Meeting The New OBGYN

I had my first appointment with my *potential* new OBGYN just before Christmas. I didn’t get a referral and I didn’t do a ton of research–I saw this doc’s bio and picture and my gut said he was “the one”. And I decided to trust my gut and wait 3 months for his first available new patient appointment.

As I drove to the office, I actually had to “tap” (EFT tapping) in the car, because I was already nervous and the Christmas traffic was *insane*.

Feeling discombobulated and overwhelmed, I was worried that I wouldn’t be able to articulate myself. How do I tell him the saga of “my life as a case study”, but without burying the lead (that I want to prepare to TTC)? Where do I begin? Will there be enough time at the appointment to get it all out? What am I forgetting? What if he HATES me because I’m such a neurotic pain in the ass?!! What if he just doesn’t get it, and I have to do this all over again with someone else??

I felt like I was on my way to some sort of high-stakes blind date… like… I felt like a contestant on “The Bachelor”… that sums it up.

Speaking of which, I felt really self conscious about my appearance–my hair (sort of styled), my outfit (leggings, t-shirt, oversized sweater and beat-up slip on tennis shoes), and of course–my *va-jay-jay*… I wished I had gotten waxed, but I made my best (still half assed) attempt to look presentable. I worried about my chipped and grown-out pedicure, but not enough to actually take the polish off and do my nails *or* find a pair of clean and matching socks in my mountain of unfolded laundry. I didn’t wear make-up to conceal my rosacea and by the time I got to the office my face was beet red. Yeah… all I can say is at least I didn’t smell bad.

I checked in and it didn’t take long–I brought a copy of ALL my medications and supplements (freaking 2 pages) so that was a time-saver. Side note: working in medical offices I noticed old peoples’ caretakers would always come prepared with a list of medications–I am a bit sour that I have to do this at the ripe old age of 37.

My appointment was for 2:50pm and I was required to be there 30 minutes early. Since the check-in didn’t take long, I had to wait awhile to be seen. I tried to stay calm but I could not shake my feelings of fear and anxiety. I was finally called back around 3pm.

The MA looked at my paperwork and then began asking me a ton of questions. I explained my autoimmune diseases to her as well as my medication list, and was satisfied that she knew what she was doing as she nodded her head and kept typing without pause (most MA’s would stop and look confused and need me to spell things for them). This MA seemed unphased–that boosted my confidence.

The main points I discussed with the MA were:

1. I have Ulcerative Colitis, Hypothyroidism, Rosacea, Lichen Sclerosus, and Depression

2. I have hormonal imbalances (too much testosterone, not enough progesterone)

3. I had 2 miscarriages

4. I used fertility treatments and conceived my living child upon my 6th IUI

5. I had a successful pregnancy and birth

6. During pregnancy I used progesterone supplements and heparin

7. I want to TTC again (so I need prescriptions for progesterone & heparin)

8. My Mother and maternal Grandmother both had breast cancer (my Mother died from it at 59) and I’m 37 so I think I need a mammogram?

9. I’m still breastfeeding

10. I want a bunch of blood tests including but not limited to: TSH, AMH, ANA, ALT/AST, and Prolactin

Since I recently switched insurances when Mr. MLACS switched jobs, I also decided to go ahead and have my annual exam (even though I just had one in May on my previous insurance) just to get that out of the way… but also to test out this OBGYN and see if he was gentle or if he gave me the creeps.

The MA said she was unsure if the doctor would talk to me prior to giving my exam or if he would do the exam first and talk afterwards, so she went to check. I was really hoping the doc would agree to talk to me first because I was in no way prepared to greet him half naked with my legs spread. In fact after the MA left the room I gave it some thought and decided I would insist on meeting the doctor first. But to my relief the MA informed me that the doctor wanted to speak to me prior to the exam. I exhaled. And I waited…and when I couldn’t sit any longer I began to pace the room…and I called Mr. MLACS to make sure he was going to be home on-time to relieve the babysitter since this was taking for-ev-er…and I looked out the 4th story window and watched people crossing the parking lot–many heavily pregnant women, women lugging baby carriers, women lugging baby carriers AND toddlers, and some much older women who were beyond childbearing age… and I let my mind wander, wondering what their stories were… until I heard a knock at the door and quickly turned around to see…

Him. The man I had been waiting (and waiting, and waiting) for.

He greeted me warmly and thanked me for waiting (as though I had a choice) and sat down. I didn’t waste any time and just blurted out “Something led me to you–I just moved here and I didn’t have a referral, I just knew you were it.” And that sounded odd, so I followed it up with “I was very close to my previous OBGYN that delivered my baby–he supported me through some hard times”. Which still sounded odd, so I said “Where are you from?” and he is basically a local. And I asked him “So what made you want to be an OBGYN?” And he replied that he prefers treating healthy people and prefers women over men, because men are difficult patients (he was being funny, I laughed) but I pointed out “But *I* am a sick person” and he said well ok sure, but I’m not dying nor am I infectious. I could see his point, although I think I expected him to say something about loving babies. Come to think of it, although Dr. Angel (my previous beloved OBGYN) does love babies, I think I remember him saying he chose to be an OBGYN because it’s so diverse–he gets to treat patients and perform surgeries, etc.

I digress…

So far I had observed that new doc had a warm smile, a cajun-southern accent, and a sense of humor. All good things in my book.

I don’t remember exactly how the conversation went, but points I discussed with him were basically reiterating what I told the MA. And I asked him some questions:

  1. My previous OBGYN managed my hypothyroid and depression (tested my TSH and gave me refills), would new doc do this? Or could he refer me to a PCP and/or an Endocrinologist?
  2. I definitely need progesterone (told him my numbers–which I have memorized). My insurance covers PIO or oral progesterone. I’ve used Endometrin and Crinone. What does he suggest I do? Will he give me a script today?
  3. Although I don’t have any known clotting disorders and only one red flag (elevated ANA’s) and 2 miscarriages, Dr. Angel had me do Heparin injections and I’d like to do them in any subsequent pregnancy. Ok?
  4. What if I need to see a fertility specialist? Which RE does he recommend?
  5. Since I’m over 35 and officially “AMA”, will he have me see the MFM?
  6. Do I need a mammogram?
  7. Who attends his patients’ labor and deliveries (if not him)?

His answers were:

  1. He’ll manage my hypothyroid/depression for now but he referred me to a PCP clinic closer to where I live and enthusiastically recommended a couple of docs.
  2. He suggested Crinone and said he’d send in a “test” prescription and if it was too costly he could make an appeal to my insurance.
  3. He said he definitely agrees I should use Heparin again–in fact one of his MFM’s uses it on anyone who has had more than one miscarriage because we can only test for *known* clotting disorders, and there are many other factors that can’t be tested. Basically he holds my mantra “An ounce of prevention is worth a pound of cure.” I was SO thrilled to hear this, as I was afraid he would say no.
  4. He said if I need an RE then he has a referral, no problem.
  5. Yes I will see the MFM
  6. They don’t do mammograms while a woman is breastfeeding unless they have a reason (like if I found a lump).
  7. His office is near the hospital and he tries like hell to attend his own patients–hence why I had to wait awhile, because he was delivering a baby. I told him since that is the case, I don’t mind waiting.

