31 July 2010

Testing the Batter

FSH test: normal.
LH test: normal.
Thyroid test: normal.
Pap smear: abnormal, but not really.
Seminal analysis: according to my husband, normal.

After a few statements of reassurance directed at my husband earlier this week--"One of your best friends has been through the same thing..." and "All of my tests required someone poking me with a needle..."--Michael put on his game face and readied himself for his one test out of the battery.  I was at work when he rushed a sample of his baby batter over to the hospital lab for the analysis (hey, it's a half-hour drive).  Although, the biohazard bag which was given to me for transporting the sterile cup was a tad too transparent for Michael's liking.  I offered him a brown paper sack before leaving for work to ease the stress.  I'm just glad we don't use the same bags for transporting our lunches to work.  That could have been embarrassing.

Michael: [averting eye contact and jutting out the paper bag] Here is the paperwork and a sample of my *cough cough*.  Well, you know.
Lab tech: Thank you sir.  [opens bag and peeks in]  Oh, wait.
Michael: *clearing throat* What's the matter?
Lab tech: Sir, this is a peanut butter and jelly sandwich and a bag of Pringles.
Michael: Then what bag did my wife pick up this morning?
Lab tech: I'm not sure, sir, but we cannot test a sandwich.  Would you like me to show you to a private room for another sample collection?
Michael: No. [breathes deep and mutters a few words of profanity]  Just give me another cup.

But no such embarrassment.  He walked right in, dropped it off, and headed home to change for the driving range.  A quick text while I was finalizing one of my bulletin boards let me know the eagle had landed.  Since the lab has to perform the analysis within an hour of collection, I figured we would receive a phone call that afternoon.  When we didn't, I assumed we would hear something the next day.  My fertility books had emphasized that you should hear something back within 2 days.  Alas, we didn't.  I couldn't tell if this was one of those "no news is good news" situations, but it was starting to piss me off.  With Michael being one of the nighttime pharmacists at the hospital where he delivered his sample, he decided to do the research on himself.

Over dinner the evening after looking up his lab report and before he left for the next night shift, he proudly told me that his results looked normal.  Since my fertility books actually break down what they test for in a seminal analysis, I had to ask about specifics.

"What was the volume?"
"Probably a couple of teaspoons."
"What about the sperm count?  Was it high?"
"I guess."
"Motility is a big deal.  Where your swimmers motile enough?"
"Most likely."
(Beginning to get really frustrated with his man answers) "Well, tell me something definite!"
"Look, subcategories on lab reports would have had up or down arrows to indicate if something was too high or too low.  There were no arrows."
"No arrows?"
"No arrows."

Since Michael wouldn't lie to me about something this important, I let the surface-skimmed information settle in my brain and I expelled a lengthy sigh.  I tried imagining how he obtained the records on himself since the labs closed at 6:00pm and he works from 9:00pm until 8:00am.  A few scenarios played out in my head: Michael sweet talking a nurse twice his age until she giggled like a teenager, then printed out a copy of the labs from her graveyard shift station.  Or him furtively passing a crumpled wad of cash to the janitor in exchange for a manilla envelope he obtained from a doctor he had threatened to blackmail.  Or him donning a backpack and his Cons, creeping down long, dark hallways toward the hospital's main computer room where he would hack into the mainframe all while nervously scouting the doors for passersby.

Unfortunately, the actual obtaining of the labs wasn't this entertaining.  While the pharmacy was experiencing a lull in the work, he simply looked it up on the computer and memorized what it said.  Still, the lab had failed to put my mind at ease by calling me with yet another "it's all normal" call.  My husband rectified that by taking matters into his own hands.  I sure do love that man.

21 July 2010

Weekend Events in Four Short Acts

normal (adj.): 
conforming to the standard or the common type; usual; notabnormal; regular; natural
normal (medical/biological): 
a)free from any infection or other form of disease or malformation, or from experimental therapy or manipulation. 
b) of natural occurrence.

ACT I: What the hell does normal mean?

It came again in the form of a letter on the same plain, unexciting white copy paper I use when I copy grammar worksheets for my students:
Your lab results are normal.  Please contact our office if you have questions.  THYROID NORMAL.
Thank you.
I'm glad to know that my thyroid seems to be functioning appropriately, but I am a woman who needs numbers.  Stats.  A data point on a bell curve.  Anything that will give me an idea of just how "normal" my thyroid is.

