Saturday, March 31, 2007


Thank you guys for your outpooring of support. I know I say it all the time but here I go again: I don't know what I would do without you. This is an amazing community, and I am so fortunate to have found friendship in all of you.

The frustration that was overwhelming me at the beginning of this week was unreal. Blogging about the dissappointment and the impatience really helped me move forward- I got all the negativity out, and am now looking ahead to the next cycle. My recap of my life-as-an-IF-to-date also served to bring some lurkers out of the woodwork. To Ann and Carrie: Nice to meet you. (And to the rest of you: Go visit Ann and Carrie!)

BUT. (There has to be a but, doesn't there? I can't just end this post on a light "I love my community" note, can I?) In your comments alot of you raised some ideas and issues that I want to talk about. Reading your thoughts about my clinic made me stop and wonder if I am aggressive enough with my clinic. And if I wanted to be more aggressive how would I do it without starting to cry while on the phone (I'm often a blubbering baby when I am in an emotinal situation where I have to be assertive. Remember the Great Records Fiasco of 2006?)

So: I want to address a number of points you guys made, give you my perspective, and then I ask that you please share with me how you would have handled the situation.

Problem One: My doctor takes too many vacations.
Ya. That's what I'm thinking at the moment. He took off 2 weeks at Christmas, and now 2 weeks for March Break. It DOESN'T seem like the right thing to do given the line of work that he is in. And I'm certain that his taking vacation probably pissed off at least 2/3 of his clientele. I understand completely about the need for vacations from work-especially for someone who works 14 hours a day, 7 days a week. I understand also that my doctor may have needed a rest period becasue he has been suffering from his own medical problems (that whole he can't speak thing.) So go ahead, doctor, take your time off- but your people should have given me the correct information concerning your time off.

What will I do about Problem One?
- Next time I am at the clinic I will be certain to inquire about other upcoming vacations. I'm sure there will be some time off taken in the summer. It is important that I know about it. (Heck! I can plan my own vacation to coincide!)
- I will tell the nurse and the doctor that I was unhappy that I did not receive all the information (especially seeing as if I had known I could have planned accordingly- my god, I was off by one day!)

Problem Two: I should just change clinics!
I have a love-hate relationship with my clinic. Actually, it's mostly love. When looking for an RE (and the best clinic for us), my research yielded the information that there are 4 clinics in the Mont.real area. One was out of the question (at a hospital, very impersonal service, had heard personal unsatisfactory accounts of treatment there, far from my house, dreadful to find parking there). Another seemed out of the question aswell (primarily French speaking-a big concern for us, far from my house, big size). So we had narrowed it down to two, and went to interview both. We decided for our clinic for the following reasons: it is very close to our house, and The C's work, we loved the atmosphere, we loved the receptionist and nurse, it was very personal (they knew our names from the moment we stepped in the door), we would be dealing with only one doctor and nurse (not doctors on a rotational basis), the doctor preformed all the u/s and procedures himself. In short-we felt really comfortable letting these guys handle the conception of our child. (The clinic that we decided against had much of the same negative points as the other two we nixed.) What I guess we weren't aware of is how a clinic with only one RE ceased to function if the RE took a vacation. I believe that we were under the impression that an alternate doctor would be brought in at these times. This is the SINGLE "hate" aspect of this love-hate relationship. To me, although this issue is huge, it does not outweigh the great things about the clinic enough to make me want to bid them adieu.

What will I do about Problem Two?
- I am going to stay put. We already looked around at our other options and don't think this is a deal-breaker given all the things that we like about the clinic.
- I will raise the fact that I was under the impression that a replacement would be availble during holiday times so that it would not affect our cycling.
- I will reiterate that I am upset that I had missed a cycle due to mis-information, and that this is unacceptable as it could have been avoided.

Problem Three: I should have a CD4 baseline u/s.
Yes! That's what I was hoping... When I called on CD1 (Friday), it was THEN that I was informed that the docotr would only be back at work on my CD4 (Monday). The receptionist told me that it was a possibility that he would see me then for the baseline, and that I should just hold tight and they would let me know on Monday when he was back at work. On Monday when I spoke with the receptionist I was told that she was sorry (as an IF herself, she really understands the disappointment,) but the doctor absolutely positively wants to start my treatment on CD3, not 4. (My protocol is that I start Fem.ara on CD3, so while yes, a baseline can be done on CD4, my treatment has to start on CD3! Of course I can't start treatment without first ahving a look at the ol' overies...) I had some hope over the weekend that I would have been able to start on CD4, as I remember that in my first treatment cycle the doctor did that. I know that when my last cycle failed we discussed about making some small changes, and I guess that's why the doctor was adamant about starting on CD3.
(Just a side note: it was CD6 when I wrote the previous entry, so a CD4 baseline was certainly out of the question by the time this was published!!)

What can I do about Problem Three?
- Ummm... nothing? The doctor made his decision, what can I do?
- Ok-I can do something: ask him why he had to absolutely positively start on CD3. Why couldn't he at least have me come in to see what was up down there, and then make his decision on the treatment? (My insurance covers all my u/s, and medicare covers the visit, so I wouldn't have minded spending the extra mooney for nothing...)

