Wednesday, May 02, 2007

The Adventures of Dismissivo and Shorty

I just got back from an appointment with our RE. And, well, the thing is, I don’t like him. (There. I said it.) I find him at best really dismissive, and at worst an ass*** who doesn’t give us his full attention.

For starters, he’s never been on time to one of our appointments. Ever. This is something I just don’t understand about doctor’s offices. If you’re always running 30 minutes late, why don’t you just stop booking appointments that close? Especially when you’re dealing with cranky, hormonal women on fertility meds. (There are some things you don’t get from book learnin’ huh?)

So, as usual, they took us a half-hour late. And they only took us that “early” because I made a little stink. I saw my nurse and was finally like, “Um, my husband has to leave for a meeting at 11:30 (our appointment was at 10:45). Should I just reschedule, because I want to make sure that we have enough time to really talk about what we’re going to do next?”

That prompted them to take us in—note to self, complain earlier—but they sent a different doc (not our RE) to chat with us. I was irritated at first, but now, frankly, I’d like to switch. I liked this guy a hell of a lot better for lots of reasons. So, the new doc (let’s call him shorty because, well, he’s short. I’m 5’10” and TOWERED over him when we both stood up. I felt kind of silly, actually). Anyway, Shorty came in and looked over our charts and admitted that our 4 IUIs have been, for a bunch of reasons, less than optimal. (Hooray for honesty!) He said that, unfortunately, it looks like my ovaries keep jumping the gun and releasing the egg early, thus making all of our IUI efforts…well…pointless. So, he suggested that, if we wanted to do another IUI, that we do a lup*ron IUI—that way they could control when I ovulated and the IUI would have a greater chance of success.

Of course, that’s the kind of thinking we could have used 2 cycles ago—back when our insurance was actually covering IUI.

Anyhow, I appreciated hearing that there was something we could do to make IUI more effective. I don’t know that we’ll do it, but it’s good to know there’s an option if we’re not ready for IVF just yet.

At this point Dr. Dismissivo comes in. (Drat!) Thank god Shorty stayed, because it turns out Dismissivo also gives us barely half of some very important stories. But, I’ll get there in a minute.

Basically, Dismissivo was, well, dismissive of our concerns about IVF and thinks it’s the best option.

“But, we aren’t comfortable destroying (or donating) embryos, so we’d want to limit the number we’d fertilize to the number of children we’d be willing to actually raise. Doesn’t that on some level minimize the impact of IVF?”

“Yes, of course. But, if you haven’t come up with your own solution, I have one.” (Note this line was delivered with a sarcasm that made my progesterone-induced ass want to lunge across the table and rip his goatee out strand-by-strand.)

“Well, no. We don’t have a ‘solution,’ that’s why we’re here. What’s you’re suggestion.” (Dickhead! Don’t pretend you have the “solution” to our very complicated ethical dilemma.)

“We can retrieve all of the eggs we can, fertilize a few—at least eight, of course, because less than that doesn’t make any sense—and freeze the remaining eggs. Note I said the eggs, not the embryos.”

Fucker. Stop talking down to me.

“Well, I’m not prepared to raise eight children*, so I don’t yet know how I feel about fertilizing eight eggs. We might be open to it, but hubby and I need to talk about it.”

--Dismissivo is notably exasperated.

“Well, yes, you have to figure that out.”

Yeah. Thanks.

I decided to move the topic away from our ethical dilemma and back to a subject where I thought he could actually add value—so I asked him what our protocol with IVF would actually be. Pretty standard fare, it sounded like: Lup*ron on CD21, stims beginning CD3, egg retrieval, transfer, beta, intra-muscular progesterone, etc.

“But, the progesterone shot is different—I’m doing the suppositories right now. Why do you recommend moving from suppositories to the injection?”

“Because sometimes on the suppositories women start spotting before their beta and get really emotional, and it’s just easier this way.”

Um…are you fucking kidding me? You’re telling me that the reason you’re going to make me to a painful intra-muscular injection is to spare yourself an emotional phone call?

At this point, hubby needed to go. So, Dismissivo took the opportunity to part as well, and Shorty and I were left. And, the first thing Shortly says to me is:

“Well, just to let you know, it’s a bit more complicated than that. The reason we do the progesterone injection with IVF is that, in your normal cycle, the corpus luteum produces progesterone naturally. In IVF, the corpus luteum is destroyed so you don’t produce any on your own. So, the suppositories wouldn’t provide enough progesterone to support a pregnancy.”

