Wednesday, September 28, 2011

The First Appointment

Eight short days after our physicals, we had our first appointment with Dr. K.  It pains me to say this but Dr. K is affiliated with The University of kansas Medical Center and as an avid MU Tiger, putting my baby hopes in the hands of a jayhawk is NOT my idea of a good time.  I guess this is one of those times where you swallow your pride and get over it.

JPug and I arrived at the office just before 8:30am on August 11th, filled out a slew of paperwork and were ushered back into Dr. K’s office.  A resident came in before Dr. K and began jotting down notes as we discussed our medical history and process to date.  I handed over my medical record from the clinic at my previous employer, the basal body temperature chart we tracked from November to April and my cycle dates and lengths for the last 12 months.  I had followed the Boy Scout motto to a T…we were prepared.

After a while, Dr. K entered the room and we started from the beginning…again.  Her appearance wasn’t notable…white doctor’s coat, average height, average build and average brown hair similar to mine.  She looked a few years older than JPug and me but not so many that we would consider her out of touch with our reality.  I thought our initial visit would be getting to know Dr. K and the practice, discussing next steps, scheduling future appointments and we’d be on our merry way.  Interestingly enough, that was not the case.

After getting the best possible picture from a 15 minute conversation, Dr. K went into action mode.  Considering my initial impression of her, this seemed out of character as I definitely didn’t get the “action mode” vibe at first blush.  Good thing I kept an open mind and my mouth shut!  Before we knew what hit us, Dr. K started rattling off a list of tests that she would complete that day, future orders she wanted for JPug and me, and finally addressed something that had been in the back of my mind for a long time...my TSH.

My previous and current PCPs were both on the mildly concerned side of interested when it came to my TSH but Dr. K basically rolled her eyes and said the buck stops here.  She went on to explain that my TSH had been on the high end of the spectrum long enough that it didn’t make sense to continue testing (and getting the same results) before treatment.  She wrote me a prescription for an extremely low dose of synthetic thyroid hormone which I started taking that afternoon.  I'll explain more about TSH, my previous results and Dr. K's decision to act immediately in a future post.

After we finished in her office, Dr. K moved us into an exam room but in an effort to NOT make this the longest post ever, I'll save those details for my next post...stay tuned!

Sunday, September 25, 2011

The “I” Word: Background Part III

In August 2011, we returned to Dr. B's office for our annual physicals…same routine, different doctor.   As the appointment came to an end, Dr. B wrote a prescription to have my thyroid panel re-taken (pre-physical lab tests showed that it was slightly elevated once again) and at the bottom scribbled a barely legible “Dx: Infertility”.  Awesome…an official infertility diagnosis.  As I left the appointment, he recommended the name of a reproductive endocrinologist (fertility specialist) he’s referred patients to previously and suggested I work with the front desk for the appropriate referral paperwork and contact information.

Later that afternoon, a quick search on our insurance company’s website proved to make our specialist choice very easy.  The specialist recommended by Dr. B was nowhere to be found.  There were only 2 practices in the entire metro area that were considered in-network and carried our insurance company’s care designation.  Both practices had solid online patient recommendations, were similar distances from our home and were affiliated with major medical centers.  It seemed as if we were comparing apples to apples so I did what any logical girl would do...some friends saw a specialist from one of the groups but didn’t have success so JPug and I were going to start our journey elsewhere…I called and made our first appointment.

Thursday, September 22, 2011

The “I” Word: Background Part II

In February 2011, I switched employers which meant we also switched insurance companies.  The new company's plan year was July 1 - Jun 30 and we wanted to get our yearly physicals in before the existing plan year expired.  After the new insurance kicked-in, we found a PCP near our home and made an appointment.  For some unknown reason, this PCP (who I'll refer to as Dr. B) likes to meet with patients and get to know them for an initial visit before completing a physical.  On one hand it's nice because you feel the provider is taking an interest in you and your health but on the other hand I couldn't help thinking the whole two visit thing is a complete scam because the office would be billing our insurance for both visits.

In May, we went for our initial, new patient visit with Dr. B which took forever...I mean FOR.EV.ER.  We were there for hours as he discussed his background, approach to care and asked various questions about our health.  During the visit, I was sure to bring up our conception process to-date.  By this point, I was still tracking cycles but we'd abandoned the basal thermometer and moved on to ovulation kits.

Those pesky little ovulation kits hadn't helped one bit...the first month we followed the package instructions to a "T" and never got a positive reading.  The next month, I increased the testing window (testing for more than a week) but still no positive reading.  By the third month, I was bound and determined to get a positive reading so I tested for two full weeks...and...NADA.  Come to find out, the ovulation kits don't work for everyone and I was definitely one of those people.  Never having a positive reading didn't mean that I wasn't ovulating...it just meant that the tests didn't work for my body.

