Remember at my first ultrasound they recommended I come back for another scan in ten days? Well, that was yesterday, and as promised, there was much more to see this time: not just a gestational sac and tiny circular yolk sac, but an actual, vaguely baby-shaped embryo whose flickering heartbeat was clearly visible. Yesterday’s fetal heart rate was a very respectable 152 bpm, and the embryo’s measurements were exactly where they should be for his/her gestational age (7 weeks, 1 day). All in all, the doctor was full of enthusiasm and sent us away feeling good, which in and of itself was kind of miraculous, given our rocky history with Dartmouth-Hitchcock’s reproductive endocrinology clinic.
Let me begin to explain that history by comparing and contrasting our experience yesterday with our previous experiences with early pregnancy sonograms at DHMC. First, yesterday’s doctor, Dr. