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 11^th, 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!

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.

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.