Today was my first meeting with Dr. F, the head of reproductive medicine at the University of Michigan.
Before I even met her, I met with a nurse who took my vitals and reviewed my file with me, and a resident who talked to me about all of my past treatments and doctors.
By the time I met Dr. F, I had already told my entire life story to two separate people, and they had relayed the information to her.
Dr. F was very compassionate, understanding, kind, and warm. That made me like her.
She was also confident, sharp as a tack, very direct, and didn’t beat around the bush. That made me love her.
After exchanging pleasantries, she made mention of the fact that we’ve been trying a loooooong time. I agreed, and she said that typically in a situation like this, she doesn’t start by dictating the course of our future, but asking where I would like to go. She understood that I am savvy when it comes to my body and what testing and treatments are out there, and that I am a professional internet research. She liked that I had asked for testing from Dr. K when it seemed like we were not getting anywhere, and she actually LOOKED at my BBT charts.
Like, looked at them. Studied them. Seriously.
And she likes that I’m in acupuncture!
I like this lady.
So, after discussing where I’ve been and what I’ve done previously, Dr. F said that it seems like I’ve had a fairly thorough workup, especially with the recent testing I’d asked for. I brought in a typed up summary of all of my recent test results, and that made the process of going through the important levels much more efficient.
She asked why I had never had a laparoscopy, especially with my history of heavy, painful periods, and I told her that none of my previous doctors had thought it necessary. She thought that was odd considering that all of my ultrasound records show what looks like a cystic area on my left ovary. Suspicious, and worth taking a look.
She schooled me on some of the finer points of recent studies showing little difference between the success rates of women with endometriosis having laparoscopies, and women who went without, but also said that diagnosing endometriosis can help to better determine treatment plans in the future. She wants to have me complete some other testing first, and then consider a lap in a month or two if we aren’t successful at that point.
She also was honest with me about my timeframe for conception… It hasn’t happened in four years, even with all we’ve tried, and without IVF, it may be even longer before we find success. She wants me to consider IVF within this calendar year if we aren’t successful soon.
Honesty. I get it. I’m right there with ya, sister.
It’s been almost three years since my HSG, so Dr. F wants to have me do a hysteroscopy as soon as my next cycle begins to rule out uterine polyps or fibroids. Let’s not waste time! I like that!
I’m also being screened for cystic fibrosis, and having my thyroid panel redrawn, including thyroid antibodies to rule out autoimmune thyroid disease.
All of these things make me feel like we’ll be getting a clearer picture of my overall health and fertility, but one thing Dr. F said took me aback.
“Has anyone ever told you that you have PCOS?”
“Well that’s odd.”
“Yes! Look right here!”
And then she proceeded to show me how I have several instances of increased androgen levels on different lab results, and that my follicle counts during the AMIGOS study were quite a bit higher than what’s normal. Per Dr. F, if I had irregular cycles and insulin resistance as well, she would diagnose me on the spot, but she sees enough evidence in my overeager ovaries and the hairs on my chinny-chin-chin (which I meticulously pluck!) to make the call.
The thing about having PCOS when you don’t have insulin resistance is that there’s not a direct game plan.
I don’t need to lose weight. I don’t need to take Metformin to control my blood sugar. I don’t need to diet (though I already am, a bit).
In my case, the treatment would be medicated cycles. In this particular case, Dr. F wants me to do Gonal-F hybrid cycles with IUI.
If we do one cycle that fails, we will proceed to the laparoscopy, and after recovery, try another before reevaluating.
All in all, I feel like there was a lot discussed today, and I feel like there’s a plan in place.
I do so hate standing still…
It’s nice to have direction, and to feel confident in medical professionals again. I know there’s still a long way to go, and that none of this may actually make a difference, but it’s still nice to feel like I’m moving forward again.
Oh, and here’s a video that made me laugh till I almost peed. Almost.