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Saturday, November 06, 2004

Fertility Specialist... an oxymoron?

So the visit to Dr. Try Me proved to be confusing... I don't know what I expected, but I left with a second opinion very different from my first opinion.

shit... why can't this be easy????

I'll start at the beginning. Dr. Try Me is a OB/GYN specializing in Infertility... he is not an RE (I am not sure if that is a problem). His office is nice... (not super fancy) and (is this weird) is attached to a Laser Hair removal office.... I knew they were next to each other but I didn't know they were actually attached. I don't know why this seems odd to me... is it?

Dr. Try Me was very casual. His desk was messy (I am very anal) but he spent and hour talking with me.... Here are the basics...

After looking at my thick chart he wants to check for PCOS. This was very surprizing to me because I have clockwork periods and have just assumed that I ovulate every month. The main reasons he wants to check are...

1. I have gained about 10 lbs recently... mainly from eating like shit... BUT... it is not the gain that concerns him... it is the inability to lose the weight... I am one of those people that can go on a strict diet and spend HOURS a week at the gym afor 6-8 weeks and not lose a pound... Seriously... once I even hired a personal trainer and she was baffled.... I think she thought I was secretly cheating on my diet... but I really wasn't.
2. I have these weird chin hairs that I am obsessed with plucking... Not like 2 or 3.... Like 20... Really dark.... I am Italian and have always just thought this was part of it.... but maybe my facial hair is "excessive..."
3. My m/c's.... maybe the egg was not "good quality" to begin with.

I think these are the only PCOS indicators I have... My original Dr... (Dr. Good) didn't seem to think PCOS was a possibility when I asked him.... but apparently he wrote that it could be a possibly in my chart so Dr. Try Me is interested in following up with several ultrasounds to moniter my follicles next cycle. They will also do blood work and check my progesterone to see if there is a need for suppliments since no one has ever actually checked my progesterone. He also recommends vaginal instead of the oral ones Dr. Good suggested.

Oh in case anyone was wondering... he also said that OPK are mostly crap and most people have trouble with them.. he doesn't recommend spending the $$$.

Dr. Try Me also disagreed with Dr. Good on the use of Lovenox... He said that he "probably" wouldn't use it because he did not think the anticardiolipids were causing my m/c... because of how early I m/c-ed and because we never got to see a heartbeat.

He also did not think that he would categorize me as a "high risk" pregnancy... He did not think that my blood work indicated the need for a specialist once I had a viable pregnancy. He also categorized my 2 pregnancies as a probably "chemical pregnancy" since we never saw the heartbeat (which I did not like) and said we would be in a whole different ballgame one we saw a heartbeat.

He seemed nice and sure of his plan... I am scared of the PCOS... When I googled it... the news was pretty scary... I also am still surprised that he thinks this might be the problem.... I swear to God I OVULATE! But... my problem might be sickly over-insulined testosterone-y eggs...

So here I sit... not exactly sure if I should do the follicle monitoring.... Mr. D. was working so he wasn't there to hear everything and meet Dr. Try Me.... so I guess I am on my own....

I do not want PCOS...

Calling all infertiles for much need advice on this news....

WWID... What Would Infertiles Do?

8 Comments:

Blogger Erin said...

Wow-he sounds like he has a plan.
I am wondering just how they diagnose PCOS...and how they rule it out...I have a feeling I'll be hearing that acronym in my near-future. (Remember my 9 mile bike rides and no weight loss, is that enough for them to pin it on me?)
And I would want him to clarify about the Lovenox and anticardiolipids--didn't you test postitive for those? That's a pretty big thing for one doc to say yes to and another to say nay to. Which is it, will they make you miscarry or not???
Maybe a third opinion?

- Erin

7:05 AM  
Anonymous Anonymous said...

If you tested positive for anticardiolipin, shouldn't you at least take aspirin during a pregnancy. I know people who have carried to term doing that. Did he mention that? Have you ever had an ultrasound that shoed any cysts on your ovaries? Don't know if this link might help: http://www.nlm.nih.gov/medlineplus/ency/article/000369.htm or this: http://www.pcosupport.org/support/quiz.php
-Abby (abfausto@hotmail.com)

8:24 AM  
Blogger Lala said...

I think that it doesn't hurt to go ahead with his tests and see what he has to say or take his suppositions back to your other doctor and say " I wanted to be tested for X". I don't know anything about PCOS but the progesterone test could be important. Tough spot to be in but a third opinion might be in order too.

9:58 AM  
Blogger Jenna said...

Jamie,
I think that if you are not comfortable with the test or the Dr I would look got a third opion. If you are okay with test just because you want to know then you might want to stick around. If it were me I would probably go for a third opion. There are a lot of Drs out there and you really don't seem comfortable with this Dr. I hope this helps.
Jenna

11:18 AM  
Blogger chris said...

How far along were your pregnancies? I've never heard of a doctor calling it a chemical unless you get your period right after (say, less than a week) getting a low positive Beta. For the record, I hate the term chemical pregnancy also.

2:37 PM  
Blogger Toni said...

I've got PCOS. Did you know that women with PCOS actually have a 45% m/c rate? B/c of the insulin levels. Have him do a fasting insulin check. You might need metformin if it's true. The 45% goes down to 8%ish when metformin is used.

http://www.health-alliance.com/jewish/glueck/polycyst.htm

Let me know if you need more info on PCOS - my "Google School of Medicine" degree has been helpful to me :)

3:51 PM  
Blogger Jen P said...

I have a major, major case of pcos, being that my testosterone is triple what it should be (and the chin hairs, yeah, not good, before my period I sprout a forest...perhaps this is why it was next door to the laser hair clinic???) I tend to have 33 day cycles very regularly but do not ovulate unless medicated. I have a 'normal' period every month, but never any eggs. This is very typical of pcos and not all women are textbook, so don't let that doctor try to rope you into any sort of stereotype. (Just as I've met many thin women who are infertile because of pcos.)

Because of the higher testosterone and estrogen dominance, it causes the sugars to get all wonky and it's the level of the insulin at the time of the follicle ripening that makes it 'poor quality' as well as the circulation of testerone during the conception. V bad for all involved.

I guess I'm lucky in that in 38 months of ttc I've conceived twice, only to miscarry before 8 weeks, so my concerns will not be dismissed as 'chemical' -- which I find absolutely appalling. I want to kick that doctor for telling you that.

Personally, I would ask for a Day 3 estrogen, testosterone, LH, FSH and blood insulin (the fasting sugar one isn't good enough -- you need to pull out the big guns and test insulin, not glucose) and have them repeat them on day 21 along with Progesterone. With pcos you'll see whether or not there's an estrogen problem (pcos makes your body mask it's own estrogen, so it thinks it doesn't have enough and it overproduces, making your body produce too much testosterone to combat it...v confused body) that changes cyclically. Glucose is such a variable that the fasting glucose test can be inconclusive given what you ate the previous night but the insulin test is the be all and end all of insulin resistance. Very good test to have done every 6 months if you do have pcos.

The Prog test was the only thing that showed them I didn't actually ovuate but was having regular 33 day cycles. Upon ultrasound they noticed my right ovary was 1/3 larger than the left and both had the 'string of pearls' look.

It's a very confusing diagnosis, being that pcos can be sooo varied among women, and without any concrete proof right now I'm sure it's a very tumultous time. I hope this doesn't come across as preachy, I just hate when doctors throw pcos at a woman and know how scary it is in the beginning. I hope it's not pcos and another woman is spared this fate, and best wishes with all the tests.

3:48 PM  
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2:32 AM  

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