I also asked him a sensitive question… what are his thoughts on medical abortion? I am older and I have a higher risk of birth defects. New doc said that if it’s not compatible with life or would cause a very poor quality of life, then je will perform a medical abortion. But if it were something such as Down Syndrome, then he would feel the need to refer me to someone else–no judgement but that’s where his conscience draws the line. And he said it really pisses him off when women use abortion as a form of birth control and have several or more. I was completely satisfied, and even moved, by his genuine answers.

He then proceeded to *ask me* which blood tests I like to have ordered. I really appreciated that. And then he asked me if I had any more questions and waited patiently while I fumbled with my phone to make sure I had checked everything off my list.

And the physical exam was probably the easiest and most painless exam I’ve ever had.

He is THE one.

God and my guardian angels never steer me wrong.

New doc will henceforth be known as “Dr. Soul”. He is the soul of the South. And he is a kindred spirit to me.

No one can replace Dr. Angel, but Dr. Soul is going to take good care of me. I believe.

XOXO,

MLACS

I Can See The Horizon!

 

I’ve been wanting to update, but we moved all our stuff into a new unit (same property, identical unit–different building), and I have no cable or internet, and updating on my phone is practically impossible–so for those of you who may have been concerned after my last “FML” post–I’m sorry it’s taken me so long to update and thanks for caring 🙂

Monday: No good, very bad day which turned into a horrible night, when I wrote my last post (click here for post).

Tuesday: Wake up feeling defeated and ask Mr. MLACS if he intends for me to cancel is appointment to give his “specimen”. He looks defeated too, and said “No, but I can’t move forward this month unless Dr. Angel calls us back and we’re able to talk to him”. Fair enough. I called Dr. Angel’s office and got the ‘usual’ receptionist (I’ve spoken to a couple of others this week that I’m not used to and got mixed results–obviously Dr. Angel didn’t call me back so I didn’t get the result I had hoped for). I told the ‘usual’ receptionist that Mr. MLACS and I are having mixed feelings about going forward with IUI #3, and we really won’t be able to do it unless Dr. Angel can see us TODAY, since Mr. MLACS is leaving tomorrow. The receptionist *communicated (*key word) that Dr. Angel was doing a C-section and would not be available for her to speak with him about accommodating us until the early afternoon–I totally understood and trusted that the ‘usual’ receptionist would follow through and get our message to Dr. Angel. She returned my call late morning and offered that Dr. Angel could see us at 3:30 that afternoon–perfect! Because Mr. MLACS was scheduled to give his ‘specimen’ right up the street at 3pm, so I took this as a ‘sign’ that this cycle might work out. Mr. MLACS agrees to give his sample, and I agree that we will wait to make our decision about doing a January cycle until after we’ve spoken with the doc. I decide to take my gifted Bravelle with me, because I just can’t dose myself without the doc’s consent (though I was not above considering it).

Mr. MLACS walks into the clinic (where we’re collecting/freezing his ‘specimen’) with swagger. I get a kick out of him boldly walking up to the window and stating his business–no hunched shoulders or looking side-to-side to see who’s listening. A’ta boy! As I’m waiting for him to *ahem* finish, a couple of young mothers with small children walk into the clinic (which is an infertility clinic)–I was taken aback, and I totes understand what other bloggers mean when they lament how insensitive it is (not to mention annoying) for women to bring their (poorly behaved) children to an infertility clinic–I’ll put that on my “offenses not to commit in this lifetime” list. We then jaunt over to Dr. Angel’s office, not knowing what to expect—we were both apprehensive and full of emotion.

But, all that angst was for naught. Dr. Angel greeted us warmly. I didn’t even know where to begin, so I just told him “We didn’t expect IUI #2 to fail, and we weren’t prepared for it, and we want to know if you have any idea why, and then what you think we should do”. And he basically said he 100% believes we will have a baby. He doesn’t know why these IUI’s failed because they “Looked good” but that it’s totally normal and it doesn’t mean there’s something horribly wrong with us. We really, really needed to hear this from his mouth, because after 2 natural pregnancies followed by 4 failed medicated cycles (including 2 IUI’s with injectables), we were starting to feel panicked and insecure. He admitted he may not be aggressive enough with his treatment and we may want to consult with an RE that he (and everybody else in town) recommends. But then, I told him that I’m not asking for 6+ follicles, just 4 follicles…and I mentioned my interest in taking low-dose steroids with the idea in-mind that I have at least 2 elevated antibodies (ANA’s and NK cells) and the ANA’s in particular may be the issue and may respond to the steroids, PLUS they’ll only help my Ulcerative Colitis. And Dr. Angel offered to consult with him on our behalf, to see what–if anything–the RE would do differently. And Dr. Angel agreed to my request to begin 150iu Bravelle on CD5, so I got my shot in the office 🙂 Furthermore, the receptionist said our insurance has been paying on the scans and we didn’t need to plunk down any money to start the cycle–AMAZEBALLS!!! We left feeling relieved and stoked that we can actually afford this cycle without having to “rob Peter to pay Paul”.

Wednesday: Took Mr. MLACS to the airport in the city to catch his plane to work, and went to the old chiro/acu doc I used to work for and got treatment. It was great to see the doc (he is hilarious) and I know the treatment did me good. I raced back to town (2+ hour drive) to see Dr. Angel in the afternoon. I had wanted to dick around in the city, but my friends were all busy and I wasn’t about to tell Dr. Angel that I couldn’t make it to an appointment the second day out of the gate. Mission accomplished. 150iu Bravelle.

Thursday: Go to Dr. Angel’s office at 8:45am and get sent away for “30-45 min”. Get Starbuck’s (half-caf) and come back at 9:30…wait in the office for a bit and get sent away with “doc is still at the hospital and we’ll call you to come in once he’s done”. Cool, so I get called in somewhere around 2:30, and probly wait another 1/2 hour after I get there. But honestly, I don’t mind. Dr. Angel looks dog tired from delivering babies this week–poor guy. The ‘usual’ receptionist tells me the only time he can see me the next day is 11:45, which I agree to. 150iu Bravelle.

Friday: Wake up and make plans to work out with a friend at 10am. But then new receptionist calls me from Dr. Angel’s office and says “So the only time Dr. Angel can see you today is 10:30”, no explanation–but I don’t require one–I simply agree. I postpone my workout with my friend and tell the maintenance guy I will call him when I get back so he can service the washing machine. I show up at Dr. Angel’s office and ‘new’ receptionist says (contritely) “So your appointment was at 8:45” and I quickly respond “oh no it wasn’t, that was yesterday. Today I was told 11:45”, to which she responds “Well it says 8:45 here on the schedule”, and I say “Well if I had been told 8:45, then I would have been here. I was told 11:45 by ‘usual’ receptionist'”, to which ‘new’ receptionist replies “Well do you have an appointment card???” and I’m pissed….so I snap back “I DON’T NEED ONE. This is no less than my 30th appointment and I NEVER screw this up.” Like, wtf is your problem dimwit? Honestly, Dr. Angel was standing right next to me when ‘usual’ receptionist said 11:45–she looked AT HIM and said “your only time is 11:45”, so hopefully this was brought to his attention and I believe he would remember just as well as I did, if not better. And he did mention something during our visit that prompted me to say “Seriously, I was told 11:45–and I take this VERY seriously, just like a job”, to which he chuckled “I don’t doubt it, you’re one of the most punctual people I know”. Damn right I am. I’ve done everything he’s told me to–from paging him to showing up for appointments–TO THE LETTER. I’m the only one who ever has to wait–not him. So, I hope I don’t have to interface much with ‘new’ receptionist because I may snap on her if she antagonizes me again. The f*cking nerve. Dr. Angel asked me to page him at 8:30am tomorrow, and I’m tired but I set my alarm for 8:20am. 150iu Bravelle.

