Thursday, 14 February 2013

Be (a) Patient

So far it seems that much of the process of infertility treatment is HURRY! Once AF makes her appearance, you have to spring into action to make sure evaluations are accomplished on certain days. If you miss this narrow window of time, the cycle could be a bust and you'll be banished into another monthly delay. I received an email informing me that my insurance authorised my hysteroscopy and I was instructed to call on the first day of my cycle to coordinate scheduling the procedure. Based on my fertility monitor, I was expecting my cycle to start on either Saturday or Sunday. The office is only open for half a day on Saturday, and a prior experience of phoning on a Saturday found that they let the answering service respond to incoming calls. I started to become a little nervous about notifying them on day 2 or 3 of my cycle.

I've taken note that my RE is rather particular about certain details. During my initial evaluation, he insisted on using a specific pen to take his notes. As someone else who is also loyal to one brand of writing utensils, this was rather comforting to me, but it also seemed to establish a trend. At the start of an IUI cycle, he prefers to do the baseline ultrasound on day 2 rather than day 3. Day 6 was favoured over day 7 for my sonohystogram. It seemed to follow suit that he would have a preferred day for performing a hysteroscopy. Husband was also trying to coordinate his schedule, as he was planning to take the day off work to accompany me, and had to set up a meeting with a client during the first week of my cycle. Left to our own devices, I was sure Husband would inevitably pick the favoured cycle day.

I called the office to gather some more information and reached his medical assistant. "Are you going to be taking birth control pills?" she asked. When I acknowledged that I was, she explained "it doesn't matter what cycle day as you're suppressing ovulation and keeping your endometrium thin." Wow. There was the obvious slapping me in the face. I have working knowledge of the effects from contraceptive pills, and yet it had escaped me. I felt embarrassed for being so oblivious.

I shared this with Co-worker (now in the second trimester with her twins) who commented, "this is good, you're taking the provider out of the equation and are letting yourself be a patient." For the longest time, I have believed the two roles could not be separated as I have been so concerned about exposing anything that might reflect any professional ignorance. When I told Myrtle that I suspected that there may be something wrong with my uterine cavity which contributed to my miscarriage, she responded, "You're so lucky that you know all this." Her words were very flattering to hear, but I was fixated on thinking that she was the lucky one -she's fertile and everything worked perfectly for her on first pregnancy. Did my knowledge really even matter? Apparently not, and may even be more of a hindrance than be helpful. The night of my miscarriage I bailed on our monthly department dinner meeting. Unable to quickly come up with a plausible excuse, I decided to tell our lead physician what happened. She revealed that she also had experienced a miscarriage, under much more heart breaking circumstances.   At the time of her nuchal translucency scan, the baby's heartrate was low and the measurements were off by 5 days. She wasn't too concerned at first, but the heartrate was persistently low and dropping on subsequent scans. The growth interval was lagging by more than a week. Three weeks later, the heartbeat had stopped, which was actually much to her relief. "At that moment, I could finally move on" she explained "leading up to that point, I still held out for some hope. I was trying to reassure myself with things that I wouldn't say to patients." Those words have stuck with me.


  1. Its amazing how many people out there have dealt with IF or miscarriage. And we don't know about it until we open up then people start coming out of the woodwork.

  2. Oh my gosh, that is heartbreaking about the NT scan and your friend enduring that miscarriage... I agree that, in a way, it might help for you to "sit back" and be the patient for once. And yet, I also think there's so much opportunity for you to use your knowledge for good. The fact is, mistakes are often made at fertility clinics, by doctors, nurses or other stuff, because they're so busy and have so many people to keep track of... if you can stay on top of stuff, on a medical level, that can only help!

  3. Even though I am a personal trainer, I have hired another trainer at times. Sometimes it's just nice not to have to think about it, and let someone else tell you what to do for a change. I'm sure it's tough to separate yourself to being a patient, rather than the provider. At the same time, it's probably nice to have the knowledge. It's a double edged sword for sure.

  4. I agree with Jen. It's amazing when we put ourselves out there and someone else tells their own story. I finally told my manager what all my appointments were for and she told me her daughter went through it all before she had her baby. It just seems to catch me off guard hearing stories that people can actually relate to you.