Tuesday, February 12, 2008

"My, what a beautiful lining you have"

Too bad everything else sucks eggs.

I pulled the plug on my IVF cycle this morning. Twenty minutes later I'm sitting in a coffee shop with my laptop and a subpar full-fat, all-caf latte. Actually, I finished that while waiting for the computer to boot; it wasn't very hot—or maybe my pain receptors are numb.

I meant to go straight home from my appointment, but I took the northbound freeway ramp when I wanted the southbound one. So I said "Frick it" and pointed my car toward a spot DH and I frequented when we first moved to town almost 10 years ago. Man, we were young(er) then.

At Day 5, my cyst has grown by 75%, and my follicle count is in the dumps: 1 decent one on the right, 2 small ones and 1 disappearing one on the left. Other follicles viewed at my suppression check have vanished.

I'll get my b/w results from my RE this afternoon and will confirm then that we're done for now. I wish I had talked with her after my second suppression check. Not that we wouldn't have proceeded just as we did. It's all a big what if, I know. Yet I wasn't totally satisfied with Dr. L's judgment on that day and now I am completely kicking myself for following it without giving more credence to that little piece of my gut that wasn't on board.

Now here's where I provide evidence that I had reason to second-guess Dr. L's judgment and that I was an idiot for waving off my instinct:

It was obvious that Dr. L hadn't given my chart more than a cursory glance. For four things: he was surprised to learn my age; he had no idea that his partner had recently performed a myomectomy on me (never mind that it was my third in 20 years of living a life of fabulous fibroidosity — and that I didn't need him to define subserosal, convert mm to cm, or question the veracity of my knowledge that I do not have endometriosis); he assumed I was doing a different protocol and gave incorrect "start injections tonight" advice based on that (which I didn't follow); and he was, I felt, more focused on putting on a getting-to-know-you floor show than paying close attention to my actual situation.

I don't know about you, but I prefer that my doctor save both playfully joking with me about my cyst/fibroids/clinic bill and patronizing the nurse ("You're wrong, as usual! But I still love you") till after he's done probing me. "Probing" was Dr. L's word; most at least use the term "wand" — without turning it into a verb.

You know how some guys, some gals too, will grandstand for you the first time you meet? They present an exaggeratedly charming/clever/funny self to seal the deal on that spectacular first impression. They are full of themselves (because they truly are talented, smart, charming, funny, or something good) and insecure with a capital I. They need that immediate feedback that you think they are the greatest, so they hit you with all they've got within your first 2 minutes of acquaintanceship. By the second time you've met, they feel comfortable enough to settle down into a normal personality presentation. And you do like them. Usually a lot. That was my take on Dr. L.

I don't blame him for my cyst growing or my follicles withering. And I don't blame him for answering my questions about oversuppression and why we wouldn't expect the cyst to grow with "In my experience, these shouldn't pose any problems." He gave me the advice he would have given to anyone else. And that's the kicker. Was he framing that advice within the context of my history, my age, anything about my case? I feared not then. And my incredible superpower of laser-like hindsight tells me NO now.

I do blame myself for not calling my RE directly to talk it through a little more. Had I done that, I may have gone ahead as I did. But I wouldn't be so freshly irritated by my visit with Dr. L and soooo mad at myself.

Looking forward to Dr. K calling later. We will figure out next steps.

Listen, Dr. K and I discussed the possibility of a poor response several times before DH and I signed up. I absolutely knew it could happen. I thought maybe it was even likely to. So this really is not a big surprise. In fact, I need to start thinking about it as good news. I had REALLY hoped, that if my meds protocol was wrong for me or I was just not going to do well, we'd get good indication of that early on. Before proceeding to retrieval. And so that wish has been fulfilled.



Anonymous said...

I am so sorry! I have been checking your blog to see how you were doing. I am also sorry you did not have a good experience with Dr. L.

I hope you get to speak with Dr. K soon. I can't believe the cyst grew.

Based on my experiences with cysts, I want them aspirated in the future before continuing. To many what ifs.

Shelley (a/k/a momtoaminihawk).

Anonymous said...

Thank you so much for the comment, Shelley. I know you have been there. And I have been thinking about your experience as we go through this. I don't know what to think now. Dr. S had 2 people call me to say continue as planned (because I told the first that I needed to hear from Dr. K; told the second one that too). We'll see.

Thanks again for checking on me!

Anonymous said...


The problem with all of this, is that they really do want you to succeed, so they do push if they think there is a chance.

I had a couple of NP's and one doctor do a check on Day 5, who said I was not responding, but then my E2 levels came back and Dr. K said go. She was right to go, as they got 16 eggs, they just were all bad quality. We do think it was the cyst that caused the bad quality, but really, we don't know.

I purposively made my failed IVF cycle follow up appt. with Dr. K for much later in the month. I needed a break from that place. I had so many ups and downs, and ups that I had to get away.

Dr. K did email me and call me to make sure I would follow up. I was surprised. I thought I would just fly under the radar.

I like Dr. S. I think he does know what he is talking about. With my cyst, he said it could go either way, and he thought it was reasonable to continue.

Do they think you should go ahead based on your age? What is the hurry?

Can you ask whether you can have them aspirate the cyst, and go from there. Can you do that?


Unknown said...

Lisa, I just wanted to tell you how sorry i am with the recent results. Is there a different protocol that would work better? If I have any meds left over that you need, you can have them. One way or another this is it for us. Hugs to you, and I hope somewhere in all of this you get a rainbow.

Anonymous said...

Thank you for the rainbow wishes, Susan. That sounds lovely all around. If we cancel and do IUI (or just plain cancel), I don't even know right now whether we'd try a new IVF protocol or call it a day. That is not for you to worry about, though. You use up every last drop of your meds and make them WORK!