ACT II: Toss your patient rights expectations out with the bathwater

Called doctor's office to trade up doctors at current clinic.  Wanted someone with a personality more engaging than a stapler.  Talked to really nice receptionist.  I asked.  She pleaded for me.  They said, "No."  Something about professional courtesy and office policy.  Reminded them they chose the doctor for me and wondered why they would punish a patient.  Held fast to their harebrained rules.  Threatened to leave their office.  They were OK with losing my business.

Hung up.


Messaged a friend to vent frustration.

Researched new docs all afternoon.  Called new doctor.  Asked for help.  They answered, "Yes, we will serve you!"  Will even come up with fertility plan.  Will even get my records sent to their office to avoid starting all over.

Hung up.


Messaged friends to share the joy.

ACT III: Have overnight bag, will travel (to Savannah)

Christy's brother, Danny, lives in Savannah as he is attending South University studying to be a physician's assistant just like his big sister.  She has already taken advantage of the free accommodations since his move, but she invited me and another friend on an excursion this last weekend.

In the Reader's Digest version, we packed in many sublime activities: eating at gourmet restaurants, reading novels on the beaches of Tybee Island, getting pedicures at a full-service salon in the historic downtown, walking the cobblestones of River Street, dancing on the stage at a dueling pianos bar.  Maybe I'll dedicate a later post to the good times we had; I felt like a novelist trying to take mental notes of every occurrence for fear that I would forget something significant or poetic when dictating later.  It was a weekend to be remembered for certain, but not even a couple of days away with girlfriends made my wacky system take a break from causing me stress.

What started out as minimal spotting morphed into what seemed like a full-blown period.  I had not packed the appropriate tools for such an event because I menstruated only 2 weeks prior.  It was like starting my period for the first time and playing the when's-it-going-to-come-next game all over again.

Poor Danny had to live with a box of off-brand tampons on his bathroom counter all weekend.  He more than earned the meals and free T-shirt we treated him to during our stay.

ACT IV: Now I'm abnormal?

My former doctor's office called yesterday afternoon and left a vague message on our home answering machine.  I was to call back.  I figured it had something to do with the fax I sent them earlier that morning requesting my files be transferred to the new office.

Boy, was I wrong.

They wanted to tell me that my pap test was in and the results were abnormal.

I was hoping they would give me more detail.  With my TSH results coming up as normal without data, I figured there was some sort of formal write-up for abnormal labs.

The woman told me that the abnormal results were most likely due to ASCUS (which stands for atypical cells of undetermined significance--yeah, I had to the research to find out what it was).  There were no precancerous cells, and my HPV test was negative.  In other words, she claimed, I was most likely OK.

Let me get this straight: Normal means I'm fine.  And abnormal means I'm fine?  Then what kind of results to you have to get in order to know when there's a problem?  Am I going to have to wait for my cervix to start glowing in the dark and singing show tunes?  I can just imagine that phone call…

Doc: "Uhhh, Mrs. Wynne, your pap labs came back as abnormal."
Me: "That doesn't sound good.  How are they abnormal?"
Doc: "Well, you see, when we were looking at your cells under a microscope, they seemed to have a bioluminescent quality.  You usually see that in jellyfish and plankton, not a human woman."
Me: "Hmmm, that is strange.  Anything else I should be aware of?  Anything I can do?"
Doc: "The lab tech did say she kept hearing 'Happy Talk' being sung whenever she ran your labs.  I told her to listen to something other than music from South Pacific."
Me: "Maybe I'll so the same."
Doc: "Pardon?"
Me: "I mean, oops, ummm…" *click*

My results could have been abnormal due to a dramatic rise or fall in estrogen, having a virus (even a cold virus), or having had intercourse too close to the test.  Well it wasn't the latter, since I have always been told to abstain 24 hours before a pap test.  I wasn't sick at the time.  And I wouldn't know if my estrogen levels were hitting peaks and valleys--unless they ran another test.  But those results would come back as normal (which is great) or abnormal (which, apparently, is hunky-dory).

End Scene.

14 July 2010

Hormones Are Working…Or Are They?

I was supposed to hear from my doctor last Friday about the results of my TSH (thyroid stimulating hormone) analysis.  They didn't call.  Is it just me, or aren't doctors' offices supposed to call when there are test results to be delivered?  When I hadn't heard from them by today, I decided to call them.

