Sunday, December 05, 2004

Missed it by...that much

Or, A Lament on Medical Receptionists

I am sitting near our bathroom, waiting. Inside, my husband is trying to ejaculate into a feminine hygiene product. And I ask myself, How did I get here? This is not my beautiful home; this is not my beautiful IUI.


Ah, sweet December. Yearned-for, anticipated December. Shiny wrapping, tiny lights, cheery shops stocked with beautiful gifts, the smell of blue spruce, my first IUI.

Or not.

Dr. Action and I started off with a bang: after waiting a few short weeks for my first appointment back at the end of October, I went in with trepidation and the certainty that she would not want to move as quickly as I. But then she sent me home that first day with slips for five tests, no hesitation, and the words I'd been longing to hear: "Unless we find something specific in the tests, I'd suggest moving on to IUI right away."

No, “Give it a few more cycles,” or, “It can take a while for some couples.” No patronizing questions about whether I was charting correctly or whether I had tried propping my ass up on pillows after intercourse. She just cut right to the chase: What you've been doing hasn't worked yet, you've been at it a long time, therefore it probably won't, so let's try something else. A simple IUI to start--no meds, no trigger shot. In and out of the office in half an hour.

Which was exactly what I wanted: seemed like just the thing for us since I ovulate predictably, my tubes are clear, my uterus looks good and my hormone levels are normal but my cervical fluid is absolute crap, while for J, there’s the sub-par morphology, and the pre-IUI sperm wash can help weed out the mutants.

Excited, we rushed out and completed four of the five tests--everything but the Day 21 blood draw--within the first nine days of seeing the doctor: Day 3 bloodwork, semen analysis, trans-vag and pelvic ultrasounds, HSG. I had optimistically thought that we might get to do the IUI straight away after my first tests came back OK, but Dr. Action wanted to wait for J. to see a urologist about the poor morphology. This, naturally, ruled out a November IUI as he couldn't get an appointment immediately. However, he found a doctor quickly--I'll call him Dr. Weinerschnitzel--and I figured, great, there's plenty of time for J. to go in, do whatever might be needed and be ready to go for December.

J. dutifully submitted to the various urine, blood and semen tests that Dr. W. recommended and got his follow-up appointment scheduled with enough time before my expected ovulation to keep us on track for this month. Perfect!, I thought, so long as I don't have an extra-short luteal phase this cycle or an early ovulation next, we'll be in great shape. My LP cooperated beautifully, clocking in at fifteen days. I was feeling just certain that everything would work out.

Though the results of J.'s bloodwork left a little something to be desired (low FSH level in a fully-grown and fully-functioning man is apparently an oddity, and Dr. W. said it "might have something to do with his brain,[?]" but J. was too unconcerned to get details). The morphology problem was confirmed with a second SA, and Dr. W. said we should definitely proceed with IUI right away. That it was our best bet, short of IVF.

So, armed with the confirmation, I called up Dr. Action's office on Thursday morning, as soon as J. had returned from Dr. W., and asked to speak with her. I was told by the Unsmiling Receptionist that Dr. Action couldn't take my call right then but I could leave a message. If I really wanted. So, I did, a very, very specific message including the fact that I needed to speak with her the same day as I would be ovulating soon and wanted to make the arrangements post haste. The U.R. took it all down and even repeated the gist of it back to me before I hung up.

I waited eagerly for Dr. Action's call, cradling my cell in my lap to make sure I didn't miss it. Hours passed. I held myself back from calling again (don't want to aggravate the front office staff--wouldn't want to sound too desperate, right?). Afternoon arrived. I broke down and called again and, much to my shock and horror, reached the utterly unhelpful after-hours answering service. They did not know why they were getting the calls already, as they usually start rolling over at six p.m. Regardless, they couldn't help me, said maybe the practice had just closed early.

Not yet quite panicking, I figured, well, I'll try again first thing in the morning. Maybe she won't be with a patient yet and I can catch her live instead of leaving another message.

