I had my first ever what we call in the biz, “WTF”.
I like Dr Hero. He’s very calm and never seems rushed. He looks like a bear. He’s happy to listen to my endless questions and he answers them carefully. Sometimes he even has to answer them three times in a row. He doesn’t have a God complex.
So yes – I like the doctors at this clinic. I trust them. They know their stuff; they are forward thinking. They seem motivated. They don’t fob me off or give me vague answers. That is where it ends. The minute my file leaves the doctor’s hand and reaches the nurse’s mitts, the wheels fall off.
NURSE RULE 1: If you don’t know the answer, say everything is fine and/or make something up. It’s usually fine and IVF is so uncertain, you’ll get away with it and it’s easier than finding out anyway.
SETTING: my final scan before egg collection
NURSE: your lining looks great! We all are set to go.
ME: my lining is 16mm. That seems extraordinarily thick. I’m worried about that… surely it isn’t normal? Should it be so thick?
NURSE: the thicker the better. It literally cannot be too thick!!
ME: my lining was 16mm. That worried me. Surely that wasn’t normal? Should it be so thick?
HERO: 16mm? That must be a mistake.
ME: no, the sonographer measured it 5 times because she was so surprised, then got another one to measure it too.
HERO: if it wasn’t written down in front of my eyes in your notes I wouldn’t believe it.
ME: so was that bad?
HERO: well, not necessarily, but we know that too thin is bad (for example, if your lining was 6mm) and I would say that the opposite is true – being very thick might not be ideal either, such as 16mm. It doesn’t mean a very thick or thin lining won’t achieve a pregnancy, but really we want it to be somewhere in the middle.
Hero spends sometime looking at the rest of the measurements and exclaiming. He falls short of saying the 16mm is a mistake, but he is clearly, like, well surprised.
NURSE RULE 2: always take the easy road. Don’t put yourself out for that 1% minority case, it’s not worth the hassle.
– I should have had a general anaesthetic for my egg collection last cycle if I had a low number of eggs. The reason being Hero thought it would be painful, and potentially difficult/impossible to reach the eggs. He even suggested removing them laparoscopically if needs be.
– The nurses said it was very difficult to arrange a general so they wouldn’t do it. “You’ll only be 15 minutes anyway”
– On the laparoscopy to remove eggs: “I’ve been here 7 years and never seen that happen”. Why thank you, that is directly relevant to me.
NURSE RULE 3: don’t waste your time reading patient’s notes. 9 times out of 10 they are all the same anyway.
– I was given a prescription incorrectly twice by a nurse for the pill and once incorrectly for buserelin. One nurse even gave me a prescription for the pill just before she gave me a Zoladex injection. Completely. Pointless.
– A nurse told me I wasn’t on a long protocol. “We don’t do those anymore”. I said I was. She argued. I told her to check my notes. I was right.
– At my down regulation scan I was told, “everything looks great!” and I was, “probably ready for egg collection.” I was left to point out that it was a DOWN REGULATION scan and therefore a lining of 10mm and 3-4 mature eggs WAS BAD.
– I was told to remind them that I had been recommended to have a GA for my egg collection, because… drum roll… they can’t promise to read my notes thoroughly. On pointing out that I had just reminded her, she said she’d forget – better to just remind them at every appointment.
Is it really that hard to read? To work a tiny bit harder for that unlucky sod in the 1% category? Is it too hard that when you don’t know the answer to a question, to ask a doctor? Find out? Don’t fudge over it and say it’s fine because 9 times out of 10 it is. That 1 person out of 10 is paying the same amount, going through the same heartache and due to your laziness it might well all be for nothing.
I just deleted a long and boring paragraph (you’re welcome) about not trusting the nurse on when I should call to book in my next cycle. I’m overruling them and calling with my next period when I start the pill. Sorry clinic, back to my old annoying ways. In theory my next cycle will be May, and pigs might fly.
This is overly long and ranty towards nurses. Sorry. I know their jobs are hard and I feel (a bit) bad because they are all so goddam friendly, but I just don’t trust them anymore. My heart feels heavy when I think about another cycle. Partly it’s the money we are wasting, partly it’s the thought of having to drag myself through the physical and emotional torment of another cycle and partly it’s the thought of having to police my own treatment plan because I don’t trust the nurses to read my notes, or carry out what the doctor has told them to. It’s awkward and exhausting. I go to most appointments on my own and I don’t want every single one to be a battle again.
Okay, wake up, you’re dribbling on me. Quickly, WTF outcome:
1. Stay on the same dose, short protocol with the pill this month to help suppress endo.
2. Egg collection with a general anaesthetic (AMEN!). Hero felt that a) my level of pain was clearly not okay, and b) because it hurt so much and I cried and flinched throughout the procedure this meant that it was dangerous. Although they are aiming at the ovaries, stabby implements, major organs all in close proximity and a patient jumping around and screaming is not a good combination. He also said that under those circumstances, they may rush to drain the follicles and wouldn’t try to get more difficult to reach ones.
2.1) Interesting note – he thought this may explain the 2 eggs from 5 follicles crap fest. Maybe they didn’t flush them enough times because of all my squirming and screaming? Maybe there were others, but they knew it would be too painful and dangerous to reach them? This makes me feel all kinds of sad and EFFING FURIOUS at that lazy nurse who couldn’t be bothered to arrange the general first time.
3. He also wants to wash my lining during egg collection. He is dubious that 16mm was all endometrium and thinks it will include a layer of mucous. All normal, but if it’s more than usual, he will wash it away. Might help. I need to google that because I’ve never heard of it and it sounds weird.
Lots of mights and maybes. This is so long and boring, I am going to treat you to a picture I took in a homeware shop this weekend. I know, lucky you. It is a lightweight flame “wand” for clearing weeds from terraces, kerbs, paved or gravel paths and patios.
Something tells me she wanted something else for her birthday.