Does Dismissivo think we’re too stupid to understand that or something? That was clear. I get it now. And, that explanation avoids the sexists “oh you women are so emotional” overtones. Fucker.

Shorty and I then talked for a while about a bunch of different things—-our concerns about IVF, about what the hell is actually wrong with us, about what the chances would be with a Lu*pron-IUI, etc. And, it came out that Shorty and his wife are stirrup queens and sperm palace jesters—-they’ve been through all of this. We even talked about how they dodged the “lifetime cap” on their IF coverage by switching insurance providers after they maxed out on the first.

I love this guy.

Needless to say, I will be calling the office to switch from Dismissivo to Shorty. But, I do feel a little weird about it. I don’t know why. It’s the same way I feel about switching hairdressers. If I’m not happy with my hairdresser, I’m the kind of person who needs to just change salons. I can’t imagine switching hairdressers at the same salon and having to face the one I left. Like that would be rude or something. I know, I know, I need to get over it. But I have an overdeveloped sense of guilt, so go with it.

Anyhow, the bottom line is, assuming we’re not pregnant right now—please, please, PLEASE be pregnant—we need to decide whether to jump on the IVF train. And, I’m so torn about it. I feel like we’ve got so much to sort out. But, for now, I’ll leave you with the Adventures of Dismissivo and Shorty, because I’m too tired to think it all through. And I’m kind of weepy. Fucking progesterone.

*Note: I realize that 8 embryos would almost never in our wildest dreams produce 8 children. But still, I was irritated at Dismissivo dismissing our concerns as ridiculous.


Ms. Planner said...

Sticky Bun, nut up and switch to Dr. Shorty. I say that with all the poking fun and total sincerity of a friend. Your body, your family, your beliefs. You have the feel comfortable with the person doing this procedure. This is important both pre-IVF, during IVF and most importantly, after IVF where you will be in a much better mental space if you get the follow up care that will help make that bun(s) stick. Just take a deep breath and call. I know, more assvice. But if I have learned anything in life, it's your intuition is usually right.

xoxo, Ms. Planner

Mary Ellen and Steve said...

I most definitely would switch to Dr. Shorty. It sounds like your current RE has no bedside manner whatsoever. I am sorry that he is such a jerk to you. If you do decide to switch to IVF, you want to have faith in your doctor. I know this from experience.

I did 2 cycles with someone who did not get our situation at all. I regret not switching sooner so so much.

You have a lot to think about. Thinking of you my dear.

Becks said...

I'd switch honey.

What you feel is absolutely valid and relevant and he should respect your feelings and work through things together. It sounds like he treats his job like a production line, as if one size fits all. Run for the hills girl, well run for Shorty instead.

The Oneliner (Christina) said...

dissmissive doc sucks! but, i guess you already knew that. grrrr. i agree with you...switch! unless, of course, you're already knocked up! i sure hope so!

Laura, the (reluctant) baroness said...

I want to say first, thanks for your blog! I've been struggling with my thoughts on my IF for a while, and running across your blog last week has really helped, and introduced me to the world of IF sites. Much appreciated!

SWITCH DOCTORS! I hated my first RE from the get-go. But, I had sooo many reasons for putting off getting rid of her. But now I have an RE I really like. I do feel, though, that my time with RE#1 was wasted and that I am now months behind where I could have been. I'm sure you want your baby conceived under the best possible circumstances. With so many barriers to this already, the last thing you need is a crap doctor. I bet you want someone you can hug and thank when you "graduate" to a regular Ob, not someone you leave with resentment.

Why would an insensitive prick like that go into reproductive medicine, anyway?

Kate said...

That is so unacceptable. I think Dr. Shorty sounds like he actually cares about your success!

Sarah said...

dismissivo is a condescending ass, i'm so glad you're switching! i think we all feel that way about hairdressers, but somehow i feel my hairdresser would care a little more than it sounds like dismissivo would. good for you.

Trish said...

Definitely switch! Assmunch. And if he should ever have the balls to ask, be honest. Might damage his ginormous ego and help. Asshole.

Reproductive Jeans said...

Hmmm Dr. Shorty sounds like the one to go with my dear...definitely will make this whole process easier when you all feel comfortable with the person that will know you VERY well!