So, at 8:00 a.m., I call. I again reach U.R., with whom I had of course spoken at length just the day before. I asked to speak with Dr. Action. And am told by U.R. that she is 1) not in, 2) not expected in, and 3) is, in fact, on vacation until December 13. Stunned and confused, I ask which doctor is covering for her. I am told that nobody is covering.

Since “nobody” covering for one doctor in a practice of seven seems improbable, or even impossible, I ask if she's sure. U.R. says that she was "pretty sure." I ask her to check. She puts me on hold. She cross-connects me to another patient on hold. We are then disconnected. I call back. Am put on hold again.

After holding for eight or ten minutes, U.R. comes back on the line and asks why I am holding. I remind her that she is supposed to be checking to see if someone is handling Dr. Action’s patients. She says, yeah, fine, puts me back on hold. A few minutes later, she says that I need to speak to the Nurse Practitioner. I say I’d love to. U.R. says she’s with a patient and, with unbecoming reluctance, takes a message.

Now truly panicked, I charge up my cell and leave the house for mandatory Christmas shopping. Turn ringer all the way up, just in case. Hours go by. I have moved from panicked to angry. And not having any luck with shopping. Bugger.

Finally, while in distant Concord at the depressing J.C. Penney buying my brother the gift card he asked for “because he likes their nice clothes,” the phone rings. Very, very loudly. So loudly, in fact, that it scares me and I drop the phone on the counter, and it bounces to the floor. Luckily, I pick it up in time. It is now 3:27 p.m. on Friday. I answer. It is the N.P., whom I will henceforward refer to as Nurse Nice.

Nurse Nice is all eager to help, and is, in fact, the one who handles all IUI’s for the group anyway, so she’s clearly the person I should have been speaking with from the get-go. Since I’m still clinging to a few wisps of my infertile dignity, I do not wish to discuss the details of my husband’s abnormal sperm and my lack of cervical goo in front of a cashier and several middle-aged J.C. Penney customers in holiday sweaters. I head for the door just as the cashier completes the transaction and almost leave both the gift card and my Visa behind. Don’t care, as I have Nurse Nice on the phone.

She listens as I explain the situation, tells me exactly what to expect, and advises me to call her—on her direct line!—as soon as the OPK is positive so we can schedule the wash and IUI for the following morning. Thrilling! Yes! Wahooooo! We're on!

As I’m saying my thank-yous and goodbyes, she says, “Oh, one little thing—I’m assuming this is already taken care of—your husband has had his STD panel, right?”

Hunh? Wha? STD screening? What the fuck?

“No,” I say, “I know he’s had all kinds of bloodwork but it didn’t include STD screening. He certainly doesn’t have any STD’s though, and as we’ve been monogamous for nearly eight years and I had a few tests done myself recently…”

“I’m so sorry, but it’s a California law. We can’t perform IUI’s without the partner being tested fully for HIV, Hep B, Hep C…”

Ohgodohgodohgod. No. Noooooo! Why didn't anyone mention this sooner? Why didn't Dr. Action say something to me, and for the love of christ, why didn't J.'s urologist say something to him? Why?

But, Nurse Nice, she has a plan: dash to the office, she’ll give us a slip for the lab downstairs which closes at 4:30. So we race westward, get stuck in traffic at the Caldecott Tunnel, break through on the other side, scream down surface streets and unsafe speeds, find an unbelievable parking space and get there just in the nick of time. Whew! All good. Wahoo and all that.

Jeff gives his blood, we’re walking out, and the lab clerk says, quite casually, “Your results should be ready by Tuesday afternoon.”

Tuesday? Seriously? No! I might ovulate before then! Is there any way to speed it up? No. There isn't. That’s how long it takes.

So, we go home and I start searching the internet for any way to delay ovulation. Any old wives’ tale, any marginally-legal product, anything. And, as you may have guessed, I got a whole lotta nuthin.

