First Consult Done - Now some questions

ewenner

Thank you all who wished me luck with my RE consult this morning.  I must say, it was not really what I expected at all, and I'm a little disappointed.  DH and I arrived with all of our paperwork filled out (10 pages for him, 15 pages for me), and I brought printouts of all my FF charts since we started TTC last fall.  We were only with the RE for maybe 15 minutes, and it seemed like he hadn't even read our paperwork at all, because all of the questions he asked were very basic things that were all covered on the forms.  He also asked if we'd had any testing done yet, which he should have known, because I had my Day 3 testing and DH had SA done - all at this RE's facility.  And then he told me that since me cycles are not regular, I am likely not ovulating.  This surprised me, since my BBT shows a clear temp rise every month.  When I pointed this out to him, and he actually looked at my charts, he still said that I am probably not ovulating, despite what the charts say.  He then jumped right into talking about starting me on Clomid and doing an IUI cycle.  We told him we weren't ready for that, so he said we could do one cycle of just testing, and then shipped us off to talk with his nurse about the next steps and do bloodwork.  

The nurse seemed to listen better, but I had so many questions and concerns, and didn't really get a chance to ask any of them, and I feel like the RE didn't really take the time to look thoroughly through our case history paperwork to fully understand our situation.  I just don't feel like I got what I hoped for from the appointment.  I am also still shocked that the RE thinks I'm not ovulating.  Has anyone else been told that they're not ovulating because of irregular cycles?  Is this common?  Why would my charts show a temp rise every month is I'm not ovulating?  Thank you all for your thoughts!

lcwed

I don't have any experience with REs, but I wanted to say I'm sorry it was not what you expected. It seems odd that he wouldn't at least explain to you why your BBT chart and cycles would differ. Can you get a second opinion or are you limited to who you can use?

Radiantly

Wow sounds like you need a different Re. I've not been to one but that is just awful.

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Davie813

That sounds so frustrating!  Are you limited by insurance, or can you look for someone you feel more confidence in?  I hope you're able to get better answers going forward regardless!

latershrader

Agreed w/ PP. My consult lasted about 1/2 an hour and our RE was very thoughtful and loved that we asked so many questions. She did recommend a clomid IUI for us but that's because we have known issues.

I would go find another clinic. This is a BIG deal and you don't want someone who is going to give you the time and attention that it deserves.

massiahl

Sorry that your first RE consultation was not what you expected.  That said, what you experienced is actually rather normal.  REs are not like our general practitioners or OBGYNs; they're scientists, first and foremost, and rely very heavily on numbers and outcomes.  As such, they tend to be a bit detached and kind of arrogant (are there exceptions? yes).  They are no different than surgeons in other highly selective fields - which renal endochrinology is.   Which means that whatever methods you used to determine your ovulation cycle can/will be dismissed because 1. you don't have his/her expertise in this field and 2. your methods will not be perceived to be at the standard/level of testing that his office is going to do anyway.  So, while you are showing a temperature rise indicating ovulation, your RE is looking at levels and thresholds associated with temperature rises.  As a result, you might be below the ovulation threshold that is desired by the field which, to him, might as well be, "You don't ovulate."  

Thresholds and ranges matter in this field.  In my case, all my doctors including my OBGYN stated that my thyroid levels were normal because they were "within range".  Upon looking at my thyroid levels, my RE said that my thyroid levels were high and I needed to be on medication. When I asked about the disparity, he simply responded: "Everyone is right, according to their field.  If you were not trying to have a child then your thyroid levels would be considered fine; however, the research is showing that women who have thyroid levels on the higher end of normal scales have a greater chance of miscarriages.  We need your levels closer to 2.  Why go through all the trouble of getting you pregnant for you to miscarry because of something we can control right now?."  I have been on low dose thyroid medication ever since and I'm in my 3rd trimester of a healthy pregnancy (Knock on wood!!).

