First RE appointment - Input appreciated

[joy]

1. Yeah, I want the ultrasound monitoring. I don't want triplets or permanently messed up lining, thanks!

2. Clomid is for naught if you have blocked tubes. I would absolutely not take it until I had an HSG. I'm rather "wtf" on the rush to get started without all the info.

3. I don't like the sound of this RE.

[lilsneezy]

The blood work should be done on 7DPO, not CD21 since we don't all have perfect 28 day cycles and O on CD14. It only checks for progesterone, which will only tell you whether or not you actually ovulated. It won't tell you anything about your follicles or your lining.

[wanderingheart]

I'm sorry you're feeling overwhelmed after your appointment, @underdog25. I'm going to agree with everyone else and say I see red flags big time. Lack of ultrasound monitoring is a deal breaker for me. Otherwise, it's just like an OB passing out Clomid candy. I would try to call the doctor and tell him you want ultrasounds. If he pushes back, see if it's a clinic wide opinion or it's just this specific doctor.

Also 6 months to get in?? That's crazy. I thought my 2 months was long!

[ldubhawksfan]

Ugg I'm sorry. Yeah, no you need to be monitored on clomid, not just cd21 to check if you ovulated. You need ultrasounds to make sure you are over stimulating (octomom), your lining isn't too thin, and that you don't have cysts (it's my understanding that is more of a problem in subsequent cycles). Red flag that she would put you on clomid before your HSG. Not going to help if your tubes are blocked.

I would first check to see if there are other drs in the practice. It sounds like your options nearby are limited, so if you must, advocate for yourself and demand monitoring. Though my trust level would not be very high with her, at least you would know you were monitored. So sorry.

[ghostmonkey]

Yeah, CD 21 would have been worthless because I didn't O until CD18 on Clomid.

I'm sorry things didn't go as you had hoped.

[zombiesquad]

Sounds like you got some good advice, as I agreed with what these ladies said. I'm sorry the appointment was a disappointment, but I hope you can find a reputable RE that will take the time discuss your issues, the plan and properly monitor you.

[Deleted]

I am so sorry @underdog25 I would call back and request to speak to one of the nurses as well as the office manager. You should not have to wait again.

edit: tag fail

[anustart]

I am so sorry to hear it didn't go so well at your first appointment. I hope you don't have to wait again to see an RE. I hope the next person you see is great!

[madamewaffles]

@underdog25, I'm sorry they didn't meet expectations. I agree with others that this RE doesn't sound like they have your best interests in mind. I hope you're able to find a better RE in your area.

[luckypanda]

Let's hope the RE has something better to say! However, I have learned with REs that you totally need to advocate for yourself. You need to let them know that you really want to be monitored and here and there and want these tests and those tests because each RE does things differently and they seem to forget that not all bodies are the same! Hugs and fingers crossed!

[ohinvrtedworld]

Just wanted to drop in and say hugs, that sounds so overwhelming. It would be frustrating to have to speak up so much on your own behalf with someone who should be looking out for your best interest and comfort. I hope you're able to work something out to see a more understanding doc.

[almachs0786]

I've only had 2 appts. with my RE so far. He was pretty rushed and didn't make small talk, but when it came down to it he was very adamant about doing the proper testing before and during treatment. I did my first round of Clomid this cycle (currently CD 22), but not before an HSG, DH having an SA, and so on. I would definitely see about getting into one of the other docs.

[brettanomyces]

I'm sorry @underdog25. I hope they can get you an appointment with a proper RE soon. I found whenever I played the "I'm sure you can understand how frustrated and upset people in our position are" card, the admin staff were actually pretty helpful at squeezing us in early.

You definitely want ALL the tests done before proceeding with ANY treatment. Treatment should be chosen based on the whole picture of test results.

With clomid, you'll want to know how it effects your lining, and how your ovaries respond, which can only be seen by U/S. Especially if the 1st cycle doesn't work, you'll want that information before doing a 2nd clomid cycle or deciding to increase the dosage.

Follicles do produce estrogen, so technically BW can give a rough idea to how many follicles you might be producing, but that's a really half-assed and shitty method of "monitoring". Ultrasounds are expensive? Yes, but they serve a purpose. Are they not covered by your provincial health care?

In the mean time, your safest bet is probably to get the prometrium to jump-start your period and proceed with the HSG.

[♪♫choppinbroccoli♫♪]

I only have support to offer. So sorry for how things panned out, @underdog25. I hope you find a good RE soon. Please let us know how it goes!

[brettanomyces]

Apr 26, 2015 9:24:02 GMT -5 @underdog25 said:

brettanomyces, I have to look into the U/S being covered by our provincial health care. When the doctor said that they don't do them because they're expensive, $80 each, I just assumed she meant that they were OOP. But I'll have to do some digging and find out!

My hunch is that the clinic is so overwhelmed that they are just trying to do the quick fix on everyone and get them on their way again. Being the only clinic in a city with a population of 1.2 million people, they must have quite the insane work load.

And FDL, I see you love titting in here....

I'm in Ontario, all my natural cycle monitoring (BW and US on CDs 3, 10, 11, 12, 13) and my Clomid cycle monitoring (again CDs 3, 10, 11, 12, 13) were completely covered. The Clomid treatment cycle was supposed to be an IUI but converted to TI- all still covered. The only thing we had to pay for was the drugs and, if we had done it, the sperm wash for IUI. 

Once I move to IVF, the monitoring isn't covered, but is part of the package charge for IVF. 

I'm perplexed as to why your Dr would even make the comment about US being expensive. Either they're billing the province or you, either way it's not THEIR expense. Definitely find that out. 

