Doctor Appointment Recap

The very short version is this: the Nurse Practitioner who I met with thinks, based on the length and irregularity of my recent cycles, that I might not be ovulating at all or at least not every month. There is prescription medication that can stimulate ovulation although it doesn’t work for everyone. Before we try that, however, we have a whole slew of tests for me and hubby to see if there is anything else going on.

For those of you with the patience, here’s the long version:

My appointment was at a clinic at one of the military installations here. When I made my appointment they’d given me the name of the building the clinic was in. When I looked at the installation’s website to see where that building was I was met with the most useless map ever. The buildings are all labeled with numbers with no key to tell you which number goes to which building. So already stressed and nervous, I now didn’t know exactly where I was going. I knew, however, that I could ask the guard at the gate when they checked my ID and he or she should be able to tell me where to go. In reality he didn’t know what he was talking about, but I was still able to find the building. They had told me the clinic was on the second floor but I didn’t know exactly where. When I got there I saw a map of the building and walked over to see if I could find the clinic. An employee whose job it is to direct people to find clinics in this massive hospital complex came over and asked if I needed help finding something. I told her I was looking for the fertility clinic. She directed me upstairs and to the left. Upstairs and to the left was the Obstetrics. She sent the lady looking for the fertility clinic to the place with all the pregnant ladies. Awesome. Luckily the ladies at the OB clinic were really friendly and nice and directed me across the hall to another clinic that included Reproductive Endocrinology/Infertility.

I checked in but I was super early so I had some time to wait. They gave me an info packet about infertility so I sat and read it. I was surprised to find out how much I was already at least somewhat familiar with thanks to reading the stories of my fellow bloggers.

When I finally got called back I went to the office of the Nurse Practitioner who my appointment was with. We then spent the next hour talking. When I left I was in information overload. She asked me lots of questions about our history with trying to conceive and my cycles. I actually told her that my cycles were mostly regular with occasional long or short ones, but when she asked for specific dates I realized that my last few cycles have been really extra long. Like, long enough that I’m probably not ovulating. It’s super frustrating to think that these cycles when I’ve had my period come so late and I’ve thought maybe I was pregnant are cycles when I probably didn’t even ovulate.

But, like I said, she doesn’t want me to go on meds to stimulate ovulation until some other things get checked. So, here is the plan for my next cycle.

• On Cycle Day 3 (or 2 or 4 if 3 is on a weekend when the labs are closed), get blood work done.
• Sometime during Cycle Days 5-13, get my Hysterosalpingogram, or HSG, done. For those who don’t know, this test is to check the path between the ovaries and uterus to make sure an egg can travel through. They inject a fluorescing dye in through the cervix and use imaging technology to make sure it’s coming out both fallopian tubes. Fun! And there are very limited days that the clinics do it and they only do a few each day so fingers crossed that I can schedule that when I need to.
• I am not having the blood Progesterone level test yet because my cycles are so irregular and she doesn’t know which day to have me do them. So instead I’ll be using an Ovulation Predictor Kit from Cycle Day 11 through 20 to see if I see any change. Holy crap those things are expensive! And only stable for 30 days after you open the container.
• Hubby gets to have a Semen Analysis done. I know he’s excited about that.
• I have to schedule a pelvic ultrasound. I tried to do that today but had issues getting in touch with the scheduler. Fingers crossed that I can get that done this cycle so that I can make my follow up appointment at the REI office in a reasonable amount of time.
• I’m overdue for a Pap smear and was hoping to be able to get that done during one of these other appointments but no such luck. So I also have to schedule that with my primary care manager.

So, when all that testing is done I can schedule a follow up appointment to go over the results (she said I can probably schedule the follow up when I schedule the HSG but depending on what’s happening with the pelvic ultrasound I might have to wait). Of course, I’m realizing this week after the chaos of moving stuff this past weekend that this might be one of the worst possible months for me to be trying to fit all this testing in around everything else I have going on. But it is what it is and we’ll get through it.

The other big thing I learned from this appointment is that my psychiatrist was wrong about the anti-depressant that I was on being unsafe for pregnancy. Apparently, whatever category it’s in (I wanna say Category C? but I don’t have the paper she gave me in front of me right now) is one that a lot of doctor’s will just automatically say is unsafe. But the high risk clinic has compiled research about the specific drugs and the one I was on (Zoloft/sertraline) is actually one of the safest. It’s okay not only during all three trimesters of pregnancy, but also during breastfeeding. So now I need to make an appointment with my psychiatrist and see about getting back on it. I think that would help me a lot. I’m kinda mad that I’ve gone all this time (and stress) without it when I didn’t have to, but as my husband pointed out I have shown a great deal of strength in getting through all this without the help of medication.

So again, the short story is I’m maybe not ovulating and we have lots of testing to do this cycle. Wish us luck!

In the meantime, on Wednesday I have to go in for my endoscopy to see if I have a stomach ulcer. The thing I’m most stressed about is that my appointment is not until 3pm and I’m not allowed to eat for 12 hours before. That is going to be torture. I’m also nervous about how the anesthesia is going to affect me. I’m supposed to go to classes the next day but I’m not allowed to operate a vehicle for 24 hours. My hubby has the next day off to take care of me and can drive me to school if I’m up for going, but I have no idea how I’m going to feel. Potentially missing four classes (Thursdays being my busiest days, of course) in the last two weeks before finals is making me super nervous. But I’m assuming that if I’m not supposed to be operating a motor vehicle, welding is probably off the list of safe activities too. So we’ll see. Fingers crossed that I can at least attend my lectures in the morning. And maybe I’ll be able to do work in sculpture class that doesn’t involve welding or other heavy machinery and tools.

One other note. I am incredibly grateful right now to have military healthcare. I cannot imagine going through all this with the added stress of having to figure out how to pay for it. My heart goes out to all you ladies who I know do have that struggle. It is not fair.