6/19/2005

Once again, something that could have been brought to my attention YESTERDAY!

Yesterday we had what I perceived to be our IVF go-ahead appointment. I was looking forward to it, because I've been in treatment limbo since March and I wanted to get things moving again. The consultant we see works within the private system, which will mean nothing to non-UK based people, but basically, it means that whatever I do next ceases to be free as it was on the NHS.

This doctor sees his clients at his personal practice rather than the hospital, and his practice happens to be based in his house. Attempting to find the house, The Dude and I were wandering down residential streets, clutching the directions we were sent. Looking for a gynaecologist's house amongst tree-lined streets of £500,000+ homes felt a bit shady and I told The Dude that it was like I was going for a clandestine back-room abortion. Yeah, abortion is legal here and how twisted am I that this is what comes to mind when attending an appointment about attempted conception, but hey...I am known for thinking innappropriate things at innappropriate times.

One of the first questions the doctor (who shall henceforth be known as Dr WhereHaveYouBeenAllMyLife --Dr WHYBAML for short because I'm lazy) asked me was, "Aside from infertility, how do think PCOS has affected you?". I snorted and let out out something that could be interpreted as a brief laugh and wondered how I could ever put my extreme hatred and resentment into words rather than gutteral noises and eye rolling. In the end I figured that he did not really want to hear how I have placed the blame for everything wrong in my life solely on PCOS, and said that aside from the ever-so-slight issues of weight gain and excess hair growth, me and PCOS are as close as a girl and her hormonal disorder could possibly be.

After looking at my history, Dr WHYBAML put a rather seductive and dare I say, rather rebellious idea out there. He suggested that rather than jumping into IVF ovaries-first, that perhaps I should try another IUI. Now, before you think that I leapt across the heavy wooden table which separated us to strangle the doc I would later ordain as Dr WHYBAML, worry not, as I remained calm. My eyes may have been bulging and my fists clenched, but I thought I'd let him explain to me why he thought this would be the best course of action after the miserable failures that were IUIs 1, 2 and 3.

Dr WHYBAML proceeded to suggest that he would like me to try Metformin, which I have never taken despite being diagnosed with PCOS for over 7 years. Previous doctors have been content to dismiss my claims that perhaps Metformin would be beneficial, culminating in the ultimate statement by one of them, who I shall call Dr Fuckhead, that "You probably won't have trouble getting pregnant." This statement was followed by a quick glance at my chart and ultrasounds, when Dr Fuckhead said the phrase that will keep her on my "People that need to die slow, agonising deaths whilst being consumed by rabid badgers" list for as long as I live: "Ooops...scratch that. Forget I said it. I didn't realise your case was so bad. Yeah, you will have trouble conceiving and will almost definitely require medical intervention. Sorry!" This was said to me at 20, prior to any concrete plans of conception, and alone in Dr Fuckhead's office after a standard pap smear. This witty anecdote now relayed, I think I could hardly be faulted for not trusting doctors.

In addition to Metformin, Dr WHYBAML mentioned a drug that is commonly used to treat breast cancer, Letrozole. Apparently when it is combined with Metformin, it yields quite great results for women with PCOS. I have yet to google the hell out of this drug, but rest assured I will do so at work to waste some time. I will be on some injectibles as well, but I believe that will only be right before the IUI itself.

Even I am prone to momentary lapses of optimism, and I confess this is one of these times. The lovely Lumi has recently found herself in the family way after starting Metformin just last month, so perhaps this is all it will take. Ok, I'm not really *that* optimistic, but I'm pleased that someone finally had the balls to tell it to me straight without either making me cry at their sheer stupidity, or blatantly recommending IVF so they could get their grubby hands on my hard-earned £4000. I do wonder why no one has recommended this course of treatment up to this point, but then again you encounter more Dr Fuckheads than you do Dr WHYBAMLs. I'm trying not to think that without all this wasted time I could already have a 2 year old named Walter Ulysses Adebisi Napoleon Swearengen, and I'll just try to be hopeful that this IUI will mean that I can instead spend my £4000 on an Ikea nursery and the next box set of 21 Jump Street.

17 comments:

MM said...

I noticed that the minute I realized that I would have a less than easy time conceiving, my running list of People Who Suck started growing at a much faster rate than before. Why are normal, competant compassionate medical professionals the exception rather than the rule when it comes to infertility? Glad you've found a doctor who doesn't have his giant, ego-swollen head up his ass. That makes all the difference.

Jenn said...

Met is something you should probably be taking even if you weren't TTC if you have PCOS. PCOS effects more things than just your reproductive ability. I've been on it for almost two years now. It is really rough on your GI system at first, but the extended release version is better if you can get that. I also found about a month after I was at my max dose (I tapered up over a month) I felt better. You may want to see a regular (non-reproductive) endocrinologist as well to help manage the PCOS. Ok, enough assvice for now :)

K said...

