I have a meeting with my RE next week to figure out the plan of action from here. Well, clearly it’s IVF now but we’ll have to work out timelines/protocols. While a lot of me wants to know why my tubes have issues, I realize that on some level, it doesn’t really matter. My main concern is whether I have something like undiagnosed endometriosis or something else that could affect implantation. Does this change expected success rates? I would think not since IVF anyways bypasses anything tube related but who knows.
I realized yesterday that I don’t actually like our RE that much. I trust his judgement but I’m feeling talked over. Like when I bring up a concern I get a lot of very friendly, very polite “oh don’t worry about it, its not a big deal.” But it is a big deal for me. None of it is major but just lots of little things are increasingly making me feel like we’re not communicating on the same plane. Bear in mind my ideal doctor is one who sits and explains the hows and whys of the process gives me the primary source literature to read. For instance, I was trying to gauge just how hard is IVF on my body/emotions/etc. His attitude was ‘oh don’t worry, its not a big deal.’ Compare this to my OBGYN (who i love!) who’s been through ivf herself – her response was “sigh, well, its not fun, you just have to power through it. But when it works out, it’s all worth it in the end.” Fair enough.
Or yesterday, after I was in shock after finding out that basically my tubes are garbage, I was still processing a little information. I was trying to ask, well, if tubes are out, how do you access the eggs? He kept saying ‘through the vagina’. Well, in my mind that means you have to thread through the uterus, through the (blocked) tubes. The nurse understood exactly what I was asking (for the record, the eggs are accessed via a needle that goes straight from the vagina to the outside of the ovaries where the eggs are. No incision, just a needle prick). Doctor meanwhile thought I was an idiot. I might not have the medical knowledge but I am smart. You just have to give me the information.
I’m not sure whether it makes sense to switch – mostly I just want to grit my teeth and get through the next several months. And there’s no guarantee that there wouldn’t be other issues with someone else. Plus, I like the nurses, general staff and functioning of the clinic.
Oh and in general, what I found – nurses are amazing. Doctors do their stuff but when it comes to being taken care of, I’ll take a nurse. They listen and make sure that I’m not in pain or anything. After the procedure when I was quietly sobbing on the side, they made sure I was warm and comfortable and got me water and everything.
On a different note, before the HSG, I made sure my legs were waxed and things down there were generally.. tidy. I’m actually really thankful for that. Unlike every other test/procedure where I’d at least sorta covered/draped, I was all out in the open in this one. Of all things to be defensive about, I don’t want to be defensive about the state of my body hair. I’m also thankful that since I started doing more regular.. maintenance last year, I’m at least sorta used to people looking at random parts of me. Small stupid thing maybe but it’s something that’s making more just a tad more comfortable with being poked around and looked at under bright lights.
countingpinklines 
So, I went through my first IVF cycle with an RE I didn’t like much. I never distrusted his clinical judgment really but he had a tendency to dismiss me as being overanxious and kept verbally sort of patting me on the head (a lot like you describe yours doing, actually – the whole “it’s no big deal” thing about IVF sounds very familiar). It’s a very long story, but it set up a dynamic that made that first IVF cycle far more stressful than it needed to be. I agonized over switching doctors (that first RE was well known in my area and considered one of the top guys in the field locally) but I finally took the plunge. My second RE and I got along MUCH better. It made cycles less stressful and I felt much more confident that my wants/needs were being listened to and treatment more personalized to my priorities. While treatment still wasn’t easy, having a doctor that listened to me made a huge difference. I still regret not putting the brakes on that first IVF after a particular incident with that first RE and at least talking to another doctor or two.
All this to say: if you’re having any doubts about the RE, listen to your gut.
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I can see that. I was planning to wait till after my consult with him and see if I still feel like I’m being ‘patted on the head’. Also, frankly I’m planning to tell him directly that telling me not to worry doesn’t help. Telling me _why_ not to worry does.
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As far as I know endo will not affect the implantation rate. But I have heard if there is free fluid in the tubes it might cause implantation issues. Have you ever had SHG done? That test can tell you if everything looks okay with your uterus.
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I did that last year and afaik it was normal. I should ask my RE when I go this week.
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I agree, it’s important to feel like your doctor listens to you. My fertility doctor was not very touchy-feely (actually rather harsh) but at least she listened when I had concerns about proposed treatment and she would change her recommendations when new information was obtained. For example based on her tests, she said I’d stopped ovulating but she listened and changed her recommendations when I said I thought I ovulated at least half the time even without Clomid (and I was right, neener neener to her). For me it is very important to not be treated like a statistic or a data point on the business plan. I’m sure switching I should stressful but for me it would come down to if i felt I was getting the best treatment. There is so much we don’t control; you want to be able to know you did your best and be reasonably confident that so did others.
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Yeah, I’m going to evaluate how I feel after talking to him. So the rough feeling I get with him is that he listens when it’s medically relevant (so if I preferred IUI, he was willing to go with it even if he thought it made sense to switch to IVF). But not so much if its touchy-feely. I suppose right now, it’s the touchy feely stuff that’s freaking me out 🙂
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Endometriosis, in general, would not affect implantation. So I was told, and I apparently have the most raging case of endometriosis on the east coast – and 3 kids.
My two cents: If you don’t like your RE, you should switch. Either within the clinic or to a different clinic. You need to be able to talk to your doctor and not feel like an idiot. I loved my first RE, but when we were ready to try for #3 she was busy starting up a new practice so I went to someone else. He didn’t listen to me, he tried to force me into things I didn’t want (double embryo transfer, after I already had twins!), and he made the process so much worse than it had to be. During your cycle, the RE is essentially God. He calls all the shots. You want to know that you’re being heard when you say you’re feeling X, or you’re worried about Y, because ultimately *you* have to live with what happens.
Unless of course you’re ok with just relinquishing all control and going with it, which is also a valid method, but it’s not how I generally recommend approaching healthcare.
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Oooh that’s good to know about endometriosis! One worry I can take off my plate!
I think what worries me is less actual decisions (he does do a good job of explaining the what’s and I’ve agreed with his decisions myself). What I am worried are perhaps more touchy-feely things which might not be common to a lot of people. For instance, I freak out when I’m in a position without control. So far, his response has been more along the lines of “don’t worry about it, I’ll take good care of you” rather than, say, “ok, will slowing down help?” or “ok, will giving you X help?”. Perhaps no doctor does this, I’ve never really been in a vulnerable position like that.
My plan is in my meeting next week, I’m going to put out feelers and gauge this better. The reason I’m not sure if I want to rock the boat is, at the end of the day, I trust his decision making. Just not his bedside manner.
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