[ghostmonkey]

Apr 26, 2015 9:24:02 GMT -5 @underdog25 said:

brettanomyces, I have to look into the U/S being covered by our provincial health care. When the doctor said that they don't do them because they're expensive, $80 each, I just assumed she meant that they were OOP. But I'll have to do some digging and find out!

My hunch is that the clinic is so overwhelmed that they are just trying to do the quick fix on everyone and get them on their way again. Being the only clinic in a city with a population of 1.2 million people, they must have quite the insane work load.

And FDL, I see you love titting in here....

$80 is cheap for an u/s. 

[joy]

Apr 26, 2015 11:22:05 GMT -5 ghostmonkey said:

Apr 26, 2015 9:24:02 GMT -5 @underdog25 said:

brettanomyces, I have to look into the U/S being covered by our provincial health care. When the doctor said that they don't do them because they're expensive, $80 each, I just assumed she meant that they were OOP. But I'll have to do some digging and find out!

My hunch is that the clinic is so overwhelmed that they are just trying to do the quick fix on everyone and get them on their way again. Being the only clinic in a city with a population of 1.2 million people, they must have quite the insane work load.

And FDL, I see you love titting in here....

$80 is cheap for an u/s. 

Right??

A whole lot cheaper than multiples or ruined lining.

[brettanomyces]

Apr 26, 2015 21:28:35 GMT -5 @underdog25 said:

Because I'm sure you're all sitting on the edge of your seat waiting to hear the next chapter of Adventures with Dr. Sourpuss, here it is.

This afternoon a nurse called me back from the fertility clinic because they had the results of Friday's bloodwork. Conversation went something along these lines:

Nurse: We've received the results from your bloodwork back, and I'm sure you're anxious to hear what your next steps are."

Naw, my husband and I just really had the hankering to lose 16 hours if wages so we could come hang out with you guys.

Me: Yep, for sure.

Nurse: Your hormone levels were very low, indicating you are still very early in your cycle and haven't ovulated yet. Dr. Sourpuss wants you to begin taking the Clomid." And proceeds to give instructions as to when to take the Clomid and what days to HIO.

Me: Okay. Now, about monitoring. I want to have ultrasound monitoring because I'm scared of HOM, cysts, and thinned uterine lining. What do I have to do in order to get that?"

Nurse: "Well, if you want to know when you've ovulated, you can use an ovulation predictor kit. Have you ever used one of those?".

Me: "Well, yeah, but see it didn't work because I wasn't ovulating.... my bigger concern, though, is that I don't want to end up with a thinned lining or too many mature follicles."

Nurse: *pauses* "Well, Dr. Sourpuss has you on the lowest dosage of Clomid. It's very safe. And because there's no medical reason to be monitored, each ultrasound is $175."

So the doctor and the nurse don't even have the same story on the cost of U/S.

Me: So basically we will have no idea if I'm going to be ovulating, or how many follicles have matured, or how my lining looks?

Nurse: *again pauses* "Well underdog, these are the risks, and you're going to have to decide whether you can handle them, or if you want to reevaluate this treatment plan."


Since I was out for brunch with my family at the time of this call, I didn't drag it out. I forgot to even ask the nurse why they wouldn't do the HSG before beginning Clomid.

At any rate, I'm not starting the Clomid, and I'm just not really sure how exactly we're going to proceed yet.

[kariann12]

Apr 26, 2015 21:28:35 GMT -5 @underdog25 said:

Because I'm sure you're all sitting on the edge of your seat waiting to hear the next chapter of Adventures with Dr. Sourpuss, here it is.

This afternoon a nurse called me back from the fertility clinic because they had the results of Friday's bloodwork. Conversation went something along these lines:

Nurse: We've received the results from your bloodwork back, and I'm sure you're anxious to hear what your next steps are."

Naw, my husband and I just really had the hankering to lose 16 hours if wages so we could come hang out with you guys.

Me: Yep, for sure.

Nurse: Your hormone levels were very low, indicating you are still very early in your cycle and haven't ovulated yet. Dr. Sourpuss wants you to begin taking the Clomid." And proceeds to give instructions as to when to take the Clomid and what days to HIO.

Me: Okay. Now, about monitoring. I want to have ultrasound monitoring because I'm scared of HOM, cysts, and thinned uterine lining. What do I have to do in order to get that?"

Nurse: "Well, if you want to know when you've ovulated, you can use an ovulation predictor kit. Have you ever used one of those?".

Me: "Well, yeah, but see it didn't work because I wasn't ovulating.... my bigger concern, though, is that I don't want to end up with a thinned lining or too many mature follicles."

Nurse: *pauses* "Well, Dr. Sourpuss has you on the lowest dosage of Clomid. It's very safe. And because there's no medical reason to be monitored, each ultrasound is $175."

So the doctor and the nurse don't even have the same story on the cost of U/S.

Me: So basically we will have no idea if I'm going to be ovulating, or how many follicles have matured, or how my lining looks?

Nurse: *again pauses* "Well underdog, these are the risks, and you're going to have to decide whether you can handle them, or if you want to reevaluate this treatment plan."


Since I was out for brunch with my family at the time of this call, I didn't drag it out. I forgot to even ask the nurse why they wouldn't do the HSG before beginning Clomid.

At any rate, I'm not starting the Clomid, and I'm just not really sure how exactly we're going to proceed yet.

Wow. That would be the last conversation I'd have with that clinic/doctor.

[♪♫choppinbroccoli♫♪]

Dr. Sourpuss and Nurse Twat can get fucked! Sorry for your troubles, @underdog25

[wanderingheart]

@underdog25, Run girl. Run far away. That nurse sounds like a passive aggressive biotch. It is your body and your fertility on the line, not theirs. Could you ask to be referred to an RE in their clinic, and not an OB?

[joy]

I'm so proud of @underdog.

I'm sorry that this isn't working out as you intended, but you know your shit and know this is a bad situation.