Saturday, January 20, 2018

Exercise . . . in Frustration

I don't think I ever updated on my CD2 RE visit. Let's just say it was an exercise in frustration. For context, during my first two cycles, my RE's office told me to test at home 14 days after trigger, then come in for bloodwork if I got a positive. This cycle, a different nurse called with trigger information. She didn't say when to test or what to do with the progesterone and estrace if I got a negative. I don't recall ever being told that.

So, tests turned negative and I stopped the progesterone 14 days post trigger. One day later, I emailed the clinic to see if I should also stop estrace. The nurse (a different one), told me yes, and that I needed to schedule a regroup with Dr. B before cycling again. Given how poorly the cycle went, that made sense, but it irritated the hell out of me that they didn't bother to tell me until the day I expected my period.

I scheduled the appointment, and was able to get in two days later, which turned out to be CD2. Dr. B asked me why I was there, and I told her the nursing staff wouldn't let me cycle without speaking to her. She seemed surprised and noted it would probably be a short consult. Given the cost, knowing that the doctor didn't think the appointment was necessary left me even more irritated.

We discussed my dismal lining. At one point, Dr. B asked me how I'd been taking the Estrace, and I told her that I followed the directions written on the bottle - "Twice a day, orally" - for the first several days, then switched to vaginal because I had a feeling the bottle was wrong. She stated that the fact that I'd been on it orally probably explained my lining issue.

If I'd been more on my game, I'd have asked some very pointed questions about why the prescription was wrong, and what was CCRM going to do, given that she just told me that error was likely the cause of a wasted cycle. Shame on me, I wasn't on my game, so we didn't discuss that. Honestly, I was just so relieved that she thought we were fine to try again, I let everything else slide. In retrospect, I'm pissed about that. Prescriptions from that office are wrong so often - the pharmacy wouldn't fill my estrogen last time because the prescription said to take it three times a day, "BID". Turns out that BID stands for twice a day. Three times a day, twice a day doesn't work. Another careless mistake leading to even more frustration on my part.

There was some benefit to the appointment. We discussed what else we would do to try to improve my lining. Two things came up: first, given Dr. Haney's feedback on the cerclage, we're going to up my Follistim slightly.That potentially risks twins, but should help my lining, and with the cerclage, twins should be ok. The second thing was that I mentioned my positive CE biopsy, and that I'd been treated and had a negative biopsy since that time. Dr. B. said she'd like to put me on 10 days of doxy, starting day 1 of stims, for my next cycle. I know there's research linking CE and thin lining, so I'm ok with this.

So, a lot of frustration, but hopefully a slightly higher chance of success next cycle.

2 comments:

  1. So this is going to sound awful of me, but have you been with the same clinic for all your treatments? If yes, given that there are continued issues, I'm wondering if a second opinion is worthwhile. Even if it's with a different RE. In my mind, it's never acceptable to have errors with medication from filling to use and it's also unacceptable for staff to give incorrect information about appointments and medical advice.

    You've been through so much, the last thing you need to do is to be fighting with your medical providers. I know it's difficult getting a second opinion (I put it off for a long time) and I'm not saying this is what you should do, but at the very least you RE needs to have a conversation with her staff. Because a botched cycle due to errors in communication on their end means they should 1) be reimbursing you and 2) taking measures to insure it never happens again.

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    1. I've thought very hard about that. There are only two other local options, both have really mediocre SART statistics, and both would be very difficult to reach before work.

      I keep coming back to the fact that this RE will treat me for my DOR (e.g., it's not one-size-fits-all). I think she's fantastic and "on it", and I completely trust her judgment. The nursing staff, while lovely people, seem to be the problem. As long as I stay on top of the details and the nursing staff, I get pregnant. It's just utter B.S. that I should have to stay on top of the nursing staff. I really wish there was a better local option. :(

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