Today was my baseline scan. This is the first time I've ever actually cycled at RBA, and obviously there are a lot of differences to be expected between clinics. However, I guess in the seven months since my last IUI cycle, I somehow forgot this little fact: cycling, like real, legitimate, trying to get pregnant via doctors and needles is CRAZY STRESSFUL!
Notable differences between my current and previous clinic:
I still like my clinic and my doctor, but I don't love the whole idea of not seeing the doctor. Today was a perfect example of why I'd rather meet the doctor for each appointment. I spoke with my doctor at my post op about next steps. You may remember I was thinking "save for IVF" and he was full of "get it while the gettin's good" kind of stuff... which brought us to today. But at that appointment several weeks ago he laid out, in detail the plan which was referred to as "the chaser". We were supposed to do Femara on CD3-7, some form of an injectable on CD8, and then a mid-cycle check on CD11/12.
Today's instructions, relayed to me from a nurse, who got the instructions from another nurse, who supposedly talked to the doctor, looked NOTHING like that. Instead, we are supposed to take Femara on CD4-8, and then Follistim on CD9 and CD10. Cue my absolute freak out! Add in the fact that I'm supposed to come in for a mid-cycle on CD10 to "see if we should continue the Follistim injections". These instructions couldn't be more different from what my doctor and I discussed.
When I spoke with her, I tried to explain the variances. I mean, I specifically asked my doctor about doing an ultrasound around CD9 BEFORE the injectables and he said that there was no point, we won't know enough, it's all or nothing, either take the shot or don't. He also repeatedly labeled the 75 units of FSH as a "chaser" meaning just ONE shot to follow the Femara. The nurse acted like I could potentially take five or six DOSES of the injectables... people, the LOWEST DOSE of clomid yielded THREE FOLLICLES. She also said that I should be prepared to be sent home from the first mid-cycle check with instructions to come back for a second mid-cycle... and that my friends, is how an IUI cycle suddenly costs $2000!!!
I finally caved, I had to get to work. But now, I'm really second guessing myself. This protocol is SO different from what my doctor and I discussed! Did he change his mind? Has there been a clerical error? Do I have someone else's protocol?
What would you do?
Despite my obvious stress, I'm doing myself a big favor by not stressing about the stress. You heard me. I'm stressed. It's stressful. Tough. End of story. I'm giving myself a pass on this one. Erika shared a great article on Facebook the other day and this was one of my many take aways: "It's okay to be stressed. Don't stress about your stress. Trying hard not to be stressed is silly." Amen brother, amen.
However, if you have insight into my situation, feel free to share. I've accepted the stress… I'm not embracing it.
So confusing! I'm sorry everyone is telling you different protocols. It sounds like they want you to start the femara a day later to better time ovulation and the iui accurately so that your follicles will be good and ready. In my experience I did clomid/femara days 4-8, follistim days 8-10 (75 units), and ovidrel day 12. That protocol was way more effective than the other cycles without injectables, but sheesh, it was way more expensive! For what they charge they should include a week in the Bahamas.
ReplyDeleteMaybe you got the other Amanda's protocol?? That seems to be an issue w/ RBA!! Haha. I would be totally pissed at the change-up, too...could you email Dr. S? I did that once when I was having issues and he actually emailed me back right away with a promise to get things sorted out and one of his nurses called me with the correct info like...within the hour. It was way more efficient than the normal get tossed from nurse to nurse procedure...anyway, glad you're not stressing about the stress...we have an appointment there next week, perhaps we'll see you there!! :)
ReplyDeleteSeriously, RBA - sometimes they can't get themselves worked out. I am totally with Erica - get a hold of the doctor! Email, call his admin and say you want to talk to him, whatever it takes! I mean, I know the nurses are very sharp, but even for your peace of mind you need to be totally comfortable with everything that is going on!! Now you got me all worked up...there are some major communication and process improvement opportunities at that place. Maybe next time I will barter my consulting services for free consults and ultrasounds... :)
ReplyDeleteI would also totally get ahold of that doctor. It is so different from what you had discussed earlier and especially would be sad if you over-stimulated and couldn't do the IUI. I would just keep bugging them until you get in touch with him and get clarification. You are paying them for services so do feel bad at all about bugging them! Thinking of you hun!
ReplyDeleteAhhhh- oh my goodness... So confusing!! Even though the nurse is in the driver's seat, can you leave a message for your doctor to call you back maybe? That's probably what I would do... I'm happy that this cycle has started for you though!! xoxo
ReplyDeleteIf there is a doubt in your mind that this is the correct protocol reach out to ur Dr. That would definitely give me a peace of mind. It gets frustrating when everything is being relayed over by a nurse. Sure they are knowledgeable but theyre not the Dr. I hated that feeling of not knowing the full scope or getting answers so I left that clinic. I just couldnt handle it. Best of luck with ur IUI.
ReplyDeleteWow. You are on overload right now! New doctor, new protocol. I bet you're stressed! I agree with everyone else. If you are concerned at all. Reach out to your doctor for sure. I will say that your protocol sounds exactly like my two IUI protocols. I did Femara from cycle day 2-6 then on day 6 I started gonal-f (FSH) injections. I started usually with 1-2 days of injections, then had my first monitored appointment on cd 9 or 10. They would then determined if I needed to continue the injections. I believe the femara will get your follies going and then the FSH will just plump them up since you are starting it later in the cycle and not from the beginning. But that's just what I was lead to believe. I still think you should confirm everything with your doctor to put your mind at ease!
ReplyDeleteBig hugs and GOOD LUCK! You'll do great!
Prayers for you!! xoxo
ReplyDeleteI'm going to preface this by saying that I've never done an IUI with injectibles so I really have no idea what I'm talking about, that said...my nephew and nieces are triplets (conceived through IVF). My sister-in-law is in a triplet moms group and she said that of the 14 women in the group, twelve conceived triplets with IUI and injectibles. That shocked me. I would have thought that IVF would result in more multiple births. But IVF is more controlled than IUI, so I guess IUI/injectibles cycles are notorious for multiples. I know that when we are going through infertility, multiples can sound like a fabulous idea - get a couple (or a few) kids at one time so we don't have to go through this (or pay for this) again for a while. But having seen what my nieces and nephew have been through, multiples scare me. They were born at 24 weeks, have had 5 brain surgeries between them, the little boy has cerebral palsy, etc. I don't say this to scare you or anyone else, especially because LOTS of people have perfectly healthy multiples. But I think that I would talk to your doctor again and express your concerns that he might be giving you too much medication. More communication can't hurt, right?
ReplyDeleteAlso, I haven't seen or even talked to my doctor since last June. Almost a year now. So I am amazed that you have that much contact with your doctor. Nurses always perform our IUIs, call with test results, etc. Ugh.
Stress sucks so bad! I don't blame you for being confused. If I were in your shoes, I'd try to get a call at least with the doctor to get your questions answered. You need peace of mind and that might help reduce your stress. Hope you had relaxing weekend!
ReplyDelete