Tuesday, May 20, 2008

Doctors and Borneo

The news from Borneo is that Japan and Norway/Sweden/Finland are off The List, due to weather concerns. It will simply be too cold in late fall-early winter. We are now down to 14 finalists.

Truth be told, Central America is my first choice. I've wanted to go there FOREVER, and I already have the trip planned in my head. It's EXACTLY what I want to do after the Big Project is over: snorkle, kayak, visit ruins, laze about on warm beaches drinking frosty local beers. Unfortunately, Terrific T is only lukewarm on Central America. He has safety concerns, I think, although he hasn't exactly vocalized a specific objection, or really any objection. It's more that he talks about other places that top his list, whenever I try to talk about the places that top MY list. Oddly, his first choice is Egypt. I'm not sure I want to go to Egypt for a month, although I would actually like to go someday.

It's a good thing we have some time to whittle down the list, because we have entirely different ideas about this trip.

In other news, I'm considering finding a new OB. It's something I go back and forth on every couple of months. I don't really like the other OB's at my current doctor's practice, which is one reason to switch, since you get who you get during L&D (notice how optimistic I'm being, assuming I'll get there?). I have stayed with my current dr. because I really like her. I thought she was amazing through our initial TTC efforts and my miscarriage--she listened, she's thoughtful, she gave her opinions when asked, and she gave me all of the options.

But, I wasn't thrilled with my visit last week, when I went to talk about TTC and my LP and my late ovulation. This is something I worry about, because I (obviously) don't want to miscarry again. I don't want to go through it, and I REALLY don't want to lose months on end after another one, waiting for my body to return to normal. From pregnancy to being able to try again, post-D&C, about 7 months went by. If that were to happen again, once we are healthy, even if everything went perfectly after that and we managed a successful pregnancy, I would be in my late 30's before I had a child. This worries me. . .well, everything worries me, but that is one of my concerns.

So anyway, although my doctor gave me options and agreed to whatever course of action I choose, she seemed a little dismissive of my concerns, as though we haven't been trying long enough to be concerned. There was one thing she said that's really kind of stuck in my head. She said that until after I have another miscarriage, the presumption is that my previous miscarriage was caused by chromosomal defect, because statistically speaking, 70% of miscarriages are caused by chromosomal defect. So, standard practice says they shouldn't really pay much attention to my somewhat short LP or my late ovulation, until after I miscarry again.

This really bothers me. This is treating the statistic, not treating the patient. You probably won't be surprised to learn that I spoke up. I pointed out that this leaves 30% of women who miscarry for reasons other than chromosomal abnormality. Taking this with my short LP and my late ovulation, I said that I didn't really want to be the guinea pig to test this theory. She seemed a little taken aback by my response, as though I am something of a crazy neurotic control freak for taking this position. (Okay, I concede THAT's true, regardless). Anyway, she offered either Clomid or progesterone supplements, so it's not like she's unwilling to listen. I am still sort of put off, though, by the suggestion that I keep at it and see if I miscarry again. While the statistics that say that more women than not miscarry because of chromosomal abnormality, does that also hold true if they have late ovulation and short LP? I don't know that I'm willing to roll those dice.

The other reason that I'm considering changing doctors is that I commute. My current doctor is near my office (an hour from home), but there are plenty of doctors close to my house. It might be nicer to deliver closer to home. It might be more convenient at the end of pregnancy to have a doctor closer to home. It would certainly be better to have a practice where I actually LIKE the people who might deliver my baby.

I just don't know. If anyone has any thoughts on this issue, I'd love to hear them.


JamieD said...

It is always so hard to switch doctors because I always think, "Well, they're not that bad. And she already knows me . . ." But you have already listed several good reasons to switch.

1. Commute. It's a pain and with gas topping $4/gallon, it's not practical.

2. Partners. After spending nine months preparing for a delivery you have waited your whole life for, it would sure suck to get stuck with one of those yahoos.

3. Wait until you miscarry again?!?! Now come on. Those are YOUR fears & concerns (and perfectly legitimate, I might add). Does she really want you to go through that kind of pain again before she will consider them? You're right - Your Queenie, not a statistic!!

Busted said...

I think Central America sounds great.

I have similar concerns about switching doctors - and I agree that your doctor's reasoning sounds questionable to me. The only thing keeping me at my doctor is that I actually really like her and think she's good, and she knows and will be sensitive to our insane history. My issue is with the office/administrative matters - if the actual doctor isn't meeting your needs though, I definitely think it's worth changing.