Tuesday, February 17, 2009

A Little Shakespeare

To Clo.mid, or not to Clo.mid. . .that is the question at hand.**

I'm not sure what to do. With 17 cycles under my belt (in nearly two years, mind you. . .since I'm not one of those cycle-a-month kind of girls), I know that my cycles are at best erratic. Since my miscarriage, they have lasted 24 to 41 days. I've ovulated anywhere between CD12 and CD28. My luteal phase has lasted anywhere from 8 to 14 days. In short, I'm all over the place. My OBGYN told me six months ago that she thought we were headed for Clo.mid, and she would prescribe it when I was ready.

I guess I'm tempted to try for a few more cycles without Clo.mid. I really don't like the risk of multiples with Clo.mid, because EVERYTHING is riskier when there are multiples involved, and frankly, I'm neurotic enough. It's more than that, though. I don't want to need a pill to get pregnant. I don't want to have to jack myself up on hormones to make this happen. I just want to be normal, and I don't want to deal with side effects.

On the other hand, it's pretty clear that I'm not normal, at this point. With cycles like mine, I think I'd be a fool to keep trying without Clo.mid. I really fear having another miscarriage, another D&C, another delay in this whole process.

I wish there were a happy medium here. I tried B vitamin supplements for months, because I found some studies that suggested that might resolve cycle defects. However, I noticed no difference, and I'm just taking a regular prenatal multivitamin now. I wish there was something else that would make me normal.

There's one other thing that's bothering me, too. My OB seems prepared to hand me the prescription for the Clo.mid without doing any further testing. Is this normal? Does anyone know? Have you had further testing, before getting Clo.mid, or is it normal to just hand it out like candy?

I've also been thinking about switching OB's. We decided to keep my current one, because she was so great after the m/c. But, the hospital and the dr. are an hour's drive from our house, near my office. The last time I saw her (6 months ago), she was TTC#2, which probably means she's PG as we speak, and who knows what her plans are once she has #2. I haven't met anyone else in her practice that I even remotely like. In fact, of the two doctors who have seen me other than her (there are about a dozen), I most definitively DIDN'T like either of them. They were both cold and rude. If I was definitely going to stay at my job, and she was definitely going to be there, it might make sense to stay with my current dr. On the other hand, she hasn't been great when I've tried to talk to her about my weird cycles. She seems to want to just hand me the script for the Clo.mid. And maybe there's nothing weird about that, but I'm uncomfortable with it.

I basically have five other practices to choose from, at three other hospitals, all of which are within a 15 minute drive from my house (and currently, an hour from my office). I'm not crazy about any of them, for various reasons. There is one that seems to have very experienced female doctors who all went to top medical schools, and all have board certification. Sounds great, right? There's one little thing that I found really off-putting. They also run a la.ser ha.ir remov.al clinic. Isn't that weird? It just doesn't feel right to me--it seems like a) something dermatologists should be doing, not OB-GYN's, and it b) seems like something doctors would do to make more money, which for some reason makes me uncomfortable and c) seems like something that would distract from the business of OB-GYN, and I want a doctor who is focused on and heavily involved in the specialty that I am there to see them about.

I wish it were easier to make decisions about this stuff.

**I'm still not sure what is going on with my outstanding medical issue. I'm working to get some forward movement on this today. In any case, I'm going to be positive that it's nothing, unless and until I know it's something. Which I fervently hope it is NOT.


~Jess said...

It is a tough decision; all of those. I would say go with the clomid. We did that only because we wanted my cycles to be as controlled as possible.

It sounds like you've already decided on the OB-GYN: From what you've written (the changes there and your uncomfort with other doctors) I'd say go elsewhere.

Thanks for your comments on my blog :-)

JamieD said...

My OB preferred Femara to Clomid - her reasoning was less side effects and smaller risk of multiples. Maybe you could ask your OB/new OB about their thoughts?

I was prescribed Femara after 1.5 years TTC, HSG, SA and one m/c.

My OB would do a CD3 u/s, then I would take Femara on CD3 - 7. Then I would have another u/s two or three weeks later. You could always try one cycle and see how your ovaries respond to it before going any further.

Ann said...

We tried 2 cycles with Clomid and it regulated my cycles quite a bit but I didn't ovulate (the real reason I needed meds). Switched to Femara this past month and ovulated ... just a BFN. So we're trying Femara again this month.

*hugs* good luck on whatever you choose.