Saturday: I dutifully page Dr. Angel, who cheerfully answers the page and informs me that he is going to be a few hours yet because he has yet another delivery. I think women who are delivering in January got pregnant in…April last year? I guess “spring fever” is legit, because Dr. Angel remarked that he has “A WHOLE BUNCH” of due dates this month, and I’m pretty sure he’s delivered a baby (or two) every day this week. The man has stamina! So I wait….all day…and finally page him at 2pm to see if he has a plan…and he has me come to the office then. Two lead follies and four small ones–I’m hoping that two of the four smaller ones can mature in time to trigger, so I can get my ‘Fabulous Four’ I’ve been gunning for this cycle. 150iu Bravelle.

I feel a helluva lot better than I did on Monday. I’m feeling optimistic about this cycle. I feel ‘touchy’ but not overly psycho and my bloating is much less (than previous medicated cycles), which I’m attributing to not taking the Letrozole this time around. I’m going to be cautious and start doing OPK’s tonight, because I’m feeling certain that I will ovulate much sooner than previous cycles.

My Grandma has her lumpectomy (for breast cancer) this coming Friday, so that’s a big deal this week…a really big deal. Thanks for keeping her in your prayers–she’s a special lady. Her prognosis looks good!

I gotta unpack all the boxes in the new place–been procrastinating. Well, but then I’ve also had A LOT of stuff going on…regardless I gotta get my house unpacked so I can resume cooking in my kitchen and stop eating out (though I’ve been eating mostly salads). It’s hard to motivate cuz I’m lonely and the place feels foreign and most of all, I don’t have cable yet. It would be SO much easier to motivate to unpack my living room kitchen if I had the Food Network or Bravo to keep me company. Mr. MLACS hooked up his PS3 in the bedroom so I can play dvd’s, but all his dvd’s suck (action movies) except for ‘Kung Fu Panda’ and ‘Juno’. Now I’m not going to watch ‘Juno’ for blatantly obvious reasons, although I do like it. So I’ve been watching ‘Kung Fu Panda’ on repeat, and I’ve probably seen it 5,000 in the last 3 days…but I really like it. I admire Asian culture and philosophies anyway, so I can appreciate the Zen teachings that are subtly communicated in the form of a cartoon movie. I love Po, the unassuming Panda who possesses the abilities to save his village and recognize his dreams to become a kung fu master–everyone tries to change the goofy panda, but what they all learn is that he doesn’t need to fit their image of what a kung fu master should appear to be, he just has to be his best version of himself and apply himself. I find it very inspiring. XO

 

 

She’s Lucky I Don’t Have A Weapon…

So, my husband’s insurance has changed–we have a new prescription provider, CVS Caremark. I thought I hated Express Scripts THE MOST, but now Caremark has taken over the #1 spot. I went to get my Delzicol (extremely vital med I take for my Ulcerative Colitis), with my new prescription card in-tow, naively thinking that I would shell out $75 and walk out with a 30 day supply. WRONG. Never, ever assume anything when it comes to attaining your medical care. Turns out, Caremark (the irony that “care” is included in this name…ha) will require an appeal by the prescribing doctor, stating why Delzicol is used and not some other prescription. Now, I get it–Delzicol is an expensive, patented brand-name drug with no generic substitute, and if it’s not necessary to pay these inflated prices then Caremark doesn’t want to pay them. But I was told it will take a minimum of 72 hours for the appeal to be processed, and I can’t even begin this process until I get a hold of my doctor on Monday (it’s after 5pm Friday). I NEED MY DRUGS NOW. I can’t go all weekend without them, I can’t even skip a dose or my ass starts bleeding. So…I realized I had a prescription on file for another (less effective but supposedly equivalent) drug, called Asacol HD. And guess what?! Asacol HD is also a patented brand-name drug that requires an appeal from my doctor in order to get coverage. So I’m left with: pay out-of-pocket for a weekend’s worth of meds OR go without meds. Of course we paid out-of-pocket…EIGHTY TWO DOLLARS…$82 mother*cking dollars for 2.5 days worth of Delzicol. OMFG. If you ever feel sorry for yourselves, just please be glad that you don’t have a chronic life-long disease that is sucking the life out of your body and your pocket book–just please count that among your blessings.

Oh, but it gets better. Today I had to call my GI to see about 1. getting some samples of something to tide me over until I can get a prescription of Delzicol and 2. Getting them to appeal the Delzicol. You see, it was actually prescribed by my former GI in Las Vegas, so Walgreens sent his office the notice to appeal for the Delzicol, but it’s really not his job at this point. So I called up my current GI’s office (which is small and full of old ladies) and the first lady asked me what I needed, so I started to explain and she cut me off and forwarded me to a woman who I assume must be either and RN or an MA (most likely an RN, because oddly most of the Dr.’s offices in this town still rely on RN’s and haven’t switched to MA’s). We’ll call her OB (short for ‘old b*tch’). I begin to tell OB about my medication drama and she keeps f*ing cutting me off–very rudely. I’m not being long-winded either. I try to tell her about the Delzicol and she says “So then we must have gotten the paperwork sent to us by the pharmacy already”…NO, b*tch, you DIDN’T because it wasn’t prescribed by you, it was prescribed by my former GI and new GI approved me to continue. Then she says “Wait a minute, I have here that the doc prescribed you Asacol HD, so why are you taking Delzicol”….well B*TCH, that is because I wanted to switch to Asacol HD because it’s easier to swallow than the Delzicol, but unfortunately I had blood and mucus coming out of my ass so obviously it wasn’t working, and I switched back to Delzicol, which immediately stopped the blood/mucus–the doc already knows this. Then OB says “Ok, so we’ll just send the appeal to them and you should be able to get your meds” and I said No, that the Caremark people told me the quickest way to submit an appeal is over the phone, and they had given me a phone number, to which she replies “Well I DON’T UNDERSTAND, I do this EVERY day and it always works so I don’t understand, blah blah rant rant…”…and I cut her off to say “Well I don’t understand either, all I know is what they told me. But if you’ve worked with Caremark before then I trust you know how to get it handled”. And then, I asked her if she has any samples of anything I can use until the appeal goes through, and she named off a couple, including Lialda–which I’ve taken before with success. I mention to OB that I’d like to try the Lialda, and I also mention that it’s actually covered by Caremark without an appeal, to which she replies “Well then why don’t you just take that if your insurance covers it, because it’s ALL THE SAME THING, it’s all Mesalamine”…OMFG why are nurses SO STUPID?! These meds are NOT all the same, they are in different preparations and release differently in the body–most recently I have not done well with the extended release meds (such as Asacol HD), and Lialda is an extended release med. Just because I took it 2 years ago and it worked doesn’t mean it will work NOW. And NO THEY ARE NOT ALL THE SAME, you stupid stupid ignorant *&^%$#!–if they were truly all the same, then we’d all just take the motherf*cking generic and not bother ourselves with calling your sorry ass to make an appeal. Right?! Right. Geezus. So, after I made it VERY clear that I still wanted her to appeal for the Delzicol, she said “Oh by the way, the hospital called to say that you didn’t show up for your most recent Remicade infusion, so I assume you’re going to call and do that this week”…well, no actually, I’m NOT, because I just talked to the doc on the phone the other day to discuss pushing out or possibly permanently suspending the Remicade, because I’m currently under control and trying to get pregnant. And he approved. And THIS is why I so urgently need to get my meds–so I can maintain remission WITHOUT the Remicade. Do. You. Understand. Me.? She said she’ll leave the Lialda samples at the front desk. Click.

