My appointment with the fertility specialist went perfectly. I had been so fucking nervous, scared that my mental diagnosis (schizoaffective, bipolar type) would slam yet another door in my face. The doctor was unlike any doctor I’ve seen since I first sought a pre-conception appointment with my GP at thirty-five. And I’m a strong-willed, difficult patient, basically walking in off the street with an Interwebs researched plan and a list of demands. She took it all in stride. I think I love her.
My husband took off work to accompany me to the appointment. He really is a great guy and didn’t get frustrated when I started wailing at him for being unshaved and sporting his work clothes–since he is a screen printer and it is a hot day, he was sporting camo long shorts covered with ink and emulsion (the emulsion stains his clothes blood red, so he basically looked like a transient who had just butchered a dead cow or something). The waiting room was devoid of patients; it was lunchtime, and I had anticipated encountering at least a couple preggos (ahem, trigger city).
So a medical assistant took my vitals, my normally treacherously low blood pressure was through the roof. “I’m not worried,” I told her, “it’s usually very low but I am extremely nervous.” She smiled at me, explained that the appointment would mostly be a lot of talking. “She might want to do a manual exam,” she advised, handing me a paper sheet. Great, a semi-naked convo about my last two years of tragedy.
I’ll be clear: this appointment was my last ditch effort. I realize the odds of having a healthy baby at this point are scant, and was not pinning all my hopes on the outcome. I am also a disabled Medicare patient and cannot afford aggressive treatments. I didn’t want a lot of testing, I’m fairly confident that I am a DOR (diminished ovarian reserve) patient with shitty remaining eggs, and I can’t afford to deal with that with donor eggs or IVF with PGS testing. I have a single year left to conceive a healthy baby and I am hopeful yet realistic–all I want is to try oral medications to improve my chances of catching a golden egg.
The make-it-or-break-it point with this reproductive endocrinologist–revealing I am on multiple medications to control a psychotic disorder (my official diagnosis is “schizoaffective, bipolar type”). Start spitting out a word that starts with “schizo” abd even trained medical professionals’ eyes will fly open in alarm. This doctor did not flinch. She said she was unfamiliar with the diagnosis, so I explained what it meant and she took it at face value, even deferring a bit to my greater familiarity with my illness. She asked compassionate, thoughtful questions on how I was managing my symptoms and if I had a plan in place to take medication that would be safe during pregnancy. I didn’t feel like I was being judged, or that she was uncomfortable treating me (I once had a dermatologist refuse to prescribe me ointment for poison ivy because he was not comfortable with my psych meds). I felt really safe discussing this with her.
“Well,” she said, “I think your plan is perfectly reasonable.”
She agreed that CD3 bloodwork, AMH and AFC would likely reveal DOR. “With your history, I would probably end up recommending donor egg IVF, but I see you’re not interested in that.”
I can’t afford it, financially or emotionally, I told her. She didn’t make me feel shitty about being poor.
“The oral medications we use are Clomid and Femara,” she said, “Did you have a preference?”
I explained I’d like to start with Femara, because of less side effects for a shorter duration. I’m terrified of mood changes–I am severely bipolar. We talked about this and she called in a script for me.
I got exactly what I had wanted, plus compassion to boot. Doctors have in the past been terrified to medicate me. I’ve been dicked around a lot since my ttc (trying to conceive) journey started in 2013. It was finally time for me to catch a small break.
Now, where are those jeans I ordered from Free People?