The receptionist I spoke to put me on hold to check my records.  I endured less than a minute's worth of elevator music before she clicked back over.

"Mrs. Wynne, your results came back as normal.  You will be getting a letter in the mail tomorrow stating this."

Am I supposed to be impressed by the fact that (yet again) they are mailing my results?  And what about the fact that all that the letter says is that the results are normal?  Where is the baseline data?  Where do I fall within the normal range?  What is the magic number of my normal TSH level?  Don't I, as the patient, have the right to know this information about myself?

So while I am glad that another test came back negative, it still doesn't give me an answer as to why I cannot ovulate on a month-to-month basis.  Don't hormones regulate this function of the female body?  I never thought I would find myself yearning to ride the crimson wave, but it would at the very least let me know my body was able to ovulate!

Before today, I decided I would change doctors.  My approximately 70-something-year-old male doc most likely isn't sensitive enough to my 28-year-old desiring to be a mom.  Plus, I would like a doctor who knows how to smile.  I've seen this guy 3 times in the last year, and I don't recall a single grin or chuckle.  Not that I want someone who breaks into hysterics over an exam; just no more automatons, please.  I just can't decide if I want to stay with the same office and use another doctor down the hall, or if I want to try a completely different doctors' office.

Athens-area ladies, your thoughts and ideas on OB/GYNs would be most appreciated.  :)

13 July 2010

Serendipity at Goodwill?

I met up at the school with two of my co-workers/girlfriends today so that we could carpool to lunch.  Nothing like a couple of hours with fellow females to catch up on your summer and admit your anxiety for the upcoming school year.  Since Melody married just weeks before, she had to run by the central office on the way to lunch to perform her name-changing duties.  But when the person in charge wasn't there, Jodie suggested we kill time at Goodwill and return to the central office after lunch.  We had a good 30 minutes before we were to meet up with our third friend, Lynn, for our official lunch date.

With us being teachers, the three of us searched for cheap books to stock our classroom shelves.  All children's books were less than $2 apiece.  I racked up on several classics for my soon-to-be-5th-grade-classroom.  Melody picked up a few, too, and threw in a video on animal adaptations.

We walked around to the row of books for adults.  Novels, self-help, cooking, references, textbooks.  Jodie struck gold when she found a new copy of the Publication Manual of the American Psychological Association that she needed for graduate school for $1.50.  When I bought the same book for my undergrad psychology classes, I paid nearly $70.  Damn lucky girl to get such a deal.

I continued to explore the rows of books.  They were in such disarray, I felt I had a better chance of winning $50 on a lottery scratch off ticket than finding a book I wanted.  I happened upon Frank McCourt's classic Angela's Ashes, so I added it to my stack.  Slackonomics piqued my interest.  The stack grew.

And then some freakish version of serendipity occurred right there in the Winder Goodwill.  I recognized the trademark black-and-yellow paperback binding: Fertility for Dummies.  Consider it bought.

I didn't walk into the store with the intention to buy such a book, but I ended up walking out with it in my collection.  Empowering myself with knowledge is something I've always done with subjects beyond my understanding.  Even though I have already done research and consulted my doctor for advice, the knowledge behind getting pregnant should be no different.

Thanks for the trip to Goodwill, Jodie and Mel!

12 July 2010

I'm Not a Nearly-Extinct Panda, but I Do Want More of Me

You can always tell who is a doctor and who isn't by the way they walk.  Doctors walk down the corridors of their practice with confidence and purpose.  They must get from Point A to Point B without being deterred by distractions that are not penciled in on today's to-do list.  Female doctors walk a little more stiff-legged to show off their calves as defined by their 3-inch heels, their skirts swishing lightly around their knees.  Male doctors exaggerate their arm movements as if they were about to break into a run for the always-impending emergency.  They have patients who need their help, and as they walk toward the room of their next case, their chins create an obtuse angle to the ground, they are so high.  That is, unless they are reading the file on their patients.  Then they turn their chins downward, squint their eyes, and bring their eyebrows together in solicitous concentration.

