CD15, There Will Be Lining

I thought about titling this post "a person who doctors oneself has a fool for a patient," or maybe "careful what you wish for," or even "who gave me the medical degree, anyway?"

Okay, let me back up a bit.

So, I'm a big supporter of the "you must be your own advocate" philosophy. I watch a lot of "Mystery Diagnosis," and I've learned from that show that if you sit back and let the doctor make the decisions, your rare-but-curable-if-caught-early-brain-cancer will probably be mis-diagnosed as a "virus" and you'll be sent home with a prescription for motrin and you'll suffer in pain until you finally make someone listen to you. I know this. I watch the show. And I also know how hard it is to speak up to one's doctor. I mean, they're a little intimidating. But as I learn more and more about this IF thing, and as I'm on my 4th cycle with my RE now, I've got some opinions. And some emotions, let's not forget those.

I'm emotionally opinionated.

About my lining.

Because when you've had periods your whole menstruating life of 4 to 5 days of medium to heavy bleeding and then 1 or 2 more days of light bleeding, which I understand is probably even a little heavier than average, and then you go to 36 hours of light to medium bleeding and then 5 days of pathetic little spotting, that doesn't feel normal. It feels like "no wonder I can't get knocked up, because I'm barely having a period at all."

So it seems that the 2 REs at the clinic I go to have very different opinions about my lining. Up until now I've been referring to them as RE#1 and RE#2, because up until now they've been pretty interchangeable in my mind. No longer. So I've decided to start referring to them as Dr. Young (RE#1) and Dr. Old (RE#2). They are neither all that young or all that old, but it's enough of a difference that that's what I'm going with.

Dr. Young is my assigned RE, but Dr. Old is the head doctor at the clinic. Dr. Old was the one who told me that pregnancy tests don't test below 50hcg. Dr. Young is the one who said that doing an IUI with 9 follicles was not irresponsible because he "does it all the time." So, that's them.

Anyway, met with Dr. Young today. My ultrasound showed my leftover follicles were now gone and we began to talk about moving forward with the cycle:

Dr. Young: "I see that you talked to Dr. Old about your lining last time you were in..."
(indeed I did...)
"...but the fact is that some women just have a thin lining..."
(perhaps...)
"... and there's not much we can do about it anyway..."
(umm... starting to disagree with you here...)
"...we could give you estrogen but it would only maybe increase it by a millimeter, and your estrogen levels were fine anyway..."
(well... really? You just lost me a little bit...)
"...and anyway what I really want to talk to you about is whether you want to do IVF this cycle."
(ummm, say... what?)

Me: "IVF? Why is that something we're considering?"

Dr. Young: "Well, we were considering it for last cycle."

Me: "Yes, but only because I responded too well to the gonal-f, and ended up with so many follicles. We had talked about doing 3 IUI cycles on injectables before moving on to IVF."

Dr. Young (defensively): "Okay, that's fine, we can do more IUIs if you want to."

Me: "Good, okay, so back to my lining. Last break cycle you had me start an estrogen patch at day 21 and my period was much heavier that cycle than it's been in a long time, so I think I would respond to estrogen. And my last period barely lasted 36 hours and I just don't think that's normal for me."

Dr. Young: "Okay, then here's what we'll do..."

He then proceeded to tell me that he'll prescribe me estrogen patches for this cycle, we'll do another IUI, and we'll cut back on the gonal-f.

Just what I wanted.

And so it kind of feels like when I would beg and beg my parents to buy me something and they would tell me all the reasons why they didn't want to buy it for me but then they would finally give in and then I would wonder if they had been right all along, and that maybe they were just saying yes so that I could realize it for myself. Yeah, it kind of felt like that.

So, the good news is, I got exactly what I wanted: estrogen. The bad news is, my doctor doesn't seem to agree that it's what I need or that it's going to do any good but he prescribed it for me anyway.

So, here's the rundown:
Today (1/4/10): stop BCP.
Thursday or Friday (1/7/10 or 1/8/10): predicted CD1
CD2: Start Estrogen patch, change every 3 days
CD4: Start 75iu of gonal-f for 4 days.
1/15/10 (predicted CD9 or CD10): Next u/s and b/w.