There’s more. I called Caremark yesterday because it occurred to me that they may not give me the sweet ass deal on Bravelle that Express Scripts was giving me ($75 all-you-can-eat, first time Dr. Angel ordered 10 viles but this last time he ordered 20 viles and either way it only cost me $75 dollars, whoop whoop!) I got a really nice guy named…Bobby? I think. So anyways, first Bobby looked up Bravelle and found that it’s not covered. And I said “Ok, well do you have a biological equivalent that is approved?” And Bobby asked me what kind of med it is, so I explained is a reproductive medication, called Follicle Stimulating Hormone, or FSH. Bobby put me on hold for a few while he looked it up, and came back with: Pregnyl and Human Chorionic Gonadatropin (he couldn’t say the words so I asked him to spell them)…well, those are both HCG shots, not FSH. So Bobby put me on hold some more and dug deeper. What he found was that Bravelle IS covered WITHOUT an appeal required, and I could hypothetically get 20 viles from a retail or specialty pharmacy for $300–for two refills–and then I’d have to go through the CVS mail order pharmacy. And I said “God willing Bobby, I won’t need more than two refills”. It’s more expensive than Express Scripts, BUT $300 for $3000 worth of meds is nothing to complain about. So, at least there’s that–BUT it’s only hearsay at this point.

Mr. MLACS will joke sometimes when someone pisses him off (usually while driving) that if he had “one bullet a day” that person would’ve gotten it. So I do it too now, when people piss me off I’ll turn to Mr. MLACS and say “one bullet a day” and he giggles. So I leave you with this: Today, OB is lucky that this is just a joke, and I don’t even know how to shoot a gun. I’ma go pick up my damn samples and she best hope I don’t see her sorry ass when I do. *spits on the ground, mean mugging*

Gobble Gobble (I’m Basted)!

turkey baster

It occurred to me how timely it is that I got “turkey basted” just in time for Thanksgiving…

Here’s the last 2 days events:

Yesterday (Tuesday):

  1. Saw Dr. Angel yesterday morning for dildocam monitoring and was happy to see that my follies measured ’21’ and ‘19.5’ and my uterine lining is circa ’12’. Got the HCG trigger shot!!!
  2. Came home yesterday after seeing Dr. Angel and tossed around the idea of having sex (against doctor’s advice)…finally Mr. MLACS was like “Screw it, we ARE DOING THIS”, and so we did “it”.
  3. We ate at Gordon Biersch and went to go see “Hunger Games: Catching Fire” at a badass movie theater with leather reclining seats–first ‘date night’ in a month!
  4. On our way home I just felt awful–headache, bloating, my Ulcerative Colitis was ‘flaring’ pretty hardcore…I’m thinking at least part of this is due to the HCG trigger shot (do you think so?). And of course, I still have my head cold–I look like Rudolph the Red Nose Reindeer.

Today (Wednesday):

  1. Woke up at 7am (even though I had intended to sleep in a little) when Mr. MLACS had to get up to go give his “sample”–he went without me but I couldn’t fall back to sleep!
  2. Mr. MLACS came home after giving his sample and picked me up (while the sperm was being ‘processed’) and then we went back to the fertility clinic to pick up the sample. (The reason we had to pick it up is because we were doing the IUI with my OBGYN, Dr. Angel, but had to have the sperm processed in the fertility clinic at our local University Hospital, then retrieve it and take it to Dr. Angel’s office.
  3. Sperm Stats**Total Count: 412 million  Post Wash: 160 million (80% motility) Final Specimen: 51 million (100% motility)
  4. My Husband is the biggest Cock-A-Doodle…literally…he’s SO proud of his sperm he’s strutting down the street practically crowing like a rooster *eye roll* But I will say that I find him entertaining when he’s like this.
  5. Dr. Angel’s office wasted no time getting us in a room and Dr. Angel almost walked in on me sans sheet and “naked-from-the-waist-down” (I have heard this phrase no less than 20 times this month, and not from my husband). Dr. Angel made quick work of the insemination and left me to “marinate” for 20 minutes while Mr. MLACS acted giddy and poked fun at me while I was in a compromised position. Again, I want to smack him when he’s obnoxious BUT I can’t help but laugh.
  6. After 20 minutes Dr. Angel ushered us to the “dildocam theater”, where we were able to admire my 2 lovely follies, which had grown to 21.5 and 21, and my uterine lining was still  a plush 12. Needless to say, Dr. Angel, Myself, and Mr. MLACS were practically high-fiving and congratulating each other on our jobs well done. I have to add, Dr. Angel was in rare form today and made us laugh with stories about his residency and some of his colleagues (who are batsh*t crazy btw). I giggled the whole time we were in the office! I just LOVE me some Dr. Angel. Seriously.
  7. Dr. Angel instructed us to go home and have plenty of sex, but what really happened is I went to make a bank deposit and buy some probiotics in hopes of pacifying my vagina and colon (Thanks Emily), and while I was gone Mr. MLACS passed out on the couch and now he’s snoring while I’m blogging–there is no ‘sexing’ going on. Oh but I promise you that we will get a session in the next couple of hours, even though I think our bases are covered between yesterday’s sex and today’s ‘basting’.

So that’s all for now folks. I have to wake up at fuggin’ 6:00 in the morning and page Dr. Angel (lest he may be delivering a baby or whatevs) and meet him at his office at 6:30am for a dildocam appointment to see if I did ovulate. I freaking hope this works! Then, I will go straight to my family’s house and prep the turkey and put that sucker in the oven–and pray that I get a nap in before dinner. Mr. MLACS (and me, sort of) are optimistic…last night while we were waiting to be seated at the movie theater he was googling strollers…it’s SO adorable…please God let this work so I don’t have to see his face crumple like a little kid who just found out Santa Claus isn’t real (again). Amen.

HAVE A HAPPY THANKSGIVING LADIES!

XOXO

 

Share Your Nuts!

Well, I’ve been telling you that I’m “going nuts” lately, and I am humbled by your responses and encouragement to continue to “share my nuts” with you. Also, I decided I needed to bake something for Dr. Angel because he’s been so kind and in my opinion he’s basically doing charity work by giving me UNLIMITED ultrasounds and an IUI for the very small fee of $350 per month…and I had a bunch of pecans at my house…and this recipe is so easy to make…so TAH DAH! I made these delicious holiday spiced pecans, packaged them in cute little Christmas treat packages I found at the ‘Everything’s A Dollar’ store, and passed them out to Dr. Angel and his office staff yesterday afternoon. And ate a whole bunch of them myself–they are like crack to me–as I was dividing them up to give away I was like “one for you, one for me..one for you, two for me” etc. Yup, one good nut deserves another, right?! Slippery slope.

