Sunday, June 19, 2005

"This fertility treatment stuff is all voodoo anyway"

On Friday, David and I met with Dr. Terrific. Following our meeting, I decided that he will more accurately be referred to as Dr. No Holds Barred. Dr. NHB first asked us what brought us to his office. I gave him a copy of my records from the IF clinic and my prior records from the GYN related to IF. I then talked him through the process that we'd been through up until now. Trying for nearly 2 years, one medicated IUI cycle, lap recommended, cysts, possible hydro blah, blah, blah.

Well Dr. NHB asked if I had a regular cycle. I informed him that I do, he then questioned why I was given Clomid. He believed that it was not necessary or useful since I ovulate on my own. I explained the logic of the medicated cycle, increasing the number of eggs, increasing our chances, etc. . . we all know the drill. He then said so "they give you meds, inject you with sperm and then wait." Yeah, that's it -- IUI in a nutshell. As he said he's "no schmo." He knows how this works.

He said that we have no way of knowing if any treatment is going to work since we haven't had a lap performed. I may have endo, scar tissue, the tubal issue etc. He asked why hadn't anyone performed a lap in the past? I don't know. I believe my RE felt there was no need for one up until now. He clearly thinks that the lap is an essential diagnostic tool, thereby questioning the wisdom of my prior doctors allowing this much time to go by without performing the lap. OK . . . there is some logic in that.

He then questioned the whole infertility treatment process. He said that this "fertility treatment stuff is all voodoo anyway." "RE's go into a room and come up with a number of different treatments and hope something works. But there is no control group, they don't really know what treatment will work to treat what condition" . . . So he critized the fertility treatment process in general. A lot of people are putting a lot of faith in the IF treatment process and it often works, so I understand that this is a relatively new area of medicine but I couldn't agree with the "voodoo" statement. But he said that someone at IF clinic could perform the lap. Hmmm . . . question the legitimacy of this area of medicine but then send me back to them to be CUT OPEN?

He then asked why I hadn't gone back to my Gyn for a second opinion on the lap. (The medical community in this area is small enough and he practices the same type of medicine as Gyn at the same hospital). I don't know. Dr. NHB came highly recommended by two very close friends and I decided to meet with him instead. He informed me that my Gyn could perform the lap, a fact that I am well aware of.

Was he trying to get rid of us?

He then asked if my Gyn had given me antibiotics prior to performing the HSG. I told him that I didn't believe so. He said that if I had had an infection, the HSG could have aggravated that infection and caused the hydro. Also, he said that the hydro might not necessarily have shown up on the HSG, so there is no point in performing another one. OK. So he critizes my Gyn. But he said that my Gyn could perform my lap . . . hmmm . . . let Gyn perform the lap . . . at my own peril.

Dr. NHB said that he could perform the lap. He has performed many many laps. He would "clean everything out" -- remove the cysts, endo, possibly the fibroids (depending on their position/the feasibility of it), check the tubes, remove any scar tissue and have us try on our own for 3 months. But I am turning 35 in August, so he expressed concern about my age.

In the end, he said that the endo and hydro could impede implantation (I know) and therefore, if present, they'd have to go. David expressed concern about the removal of the tube (which David describes as "radical") and asked if there is anyway of repairing it. Dr. NHB said that the only real way to know what's going on in there is to take a look and make a judgment call. He assured us that there is no way he'd remove the tube if it looked normal. Unfortunately, if the tube is badly damaged and infected, it would not be useful to try to save it and the hydro would likely return. We talked about the fact that frequently your body compensates if you have only one tube and that our chances would not necessarily be reduced by 50%. He also said that a functioning left tube could "conceivably" (he, he) get an egg from the right ovary for fertilization.

So here we are. Do I personally like Dr. NHB better than Dr. Patience? Of course not. Dr. Patience was a very nice and I would be more likely to invite Dr. Patience to my home for dinner than Dr. NHB any day of the week. Is Dr. NHB a bit of a jerk? Probably more than a bit. Do I trust the skills of Dr. NHB more? Yes. He came highly recommended. My friend L received the recommendation from two of her doctors. (L has many doctors). One of whom told L that Dr. NHB was the only doctor that he would allow to perform his wife's procedure. And of course, he performed Ober's myomectomy and will be performing her c-section in a few weeks. So tomorrow we'll try to schedule the lap with Dr. NHB in either July or August.

If he can squeeze us in . . .


At 2:00 PM, Blogger Mellie said...

Wow Chee Chee. Sounds like you went through quite the appt. The doc calling IF treatments "voo-doo" is a bit disheartening, but I suppose it's similar to stockbrokers (which I was in a former life) admitting that they have no idea how the market's gonna go. You make judgements based on the info you have at the time and hope for the best. If you can stand being around Dr. NHB, continue seeing him since he seems to be so highly rated.

At 8:22 AM, Blogger K|nneret said...

Holy Crap. *sigh*. A touch attitudinal, huh? Here's my feedback, not that you asked for it :)

I agree with him that a lap should have been done by now,but ... heck, I'm not a doc and don't even play one on TV. Also, you should be given antibiotics prophylactically for HSG.

Definitely think he's out of line for calling IF treatment "voodoo". What a shmuck. Anyway.

From my own research, repairing damaged tubes doesn't usually work. The repair job often causes more scar tissue so you have a limited time frame in which to work. Assuming your tubes ARE damaged. Which you will only find out by a lap. Dr L did mine and he was excellent, but I trusted him. That is an imperative when choosing a surgeon.

Just so you know, during a lap you are not "technically" "cut open". You will have about 3 or 4 tiny incisions which will heal quickly.

Ultimately - you need to be comfortable with your choice in physicians.

OH, and btw, I received an email from A, Dr L's old nurse - she's left the practice which is probably why no one called you back ... not that it's an excuse but - ok, yes it is. :)
We should do coffee soon.

At 6:15 PM, Blogger Em said...

Likewise. I've linked to your blog on mine.

At 3:50 AM, Blogger Dramalish said...

Darling CheeChee. I couldn't do it babe. I'd want to throttle the guy. But God bless your determination and patience. If he's good; go with it.
What kind of a doctor is he, by the way? I'm guessing NOT an RE, since he thinks the genre is "voodoo." Can I ask why you're going with a non-RE? No judgement call here, just curious.
Good luck. I hope you are back in the saddle soon.

At 2:51 PM, Blogger Rooshie said...

Hi, me again, catching up... I don't like Dr. NHB! But I do like a competent doctor, especially when my insides are in the picture. Maybe having a great but bad personality doctor will get you to the goal, and then you can find the nicest, handsomest, charmingest doctor to take over from there!


Post a Comment

<< Home