finding a new doctor…

So you may recall, I broke up with my old ob/gyn (see the full story here) due to many issues (some of which are also explained here).  Shortly after I decided I was done with Dr. Tam, I google searched for gynecologists in Chicago.  I know, I know…dangerous thing to do!  Who knows what you could end up with!  Since moving here, I’ve always gone to see doctors either by referral from another doc, or by advice from a friend.  My regular doctor had referred me to Dr. Tam, so I couldn’t ask him for another referral (he seemed to really like her and think she would be good), and I of course couldn’t ask Dr. Tam – that would be rude: “Hey, ya know, you kinda suck as an ob/gyn…could you maybe give me a name of someone way better than you?”  Yeah, I’m not that kind of person (I hope)…so I googled.  I found someone online, who took my insurance and had nothing by 5 star reviews from current patients.  So, I took a leap of faith and called to set up a consultation appointment.  I figured there would be no harm going in to talk with her and see what she had to offer!

So, I was looking for someone I could feel comfortable with, someone who seemed to either understand my particular fertility problems or at least be willing to work with me and learn.  Boy howdy, did I find her!

My first clue that this was going to be the right place was the paperwork I had to fill out before getting there.  In the section to fill out about past pregnancies, not was there a place to mark if the pregnancy had ended successfully, but had a column to fill out about miscarriages and a spot to put how far along in the pregnancy you reached!  Seriously, this place understood pregnancy does not = healthy baby all the time.  Other forms I’ve filled out in the past just asked for pregnancy and how old the child is now.

I got into the office and the nurse brought me back for a few medical history questions and to check my blood pressure.  Then the doctor came in.  She was so nice!  I was immediately at ease!  She went over more history with me, spent time with me trying to get the time line of my pregnancies, losses and diagnosis figured out so she understood the steps I’ve already taken.  She has a relationship with Dr. Freaking-Awesome (my MFM doc) already and was happy to let me continue to see him if/when I get pregnant again.  She then talked with me about possible next steps – she really understood my diagnosis and current treatments!  I couldn’t believe it, I doctor that actually understood me and was willing to help me!!  It was a miracle.  Right away there were some tests she wanted to run (that should have been done when I had first mentioned to my old gyno that I was thinking of trying to get pregnant).  I’m going in today for some blood work.  First off, she’s checking my Progesterone levels to see if I did in fact ovulate this month (I should be 7dpo if I did).  She wants to see if I’m Oing on my own.  She mentioned clomid, that it might be a good thing to introduce to my current regimen.  I don’t know why but I’ve ALWAYS been hesitant about taking it.  All of my docs (old gyno, RE, MFM) have mentioned it to me and I’ve always said no.  But having stepped back now, I think it may be time – if it helps I’m willing to go there now.  New ob/gyn seems to think that it may just be that extra push that I need.  Okay, I’m ready for it then!

I’m also being tested for cystic fibrosis carrier and to see if I’m still immune to chicken pox and rubella.  I guess this should have been tested for when I first wanted to get pregnant.  If I’m a carrier for cystic fibrosis, DH will need to be tested too.  If both parents are carriers then the baby would get it.  I really hope that I’m not!

Step 2 of the new plan is to go in a few days after my next cycle begins (hopefully it won’t!) and get an endometrial biopsy.  I’ve never had this before.  She says that I have certain risk factors (PCOS, MTHFR, over weight, etc…) that could lead to Endometrial cancer, and she just wants to check and make sure all is well.  It should be no worse than getting the saline sonogram that I had with my RE, so I’m not too nervous about it.  She said I may get a bit crampier than the other test, so I’ll just take some ibuprofen or Tylenol before the procedure to help with that.

Can you believe this – all from a consultation appointment to see if I’d like to stay with this doctor!  I can tell you, about 1 min into my conversation with her I’d already decided!!  She even said if I get a positive pregnancy test to call Dr. Freakin-Awesome first to confirm viability and then to call her – she takes this high risk stuff seriously!!  I know she’ll be able to deal with crazy pregnant me if/when I get to that point!  I’m so happy with how this all worked out!!!

Okay, so now for the naming ceremony.  I need to give her a clever nickname – oh, and by the way, if you live in the Chicago area and want to check out my new doctor, send me an email at somedaybabyt at gmail dot com and I’ll give you her contact info.  Hmm…how about, Dr. Understanding?  Dr. Delightful?  Dr. Proactive?  Any good suggestions?  I’ll take them!!  Maybe we’ll even do a poll if I get a bunch of good ideas!  Leave your name suggestions in the comments!

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more info on my mthfr…

Okay, got the test results in “writing” back from the doctor.  Here’s what it says:

“This individual [yours truley] is homozygous [I have 2 copies of the mutation] for the C677t mutation and neagative (normal) for the A1298C mutation in the MTHFR gene.”

So the fix is to add 81 mg of Baby Aspirin (the chewable kind, yay) and 1 mg of Folic Acid to my already growing drug regimen.   Like I said in the last post though, anything to get my baby!!

I’m also being sent in for one more blood test, Homocysteine Level.  Basically to see if I have B12 or folate deficiency.

I’m happy with this result, because it seems fixable, but 2 things kind of scare me about it:

1) Apparently the MTHFR gene mutation can tie in to vascular disease.  I’m now in 3 high risk groups for a heart problem (women, obese and MTHFR gene mutation).  Great.