Sweet Spiced Nuts

The situation with Dr. Angel was a bit precarious yesterday, as when I had suggested “Same time tomorrow?” at our Monday visit, his reply was “Well no, it’ll have to be in the afternoon–I’ll call you.” And I was like, “Um, ok then” and left wondering how that was going to work out. I woke up yesterday and called Dr. Angel’s office, and they informed me that Dr. Angel was out of the office and they had no idea when to expect him back that day. Hmmm. So I went about making my nuts and finding cute little packages for them at the dollar store (you know, one of the many important ways I fill up my unemployed time now) and waited…and waited…and finally I called them at about 2pm to say “Hey, it’s after noon now, so, um, any idea when he’ll be back?” and the lady sounded really awkward and cryptic in her reply that went something like, “Um, I haven’t talked to him to tell him you called earlier..and um…I’m not sure WHEN or IF he’ll be back in the office today…” And I recited what Dr. Angel had told me, verbatim, about me coming in the afternoon. It got me nowhere. I was concerned for several reasons, because they have my damn drugs in their office and because it was already 24hrs after my first shot and I knew I should be having it about the same time each day. I was shocked at how clueless they seemed, I mean, it was the middle of a regular business day so I would expect them to know a ballpark of where their damn doctor is and/or get a hold of him to ask him what he’d like to do about me. Geezus. But they finally called me an hour later and chipperly announced that Dr. Angel was back in the office and I could come by. So I came by and passed out my nutty treats (maybe this little PR stunt will get me a better response next time this happens) and experienced the fancy chair/dildocam, then got my Bravelle shot–bless his heart, Dr. Angel had found some smaller needles in his office to use for the shot and I didn’t even feel it this time.

Today, I went to see Dr. Angel and crew at 11:30am. I’m happy to report that my left follicles #1 and #2 had grown to ’13’ and ’11’ respectfully (and Dr. Angel taught me how to convert his measurements so that’s why I can now report my follicle sizes). The hemorrhagic cyst-y looking follicle on the right is at ’16’ and holding, so maybe it’s not such a problem after all. I told Dr. Angel and his nurse about my delusions of Ovarian Cancer and they laughed at me, so I guess that means I have nothing to worry about cancer-wise (yet). My lining is measuring between ‘4-5′ and I’m CD10 today, which doesn’t seem to concern the doc but what do you ladies think? Judging from these measurements do you think I’m doing ok with my follie sizes and my uterine lining on CD10? Or am I behind? Dr. Angel seemed unconcerned and figures my follies will be over ’20’ and we’ll do the IUI on Saturday. Oh but you can bet your sweet asses I will be getting some lovin’ from Mr. MLACS on Friday after I pick him up from the airport. Whether he wants it or not. Game ON.

As far as how I’m feeling mentally/emotionally, I’m better on the Bravelle than I was on the Femara. But physically, the Bravelle has been causing me headaches (which are rare for me unless it’s sinus-related). My butt no longer hurts because Dr. Angel is using a smaller needle–not sure what size but I hardly feel it. I’m slightly concerned that the Bravelle is kicking up my autoimmune issues, which I had considered before I used it–it’s highly purified but it comes from somebody else’s body so there’s always a chance that my body will consider it an intruder. My colitis has been mercifully ‘quiet’ for the past 3 weeks but I was having symptoms today, which made me think the Bravelle may be the cause. Or not. I will keep you posted on that. I had previously considered using Gonal-F because it is synthetic (when I was wondering if I might need injectables) but it’s more expensive so I wanted to try the Bravelle. We’ll see how this little science experiment works out (hence the title ‘My Life As A Case Study’) TTFN. XO

 

 

You Can Take This Job And…

Oh yeah, yesterday was “the straw that broke the camel’s back”. I am diggity-done.  

The “training” I received consisted of me watching my supervisor work at the speed of light for 2 days without her explaining ANYTHING to me, but then asking me if I “have any questions”…Lady, where the hell do I begin?! I took a few patients on day 2, which sort of familiarized me with the computer program and order of events, but I had no idea that on day 3…I was expected to do everything seamlessly and almost independently…guys, this clinic is an urgent care clinic and they see 100+ patients a day and most of them are new patients (which means a lot more paperwork and data entry) and the clinic wants everyone’s waiting time to be 5 minutes or less in order to stomp the competition. HOLY BALLS. I was stunned that they just threw me in the mix on day 3. They are lucky I have worked at clinics similar to this one before or I would’ve just gotten up and left because it was so stressful–I sure as f* thought about just getting up and walking out–it was mind numbingly difficult…I had to concentrate so hard…I was just barely coping…my face was beet red and I thought my head might explode…

 Things I did Perfectly:

1. I greeted each patient as they walked toward the counter,asked if they would like to be seen, and asked if they had previously been seen at the clinic. If existing patient I verified their demographic (address, phone) info.

2. I asked for I.D. and Insurance cards (if new patient) and if they were current or not (existing patient) and scanned them into the computer

3. I explained the new patient paperwork, made sure all the new patient forms were signed, scanned them into the computer and labeled each file correctly in the patient’s chart (ex: HIPPA privacy practices form).

4. I made sure I entered the insurance info correctly (double checked the member & group numbers) and noted their copay in their chart.

5. I collected the copays and scanned the receipts to the patient’s chart AND recorded the copay in the system, accurately.

6. I scanned and allocated incoming lab results to the correct doctor to be reviewed.

7. I scanned lab orders and placed them in the bags with the correct specimens (urine, blood, culture).

8. At the end of day 3 I attempted to answer the phones and direct calls, which I handled appropriately (no one sitting on hold or getting hung up on).

9. I refilled the printer and the toilet paper without being prompted…I asked how I could help when they were busy and I was observing…I remained calm when a woman passed out cold (face first) in the waiting room on day 2 and an ambulance had to be called to transport her to the hospital…

10. I put up with having no lunch break (or even a break) on an 11 hour shift.

That is more than what they should dare to expect on day three at a clinic like this (for $11.50/Hour), and really, they are fools for letting someone so new take on so much responsibility because I could have really messed things up. I did make 3 mistakes that I know of

1. I checked in a patient under the wrong name/person (they don’t use people’s birth dates to look them up in the system, they use names, which has a larger margin for error).

2. I listed a guy’s middle name as his first name when I entered him in the system (then they called in scripts under the wrong name, but someone caught it before the patient left the building because they called him ‘Robert’ (his middle name) and he was like ‘my name is Andrew’)….and do you know what my b*tch supervisor said to me??? She said, “Do you not know how to read people’s names off an I.D.?” Thing was, it was 5pm and I was shaking from hunger and stress, having NOT EATEN or taken a break ALL DAY…that is why I made that mistake.

3. As I was learning the system while checking in 100 patients while trying to do everything quickly, I did scan a few documents to the wrong patient’s charts–BUT to my credit I caught all but one of those mistakes and corrected them–of course b*tchy supervisor caught the one I didn’t catch and redundantly told me “you can’t be doing that”. Assphinctersayswhat?

