Tuesday, January 1, 2008


OK, I need to write now or else it's going to seem too overwhelming to catch up later.

I almost wrote a long, whiny entry on 12/22, but I had too many other things to do and I didn't find the time. The brief story is that I went in for my CD2 ultrasound on what ended up being CD1. At the time of the appointment I had just *barely* started to spot. However, I needed to get the appointment on 12/22 because I was leaving for Florida at about 6:20 AM on 12/23.

Well, the ultrasound was fine: no large cysts (but still many tiny cysts that define me as having possible PCOS.) My endometrial lining was really, really thick, which was OK since my period wouldn't really start for a few more hours. I asked Dr. A whether he would be changing my Clomid dose, but he said no, 2 eggs (last month's result) is "perfect." So, I was pretty happy.

However, my interaction afterwards with the nurse (Susan) was really irritating. As I was planning a Clomid/IUI cycle, the usual protocol would dictate that I would get a CD12 ultrasound. Unfortunately, CD12 is tomorrow (1/2/08) and I am starting to work in a new clinic (hematology) tomorrow AM, and I can't really get to clinic during the morning (when they are available to do ultrasounds). Thus, I requested the ultrasound on CD11 (1/1/08). However, it turns out that the RE's office is closed on 1 or 2 days per year, and New Year's Day is one of them. I next requested for my ultrasound to be done on CD13 (1/3/08).

The nurse then said that CD10 (12/31/07) would be preferred. I asked, "Why is that?" I swear that I wasn't rude about it, just genuinely curious. She replied, "Because we need to monitor you."

Ummm, OK. Monitor me for what? I understand if I were doing injectables and the dose would be changed based on the ultrasound findings, but the Clomid is over and done with by CD10. I don't see how my behavior, or the clinic's, would change based on this ultrasound. The nurse became frustrated with my questions and began to speak with me in a very condescending manner. She just kept repeating, "We're prescribing medication and we need to monitor you. You are making it difficult by not making yourself available on CD12."

My reasoning was, "Yes, and unfortunately your office is closed on CD11." In my mind, the next best option is CD13, as that is also close to the preferred date of CD12. I have never in 12 cycles ovulated before CD15, so it's not like we're going to miss the egg. (I suspect this is the reason for the clinic's preference for CD12 or earlier, but I don't think that Susan even understands this. She is really concrete.) Anyway, I don't want to go there on CD10 and see several medium sized eggs and then have them tell me to come back 3-4 days later for another look for another $150. Anyway, Susan and I went back and forth on this several times, with me repeatedly saying, "I am not trying to be difficult. I am just trying to understand the reasoning here." Finally, Susan told me to go up front (to pay) and she would ask Dr. A. She pulled him aside (out of my earshot) and a minute later they both came up and Dr. A asked me when I usually ovulate. When I told him CD15 or later, he said, "It's fine for you to schedule your ultrasound on CD13."

OK, so I "won", I guess, but I left the clinic and started crying on the way home. I really fear that I am now branded as a "difficult patient", probably by both Dr. A and Susan. I could sort of sense that Dr. A may be a bit tired of my frequent questions, and Susan definitely got really annoyed with me during our interaction. I really want to be the patient that everyone really likes and wants to succeed. An RE's office is the last place that I'd want to be disliked. :( And I'm sure that I will have even more annoying questions and requests during IVF.

That long tale now done, we had a wonderful trip to Florida and we returned on Saturday afternoon. I took Clomid again on CD3-CD7. I definitely started having night sweats with it, and those are continuing even as the Clomid is gone. My cervical fluid is not affected; it's very good, actually. My pre-O temps are still much higher than they were back in the days before metformin and/or Clomid. So for now, I'm scheduled for an ultrasound on CD13 (Thursday 1/3/08). I really hope that the IUI will be either CD16(Sunday) or CD18 (Tuesday). Saturday and Monday are really bad due to work obligations, but I'll do whatever it takes (beg someone to cover me) to make sure that I can get there if need be.


alison said...

It sucks that the nurse was so condescending. I, by nature, ask a billion questions no matter what I'm at the doctor for. The nurses at my office are (generally) dumb (not all of them, but most of them are clueless). It frustrates me to no end, so I feel your pain. Lots of luck with this cycle!

Lauren said...

I really feel like you should be able to ask every single question that you want to. It's your body this is all happening to, for goodness sake! If I were a nurse, I think I'd rather have a patient who asks questions and wants to be part of the process, rather than one who just obeys whatever she's told and doesn't understand the reasoning behind decisions. I think you're totally within reason to ask your questions. Maybe they were just having a stressful day and you got the raw end of it. I'm sure you won't be labeled anything by just one interaction.

Cindy Nguyen said...

I know what you mean. Every time I call my Dr. and leave a message for her I feel like I can almost hear her saying. "What now???"

JJ said...

It irritates me to NO end when a nurse doesnt take you seriously, or treats you condescendingly for asking questions--ugggg.
Anyway=) LOTS of hope for your cycle, and a happy 2008!

infertility just sucks said...

No! You are not being difficult! You are just making them do their job. Just because she doesn't know the answer she can't bully you.

I say that if you are the patient that keeps them up at night then good for you!

Hilary (The Trying Game) said...

I'm sorry you had to go through that.

jennifercarol said...

Wow, I'm shocked they made such a big deal about waiting for CD13. I did that last IUI cycle because I was out of town and it was no big deal! Plus I used OPKs ahead of time, so I would have known if we were going to miss O. Weird.