But I was still hopeful. I mean, all my body has to do is hold out till after CD 14 for ovulation. I've ovulated as late as CD 18 in the past, so CD 15 or 16 or 17 isn't all that much to ask, right? Right?


OPK+ today at 1:30. It’s only Sunday. It’s only CD 12. Fuck.

To make matters even better, my brother-in-law is here, in our house. Our teensy, tiny house. He’s in the basement for half an hour, but he’s still in our house. You can hear every creak and groan of the floorboards from the basement, and when you're in the second bedroom, there might as well not even be walls. There is absolutely, positively no way for us to have sex with him here, and if we don't have sex tonight, then there's no hope for the cycle at all, even the slimmest glimmer, because J. will be gone with said brother-in-law from 5:00 a.m. till late afternoon tomorrow.

Which is why J.’s in the bathroom, shower blaring, attempting to spooge into an Instead Softcup. Which I will then, by dint of some as-yet-incomprehensible contortion, manage to insert into my cooch. Without spilling.

Like that’s going to work.

Since I need someone to blame right now, I have chosen to blame the receptionist. If she had put me in touch with Nurse Nice when I called the first time, we could have done the bloodwork Thursday and had the results Friday. I would be having an IUI tomorrow morning. I would have more than a tiny, grimy glimmer of hope this cycle. Fucker.


Blogger Janet said...

I kept reading, unable to take a breath from the anticipation of what I thought of course would be a happy ending to this all.
What a frustrating turn of events. I say we string up the bitch receptionist and torture her withing an inch of her life.

Here's hoping to that the Instead cup become the golden chalis of fertility. I am convinced that they are seriously missing the mark on how they advertise. I became very, very familiar with those myself.

Best wishes and good luck, fingers crossed.

12:39 AM  
Blogger Stacy said...

How frustrating. I hate receptionists at any doctors office. I assume one of the hiring conditions is that they be surley, evil, and incompetent.

So sorry your going through this. I hope the cups work.

1:37 AM  
Blogger Miss W said...

So sorry you had to deal with all of that. Not quite understanding why Dr. Action didn't know to tell you about the STD scrren way back...but at the very least, if the Instead cups don't do it for you, you're ready to start the new year out with a bang (or an iui).

5:14 AM  
Blogger Dee said...

I agree with Stacy when it comes to hiring RE receptionists. Apparently, they must be complete morons with the equivalent of swiss cheese for brains. So sorry you had to deal with this on top of everything else. I'm hoping the cup is the charm and that a pleasant surprise will be yours come (just before) Christmas time.

5:52 AM  
Blogger JJ said...

I know just how you feel! Where do they find these people?

Best of luck with the cup, we know it works...

9:43 AM  
Blogger Sheri said...

That just bites! So sorry.

1:36 PM  
Blogger Sarah said...

I'll continue your lament "my god, how did I get here?" and then marvel at how well that song captures the state of many of our affairs so well. Brilliant and annoyingly stuck in my noggin.

So, first, cheers to Dr. Action. It absolutely sucks that this cycle is how this cycle is...but I must give you props for original use of a feminine product. And just think of the endorsement deals you'll get if it works.

Here's hoping it does!

11:44 PM  
Blogger Kath said...

I hate medical receptionists too. Unfortuantly they stand in between us and our Dr and we have to suck ass to get past. Bitches.

7:46 PM  
Anonymous Anonymous said...

Oh, Janet, how I love that "golden chalice of fertility" line. Priceless. And I applaud you for your ability to successfully use INSTEAD cups; I think my first try was my last, though who knows what desperation will bring me to next month?

Sarah, wish it was my own novel idea, but I copped it from some nice ladies on a chat board one day. No royalties for me, I'm afraid...especially after my latest post.

Everyone, do you think we could maybe develop a sensitivity training program for medical receptionists and get it mandated by law before they answer their first call? The first lesson could be, "Your job is to help people."

9:44 PM  

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