Good is good enough

I’ve spent several days “processing” my REI appointment and first meeting with Dr. M. I didn’t want to make hasty judgements before posting here, so I really gave myself time to consider what he said and did at the appointment.

First of all, the nurses and administrative staff at UNC were fantastic. They were kind, patient and reassuring (as I am sure I had a nervous look of terror on my face.) Dr. M met us a few minutes after we were scheduled for our appointment. From the onset, I knew he was no Dr. S. He was to the point, all business. There was no “getting to know you” conversation. Apparently, everything he needed to know about us came from my charts and questionnaire. (Yes, that is snarky).

He rehashed my answers to a few questions, and came up with a plan for the next few months. I asked about an alternative drug that Dr. S had mentioned a number of times. Dr. M says he doesn’t regularly use it. Much to my relief, when I asked about injectables, Dr. M said he isn’t a fan since they lead to too many cancelled cycles. He repeated the vials and vials of blood work and some of the tests we had done previously. He (and his resident) did an exam and I was on my way, with directives for my local doctor for lab work when needed, as well as prescriptions for the next few months.

Here’s what I learned: I have already been in very capable hands. Dr. M is not changing much of anything (he’s only tinkering with the timing and dosing of meds I have been on) until we get a little farther down the road. All of the tests Dr. S performed months ago were roughly the same now. In short, Dr. S was right about things. It doesn't give us a whole lot of answers, but it validates my reluctance to move on.

Jeremy and I had a very “passionate” discussion about my reaction to this visit. (Passionate discussions between two former debaters are to be expected :) )  I am an emotional person and react accordingly to all things related to my fertility care. Jeremy saw Dr. M as capable, objective and to-the point. I saw him as cold and detached, even a bit judgemental. I don’t think either of us is wrong; it’s all about perspective.

I’ve mentally made pro/con lists about continuing treatment with Dr. M. I’ve decided to stick with Dr. M and UNC. I’ve met him once, and first impressions aren’t always the be all end all. Secondly, he came up with a plan that seems to fit into our lives at the moment. Another major pro is the fact that he’s happy to allow me to be monitored remotely by my local doctor’s office, allowing me to miss much less work and cause fewer disruptions to my daily life. Also, Dr. M is very quick to communicate with me. Dr. M emailed me mid-day Sunday to let me know everything was “normal” from my lab results and we would move ahead as planned. I replied with a quick question and had a response within 15 minutes.

Finally, the most decisive reason I am sticking with Dr. M is because Dr. S highly recommended him. I still trust Dr. S more than Dr. M, but that might change with time. When he asked flat out if I would return to Dr. M, I told Jeremy yes. He knew immediately it was because of Dr. S’s recommendation. What can I say? My husband knows his wife.
I also talked with Dr. S about Dr. M's findings. Dr. S is going to be monitoring me locally, so he wants to stay "in the loop" with regard to everything that is happening. He's actually ordering more monitoring than Dr. M wanted, so I'm on board. He told me he knew I would feel better if I knew what was going on. Dr. S knows what my type A, teacher personality does to me.

I actually feel very strange about my reaction to this new doctor. I’ve frequented a couple of infertility message boards online. Everywhere, it seemed women with fertility issues had epiphanies in the REI’s office. They learned that their OBs were naive, Clomid-dispensing machines that didn’t really understand female fertility. The OBs overmedicated, under monitored women in the trying to conceive process. Women were relieved and happy they made the trip to the specialist. They knew, whatever their family building future held, they were in good hands with their REI. I expected a similar personal revelation, thinking about how great my treatment was in an office where no one had a baby bump.

It didn’t happen.

In reality, Dr. S monitored things much more closely than Dr. M. I walked out of Dr. M's office with 3 months worth of plans. Dr. S always took it one month at a time. I still like Dr. S and think his judgement is sound. I'm glad he is still part of my treatment team because otherwise I would miss the optimism he offers me when we discuss the next treatment or phase. His positivity, while always professional and realistic, makes me feel like having a baby is a real possibility. He understands that I live in the place where the pregnancy test never turns positive. He knows I understand how small my odds are every month. He knows I need to hear, that despite those odds, there is always SOME hope. Seeing a few baby bumps in the waiting room is worth the personalized care I receive from Dr. S.

I feel like this post is a bit more melancholy than I like to be in my blog. I am still happy to have a fantastic medical center available to me. I have faith that Dr. M will make good decisions and help do everything he can to make us parents. As some people have said, it might be great to have such opposite personalities on my team to help me make the best decisions possible.  I’m just going to have to get accustomed to a different kind of doctor, when it comes to Dr. M. I think I summed it up best when Jeremy and I were discussing it for the millionth time (because of me, not him). Dr. M seems like a good, competent doctor. It’s just that Dr. S is an excellent, empathetic doctor.


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