Friday, September 4, 2009

in which the misfit actually ATTENDS a scheduled doctor's app

First of all, I have to note that Dr. L (whom I sometimes refer to as Dr. C, which seems to me to make more sense if the other fellow is Dr. B, but moving on) is an absolute angel. I think the nurses at Tepeyac are going to have my number BLOCKED on their caller ID at some point, because I call a LOT and I am pretty much always a pain in the @$$. Speaking of which, that's something I probably need to work on.

Anyway, I begged for her to call me (but added that she couldn't call me Thursday because I couldn't answer the phone, given work stuff. I don't want to be so demanding - no, really. I know I'm pretty demanding in general - but I just knew she would call and I would see the number, sitting in training unable to leave, and I would have a Rage Episode. I have had several of these with regard to missed calls from Tepeyac, because if you call them back THAT SECOND they DO NOT ANSWER and I have used up my LIFETME ALLOTMENT OF PATIENCE on FOUR YEARS OF INFERTILITY and I just can't deal with it. I feel like maybe they have a referral relationship with some local shrinks and they're trying to drum up business, because I am seriously in danger of busting a vein). She very, very generously called Friday, and allayed my fears that, despite my many clarifications, Tepeyac is secretly planning to schedule me ONLY for a laparoscopy and telling me when I wake up that they're scheduling the laparotomy for a month from then, so that I can quit my job to make time for surgery and have the joy of being unemployed AND childless. (I note that I recognize the value of voluntary unemployment. As long as I have this much law school debt, however, I will be employed until or unless I have children.) Anyway, she was super-sweet and explained that they will, indeed, do the laparotomy at the same time, which is all I wanted. Now I'm happy, and it was so nice of her to confirm this with me. I get that the nurses can do it, but they kept giving me contradictory information, and I thought my head might explode.

So anyway, the appointment I actually attended was yesterday, with an endocrinologist (NOT an RE) at VHC. They take all my blood, and I like them, so I went there. I was initially VERY apprehensive when the doc walked in and she looked about my age or possibly younger, but then I did the math and realized that she just looks young - she's somewhere close to ten years older than I am. Also, she obviously totally knew her way around a thyroid, so I felt much better. She explained that their goal as a practice is to get women who are trying to get pregnant to under 3 for a TSH level (I know I've heard lower from other people - how low??) and suggested some things. For the benefit of others, the details: there's synthroid (scientific name levothyroxin), and then four generics of it on the market. Though the dosage is technically the same for each (50mcg, for me), each has a slightly different formulation, and if you change types, it can affect the amount your body is absorbing. But you can't request a particular one of the generics - the pharmacist uses whatever he has on hand, which could change from refill to refill. If you use the synthroid, though, it will always be the same. So I'll switch to that. Then, she said, if you're trying to get pregnant, they see you at six weeks, then five-ish, then four-ish, to make sure that your dose is exactly right, and your levels are exactly consistent. After they've achieved that, you come in every couple of months "until" you call them and say you're pregnant - then they see you within the week, and every two weeks thereafter, to get you to the right pregnancy dosage (apparently the pregnant body needs more thyroid). I didn't tell her that the word she wants is "unless," because she seemed so sweet and positive. I don't want to burst your bubble, lady. Sure, everyone can get pregnant if they just seek treatment responsibly! And there are rainbows and unicorns greeting patients in your scary parking garage. Whatev.

Anyway, I decided I like her (after another rage episode walking around the parking lot for 25 minutes trying to find her office after they changed locations FOUR DAYS before my appointment and never told me, but I am not going into that now), and I am happy that her attitude is all close monitoring and precision. Let's have something in this whole defective mess that can be measured exactly and corrected with scientific precision. Awesome. Also, I still feel lethargic a lot, so I wonder whether my current dose is too low. The other possibility is that it has nothing to do with hypothyroidism and I am just depressed, but I don't wat to see a therapist right now (I can't understand why I would be depressed. Infertility, yes, but why now? Especially when I feel like I'm addressing it better than at least I usually do), though I've been meaning to email Fr. Paul to recommend a spiritual director for a month or so. And I definitely am not adding psychiatric medication to the delightful cocktail of treatment I'm currently enjoying.

So this post was supposed to be lighthearted and informative because I was all proud of showing up to my appointment and maybe making a sliver more progress. But I sound kind of pissy, huh? Like I said, I need to work on that.


  1. I got knocked up (with drugs and IUI) when my TSH was around 2.3-2.5. However, there are some endocrinologists out there who feel a TSH of 1-2 is ideal. And here's another wacky thing: My TSH improved (i.e. went down) throughout my pregnancy, though my dose remained the same. That is not typical, but just thought you'd find it interesting.

    Anyhoo, there might not be one big thing that's making it hard to get pregnant. It could be a bunch of little ones, and between the surgery, the thyroid treatment, etc, you could reach that tipping point...

    Not meaning to call in the happy unicorns and smiling elves, but just saying.

  2. I think you've got the right to feel the way you feel. No unicorns and rainbows in this particular garage! ;)

  3. 1-2 for TSH. I LOVE synthroid, I take the brand and feel AMAZING. Waiting for appointments just add to the waiting for a pg...can make you crazy. I know.