So, I am going to finish laying out my treatment plans here.
The other day I just kind of rushed it, but I wanted to finish the story.
So, I was not expecting to have a look down under at my consultation. I was surprised that she wanted to go ahead and look at the old ovaries and uterus. But, I figured sure. It'd probably be a good idea.
So, it wasn't embarrassing enough that I hadn't shaved my legs in... awhile. No, let's add some more humor into the mix. How about I'm naked from the waist down, and I'm assuming the position... when I almost fell off the table, and totally flashed everything like it's nobodies business.
Yeah, that would happen to me.
We got out to the car, and my husband had to say, "The best part was when you almost fell off the table." And he proceeded to laugh about it. Thanks honey.
Of course, I have to laugh too. It was pretty funny.
Now what is that they say about first impressions?
I hope I made a lasting one, ha ha.
My new RE, let's call her Dr. Incredulous. She couldn't believe some of the stuff I wasn't tested for, which is why she's ordered a slew of stuff. She wants to more thoroughly test my glucose and insulin levels, retest my liver enzymes, and retest my TSH and Prolactin. She also wants to test me for a complete Thrombophilia panel (Since Dr. BlowsSunshine only tested me for APS). And then at CD3, I am having my DHEAS and Androgrens tested, and possibly some other things, because Dr. BlowsSunshine didn't test them, because they don't test them at their clinic. Yeah, odd, I know.
The reason we want to go ahead with the injects this month, rather than waiting for a laproscopic procedure... well, the main thing is that the medicine I have is going to expire. That's the main drive. But also, I have my final quarter of college starting soon. If I go ahead with the laparoscopic surgery I don't think I'd be going ahead with it until after I graduate in December. It just makes more sense to us right now. Plans are always subject to change, of course. But I think it'd just be better to wait to try it. Besides, I still should still respond to the injectables- cysts or not.
Darn PCOS. How I loathe you... always rearing your ugly head.
We will see what happens with the blood work, and what she wants to do. She is leaning towards wanting me to up my dosage of Metformin to a higher dose. I also get to take vaginal progesterone suppositories after ovulation from now on, if I ever ovulate. She also thinks I might benefit from adding Dexamethasone during my treatment. Dexamethasone is a glucocorticoid just like Prednisone.
I am inclined to agree. One, the first cycle I ovulated on Clomid I was on a higher dose of Metformin. And the second time, when I got pregnant, I was on Prednisone (for whiplash) And so, I am thinking those two variations had something to do with it too.
During my research over the last few weeks, I actually found articles about that too (Here's one, here's one, here's one. For more, feel free to look it up on Pubmed.gov and just type in glucocortoids and clomiphene citrate) For anovulatory women with PCOS, who are clomiphene citrate resistent, and have elevated DHEAS levels, there has actually been some success with adding glucocortoids to an extended clompihene citrate regimen.
I was surprised to find those articles. And I actually got a little excited, and wondered if this was the cause of my very successful clomiphene citrate cycle. I was on Prednisone, and I took clomiphene citrate for 7 days instead of 5. Extended clomiphene citrate alone did not work after again two months after the miscarriage. Coincidence?
At the very least, it is fascinating. This research still looks fairly new, but fairly promising too. I hope they look more into it, this could be a cheaper answer than injectables for some of us anovulatory PCOSers.
We are still thinking about embryo adoption. I would love to move forward with that, but we are going to go ahead and give this a try first. And if this cycle of injectables fails, we will try Clomid again- probably with Dexamethasone- while we keep saving for the possibility of embryo adoption. Because I am still very interested in embryo adoption.
I know my child is out there somewhere, no matter how it shall come to me- biologically or adopted. And until then, I'm just going to do what I can.
12 comments:
Sounds like your new RE is a seriously kick ass doc (in a good way).
If your new bloodwork shows a shortened PTT, get your doc to look at this article. The most important line in the whole synopsis is "A shortened aPTT before conception is associated with further miscarriages in patients with a history of recurrent spontaneous abortions who have no antiphospholipid antibodies." I was found to have a shortened PTT and with treatment with lovenox, I was finally able to have Gabe after 6 miscarriages in a row.
So glad Dr. Douchebag is out of the picture and this new RE seems great! Sounds very promising.
As a note, when I was first diagnosed with PCOS, I also had slightly elevated DHEAS. I was put on dexa. I had to self prescribe myself off of it due to my extreme bitch factor (more so than usual). My Met was upped and IUI was done and I was pg after.
Hmmm...this new gameplan and new RE look promising...
Sounds like she's a keeper. Glad you have a plan!
It sounds like your new RE is wonderful and very thorough! I am so glad you are sounding so positive. Good things will come :)
LOL I have to laugh because I have done that as well. Oh what fun we IFers have. I know others are jealous. It sounds like you found a good RE and she has a good plan.
I am going to read that info about PCOS very interesting.
PCOS DOES SUCK....BAD!!!!
I loved reading your post! We have the same doc and I can see that we both agree that she's fantastic. :)
I'm thinking of getting a lap after December too, assuming we don't get pregnant before then. Normally I'm not a huge fan of doctors, but I will unflinchingly place my uterus in her hands. ;)
OceanicSix (soulcysters)
Michelle, I am so glad I'm not the only one! LOL
Reading about this new doc just makes me smile! It sounds like she is completely on top of things, which is the best feeling in the world. So hoping she makes some magic happen :)
Glad this RE is paying attention! Big hugs.
Smiling at the flashing business...
Am so glad that there is a new plan in place...and that the doctor is able to offer insight in directions that you previous one could not see.
Good Luck with the research...Good Luck for the baby!
Your new RE sounds great! I have heard about adding dexamethasone to Clomid, and that is great she wants to try that and test for more stuff. I think it is definitely very interesting that the second time you got pg you were on prednisone!
Good luck this cycle! And yay for thorough doctors!
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