Does that mean that your RE is not an all-around asshole? Maybe, maybe not.  What it does mean, however, is that you're going to have to readjust your expectations of what you think your experience ought to be.  What is most important to you? And what are you willing to deal with in order to give yourself the best shot of achieving what is important to you?  So, if you're looking for someone who is more comforting or assuring, I'm afraid that you may not find that in your RE - at first. Connection comes with time. Since you have further questions, call your RE's office and see whether your RE has some time in his schedule during your next visit.  If he does, set-up a consultation appointment and get your questions answered.  If he doesn't, set-up a consultation appointment for another day.  A good doctor, regardless of field, expects their patients to have questions.  Write out your questions before you go so you don't feel overwhelmed.  Feel free to let him know that you may have further questions and may need to call him again. Always bring paper and a pen to sessions with your RE.  The information can get so overwhelming you might as well use all available tools that allow you to get a handle on your situation.  In the meantime, go back and review your RE's qualifications, results and what other patients say about him and his office so you don't feel like you walked into the situation unprepared or with a level of expectation that is unwarranted. 

Also, you should know that the people with whom you will mostly be dealing 95% of the time will be the nursing staff in your RE's office.  They will be drawing your blood, calling you regarding your protocols, and giving you updates almost on a daily basis at some point.  The only time you'll be seeing your RE is for diagnostic purposes and for retrieval (if you're doing IVF).  THEY will be your source of comfort because they're on the front lines with you, not your RE.

Lastly, as hard as this will be to do or hear, you're going to have to learn to let go and give yourself permission to do so.  Most of us don't realize that when we walked into that RE's office and decided to undergo treatment that we also decided to give control of our reproductive systems over to someone else to manage.  Your schedule and that of your body will no longer belong to you. It is a hard and difficult pill to swallow especially if you're someone used to having a sense of control over your life.  It will be both a struggle and a relief.   If you're having a hard time with this, think about it this way: if we were all experts on what is going on with our bodies, there really wouldn't be a need for REs - right?

I hope this helps.

  

ksgsmu

I agree with pp that RE's are known for not the greatest of bedside manners.  They can be quick, blunt and sometimes seem arrogant.  I always had to remind myself that they are not hear to hold my hand but get me knocked up.  Overtime and several heated discussions I finally won over my RE. ( My husband still can't stand him).  He has the best stats in the state so I wasn't going to move.

ALL THAT BEING SAID...
If you don't like him get a second consult...can't hurt! you have to feel comfortable and confident in your RE. Go with your gut!

As for the ovulation thing.  I have a consistent cycle and get a temp rise etc when charting... BUT when my progesterone levels are checked after ovulation they are horrible. I was told I do ovulate but it is "weak" or "immature" ovulation. This confused me for the longest time especially since my charts were so pretty etc...

stellasoo

I'm sorry it wasn't what you expected. I agree to a large extent with @massiahl but I also think you need to find someone who you are comfortable with. You are putting your hopes and dreams into their hands and you want someone you can trust and have confidence in. It can't hurt to have a consultation with another RE - or more - and then decide. 

Our experience with our first RE was just like yours. After 6 months of working with her, we felt like we were getting nowhere and her nurses were even worse. We switched to a new RE and it's a completely different experience. For example, the first RE told me to stop charting my temps because it was a waste of time. The new RE and his nurses appreciate that I chart and said it gives them valuable info. Charting helped me catch my surge yesterday so we didn't miss ovulation for our IUI. I would have never know to take an OPK test had I followed the first RE's advice and stopped charting. 

ewenner

Thank you all so much for your input.  I don't think I am limited by insurance, so we could probably get a second opinion, but DH liked the RE and thinks I'm being overly sensitive.  Maybe he's right, and maybe it will just take time for me to get comfortable and develop a relationship with the RE. I guess I just wish he had spent more time reading through our papers before sitting down with us so that I didn't feel like just one of a million patients the he gives the same recommendations to.  I think we will do the testing he recommends this month and then next time we meet with him, bring a list of all my questions, so I am sure to get everything answered and hopefully feel more comfortable with everything.