We Have a Diagnosis!

I saw the RE everyone has been raving about yesterday, and he is as good as the reviews claim. I'll call him Dr. R. There was a bit of a wait in the office, but once he came in to see us, his full attention was on us (DH came with me). The first things he said when he walked through the door were, "So you've been through a lot, " and "There is definitely something going on here." He went over the relevant points of my labs and my history with me, and then told me what tests he wanted to do. He covered just about everything I wanted to find out about, and more besides. On top of that, he has a great bedside manner. There is no sense of the "God-complex" that so many doctors have. He talks to you in understandable language and explains things without lecturing. He also complimented me on my overall good health and took my knowledge of my own body seriously. He's even familiar with TCOYF! Such a change from the previous RE I saw.

Speaking of the previous RE, turns out he didn't really test me for FVL, so Dr. R. ordered a diagnostic test for that, along with MTHFR, prothrombin gene mutation, chromosomal kereotyping, prolactin, vitamin D, and ferritin. He said my TSH was slightly elevated. He didn't think a full thyroid panel was necessary, but just went ahead and proscribed a low dose of thyroid hormone. We also talked about my family history. Since I have a family history of fibroids on one side and type 2 diabetes, he wanted to do a dildo cam scan to look at my uterus for fibroids (he also wanted to check for a septum) and at my ovaries for cysts. My uterus looked great, but my ovaries had lots of cysts. He called it polycysitc ovaries (PCO's), rather than PCOS, I'm not sure why. He proscribed Met.formin for that, explaining that he suspected insulin resistance as the cause. He felt that testing my insulin levels wasn't necessary, because the levels vary so much that it doesn't always show up. He felt the same about testing for progesterone--that levels vary so much that testing wouldn't give us much information. He also said there are three main causes of LPD: PCO's, endometriosis, and prolactin. He saw the PCO's and ruled out endo on the scan, and he's testing me for prolactin.

He explained how the insulin resistance would cause pretty much my whole pattern of short cycles, copious CF (sorry if TMI), and miscarriages. I don't have a lot of the typical PCOS symptoms, but the way Dr. R described it explained a lot about why my body works the way it does. He is very confident about my chances of having a successful pregnancy, and his confidence is infectious. I feel so relieved to have a diagnosis to hang on to and that it is treatable! Oddly, though, I've been crying a lot since seeing the doctor. I think mostly it's relief and release. When I was driving home, I started crying just thinking about the possibility of seeing a heartbeat at an early ultrasound. I can actually begin to imagine myself pregnant.

Another interesting thing was that it didn't bother me to see pregnant and new moms in Dr. R.'s office, because I know that he's a fertility specialist, so probably a high percentage of them are pregnant after IF or loss and have been in my shoes. Of course I can't tell which ones they are, but I felt less out of place than in the other Dr.'s office, where most of the mothers are blissfully ignorant.

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On Monday, I had an interview with a second acupuncturist--I'll call her CI. I felt much more comfortable with her than with the first one I saw. She never brought up the possibility of a third miscarriage, and in fact, she has had a miscarriage herself. I believe she said something along the lines of "Two is too many," referring to my miscarriages. She had heard of Dr. R. and wanted to hear my reaction after seeing him. She also gave me a sense of confidence that my chances are good for a successful pregnancy next time. When she spoke of my age, it was to say that, since I am relatively young, two miscarriages are an obvious indication that something is wrong. I thought that she took my concerns seriously, was quite knowledgeable, and would be very supportive throughout the process of getting and staying pregnant. She also knows my midwife, and my midwife had recommended her, so that will facilitate good communication between my "health team".

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Finally, last night at my music docent training, I spoke to the training leader who is in charge of making sure docent placements are going well. I ended up telling her much of my story. It turns out that she had her own fertility journey, and she really understands how difficult it is for me to have any extra challenges in my life right now. We both had felt a connection to each other since the beginning of training, and it felt good to share my story with her.

She promised to figure out what is going on with the teacher I got assigned to and do her best to resolve the situation, so that it is comfortable for me, even if that means reassigning me. She also let me know that she is available to help me get adjusted to teaching in the classroom even after my training is over. It really helps to know that she is on my side, and will work to make sure my experience as a docent goes as smoothly as possible.