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Monday, January 4, 2010

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..."
"... 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.


  1. I love that phrase...emotionally opinionated, it can be a dangerous combination! And I truly think sometimes we do really know whats best for our bodies, like a sixth sense or something. I hope this is the formula that gets you that BFP!!!

  2. I really do think you have to make suggestions based on your knowledge-- yeah, I know they are doctors, but I truly believe that there's some things they just don't consider when it comes to our treatment.

    Have you tried POM juice? I hear it helps thicken lining... Worth a shot?

    Good luck this cycle!

  3. Maybe you can teach the doctors something. And I'm a firm believer that you're the one that knows your body the best... so... I think we've got a winning recipe :)

  4. Ha! I'm emotionally opinionated too =)
    I had the lining issue while I was on Clomid also and my Dr didn't think that I needed estrogen either. But in my case my E2 levels were high anyway, so I started taking baby aspiring... without telling them.... and it made a difference.
    That being said, I think that even if your Dr(s) don't agree he wouldn't have given you the prescription if he thought it wasn't going to make any difference. I think your lining will show them who is right, so stick to your guns. Personally I think you were right...but then I am a fool... lol

  5. I'm going through the EXACT same thing with light periods and thin lining. If this cycle doesn't work, I'm going to have this very same convo with my RE about giving me estrogen patches. Glad you got what you wanted and NEEDED!

  6. Good job standing up for yourself. It sounds like you have a wonderful plan set out for this cycle.

  7. I am so glad you stood up for what you are feeling like is happening! Kind of like what I did last cycle with the progesterone check... Sometimes we definitely know our bodies better!

  8. I think any CHANGE is important and should be noted. My acupuncturist asks all kinds of questions about my "flow" that my doctor NEVER asked. Good for you for standing up for yourself.