Wednesday, November 20, 2013

Our First RE Appointment

I apologize if this post is not well structured, we got up at 4:45 to drive to the appointment, so to say that I'm exhausted is an understatement.

To sum it up quickly, Keegan and I both love our new RE, Dr. M. She's exactly what we need at this stage of our infertility journey.

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After finding our way to Birmingham, and through the winding halls of the hospital, we found ourselves at the registration desk. We checked in, got a packet of information to fill out, and were told to make our way down to the waiting room. After a few minutes, a nurse took us back to a room in the infertility department, and also took my vitals. We were left to finish filling out the packet of information, and to wait for the doctor.

A few minutes later, Dr. M walked in and it was pretty much love at first sight talk. During our close to an hour long conversation, she sat at our level, made eye contact, asked questions and most of all, listened. I never once felt rushed or silly for making the decisions we have made in the past. She never once talked down at me, and she tailored our conversation in a way that showed that she realized I had done my research and knew what we were talking about.

While she didn't look at my Fertility Friend charts (she actually wants me to stop charting!) she did look at the copy of Keegan's SA that I brought as well as listened to all of the procedures and medications I rattled off. She commended me for the almost 40 pounds I've lost and also said that while my doctor doesn't sound like he's interested in treating us anymore, he did lead us down the right path over this past year.

We talked about treatment options and as of right now, our two suggested choices were doing a laparoscopy to check for Endometriosis, or do a few rounds of IUI with Letrozole (Femara.)

Side note: I brought up the idea of a laparoscopy, mainly because Dr. B suggested that be our next step. I know the symptoms of Endo, but I've always been confused as to what constitutes "painful periods." I felt like that was such a subjective term that I never brought up the pain I have the first few days of my cycle because I can control it with pain medications. I explained this to Dr. M and she suggested that since I do have somewhat significant pain, that checking for Endo wouldn't hurt. 

While I want to do the laparoscopy at some point, we're just not sure right now is the right time. We decided to go ahead and do an IUI cycle in December, assuming our current cycle fails. I'll do 5 mg of Letrozole cycle days 3-7, come in for a monitoring ultrasound around CD 14, and then do a trigger shot and the IUI. We were quoted the price of about $300 for the IUI, and anywhere from $20-$100 for the trigger shot, depending what insurance covers. I'm not sure how much the Letrozole will cost and we're not sure if insurance will cover the monitoring ultrasound, but overall, I can't see the IUI costing more than $600-$700. While not the cheapest option, it's certainly not the most expensive, either.

Dr. M agreed to changing protocols as we go, letting us dictate how aggressive (and expensive) we want to be. What I love most about her is that she gives us the treatment options, backs them up with both her opinion and facts, but ultimately lets us make the choice. One of the things that irked me most about Dr. B was that he would either dictate exactly what the protocol was going to be without my input, or would go to the extreme opposite and have me make up my own treatments. While I've done my research, I'm not a doctor. What I need is a doctor that will give me all of the facts and figures about a treatment option, as well as their opinions, but ultimately allow me to make my own choices with their guidance, which is what Dr. M does.

She also kicks ass because she's allowing us to do some of the monitoring (like lab work) at home so that we don't have to spend the time and money to drive the 2+ hours for a five minute blood draw.

Overall, we're both extremely happy with Dr. M. While I hope we get pregnant soon, if we don't, I feel confident under her care and won't mind going to see her a few times each month.

19 comments:

  1. This sounds good! It is important to like your RE. I hope you feel better with your plan and can now move on!

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    1. It is so important! I didn't realize how much I didn't like Dr. B until I met with Dr. M. She's a breath of fresh air!

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  2. I'm really glad to hear how well your appointment went! It sounds like your doctor is a winner. It's really important to have a good relationship with someone who will have a big impact on your life over the next few months or longer. I'm so glad you're going to have a plan and move forward!! Hugs!

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    1. Thank you! Of course I hope this cycle works, but if not, I'm excited for what's to come!

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  3. This sounds so great! What a relief to find someone who is exactly what you need, and even let's you do monitoring at home. Are the blood draws just finger sticks? I've always been confused by the pain level associated with endo, too. It seems like it should be SEVERE pain, but my period pain is nothing close to severe. I pop 400mg of ibuprofen, don a heating pad for a couple days, and I'm okay. But it's still *painful* so...? I don't know. I'm hoping it's all moot and I'm pregnant right now. You too. Deal? :)

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    1. Nope, the blood draws are the full on needle in the arm, take a million vials of blood type. As well as checking for CD1-3 levels, she also wants to re-do the labs Dr. B has done to make sure she agrees with his diagnosis.

      I never thought endo would be a concern because my periods can be dealt with medications and a heating pad as well. I guess if these next few cycles don't pan out, then we'll figure out if I have it or not!

      We're both totally going to get pregnant this cycle, the universe owes us by now!

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  4. I'm so glad to hear everything went well!!

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  5. That's so great! I'm glad it went well and you like her!

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  6. I'm so glad things went well! Having a doctor you like and treats you well really is a must, I think. Letrozole can be pretty pricey but if your insurance doesn't cover it all you can get a goodrx coupon that makes it less than $10.

    Sorry I haven't been around lately, but I think about you often!

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    1. Ooooohh I'll have to remember that coupon. I'll probably email you with questions about it if my insurance doesn't cover the Letrozole.

      I've been thinking about you as well!

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  7. i love that you love her!!!! the pricing sounds great. ours was mega bucks. and the progesterone!! $$$$$. laaaame. but worth it, as you know.
    i am so so so hoping and praying that this is it for you!
    I've had a lap done and i really hope you don't need that. serious yuck.
    xxo

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    1. I'm so torn about the lap! Part of me wants to have it so that we can check everything off the list before spending a lot of money on treatments, but the bigger part of me doesn't want to have surgery. I just know that if we do the lap after a few rounds of treatments and find endo, I'll kick myself for basically wasting the money.

      Keegan feels confident about going through with the treatments, so I'm going to trust his gut and do the IUI in December (assuming this cycle doesn't work.)

      Thanks for the well wishes, they really mean a lot!

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  8. Hi from ICLW! Congrats on finding an RE you like! That's huge. It's not always easy to do. Wishing you lots of luck on your upcoming cycle!

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  9. Your RE sounds a lot like mine. She gives me all the options and lets me decide, and also recognizes that I have done my research and know how my body works so she doesn't need to dumb it down for me. An amazing supportive doctor makes you feel so much more hopeful and relaxed!! Good luck!

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  10. I'm so glad the appointment went well and you really like your RE!! How exciting to be moving forward. It's great that you'll be able to get the lab work done closer to home. I'll be rooting for you guys!

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