I could tell she was waiting for me to apologize and say “Oh my goodness I’m SO sorry” but I just looked at her and slowly nodded my head and resumed what I was doing–because what I wanted to say was…well I just wanted to punch her in the mouth. The supervisor was snide–I could tell she wanted to tell me off but instead she just kept looking at me sideways and using a nasty tone (um, same difference, she may as well have just spat it out). She rolled her eyes when I asked questions and flippantly said “I don’t understand what you want”. She gave me the evil eye. She knew I was floundering and NOT ONCE did she ask me if I was ok or if I was feeling comfortable with what I was doing–she KNEW I was uncomfortable. All I got was either silence or negative feedback. The “head” doctor ordered pizza for the staff and she didn’t even offer me any and I know it wasn’t because I’m gluten-free…it’s because she’s a b*tch. And the “head” doc that day is a dick compared to the other doctor (the one that hired me) and I guess he was riding my supervisor’s a** that day and I KNOW it’s annoying to train people but bottom line: she railroaded me right on outta there. And it’s not because she felt threatened by me–they LOVE her there and she really is a wiz at everything, but she has no business being in a supervisory position, because she doesn’t want to teach–I don’t think she wants the added responsibility, but she loves ‘running sh*t’ at the clinic. And hey, more power to her–but God have mercy on the new people that are supposed to be learning from her.

I had already planned to go out to dinner with a friend I call my “fairy godfather” (he’s older, wiser, and extremely resourceful) last night to discuss my options and I went straight to the restaurant in my scrubs and slammed a glass of wine before he even got there. I hadn’t eaten all day so I got a delightful buzz from it. And when “fairy godfather” showed up I ordered another glass of wine along with a phat dinner of prime rib, broccoli, and sweet potato *drool*. He waved away my concerns and entertained me by hitting on the very sweet young waitress (making her stammer and blush). I had another glass of wine for good measure. Since I had worked from 9a-8p with no lunch break and FedEx was delivering my package of fertility drugs today, I had begged the office at my condo complex to accept the package and put it in my garage, which they thankfully did, because their office closes at 5pm and doesn’t open until 9am and I needed to be at Dr. Angel’s office at 9am to learn how to give myself the Bravelle shots.

I woke up this morning with a hangover-ish headache (gawd that makes me feel old) and showered and got ready to go see Dr. Angel. I took the package of Bravelle out of the fridge (p.s. freedom pharmacy shipped it without any cold packs, is that bad?) and I set it on the kitchen table so I wouldn’t forget it…I was preoccupied thinking about how and when I was going to offer my resignation to the clinic, whether or not I would add any critique of my “training”…I was almost to Dr. Angel’s office when I realized I forgot the damn drugs and after the doc had most graciously agreed to squeeze me in on a Friday, I had to walk in the clinic with my ears and tail drooping and tell him I didn’t have my drugs with me. And bless his heart, Dr. Angel said “well aren’t you supposed to start the injections on Sunday?” and I said yes, and he said “well can you perhaps come in early on Sunday?” and I said yes–but didn’t want to inconvenience him–to which he replied it would be better this way because then he can take more time to go over everything with me, if I didn’t mind coming in at 7am–and I ask you…how lucky am I??? I mean, if I needed a ‘silver lining’ for this week this is IT.

And around 4pm today, I sent my resignation email to the (nice) doctor who hired me. I know, email is not the best way BUT he offered me the interview and the job by email, so since I only worked there a cumulative 26 hours, I figured I could quit via email, and after careful consideration, here is what I wrote (with names excluded):

Dr. Nice Guy–

Thank you for the opportunity to join your staff, but I am writing to you to give my resignation. I would definitely recommend ‘ABC’ to friends and family, as I believe you provide the best Urgent Care in ‘XYZ’. I appreciate how dedicated the staff is and how they synergize.

However, I would offer that if the “training” I received is how your other new front office employees are going to be trained, then you may expect a bumpy road ahead of you.

If you would like to have an exit interview with me then I’d be happy to take the time to give you some feedback that may help you retain your new front office staff and set your new clinic up for success.

Otherwise, I’d appreciate it if you could mail my check to:
(My Address)

Best Wishes,
MLACS

Then I waited on bated breath to see what Dr. Nice Guy’s response might be. And this was his email reply:

Wow, did I miss something?

I would definitely like to discuss what comments you have. If there is something to improve, obviously that is something we would like to do.

If you can give me a call at the clinic today I’d appreciate it, I’m here until 8 pm.

555-5555
Dr. Nice Guy

I know, really nice huh? I was thinking more like “go f* yourself, I hate myself for even considering hiring your ungrateful incompetent a**”. But obviously, Dr. Nice Guy has a touch of class. I thought about putting him off so I could take time to choose my words carefully…but then I thought “Nahhhh, I wanna get this over with so I can enjoy my weekend without anything hanging over my head”. So I called him. And I very tactfully told him what I thought–that he has a great thing going with his clinic and staff, but that the training lacks:
1.Objectives (these are the goals of the clinic, this is the role of the front office staff, etc.)
2.Expectations (our front office staff handles ‘xyz’. You are expected to be able to ‘abc’ within 2 weeks of training and to be able to fully integrate by ‘xyz’)
3.Method (how to train an employee, such as: explaining each task slowly–giving time to ask questions as the task is carried out–having the employee write down the steps to the task in a personal notebook to be reflected upon as needed–having the employee practice the task so that they’re comfortable BEFORE being expected to carry out the task during work flow).
I remarked that while I am not aware of the experience level of other new hires, I myself have gone through training to work at two other large and demanding clinics and I was overwhelmed, so I could only imagine how impossible the task might seem to others who have no medical office experience or those who have only worked in smaller offices. Not to mention, that a less experienced person who was thrown into the work flow as I was would most definitely make a lot more mistakes. AND YES, I ‘went with it’ since I had his ear and mentioned that, while his supervisor is extremely skilled at her job, she is NOT a good teacher and in fact was the antithesis of helpful. I mentioned that another coworker was the only one who actually offered to explain things to me and give me helpful tips on how to navigate their software, etc.
And Dr. Nice was actually quite appreciative and offered that he would still like to have me as part of the team, but I took that opportunity to add that I also had some personal reasons involved in my decision–but that ultimately it was yesterday’s events that tipped the scales (intoning that the option of me coming back was off the table). I told him I didn’t want him to feel as though my presence there was for naught, and I had reached out to offer the feedback because I genuinely want their new clinic to succeed. I told him that everything at the ‘home’ clinic seems to click because his staff is so dedicated and they work so well together–they have an unspoken system–but that that sort of synergy is non-transferrable so the new clinic will need to rely on clear objectives, expectations, and method. Yeah…I may have said too much. But you know what? F*ck it. I’m proud of myself. XO

Open Mouth, Insert Foot

Lately, all the people I talk to in the medical profession (mostly nurses), treat me as though I have never researched a disease I’ve had for 10 years. I don’t know what sort of idiots they’re used to dealing with, but I know a helluva lot more than they do–both from a scholarly perspective AND from a personal perspective. For example, one haughty NICU nurse said she had been diagnosed with UC a year ago. I asked what meds she took and she couldn’t even name them, but recognized them when I rattled off the different brands/types. She said “well it doesn’t matter because they’re all the same”. I didn’t bother getting into a pissing match with her, but she couldn’t be more wrong. The meds we discussed were all variations of the same ingredient (mesalamine) but they are NOT biologically equivalent–which is to say, that they are not all broken down, absorbed, and utilized the same in our bodies. Prime example: I was thrilled when I recently switched from taking 6 Delzicol capsules, to 3 Asacol HD tablets (twice daily). But the extended release meds I tried previously (Lialda) never worked as well for me, and unfortunately neither did Asacol HD, so I switched back to Delzicol this week and have seen improvement. This nurse also uses Canasa suppositories (as do I) but she crinkled her nose when I told her I’m using Remicade. Which brings me to…

ALL my doctors (particularly my GI’s) tell me to use Remicade while ttc and throughout pregnancy. ALL the boards I’ve consulted where women posted stories of their pregnancies while on Remicade and their children’s health afterwards have been nothing but positive. ALL the infusion nurses I’ve had have told me stories of Remicade patients who delivered healthy babies…

But on the flip side, all the nurses (both acquaintances and my infusion nurses) have this nervous, worried/confused look on their faces when I say that I intend to use Remicade during my pregnancy. What gives?! None of them have offered me a “cautionary tale” and in fact each of them can recall at least one Remicade patient that had a normal pregnancy.