There we have it: my problems that I want to solve, and my proposed ways to address them. (God, I hope I didn't bore you to tears.) Do you guys have any suggestions? Any tips on how to stay calm cool and collected when sticking up for yourself? As always, your input is so greatly appreciated (and desired! and needed!)

Enough rambling! It's Saturday morning and there's work to be done!


decemberbaby said...

To me, problems one and two are pretty much the same problem. Definitely ask about bringing in an alternate doctor while your doc is away... if they won't (or don't) do that, than you either have to accept that you'll have to skip quite a few cycles, or you'll have to switch. Honestly I can't tell you which is better... that's a very personal decision.

As for being assertive... when all else fails, I ask Mr. December to do it. Would Mr. C. step up to the plate for you?

carrie said...

Thanks for the shout-out! I think the way you're approaching the clinic situation makes a lot of sense, given the other info. It really stinks that they don't have back-up for when your doc is on vacation and that they didn't communicate about when he was going to be away. So if you get those questions answered, and express how difficult it was for you to have to miss this month, when you could have easily organized it otherwise, hopefully this stuff won't happen again. I think the fact that you otherwise really like this clinic is really important. It's hard to find docs and clinics that are a good fit, personality and comfort-wise, so I wouldn't be in a rush to give that up either.

Adrienne said...

As with most choices in life, you have to take the bad with the good. In this case, it sounds like there is a lot of good to take into account.

Your plan of action sounds great. And I agree with Decemberbaby. If you're having a hard time being assertive because this is such an emotional issue, can you have Mr. C do it for you?

Flygirl said...

Oh wow. I guess that I found assertiveness to be next to impossible because in Ottawa we have only 1 Fertility Clinic and they have us by the short and curlies so to speak.

I felt that if I complained that I would be screwing myself in the end. We have at least 6 doctors and numerous nurses on hand and still get put off for frustrating reasons.

I wish I knew what to tell you.

Lut C. said...

Sometimes there's little you can do but throw your hands up in the air, and take it in stride.

Samantha said...

I'm probably not the best person to be asking for assertiveness advice, because I frequently have the same problem with my clinic. I go to a big clinic, where they are open 365 days a year, so I don't have the scheduling problem, but no lack of other communication problems. If you are comfortable with your doctor, then you are making the right choice not switching.

Maybe it would be good for you and The C to have a consult with the doctor, or both talk to staff to explain to them how while you really like the clinic, there are some ways in which their communication needs to improve. I think IF clinics forget that patients have other things to work around. And you can't even follow their schedule if they don't tell you what that is!

sariel & shlomit said...

hey girl...
glad you're feeling better about stuff...and you sound very clear-headed!
i'm also happy to hear (again, cos i remember now when you were looking) all the positives of the clinic you're with -- yaaayy!!

as for raising your concerns about communication without sobbing...shit. i don't know. i've been doing lots of crying in front of my RE lately. This stuff is just so friggin' emotional...but i wouldn't worry too much if you start crying...just breathe deeply, take your time and keep going...

or mr. c is up to it -- by all means...maybe one of you can get started and the other can fill in?

good luck! here's hoping you only need to do one more cycle anyway!

Mary Ellen and Steve said...

The vacation thing would definitely be frustrating. It would be great if he could just let everyone know when he was leaving so that you could troubleshoot any potential problems with him before he goes.

It sounds like your clinic is good for you guys in a lot of ways. As frustrating as it is, I agree with Lut. Sometimes you just have to take these things in stride.

Hang in there my dear.

TeamWinks said...

Not bored to tears...

My Reality said...

My RE works out of 2 clinics, his little clinic was where I started. The place is closed for 3 - 4 weeks in July/August and then for another 3 weeks in December. What does this mean when you are cycling? You got stuck on lots of breaks. It sucked really bad. What did I learn from it? I need to go and work in a fertility clinic and I will get 6 weeks vacation a year. And if you got a discount on treatment, that would make it even better!

The big clinic is only closed for 2 weeks in December.

I think if the only thing you hate about your clinic is their time off, then you are lucky. You don't hate the doctor or the staff and you like the treatment you are getting.

If you are able to play with your cycles so that you are able to work around their vacation schedule, then I would demand their vacation calendar until the end of the year.

I hope you can get some answers and hope even more that it won't matter when they are off again because you will have success with your next cycle.

Anonymous said...

Hi! I read your blog often, but have never commented before. I thought I would chime in a bit on the question of clinics. I live in Vermont, but go to a clinic in Montreal. I believe you mentioned the one I go to--the one in a hospital. Anyway, I just wanted to say that I have done two IVF cycles there (one canceled very early, one BFN), and while it is a very large and busy clinic, I have been quite happy with the care. I think any time you have such a large clinic, there's a possibility that you lose some of the personal touch. They may not be as personal as some, but definitely not a bad choice. If you really get fed up with your doctor, I would consider them. Have you ever researched IVM? They do it, and as a PCOS patient, it may be a viable option for you.
Anyway, just thought I'd give you my perspective. Good luck with everything!!
p.s. you were right about the parking, though--it can be a real mess!

Princess Barren said...

Sorry, I'm a zero on the assertiveness factor. I usually just bitch and moan about it, which is where the all-powerful blog comes in handy.
I think you DEFINITELY have some valid points though, and I think you DEFINITELY have the right to raise the questions you have.