Thursday, September 07, 2006

let's go crazy

My doctor called me this morning. This is highly unusual, as her nurse has always been the one to call me with results in the past. Thyroid was normal. Cholesterol and testosterone were both slightly elevated, which she says is "suggestive" of PCOS.

Here is what I love about my doctor: she is very reassuring. She reminds me of the shrink in that song by Prince, "U know the one - Dr Everything'll Be Alright". She is personable, upbeat, calm. I have a tendency to assume (fear?) the worst when it comes to my health, so she is a good foil for me in this respect. She allays my fears even before my mind can generate them. For instance, here is how she relayed the news that my testosterone level was elevated, "It's at the high end of normal for a woman. It's nowhere near a man's testosterone levels. But it is one of the things I would look for if I suspected PCOS." Whew, I'm not a man! (Although that would have explained the anovulation.) I honestly value her unflappability. I imagine she is just the person I would want holding my hand through pregnancy and coaching me through labor. She was highly recommended to me by a few (fertile, of course) friends for this very reason. She is much beloved as an OB.

Here is the thing I don't love: I worry that she is not aggressive enough in her search for a cause of my anovulation. She would not even have run these most recent labs if I had not requested them. I worry that she is not as knowledgeable as I need her to be when it comes to the root causes of and best treatments for infertility. I worry that while she may be a fantastic OB, she is a poor excuse for an RE. For example, in light of the "suggestion" of PCOS, she still proposed going ahead with clomid. I asked about trying glucophage instead (no risk of ovarian hyperstimulation syndrome or multiple ovulation, addresses the root cause of the anovulation, doesn't wreak havoc with uterine lining, may help with cholesterol, etc.). She basically implied that I would be wasting my time until I just took the damn clomid already, but she was willing to play along and provide a scrip for the glucophage.

Then again, what do I know? Maybe it is crazy not to try clomid first, since if it works it is just about the cheapest, easiest route to take. Maybe I am just looking for trouble where there is none. I don't know. I think I will go ahead and give the glucophage a try. Despite this ambivalence, I am excited to be moving in any direction at all. I hope it will turn out to be forward.

2 comments:

Thalia said...

I do think you need to see an RE, just to get someone who will really look into this for you. How was your LH/FSH ratio? If the LH is about 2x higher on day 3, that's indicative of PCO(S). And there's the ovarian morphology - has she checked that? I'd either kick her or have that other consultation sharpish.

Elizabeth said...

Thalia, you are right, of course. I know in my heart that I need to see an RE.