Yes, I do read medical journals (not just google), and I’m not blindly following my doctors’ suggestions. Unfortunately (fortunately) researchers aren’t allowed to use pregnant women like lab rats, so there’s just not a lot of data available to support/refute the use of Remicade during pregnancy. So I have to base my decisions on the data I have, the severity of my disease, the experiences of other women who’ve used Remicade in pregnancy and my doctors (who are confident in prescribing Remicade to pregnant women).

So why are these nurses making me feel like I don’t know what I’m doing? Like I’m doing something wrong? I’m ok with every other ignorant “crunchy mama” telling me to quit the drugs, eat paleo and do yoga–and I appreciate everybody’s (judgement) concern, but honestly I expected nurses to be more (educated) understanding.

When I went in for my Remicade infusion today and told “Nurse Carol” that we are ttc, she said “but you’ll quit when you’re pregnant” and without hesitation I said “No”! And proceeded to fill her in on the details of my decision. I could tell she was a bit embarrassed about opening her big mouth–and she should be.

I admit that I’m pretty pushy with my friends, but even then I don’t advocate things if I can’t back my claims up with data and examples. I certainly don’t push my (medical) opinions on strangers! And knowing what a big decision Remicade is and that doctors (are supposed to) only advocate it when less invasive treatments have failed…knowing that a woman with an overactive immune system would rather risk the unknown and take Remicade, rather than lament the demise of her baby because her own (broken) body attacked her pregnancy…me personally, I would wish her well and keep my f*ing mouth shut. But that’s just me.

Glass Half Empty? Glass Half Full?

Ha! So appropriate

Ha! So appropriate

Couple ‘o things. And I’ll start with “Warning: Massive Profan*ty” for those who are overly sensitive. Um…yeah, you might need to sit this one out.

1. Glass Half Empty
We moved to my hometown because Mr. MLACS took an assignment on a project that will take him away from me for (supposedly) the first two weeks of the month. I agreed, as long as he would be home for procreational purposes (I ovulate toward the end of the month) and the holidays. I didn’t want to put this much info out there, but whatevs, Mr. MLACS’s job is in Canada, and between his HR screwing up his paperwork and the US government shut-down (don’t get me started, I am NOT a fan of Obamacare, as I know plenty of under-insured hard-working poor people who don’t qualify because they make too much money! And today an unemployed-pothead-musician friend was bragging about signing up for Obamacare on facebook–he’s a nice guy but he does not deserve free healthcare! But I digress…)
Basically, Mr. MLACS is still at home (oh and SUCH a joy to be around. Note: workaholics who aren’t working are as pleasant as junkies with no drugs). So besides dealing with his b*llsh*t tempertantrums, this means my ttc schedule is totally screwed for this month. And I’m begging him to change his schedule so that he’ll be home for us to ttc and also for the holidays. But he just snaps at me and brushes me off…no “Honey that’s what I want too, I’ll let them know that my FAMILY comes first and I’m sure it’ll work out” or even a “Babe, if I can’t be here we’ll do IUI or whatever we need to do to have a baby”…Oh no, not this dude, he offers NO reassurance. We engaged in a fight yesterday where he had the nerve to say “It’s not MY fault YOU can’t get pregnant!” Which besides being the jerkiest thing he could possibly say, is also factually bullsh*t: I can totally GET pregnant, I just haven’t managed to STAY pregnant. F*cker. At least get your facts straight. Oh, and I love how he throws completely IRRELEVANT insults into a fight that had nothing to do with ttc–like a suckerpunch. Lame.

So I’m like, now wtf am I supposed to do? How will I get pregnant if Mr. MLACS is not going to be around pre-ovulation? Will he fight me about doing IUI’s cuz he doesn’t want to pay for them? Will he actually grow a pair and give his work an ultimatum? I think right now all he’s concerned about is his job, and he considers ttc MY problem (obviously, from his malicious comment about it being “my fault”). Hmmmmmm. So this always comes back to: Mr. MLACS gets stressed about money and work (which makes him volatile and unapproachable), I have issues I need him to work on with me, but instead of working on stuff with me he finger-points and blames and hurls insults, and NOTHING is accomplished. Always predictable, gotta give him that. Mr. MLACS, can you please stop being such an a**hole? Thanks. Cuz this sh*t is hard enough as it is. Also thanks for doing the damn dishes–but that does NOT make up for the other bullsh*t. It’s called a c-o-n-v-e-r-s-a-t-i-o-n, and we should definitely have one of those (not to be confused with: fighting).

2. Glass Half Full
Since we’ve been back in my hometown, Mr. MLACS has given me some compliments–he really likes the apartments I chose; he really liked the chili I made for dinner last night. He’s been quite agreeable to hanging with my family and friends–who all consider him part of the family. He’s been trying-ish to quit smoking cigarettes. He’s sweet to the cat. He’ll put a blanket on me when I’m cold and twice this week he has slept on the couch to give me room in the bed (I guess I was flailing about). He offered to make me breakfast this morning. Obviously, he supports me financially and takes his role as provider very seriously. I mean, he’s got his finer points. I won’t poison his apple just yet 🙂

Also, I’ve acquired 3 new doctors this week: Gastroenterologist (GI), OBGYN, and a Chiropractor. I like them all, but particularly my new OBGYN, who we’ll call Dr. Angel.
Dr. Angel is the soon-to-be FIL of a good friend of mine. He was listed as one of the providers who takes my insurance AND delivers at the hospital I was born at (which is where I would like to, God willing, have my own baby). My friend put in a good word for me, because Dr. Angel is established and can pick-and-choose his patients. My friend told me Dr. Angel is quite conservative and religious (hence I call him “Dr. Angel” as a nod to Christian faith). Dr. Angel’s children are examples of the doc’s firm beliefs–his kids are the most level-headed, goal-oriented, pleasant and polite people you can possibly meet. I finally met Dr. Angel today. He is a blessing.

