Chapter 2

November 13, 2012

All that I asked for from my fertility doctor was compromise. He was finally willing to work with me, so this means it’s my turn to work with him. (Hey, Congress! Maybe you could learn something from this!) My appointment today was for an FSH consult. Yes, I initially said that FSH was not an option. And initially it wasn’t. There was no way I was going straight to the hard drugs without trying something less invasive first. But that was six months ago.

My appointment this morning was at the annoyingly awkward time of 10 a.m. It takes an hour to drive from Kalamazoo, plus some cushion for traffic and stopping to pick up my mom. Same thing in reverse. I like to go into work early so that I have my afternoons free. That’s probably a holdover from when I was still a classroom teacher. And since my boss doesn’t care what my schedule is as long as the work gets done and people are happy, I get to set my own hours. Within HR’s guidelines, of course. This would mean I have to take a minimum of 30 minutes for lunch, and I cannot flex more than two hours out of any day. (In other words, I have to work for at least six hours if I’m going to use flex time and no PTO.) I say my schedule is 7-3:30, but I usually get to work by 6:45, so I always have flex time for Friday afternoons. But like I said, 10 a.m. is an awkward time for me to be in Grand Rapids on a work day. I could pick up an hour or so before leaving, but I’d have to stay way too late into the evening (at least compared to my usual 3:30) if I went back to the office afterward. So I took the day off.

The more my mom sees of this doctor, the more she is convinced that he’s on the autism spectrum. He’s old enough that he’s probably never been diagnosed, but the signs are there. His complete lack of social skills, for one thing. And then there’s his office. I’m not talking about the clinic as a whole. I’m talking about his specific corner office within the clinic. It is the most barren doctor’s office I have ever seen.

For example: I once received a complaint that the certificates of attendance we provide at our CME conferences aren’t fancy enough. This doctor wanted to hang it on her office wall. You know, next to her medical degree.

His office? The complete opposite.

(Okay, while true, the CME attendance certificate posting is a little extreme. I’d never heard of a doctor posting those before, and I have yet to tell that story to anyone else in medicine who doesn’t agree with me that it’s just plain weird. But maybe one of my doctor friends will contradict me on that point.)

Back to his office. He’s got some text books, the 2011 PDR, a photo mug that some happy patient made. At least I’m guessing that’s where it came from. Maybe it’s from one of his kids. (Does he even have kids? I know he has an ex-wife. And while I’m in a parenthetical, the PDR is the Physician’s Desk Reference, the current pharmacopeia.) There’s nothing on the walls. There’s no plastic model of the uterus. There’s a desk, a sofa, a couple of chairs, a not-full bookcase. My mom thinks he can’t take the stimulation.

So here’s the deal. A woman my age has a 12% chance of getting pregnant any given cycle. FSH increases the number of follicles produced, which increases that percentage. It also increases the probability of multiples. (Yes, he brought that up himself. And, yes, you will recall that he scoffed and insisted that the chance of multiples on FSH is very low. Apparently that’s what he says when he’s not telling you the truth.) In order to minimize that risk, I will have ultrasounds every few days. I will be driving to Grand Rapids a lot. Oh, and this whole process? It starts on cycle day 3. That would be today. And since we have to order the drugs from a pharmacy in Massachusetts, and since he’s going to be out of town for Thanksgiving next week, I can’t do anything until my next cycle. (So, again, back in June when he put in my chart that I was starting FSH, he wanted me to come in for a consult after the first day of my period. We would have missed that month, too, apparently. Oh, and I hope this means Jenny was right. She thinks I’m supposed to have a September baby. If I get pregnant on my first FSH cycle, that puts my due date in September. I really don’t want to have to do this for more than one cycle.) But this was the most frank he’s ever been. He looked me in the eye. He looked my mom in the eye. It was clear that he was working very hard to do that. (That autism spectrum again!) But he did it. And he asked with great sincerity whether or not I was okay with taking this course. I told him that all I had been asking for was the chance to try without it, and now that we had, I could move on to something else.

The next step was to meet with the nurse. Angela is who did my initial intake. I remember this because she’d just gotten back from maternity leave and all of her files were in the wrong place. I have to double-check my insurance policy, but I’m pretty sure FSH is not covered. Between the drugs and the appointments, I’m looking at a couple grand. I’m not sure how many cycles I can afford to try. But I’ll definitely try at least once because the clinic still has a vial of sperm in the freezer. She wrote the prescription for two different FSH brands and added the note “whichever is cheaper or covered by insurance”. I’m hoping I’m wrong. Maybe fertility drugs are covered. She did give me info about a refund program for the cheaper drug, so if my insurance doesn’t cover the drugs, at least I’ll be able to get a couple hundred dollars back. That makes it slightly less painful.