But not my doctor.  His days of confident, head-held-high walks are behind him.  He shuffles down the same corridor, arms close to his body with one hand to his chin.  He doesn't squint over documentation because he dons large bifocals.  His shoes appear to be meant for comfort for the long hours he stands and walks, not as a symbol of status nor to brag, "I bought these on my last trip to the Italian Riviera."  While other doctors in the same practice are most likely to rest their hand on your arm in warm comfort over your concerns, my doctor is quick, methodical, and logical in his delivery of information.  He moves from one patient to the next, down the line, ticking off the check list until it's time to go home.  He is obviously well-educated and deserves to be in this GYN practice based on his wealth of knowledge alone, but he doesn't conjure up warm and fuzzy feelings when in his presence.  You ask a question, he answers it succinctly in 2 sentences.  He explains everything in medical language.  Nothing is flowery or in slang.  He never talks in "what ifs".  And he absolutely never calls you by a term of endearment like his nurse does (who calls me "Sweet Pea").  My guess of his age: 72.

It is a little strange to have a man who is old enough to be your grandfather to be the one to check you for breast lumps and run your pap test.  Like his answers to questions, the session with him is quick, methodical, and logical.  My former GYN, at least, would warn you of what was coming.

"You're going to feel a little pressure when I press down on your abdomen."
"This stethoscope might feel a little cold when I hold it against your back."
"OK, now I'm going to insert the speculum."

All you would need is a little mood music and a cold glass of water with a lemon slice, and it would have been a day at the spa.  Minus, of course, the pap smear part.

But this is not the case with my current doc.  He leans over from his stool for his nurse to glove him and doesn't even nod at her in gratitude.  You never even see the speculum coming your way.  Suddenly, it's knocking on heaven's door, keeping its foot in the jamb for its cotton swab buddy to join in the fun.  Specimen is contained and capped.  Speculum is trashed.  Gloves are removed (by his own hands, this time).  Orders to sit up and get dressed are made.  I am to meet him in his office.

His concerns with this exam were twofold:
Concern numero uno: apparently my thyroid felt slightly enlarged.
Concern numero dos: I'm not ovulating regularly enough (no shit).

He didn't seem overly worried about my thyroid since it checked out in a TSH analysis 6 months ago.  Just to be on the safe side, he ordered another TSH analysis and had me walk across the medical office to have my blood drawn after my appointment with him concluded.

As for the ovulation part, he can't figure out why I'm not ovulating.  He tells me it's not natural to menstruate only 6 times in one year and that it could cause problems with my uterus.  He begins with a list of what to try next:

1.  "If you don't have a period 8 weeks after the one you just had, I want to give you a shot of progesterone to jump start your period."  I'm not sure if this would become a regular thing should I not get pregnant with the next ovulation cycle, but I'm already tired of needles with the two blood tests I've had done this year.  I might have to opt for progesterone in pill form.  This is an option I'm ready to try.

2.  "Since you have been trying to get pregnant for a year to no avail, we can try Clomid during your next menses."  This would stimulate egg production.  Can't make a baby without those eggs.  Although, there would be an increased chance at producing 2 ova at the same time, which could result in twins.  I would have to go back to the doctor for an ultrasound after taking the full round of Clomid to see if it properly produced mature follicles.  I always imagined my first ultrasound being one to confirm pregnancy, not to see if my ovaries were doing their job.

3.  "If we put you on Clomid, we could could perform artificial insemination."  Umm, let's leave that option for beef cattle and nearly-extinct giant pandas.  At least for now.

4.  "We should also perform a seminal analysis on your husband."  Great.  I get to hide a stack of forms, a plastic cup, and a biohazard bag in my purse until I get it home, where--once presented--I'm sure will go over real well with the hubs.  I know he's just as committed to starting a family, but there are so many rules for collecting and delivering a specimen, it's laughable.  Didn't know there would be an instruction manual on a date with Rosy Palms.

On the way home, I mulled over these options while listening to my preset radio stations à la carte.  The Eagles, UB40, Mellencamp, Kelly Clarkson, and Hootie and the Blowfish all kept me company while I cried a little and thought a lot.  It already feels overwhelming, and we haven't even faced the most serious trials of infertility.  There's the chance I could not get pregnant at all.  I could get pregnant with help, and then miscarry.  I could miscarry multiple times.  I could have an ectopic pregnancy.  Who knows?

What's meant to happen will.  We just hope to help repopulate the planet with actual pieces of ourselves.

Couldn't resist.


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