Thursday, August 19, 2010

The August appointment

I had hopes about today. I was hoping it would go well. Just that we could go to this appointment, that I could avoid being completely stirred up like a snow globe, and that we could get news that would make me feel like we are going forward. I'm pleased to report that this was accomplished.

First, I had of course written down notes and questions to ask Dr. RE and when we were waiting in the exam room, I had narrowed it down to 2 categories: discussing my current hormone dosage and discussing egg donation. Dr. RE walks in, looks at us and shakes our hands, and then says: "You are here either to discuss the hormone dosage or egg donation. Which one is it?" "Both", I said, "which one should we start with?" He picked the hormones, which is how I had it laid out in my book (and he wasn't reading it!)

I've been feeling for a while that my estra.ce dosage was too low. Remember from an earlier post that my body does not produce LH and FSH, hence, does not produce estrogen and progesterone. So, I'm completely dependent on meds. You will also remember from my February post that he wanted to know at the last appointment if my mood was very low and could that be related to lower than optimal levels of estrogen. Well, I was in fact quite grief stricken still at that point, and really, let's call a spade a spade, I was depressed. But I couldn't really tell if it was the estrogen, because I've been depressed before while taking the bcp, so I couldn't parcel it out. But lately, I've been thinking I shouldn't really be feeling THIS crappy ALL the time. Again, it's not only the estrogen, but coupled with word finding problems and atrociously low sex drive, I was thinking maybe there was something to do. I didn't even need to tell him that. He just said "Oh, if you think it's too low, it is too low. We'll up it to 3mg and then 4mg if you need". I liked all that trust he gave me.

Then came the egg donor topic. Dr. RE is quite unflappable (perhaps one needs to be after working with infertile couples for decades...what with all that affect from patients), but I think in his range of expression, he was positively psyched to hear we had a donor. Ok, the cues were very subtle. He says we need to have an appointment with me and the donor to discuss it with her and start the testing. He want me to have a sonohysterogram to look at my uterine cavity. He thinks we can all do that in the same appointment (the hospital is a 90-120 minute drive from where we live). He explained that the rates of success are not those found in the literature since those data come from US clinics with strict criteria for donors. He did not say she was too old, but instead thought that the age of her last child presented as a good omen for her fertility. He did explain that she could be running low on her reserves, but that of course, we won't know if we don't try. He reported that they will attempt egg donation with donors who are 38.

Dr. RE also assuaged my fears about sustaining a pregnancy by explaining that supplementation with estra.ce and pro.metrium during the first trimester would sustain the pregnancy, and that after that, the placenta would take care of it. He said that without the meds, I would not be able to sustain it because my ovaries would not produce the estrogen and progesterone needed while the placenta develops, but that the medication would suffice. And then he said something that pleased me. He said "You're a healthy woman, so I don't see why you couldn't carry the pregnancy". For someone who visited death's door (when I had anorexia), being told I am healthy is really, really lovely. I take so much pride in my red cheeks, and love when my health is recognized. I have worked so bloody hard for it.

One last thing before I close and go hang out with some wonderful women friends. When I arrived at the hospital, I was starting to get the feeling of being overwhelmed. The environmental cues, the nervousness about the appointment, the coffee, were all contributing to a sense impeding doom. However, I went to the bathroom and once I was alone, I noticed that I was starting to feel off my centre. (warning: I'm about to get a bit sappy). And then I thought of all of you. And I felt your presence with me. I thought about Bunny having her IUI. I thought about Kelly's appointment at 11:30. I thought about what you have all gone through in the land of IF. This comforted me greatly by making me feel so much less alone. Thank you so much. Thank you to you who read my thoughts, and leave a comment or even those who don't leave a comment. Thank you for sharing your story and allowing me to share mine.


  1. I'm so glad you had such a positive appointment! Sound as though you and your doc are a great match. Hooray for paths leading forward!

  2. I am so hopeful for you and am impressed with your RE. I suspect that my doctor doesn't remember me from appointment to appointment. It is a lot like a snow globe when you get a plan together. It's a swirly feeling that I beleive other folks call hope. Your hormone situation sounds dreadful and if that isn't working against you for depression, just being thwarted in this plan for children is enough to kill lesser beings. You are a healthy woman and should take great pride in that. My hope is that this new plan is smooth sailing from here on out.

  3. Awww, TEARS! I was already so happy that things had gone well ('cause you just never know, when meeting with doctors), and that someone gave you props for being healthy (YAY!), and then to be told that we might actually be a source of support...well, I'm a sap, too. (And I am so grateful for your good thoughts--this old carcass needs all of them that it can get). But mainly I'm TOTALLY PSYCHED that your egg donor's age is not an automatic issue and that your doctor thinks you can move forward!

  4. I am so glad the appointment went well and that you have a starting point. Only good things from here on out.

  5. We were with you! I am glad to hear the doc thinks he can knock you up! Congrats, glad it went well.

  6. What great news to hear that today went well. I know that it's overwhelming, but your doc seems to be a very good fit for you!

  7. Augusta,

    That is so wonderful! I am so glad your appt went well and that the doctor met your expectation.

    I loved your sappy paragraph. We were thinking of you. You are such an amazing person and you strengthen me as well!

  8. Augusta, I'm thrilled that your appointment went like this, and that you were able to drive the sad thoughts back. It's such a tough road, but you've walked it and you WILL get to your destination. And I can well believe how meaningful it was to hear that you are a healthy woman. (We already know that you're going to be a wonderful and loving mother).

  9. Beautiful comments! I'm really moved. Thank you women!

  10. I've been thinking of you (even more than usual) yesterday and this morning, and am SO HAPPY to hear how well the appointment went. Will be in touch very soon. SO MUCH LOVE!
    ~ HVF-H

  11. Augusta it sounds like a really great consult!! You're Dr sounds lovely too, which is so important (and not that common!).

    You know what, you should be so proud of yourself to be standing here where you are today after struggling with anorexia. You must be one strong woman and given what you've been through I can only imagine that hearing a Dr say you look healthy is an amazing compliment.

    Hugs. x

  12. Happy Sunday - I really appreciated your comment on my post about hope. My mom actually gave me that book, When things fall apart, a whole back. Its been sitting on my desk (sometimes my mom gives me awesome helpful things, and other times the info turns out to be less than helpful. I was waiting for the right time that I was ready to decipher this gift.)

    I've really been wanting to focus on how I can be more present with myself and in my life as we navigate this hurdle. Focusing on the future feels so dangerous, and yet everyone around me has the faith that I have such a hard time finding. I feel so betrayed by this idea that hope is a 'given'.

    I can't wait until next weekend when I have some time to read that book. Many thanks for the suggestion - and for the validation that my view of hope is shared.

    I really do love your blog, your comments, and YOU! So glad that I fond you here :)