2) I’m absolutely TERRIFIED of blood clots.  Seriously, I’m constantly worried when I’m in a car for too long I’m gonna get a clot.  My grandpa and aunt both in the past year have had blood clot issues and it scarred the tar out of me.

Anyway, that’s what’s going on in my life.  One fun thing with my blood work, a copy of all my genes was in the envelope!  Now I have pictures of my DNA…it’s pretty interesting!

Oh, forgot to add this…an interesting article I found on MTHFR and Miscarriage.

dr. freakin’ awesome & answers…

Have I mentioned how much I love my MFM doctor?  I really do!  He’s been amazing to me…I’ve only seen him once, but when I have questions or tests come back HE calls me personally!  Can you imagine that??  A DOCTOR that makes phone calls with test results???

Therefore I dub thee: Dr. Freakin’ Awesome!  From now on, that shall be how I refer to the MFM doc.  I wish I could have him for all of my ob/gyn, infertility, MFM related appointments…

Anyway, he called me this morning on my way to work (DH was driving luckily so I could take the call).  My über blood work came back (really quickly too, as I though it’d be late next week before I heard anything).  He said everything came back normal except the MTHFR – basically it means that my body doesn’t hold on to folic acid (which is a tiny bit important when trying to create and sustain a life…).  It also can cause clotting problems that can lead to miscarriage.  He thinks however (and he told me this when I met him the first time) that my 2 losses had just been bad luck and it didn’t seem there was anything particular that led to the losses.

He’s going to send me in for one more test…some sort of enzyme.  I don’t recall the name (I’ll tell you when I get my requisition form).  He’s also giving me copies of ALL of my test results, in case I ever move or get a new doctor so I don’t have to repeat the tests!  Did I mention how freakin’ awesome Dr. Freakin’ Awesome is??  Cause, well…he is!  My DH is heading down there after lunch to get my results and the blood work order form.

So…what is the next step?  I will be adding a folic acid supplement to my daily Metformin and Prenatal.  Also I will start taking 1 baby aspirin a day.  So that’s a total of 6 pills a day!  Oh well…if it gets me my baby in the end it is absolutely worth it!!!

Can I just tell you all how happy I am right now???  It sucks that there is so much wrong with me, and that it’s been a constant battle with my body and doctors these past 3 yrs, 3 mo – but now there is a better answer, and a way to deal with it that just may work.  Now with the combo of my Metformin (so I am FINALLY able to ovulate on my own) and the Folic Acid/baby aspirin (to keep my baby once s/he is concieved), this just may work out!!  A huge swell of hope has hit me again, and it was MUCH needed!!

I emailed my best friend yesterday because I’ve been having such a hard time the past month with all of this.  Baby announcements, births, preggo bellies everywhere and nothing for me but empty arms where my 2 little ones should be.  It hit me hard yesterday…if you’re on twitter, you probably saw my Infertility Pity Party tweets all day…it was a rough one.  But, now today!  I have hope again, something which is desperately needed.  This just might work…

PCOS

So, when my doctor told me I had PCOS, I really had no clue what that meant.  In all reality, I still don’t really know what that means.  And also, the diagnosis I feel was kind of a default one – they couldn’t find any other reason why I wasen’t getting pregnant, so I think they just chose that one.  I’m not saying I don’t have PCOS – from what I’ve read about it, it makes sense.  What I am saying is, I kinda feel like the doctor labeled me with this without any proof or testing for it.

That’s not the point though – I wanted to share what I’ve found out about PCOS, mostly from WebMD – the default source of medical info for those who don’t know anything!  If you’d like to read the whole article where I got my information, it can be found here.

PCOS stands for Polycystic ovary syndrome.  From what I can figure, PCOS basically means that my hormones don’t work the way they are supposed to.  I don’t produce the right amounts of hormones essential not just for making babies, but for having regular cycles and ovulating.  This is why I was given certain hormone shots during my IUI cycle, given a shot to make me ovulate, and then given progesterone suppliments to guard against miscarriage.

Symptoms of PCOS are (according to webmd):

  • Acne.
  • Weight gain and trouble losing weight.
  • Extra hair on the face and body. Often women get thicker and darker facial hair and more hair on the chest, belly, and back.
  • Thinning hair on the scalp.
  • Irregular periods. Often women with PCOS have fewer than nine periods a year. Some women have no periods. Others have very heavy bleeding.
  • Fertility problems. Many women with PCOS have trouble getting pregnant (infertility).
  • Depression

I’ve always had acne and weight problems.  My periods have also always been irregular.  I didn’t start my period until about was about 16 or 17 years old.  Since then, they come and go as they please.  I used to have very short periods – sometimes as little as 2 or 3 days, but never more than 5.  Over the past 4 or 5 years, they have pretty much settled into a rhythm of occuring every 3 months and lasting about 6 days.  However, there have been times where I would bleed for over a month.  I didn’t go to a gynocologist until about 3 years ago, and then decided to try to have a baby 1 year after that.  I was never on birth control.

Looking back on the history of my cycles, I should have known something was wrong and done something about it long ago.  I always had a fear in my heart, the “what if I can’t have kids?”  But I never took that thought seriously, until it actually happened.

So here I am now.  Waiting.  Waiting for that period to come, that I’ve always dreaded because of the cramping and the inconvienience.  I was always so happy that my periods were short and few.  I now no that’s not a good thing.  And even when this one does start, I’ll have to wait for the next one before we can try again.  Frustration is a word I understand well.