THE APPOINTMENT WE HAVE ALL BEEN WAITING FOR

"I can't wait to see what you write about this appointment," said The C as we emerged onto the street yesterday.

Let's begin by labeling this clinic Clinic #1.

Because, OMG, that’s what it is. Here is a full description of the appointment worth waiting for (formerly known as the appointment I made seven months ago.)

The C and I walk through the door into a small reception area decorated in sunny yellow and royal blue. “You must be Ms. C,” says the receptionist who has battled with IF herself. (I immediately forgive the black and white massive arty photograph of a newborn resting in the palm of an adult’s hand that is hung on the wall behind her.) We take care of some paperwork and take a seat in some rather comfy chairs to wait for the doctor.

CLOMP, CLOMP, CLOMP is the sound we hear coming down the hall. A tall man reminiscent of Kramer emerges from behind the wall. He’s wearing royal blue scrubs with “The World’s Best Doctor” along with 5 stars embroidered on the back. And he’s also wearing wooden clogs from Holland. You know, the ones the tourists buy, with windmills and pastoral scenes painted on them. He mouths something garbled and mimes for us to stand up and follow him into his office. The C and I nearly piss in our pants laughing.

The nurse joins us, and explains that The World’s Best Doctor has laryngitis, so she will sit in to help communicate. So all the mime stuff: because the poor man can’t talk today. Let’s just say that this added much interest to our appointment. I liked him instantly, and felt very comfortable even though the man could not talk. I was at ease in his office which had fun doodads, colourful furnishings, and no grand doctor’s office desk for him to hide behind while he discussed our future children.

We cut through the crap immediately by showing the doctor all our previous investigations. PCOS-check! He noted my blood test showing elevated E2 (which I was previously told was normal); my high FSH:LH ratio (which I was also previously told was normal) (do I have the ratio correct btw?); and my previous ultrasound reporting polycystic ovaries. He immediately indicated that he wanted to do another ultrasound, as I was on CD5, so he would get a good indication of what was going on himself. At taking a look at The C’s semen analyses he noted the inconsistencies of the 2 tests, and though the results were not abysmal, wanted him to do a third to see where we stand. Off we were to do our tests! But wait a minute- I have a million questions! Not to worry, I was assured, we will discuss everything after we have a look at our girl and boy parts.

I was actually excited for The C to be party to the ultrasound festivities. He was a bit unsure about sitting back while another man fiddled around my hoo-hoo, but soon got over that when he saw the cool stuff on the widescreen tv they have set up on the wall for easy viewing. Verdict: uterus normal, ovaries enlarged, and, duh, lots o’ cysts. Just as he suspected, but content to have seen it himself. All this communicated by the doctor with no voice.

Up next: semen analysis #3. Now I can’t say that their man’s room compared to the other clinic’s facilities, but it was certainly better than a cold bathroom. There was mood lighting, a basket full of mags, and a comfy leather chair. (Oh, and another large black and white arty photo of a nude man and nude pregnant woman. I don’t know… is this a turn on? I was laughing to myself the whole time I was helping The C. I chose to ignore it… this room isn’t really meant for me, after all.) We handed over the specimen to the nurse who asked us to wait in the waiting room until the sperm liquefied.

When this happened, we were ushered into the lab to have a look at our swimmers which were magnified and projected on a computer monitor for us to have a look at!!! We were both loving this participation. Normal, Normal, NORMAL people! Everything looked good. And we had a count of 28.8 million. Not off the charts, but certainly plenty to work with! The C looked mighty proud.

Back in the World’s Best Doctor’s (and I was starting to see why he wore this on his shirt) office I got all my questions answered and we discussed a game plan. We went over the Met.formin bit, and he was glad that I was on it and tolerating it well. I should certainly continue working my way up to 1500mg a day. He definitely feels that while the Met will help out in this whole process, on its own it will not make me ovulate. (To me that was good news and bad news… Good: let’s get going!; Bad: this ain’t no easy PCOS.)

It was really unfortunate that I am already on CD5, as he would have started right away. RIGHT AWAY??!! Well yes indeed! But, ummm… my periods aren’t regular, how long are you going to make me wait? (Really I wanted to yell: HOW MUCH LONGER AM I GOING TO HAVE TO WAIT, FOR CRYING OUT LOUD??!!) “No problem, Ms. C. Here is your prescription for 14 days of BCP. After you take them your cycle should start 3-7 days later. CALL US on CD1, and we will get started!” (I was told that TWBD would be out of town on a conference Novemeber 17-20, so I should time myself accordingly.)

So our first game plan:
14 days BCP to bring on period and reduce amount of cysts in ovaries
CD3 blood work and ultrasound (I get my CD3 bloods!!)
Femara for 5 days (not sure of dose, I do not have the prescription yet.)
Continue monitoring for ovulation
Try naturally this cycle (ie: sex-on-demand)

Of course I am not thrilled about the sex-on-demand, as I am not convinced it will work (even given the “normal” status of The C’s sperm.) But I do have some action, and we are not talking about Clo.mid, so I am still on the good side of thrilled. Also, I know TWBD has to start somewhere… and getting me to ovulate is on the top of his priorities.

As for my questions, I used the same list as with the previous clinic:
Will I always see you (TWBD) when I come in? Yes, always. Except on rare weekends where there will be another RE available. This is ok with me… the man is entitled to a day off.
Will you preform all my procedures? Yes. Ultrasounds and inseminations.
So your role exactly? He is the one who is going to make it all happen.
When I call with questions who should I/will I get to speak to? There is the receptionist, the Nurse, TWDB and a technician at the clininc. My questions will be directed accordingly and answered within 24 hours, depending on the urgency.
Can I leave messages for you? Yes.
Do you have one nurse who is assigned to work with your patients? There is only one nurse at the clinic. She works with all the patients.
Are all procedures done in the clinic? Yes in terms of IUI, IVF, Egg Retrivals, etc… But they do not do HSG, so I will keep my appointment at the other clinic to get this done.
So you will know me by name from here on in? Absolutely. They purpose is to provide personalized care, one on one. I will not be a random file. This is why I had to wait 7 months to be seen.
So it won’t be another 7 months till I get to speak to you again? Certainly not! We will see you as soon as you give us the call that you have started you cycle! Let’s get cracking!

So Clinic #1 and The World’s Best Doctor it is! Let’s hope they live up to their names.