that we considered her our lifeline and the one real and human point of contact there. We didn't know what we would do without her. Long pause. She said, "then I am going to keep your file. I'm supposed to turn it over to another nurse now that you are doing FET but I won't and I am going to use this conversation as my justification."

And we told her we were so grateful for that. She has been with us since the day I called almost a year ago and set up an appointment for a consult. She was the one that hugged me when I cried during the needle training. She was the one that held my hand when I got my stitch put in before the first transfer. She was the one that had to call and tell me about the BFN. To go through this without her would be rough.

So, it's day 5 of lupron. So far, so good. I need to get back in the habit of good breakfasts and healthy days. But we are looking forward to our first FET, scheduled tentatively for early March, with nurse by our side.


Grover20 said...

Wow, its amazing the power of a well timed conversation that comes from a place of truth... best of luck with you in the weeks to come.

stacyb said...

The best thing about the clinic we went to was one nurse we worked with, like yours, she was with us from the beginning and we went through her for everything, her caring and assistance was AMAZING. It truly made all the difference in our care at the big clinic we were at. I am SO GLAD that you have someone there for you. And so great to read that you and your husband were on the same page regarding how to proceed -- it makes things easier.

I am looking forward to your FET in march too.

Oh, and I'm tagging you! See my blog for details.

Anonymous said...

Before this current cycle, my doctor (who by the way, I got by default when the doctor I CHOSE left the practice), suggested that same biopsy, as well. Like you, I couldn't imagine doing all of the drugs, checks, etc for nothing. AND...she told me that the biopsy would hurt. UM...hello!! In this day and age, there is no reason for that. I told her she would have to give me some VERY heavy drugs if I went ahead w/ it. I do not believe in physical pain (we get enough emotional pain from this). But she sort of has a "grin and bare it attitude." I hate her. Anyway...did they mention sending your samples to Yale? That is what they wanted to do w/ mine. I declined the procedure, anyway. But they did tell me, that it is not usually something that they recommend w/o several failed cycles with no apparent reason.

m said...

Dear pretty, I am so sorry to hear you're not happy with your current doc. There was no mention of sending samples to Yale, but I wouldn't doubt it.

I could understand the recommendation better if this were our nth failed cycle. But the first 2 cancellations had NOTHING to do with us - our chosen donor didn't respond to the protocols. So this most recent transfer was actually our very first attempt to sustain a pregnancy. Our first failed attempt.

I am glad to hear that I'm not the only person that said thanks but no thanks to this seemingly cruel and unusual procedure. There's got to be a better way!

Kami said...

I am angry for you too! That if awful. I'm glad you have at least one link to a human.

We were lucky to have a small clinic with only one doctor and still very good stats.

GL with this cycle!!!!