Dr. Angel greeted me warmly! He then proceeded to let me babble on about the issues of the past year, carefully listening to every word and asserting questions–very politely, of course. He was soft-spoken and I sounded very boisterous compared to him, but either he liked me or he deserves an Oscar because he chuckled at my jokes and his eyes twinkled the whole time we talked.
Right off the bat, he suggested doing an HSG–which is cool, because I was going to ask him if we might ought to try one to see what’s happenin’ in my ute. He said what other doctors, including my RE’s, would not say: it’s NOT normal to lose a baby with a heartbeat of 160bpm at 7w2d. In fact, something was clearly very wrong. Hallelujah! That innate knowledge is what has spurred my medical quest for answers, so that another baby wouldn’t have to perish from whatever ill befell this first unfortunate child en-utero. But other docs just completely dismissed me and said “oh miscarriages happen so often and they’re usually chromosomal, blah blah blah”. However, I started bleeding BEFORE my baby died…I started bleeding and went to see my doc and the US showed a baby that measured almost right on target, a baby that had a heartbeat of 160bpm…not a dead baby, not a baby with a slow heartbeat or an empty sac…this baby may well have been normal, but I’ll never know, because my old OBGYN dismissed it as “typical loss of first pregnancy”, didn’t test the tissue for abnormalities, and told me to go try again. And my RE’s both acted as though I was overreacting (but kept offering up IVF like McDonald’s slings hamburgers). Not Dr. Angel though. He’s different. He seems to want answers just as much as I do. If something works or doesn’t work, he wants to know WHY, not just guess. We’re kindred in our lust for empirical data. I can tell he’s awfully sorry that I’ve lost 2 pregnancies already, and he is concerned that I not lose a 3rd. *Sniffle, Tear*

So, we talked, he examined me, and the plan is that I will start my menses (any day now that I’ve quit progesterone) and then I’ll call to schedule the HSG with his office. I won’t take any hormones this month–no Clomid or Endometrin or even Metanx. I’m relieved, cuz I need a f*ckin’ break from this stuff–the hormones mess with me physically and emotionally (you probably know what I’m talkin’ bout, right? Hormones SUCK!) Also, Mr. MLACS will most likely be in Canada when I ovulate (please God, let him go so he can get his wits about him), so there’s really no point in taking hormones. Dr. Angel said to just take this month off. He’s reading through the thick binder of medical records that I offered him, and he said that he’ll give it some thought, we’ll do the HSG, and then we’ll formulate a plan. Sounds good to me! PLUS, he has a deal in his office where you pay a flat fee of $350 per month and it covers as many ultrasounds as you need for monitoring, plus I believe it covers insemination too! Or a-la-carte I think insemination was only like $70.
That is a great deal, don’t you think?! And it means I don’t need to go see a (greedy, agenda-pushing) RE! Dr. Angel said he is PCP for most of his patients, and will be happy to monitor my thyroid and manage everything beyond my GI. Do you have any idea how happy it makes me that I only need 2 doctors?! I’m ecstatic. I really, really adore Dr. Angel. I mean, I wish I didn’t have all the issues I have, but I feel very fortunate to have good people helping me through them (yes, that includes you Mr. MLACS).

October is now officially “taking a break” month, and as much as I hate to postpone baby-making for a month, I know it’s an opportunity for me to get my sh*t together: work with the chiropractor, work-out, eat better, settle into our new home, take a break from hormones, have the HSG, figure out Mr. MLACS’s schedule, possibly set up an IUI, etc.

I Finally Found the Doctor of My Dreams (and now I’m moving)

Today I had my last appointment with my beloved GI, who I will refer to as Dr. Handsome. I first met Dr. Handsome in April, in the midst of my post-miscarriage health crisis. I had been misguided and bullied by my former GI doc, and I came to Dr. Handsome feeling beat-down, scared, and vulnerable—I really hoped that he would hear me out and see my point-of-view, and empower me to make weighty decisions about my treatment.
When he walked in the room, I was captivated: Tall, athletic build, silver hair, ice blue eyes, nice smile, and a friendly voice (hence the name “Dr. Handsome”). He immediately put me at ease. He listened to me nervously rattle on about my medical history, and he rolled his eyes (appropriately) when I told him about the crazy bullsh*t my former GI was trying to pull. But where he stole my heart, was when he shook my hand and looked me in the eye as he was leaving and said “We’re going to take GOOD CARE of you.” I get all teary-eyed just thinking about it—no doctor has ever said that to me before. I believed him.
Dr. Handsome had suggested Remicade at that first visit, but I was not ready to go to “big gun” meds, as there are risks and once you’re on it you will stay on it for years…most of the time it buys you 2-5 years at most, and then you have to look at other meds or surgery if your Ulcerative Colitis can’t be controlled. I didn’t want to be pregnant on Remicade. I didn’t want to have my colon out. So Dr. Handsome referred me to Cedars Sinai for a second opinion. At first I thought he was just trying to get rid of me because I didn’t want to take his advice, but when I said that to him he chuckled and said “Noooo, I’ve never fired a patient before and you ‘re a sweetheart! I genuinely want you to have the second opinion and Cedars is the best of the best.” WOW. Like, wow…I left his office with a smile. In the meantime, my UC got remarkably worse and I started feeling pretty desperate to get it under control.
After a couple of weeks of enemas that weren’t working and a mostly liquid diet, my patience was wearing thin. Then I learned that I have slightly elevated NK cells (which can affect implantation of an embryo) and I learned that Remicade helps to regulate NK cells. After a lot of prayer and soul-searching, I finally decided it was time to try the Remicade, so I went crawling back to Dr. Handsome and practically begged for it. I told him I just want to get pregnant and have a healthy baby. And he said to me “We are going to take CARE of you, and you are going to get pregnant and have a healthy baby.” I was so relieved, I cried.
I bought Subway for lunch for their whole office (20 people) to say “thank you”. What you may not know, is that doctors used to get lunches provided by the pharmaceutical reps almost daily (I worked for a Neurologist and the whole office got catered lunches at least twice a week). BUT there was a law passed in January whereby doctors can no longer accept these catered lunches from the drug reps. SO, if you are trying to get on your doctors’ good side (and really, you ought to butter-up his medical assistants and office staff because they call the shots) then food goes a long way, especially since this law was passed. Just sayin’.
After that, the office staff and medical assistants rolled out the red carpet for me! Now this was not my motivation and I didn’t expect it, but it is nice to have your calls returned promptly and to hear a bubbly voice that is happy to help you.
Anyhow, the reason I went in today wasn’t just to say goodbye. It was to ask Dr. Handsome how I should plan for the future of my disease (UC). We both agreed that I need to stay on Remicade (and all the other sh*t that I’m on) for now, and that it’s not time for surgery. For me, my goal is to hurry up and have a baby before it gets any worse. And then if it gets worse after I have the baby (inevitably it will) I want to seriously consider surgery. Fun facts about surgery:
1. I would have the J-pouch surgery. First, they remove my colon and fashion a colon out of my small intestines. While it heals, I’d have a colostomy bag. But a couple months after the first surgery, I would have a second surgery to re-attach everything. Presto!
2. After the surgery, I would be considered “disease free”!!! Did you know that Ulcerative Colitis is the only disease that is curable?! It is! Because once you remove the colon, it’s gone. No more meds.
3. I’d have more frequent bowel movements (like 7 per day). I could handle that, I think, if it meant no sickness and no more meds!
Dr. Handsome suggested that his preferred surgeons were at the Mayo Clinic in Scottsdale, AZ. He said I can always call him, and gave me a hug. I also got hugs from his medical assistants. They said come by and visit whenever I’m in town. I wonder if it’s because I brought them cupcakes today? Or maybe it’s the hilariously long and rambling messages I leave for them. In any case, I hate to leave them, but I’m confident that they are there if and when I need them. I feel good now that I have a plan for “what if”. God Bless Dr. Handsome.
***I brought Dr. Handsome and staff generic grocery store cupcakes. Normally (when I’m not in the middle of moving) I would go balls-out and attempt something pinterest-worthy, like the picture below.
WHOOOOO wants a cupcake?!!

Remember, the way to a doctors heart is through his staff, and they way to his staff is through their stomachs

Remember, the way to a doctors heart is through his staff, and the way to his staff is through their stomachs