Maddy (of Late for a Very Important Pregnancy) has a recent post that, among other things, defends her choice of doctor from the anonymous naysayers who've been commenting on her blog. On the one hand, it seems like a kind of useful thing on a blog for folks to pipe up when they think their friends aren't getting good medical care*; on the other hand, if someone told me that Dr. Gorgeous was a whack-job, well, I wouldn't be happy about it either.
I've gone to four REs over the course of my ttc attempts. The first, whom I've referred to here as Wonderful Former RE (WFRE), worked out of a medical school known for its REI fellowships. It was a big place with a small feel, and it was a fantastic choice for me. But I picked her for the very simple reason that I wanted to work with a female doctor. She saw me through a year of ttc attemps, a miscarriage, an APA diagnosis and heparin therapy. She recommended my OB. And, seven years later, we email on occasion. I never had any doubts about working with her. We "broke up" when she referred me to her colleague who was in charge of the IVF program; a day after my consult with him, I found out I was pregnant with LG.
My second RE was Dr. Evil, who works out of the university where I teach, directing the ob/gyn program at the medical school. I didn't exactly "choose" him as an RE; I got stuck with him when my ob/gyn, whom I planned to use to do some low-tech IUIs, moved the same month I wanted to start ttc. He took over all her infertility patients. I did 3 cycles with him (a fourth was cancelled due to his stupidity) and then fled to Dr. Gorgeous.
Now, anyone who reads this blog even semi-regularly should know how I feel about Dr. Gorgeous. Although we've had a couple tense moments, I adore her. I don't think I'm misrepresenting our relationship to say that if we'd met under other circumstances--like if her kid and my kid were in the same first grade class--we'd hit it off as friends. Sometimes (and here's the real point of this post) I wonder if that sense of comaraderie isn't a good thing. I wonder, for instance, if she would have told me more bluntly to move to donor egg a long time ago if I didn't get all weepy on her. I wonder if she lets me do some of my half-baked ideas because she likes me and not necessarily because they're great ideas.
As I said the other day, I haven't committed to doing DE with her, but I'm very much leaning toward it. Is that a good choice? I don't know. It feels like a comfortable choice, and given how much I really don't want to do DE, I'm inclined to go with the person who really understands that, who's seen me to go back and forth for many months trying to figure out what to do. I'm inclined to go with the person who has recommended acupuncture and stress reduction and therapy, along with Folgard, heparin, and a freaking ton of progesterone. She knows me. And as "good" as Dr. Slideshow is on paper, I'd be just another DE patient among his many DE patients, or at least that's my concern. (In the approximately 1.5 hours he spent talking to me, the fact that I have an RPL diagnosis [along with MTHFR and APA] never even came up).
What it comes down to, as I told A, is the bathrobe. See, instead of making you wear a paper sheet for physical exams, Dr. Gorgeous's office has actual bathrobes. The kind of plush things you'd find in a hotel or a spa. She's got blankets and space heaters for that post-IUI time. She gives out little care packages after IVF transfers. These are nice details, to be sure, but what it suggests to me is a metaphor for how she runs her practice. It's a woman-centered, woman-run place that treats patients holistically rather than as walking ovaries with problems. Turns out I really like those bathrobes...
But there's this niggling feeling that I'm choosing what's comfortable and cozy and warm and not necessarily what's going to work. But when it doesn't work, when I fall once again on the bad side of the statistics, I know she'll be there with a hug and a plan. I can't say the same about him. I think this is one of the things I'll end up talking about in therapy next week, assuming I keep my appointment...
*The fact that these commenters are anonymous, in Maddy's case, makes the whole thing ickier.
Robes?! Wow. I would have loved that.
ReplyDeleteI wonder if there really is all that much difference between the different REs in terms of treatment. There probably are differences when it comes down to the complicated technical parts, like fertilizing and growing the embryos, and experience really helps. But tinkering with the stims, etc.? I don't know.
And because of that, I sincerely believe that going to an RE that makes you feel good is extremely important. When it is all said and done we've paid a hell of a lot of money by the time we walk away. That might end with a baby or it might not, but either way it is a significant set of memories and emotions. If an RE can make you feel like no matter what the outcome you did the right thing, tried everything you were comfortable doing and could afford, and feel good about the process, then that was the right choice for you/me/Maddy/whomever.
Dr. G is a keeper in my book.
I'm with in between -- this is such a clinical, soulless process sometimes that whatever makes you feel comfortable and like a whole person and safe and -- dare I say it -- happier is the right answer. Because doing a cycle at a place you don't like? That seems really like a recipe for self doubt, second guessing and frankly disaster.
ReplyDeleteYou are allowed to do what is comfortable -- hard isn't better because it's hard.
Yes, there's no doubt that she's a "keeper"! And I agree that any patient needs to go through treatment in a positive environment. But in the end, if Dr. Slideshow is more likely to get me pregnant--and I don't know if he is, but I'm raising the issue--that's the bottom line. What I'm trying to figure out is I'm overlooking the real issue--the likelihood of success--because I'm focused on how I feel. This isn't about tinkering with stims; this is about spending $25,000+ and giving up the chance of having a genetic connection to a child. And if I do that, it HAS TO WORK the first time. This is probably the biggest decision I've ever made in my life.
ReplyDeleteI think it's smart to take a step back and reflect on your decision-making process, especially as you say, it is such a huge decision. Why do you think Dr. Slideshow didn't specifically bring up RPL/MTHRFR etc.? Did these things factor in to his approach/recommendation and he just didn't directly bring them up? Statistically, you mentioned he has slightly higher success rates, but I'm not sure I would consider 10% slight. . .It's not huge but to me it does have some significance. But I absolutely do think that comfort and connection to RE matter and I know it would (and has) made a big difference to me, as well. Sending good wishes for your decision making and hope the session tomorrow is helpful.
ReplyDeleteThe stats issue is fuzzy, Kristina. What Dr. Gorgeous told me is that currently her live birth rate (LBR) for donor egg is at 75-80%, which is EXACTLY what Dr. Slideshow told me as well. The number on Dr. G's website is lower (only 67%), so that's something I need to ask her about (it might not be current info). The major difference is that Dr. Slideshow does about 4-5 times as many cycles per year as Dr. Gorgeous. That has to count for something; I'm just not sure how much.
ReplyDeleteBeing comfortable with your doctor goes a long long way. And then add to it all the stress of travel and coordination you'll avoid by staying with Dr. Gorgeous....I think that might out outweigh the fact that Dr. Slideshow does more.
ReplyDeleteBut then again, when you consider this is a one time only shot....
I dunno. I think you're going to have to figure out what your gut is telling you and go with that. Good luck with this decision!
Gwinne - thanks for your sympathy for the "ickiness"...:-)
ReplyDeleteThe doctor dilemma is a such a tough one. I think the hard part for me is that I wonder if there's only so much a doctor or protocol can do - every situation is so unique. If a good egg rolls down the pipe and meets up with the right sperm, does it really matter which doctor we're with? I guess for women who respond well to stims and can produce more eggs, maybe the doctor who can help them produce the most eggs is going to be most attractive. But for a donor egg cycle, I don't know what the criteria are...a doctor who has a great donor pool? who can give you the right drugs to plump up your lining? who can time everything perfectly? (Sigh) And how strong a factor for success are things like fluffy robes and emotional support and not having to travel?
It's like that movie Sliding Doors - unfortunately you can only choose one path right now. My wish for you, my friend, is that your choice won't matter in the long run because BOTH paths will lead you to a baby.
Love,
Maddy