I went online and looked up New Doc - to see if there was any info on her. She has her own website, and it includes her email address! I have been composing a list of 'concerns' to bring when we talk to her... and yesterday figured... what the heck! And emailed it to her. The gist of the email was (after a brief intro):
At a high level, I went off the pill in April of 2005, had well timed intercourse for a year with no results. Went to my GP, who referred me to Dr. N. We had all the 'normal' tests, and everything came back normal. Did one cycle of clomid, then 2 clomid with IUIs. Had a rest cycle, during which I had a VERY painful HSG. I had a positive HPT on Oct 7, but found it was ectopic Oct 19th (I have listed my total history below, but I also assume that you have my charts).
I am very frustrated with how my case is being handled. Below are my concerns (can you tell I'm a tech geek - I like to list things out)
- I don't feel like my issues in Aug-Oct were really looked into. I feel like the HSG was just a checkmark on my medical record. He told me it was something to be done before we moved onto the injectables. He made no comment of what it meant that the procedure was so painful (isn't the pain diagnostic in itself? Couldn't it mean that the procedure itself cleared a partial blockage or opened up a full blockage to partial? )
- After the ectopic, I would have expected some sort of follow up on my tubes, which wasn't done. Isn't the fact that I got pregnant after the HSG make it a strong chance that I could have tubal factor IF? Isn't an HSG after an ectopic is simple logic--why haven't I had one yet?
- Current doc is always commenting on my weight. All my hormone levels have come back normal, and I work out once if not twice everyday (Bikram yoga 4 times a week, and walk approx 20 miles a week). He will comment that our fertility issues are NOT related to my weight, but brings it up in every conversation. This upsets me. Either it's an issue, or it isn't. I have been trying to healthfully lose weight since the ectopic, and have succeeded with losing 20 pounds. I am trying to lose more. I have listed my weight history in this email also, as I want you to understand that although I'm overweight, this isn't a new thing, and I'm also in good shape.
- Also on the topic is weight, Current Doc said my weight OUT LOUD in front of my husband. This was very embarrassing to me. Although Aaron doesn't care, it's a sensitive topic (isn't it for most woman!?).
- Current Doc has mislead us about the timing of when we can start IVF. He had us all geared up to start IVF in May. Then they forgot that Aaron needed another SA. We were pushed off to June. Then we got the denial. I would have to think that the 'rules' for insurance approval are very well documented (as a matter of fact, I was able to go online and see the rules myself after the first denial). If we had known in advance that we couldn't start IVF until October of this year, we would have had a much less stressful time this summer, worrying about getting tests done and expecting to be approved for IVF when there was no way that would happen until 12 months from the ectopic
I also included a high level history of my TTCing and my weight. I sent this at 4 PM yesterday - and she wrote me back the same day!!!! Here it is:
I have the picture. Please make sure I have your records before we meet. weight per se isn't so much of an issue. We do pay attention to body mass index-- a measurement of the relationship of your height and weight. Ideal BMIs are 18 to 28 from a health standpoint, but we don't see a difference in pregnancy rates until >40. HSGs are generally painful, and the pain isn't a reflection of your tubal status. If you had 2 open tubes, and had surgery or treatment for an ectopic on one tube, it's not absolutely indicated to take a look to see if that tube is still open. Any ectopic is presumed to indicate possible tubal disease, but 90% of the time your next pregnancy will be in the uterus..ie the tube or tubes remaining usually work fine. See you next week.
I'm already excited about the visit.