And that was that. I’m on hold. I was going to say in limbo, but that’s not really true. There’s less hope in limbo. And this does mean I can have wine with dinner when my brother and his family are here for Thanksgiving. And I can pop my traditional split of spumante when I reach 50,000 words this NaNo. That really makes me sound like a lush, but I’m not. I swear I don’t drink that much. I drink much more when I’m with my brother than any other time. He says the same thing about me. I don’t believe him. I think it’s him, not me. (Our Aunt Elizabeth would most definitely approve, though. My brother makes cocktails. Aunt Elizabeth and Uncle Ed always did cocktails. I do have Kahlua for when I have cream leftover from cooking. And I do now and then make a gin and tonic in the summer. But mostly, I’m a pour-a-glass-of-wine girl. And that I rarely do more than once a week. Unless I’m visiting my brother.) I’m trying not to think too much about it. There’s nothing I can do. As overused as the statement has become, it is what it is.

As a reward, we went home via the library in Parchment. (Yeah, I really should get a Kalamazoo library card one of these years. I’ll get around to it eventually. The serious deficiency of Parchment’s Sarah Vowell collection will probably make it happen sooner than it otherwise might have.) I am in desperate need of fluff. I decided that because it’s NaNo, I would just try to finish the various books I have in progress. You know, the ones I own. I’ve realized there’s a reason they are all still in progress. None of them make for good silent sustained reading. They’re all better for reading a page here or a page there. You know, when you’re ready for work ten minutes too early or on hold with the phone company or in the bathroom. The one I found first while going through my boxes of books in search of those in progress is Sexual Life in England Past and Present, written by a German in the ’30s. It gets really old really fast. There is some unintentional humor to it. The author quotes himself multiple times, in the third person. Whoever translated it from the German left whole passages of quotes in their original French. (Yes, if I try I can usually read those parts. I’ve gotten tired of doing that, so I’ve taken to just skipping right over them.) He’s quite obsessed with the character of the English person. And then he spends 100 pages on S&M. How stereotypically German can you get? (And, yes, 50 of those pages have nothing to do with England. He quotes the Marquis de Sade frequently. When he’s not quoting himself.)

I brought home the perfect antidote: The Hitchhiker’s Guide to the Galaxy. It’s fast. It’s funny. I’ll have it read in less than a week. (Yes, I checked out a second book, too, the second in the Thursday Next series. I liked the first one, so I’m hoping the second is also to my taste.) And then I took my mom home. She has graciously loaned me the table lamp that matches the floor lamp she had already loaned me (with the express statement that she wants them back and soon so they do not get to live with me until I move again).

I cooked a little. I knit a little. I watched a little Hulu.

And then the pharmacy called. Or rather the pharmacy’s computer called. It was a bit like getting a call from prison. It said the call was for me and then asked if I wanted to take it. I said yes. It then asked if I wanted to speak to a customer service representative. (Seems like an odd question, but that’s what it asked.) I said yes. It then put me on hold. It then came back and told me to press one to continue. I was not on speakerphone, so I had to take the phone away from my ear and hit the “keypad” button before I could press one. By the time I had the phone back to my ear, the computer was reading off the pharmacy’s phone number. It then asked if I needed it to repeat the number. I already had the phone number, so I said no. The computer then said thank you and hung up. Yes, the pharmacy called me and then hung up on me.

So I called back. And I got a different computer telling me that due to high call volume, the wait would be longer than normal. It also said something about calls being recorded to “maintain their high level of customer satisfaction”. I wonder if they have a recording of the computer hanging up on me… Anyway, it’s not urgent, so I hung up. I’ll call them back tomorrow morning. I don’t need the drugs until December.

And that was today. I’m glad that I took the day off. I really enjoyed my quiet afternoon. It’s going to make going to work tomorrow difficult, but I just have to keep telling myself that it’s a short week next week. And maybe I’ll be able to focus at work now, at least for the next 25 days.



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2 responses to “Chapter 2

  1. Maria Meintanis

    I’m going to send you a message on FB with a personal story, but I love commenting on your blog, so I’m going to do it. I would hate to be driving over an hour to go to a clinic like that, especially when you’re talking about tests that occur randomly depending on when your cycle is.

    What’s the reason for using FSH vs. Clomid? (it just seems like everyone with fertility issues uses clomid, so I wondered).

    • One of Clomid’s side effects is that it can thin the uterine lining. That’s why I was on Femara instead of Clomid. Femara, however, doesn’t help improve the lining. FSH both increases the number of follicles produced and increases endometrial thickness. But a lot of people use Clomid first because it’s oral. FSH is an injectible.

      And I love that you love commenting on my blog. You’re officially my number one commenter. 🙂 (Seriously. You’ve made more comments than anyone else. At least directly on the blog. Lisa comments a lot on Facebook when I link there, but I can’t easily see those stats.)

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