The Femara (Letrozole) has some really good effects on people. I've known many PCOSers who added that to the mix of met and IUI and had success. I hope you're one of them

Internal Spring said...

I cannot believe you haven't been put on Met before, unfuckingbelievable!

I take it for just insulin resistance, seems I'm definitely not PCOS or definitely am depending on the doctor or the day of the week or something.

I agree with Jenn take the extended release, tapper up slowly, and one thing I found that worked well is to take the pills in the middle of a big meal like dinner.

One side benefit is that you will never be constipated again.

kiwi said...

So glad you found a dr you feel good about. That makes a huge difference.

I am PCOS too and Metformin + Femara did the trick for me, after so many treatments and IUI and injectibles. Hope it does the same for you!

Oh and good advices from the girls about the Met. Good luck!

Panda said...

Being now "in-between treatments" since my last specialist completely ballsed up my diagnosis, I totally understand your joy at finding Dr WHYBAML. I have an appointment next week with a Reproductive Immunologist whom I am hoping will turn out to be such a medico.

God help the medical profession if all us hormonal women ever get together and find a few uzi's....

I think its fairly safe to feel a little optimism at finding someone who *actually* takes your medical history into consideration....

Dooneybug said...

It's wonderful that you found Dr. WHYBAML! Hope the metformin works for you. I know I've heard of it working for many others with PCOS. Much luck!

tania said...

So glad you've found a WHYBAML who is actually starting your relationship doing something that makes sense without you having to push for that something to happen. This whole thing is stressful enough without the help of Fuckheads. I haven't had the joy of dealing with PCOS, but it sounds like you're on the right track now. And after only 7 years!
Good luck!

Em said...

Great minds think alike...I have the 21 Jump Street box set. It was essential Saturday night viewing when I was 13 (It was shown prime time in Oz).
The Metformin sounds good. I have wondered whether I should have it. My ex's sister has PCOS and she has had two kids on a combo of metformin and clomid.

T said...

Yay for WHYBAML - isn't it amazing when you find a medical professional that you like AND respect? So rare.

Good luck on the met - I've heard the first few days are the hardest.

Julie said...

Pru, I'm so glad you found Dr. WHYBAML. I hope he's right and you're on your way to making your baby.

PJ said...

Ah Pru, that is awesome news. Spending money on a nursery seems much better than on IVF. I had no idea that you'd never been on metformin my PCOS cyster [get it :)] (alright, stop laughing now, if you can't laugh at the disease what can you laugh at).

I hope the metformin/letrozole combo works for you. I've been on metformin for about 1 1/2 years. As Jenn said, you feel better on it and the GI side effects do pass. Occasionally, with a high carb meal of pasta, bread, and a sugary dessert I will have a bout of diarrhea, but nothing too bad. Also, as Jenn said, go with the ER it seems to help tremendously. I started out on the ER so I don't have any direct experience, it's just what I've heard.

Good luck Pru, keep us posted.

Molly said...

Someday soon Walter Ulysses Adebisi Napoleon Swearengen, Zeus Napoleon Dynamite Swearengen, and Zebediah Fitzwilliam Darcy Dynamite Swearengen (yes, that one's mine) can all get together and hang out.

Yay for Met!

Nico said...

So glad you found a doc who tells it to you straight, and has actually bothered to think about you and your case! It really shocks me how much of the IF treatment has to be patient driven. My three future sons, Phred, Fwed and Schweffel will hopefully join the party with Walter, Zeus and Zebediah!

Emma B. said...

Metformin is great news -- I know a lot of people with insulin resistance say it really helps them all around, not just with fertility. I've also heard really good things about letrazole, too. It's an anti-estrogen, so it works similarly to Clomid, but my mom (the RE nurse) says patients seem to have fewer side effects with it, and it's what her clinic generally provides.

Here's hoping Dr. WHYBAML (I really wanted to type that as WHAMBAML) turns out to be The One!

Manuela said...

First... look how popular you are, girl! I go away for one freaking day and you have 15 comments... I guess you're officially one of the cool kids now. I'll pretend not to be jealous.

Second... thank GAWD you found a wonderful Doc... I know nada about PCOS treatment... but I love that he's recommending a protocol that sounds as though it's approved by all your savvy readers. Yeah!

Pamplemousse said...

Hmm, 5 years on Met here and my ovaries are still fucking resisting. However, it does work for some lucky bitches so anything is worth a try. Do a search on Soulcysters about Letrozole/Femara.

The extended release Met is not available yet in the UK.

I love a man with a plan, though, especially if he is a doctor!