After hearing an abridged version of our process over the past 9 months, Dr. B's big-time, professional, medical opinion was that we were trying too hard.  "WHAT?!?!" shrieked through my mind as the words spilled out of his mouth.  He suggested abandoning the ovulation kits, cutting back on exercise and concentrating on us...our marriage, each other, us.  An an avid runner, cutting back on exercise was not something I wanted to hear but if it would lead us to the desired end result, I was on board.  Plus, I'd be spending more quality time with JPug so I looked forward to the change.  Dr. B asked that we push our physicals to August as that would give us some time incorporate his advice into our lifestyle and it would also mark the official 12-month point in our journey.

Monday, September 19, 2011

The “I” Word: Background Part I

In June 2010, I went for my annual physical at the on-site clinic offered by my then-employer.  The physical itself was normal…the doctor performed standard tests, discussed new issues and asked if I’d like to renew maintenance medications.  Before you knew it, I was announcing that I didn’t need a renewal for my one and only maintenance medication (BCPs) because JPug and I were going to try and start a family.  I’d finish out my existing prescription which would be one more month and then we’d get down to business.  The type of BCPs I was on didn’t need a detox period (for lack of better words) so once I was off, we’d be good to go.  The doctor’s mind quickly switched from prevention mode to go baby go and she wrote me a prescription for prenatal vitamins which I was to begin taking daily.  After that, the appointment was over and she whisked me out of the office with a good luck sort of smile. 

The following month, I went in for my annual blood work to ensure all  lab levels were within the appropriate reference ranges.  It's important to ensure hormone levels are within the recommended ranges before attempting conception for two main reasons:  1) discrepancies can affect the ability to conceive and 2) issues are almost always easier to fix without a baby on board.  Once the results were in, all levels looked normal except one...my TSH (thyroid stimulating hormone which I'll go into in a future post) was 7.15.  The doctor asked me to come in for a follow-up test the next month but didn't express further concern. 

One month later, my lab work was re-run and results showed my TSH was slightly elevated at 4.54 but much closer to normal; the doctor asked that I come back in 6 months to have my TSH analyzed again.  In February 2011, my TSH was finally within the normal range at 3.55...I felt a sigh of relief and thought we were finally moving in the right direction.  During that appointment I also discussed our process to-date with the doctor...cycle dates and basal body temperatures over the last 6 months.  My cycle hadn't been spot-on regular but wasn't cause for concern and the temperature tracking didn't provide the obvious spike to signal ovulation that health professionals look for.  Rather than drive myself crazy because my body didn't seem to be acting the way it should, the doctor recommended abandoning the basal thermometer and trying over the counter ovulation kits.  

By this point, we were 6 months into the process and emotions were a mix of mild frustration and hope for the future.  The process didn't stop there but I can't give everything away at once (duh)!


*Please note*  I am not a healthcare professional...the information provided in this blog is a description of our personal process and research I've completed since we began our journey in June 2010.

Wednesday, September 14, 2011

Just Getting Started

I’ve considered the possibility of blogging for quite some time.  Having been away from my hometown for nearly 10 years and college for more than 5 (eek…that makes me feel old), I thought it would be a good opportunity to keep friends and family in the loop without repeating myself over and over again.  Plus, I’m mediocre at best when it comes to staying in touch so allowing folks to seek me out and read updates when it was convenient for them seemed like a good option.  

I regularly read a handful of blogs…some are written by well known bloggers and others are friends writing about their lives and experiences.  A close family friend and avid blogger passed away suddenly this past spring…her family was able to back-up everything from her blog and have her thoughts, feelings, stories and observations as they remembered her and began to heal.  One might think her passing would inspire me to begin blogging myself but unfortunately, it didn’t.  I considered blogging before…while she was still here on Earth…and still couldn’t get started after her passing.

My reasons for taking such time to begin a blog are…admittedly…ridiculous.  I couldn’t get my blog to look just right (it’s still a work in progress) and hated the fact that I would be putting time and effort into something that might just downright suck (failure and I do not get along).  All the while, things were happening in my life that I wanted to share and speak openly and honestly about and the one thing holding me back was…me.  Luckily I got over myself, realized that the look of the blog may not be perfect and the posts may not be earth-shattering but the blog itself would give me the opportunity to share what I’ve been keeping inside…good, bad or indifferent.

I’ll warn you, a good majority of the first posts are about a serious topic that’s brought a lot of sorrow over the last year.  I promise the blog won’t always be serious or sad because that’s not my personality…the serious stuff has just been weighing on my mind and I can’t wait to get it off.  Once that weight has been lifted, I’ll be sure to mix in a healthy dose of other topics including DIY projects and cooking (two of my favorite things) and anything else random that comes to mind.

So, I guess it’s official, my blog has begun.  Thank you for coming along with me on this journey!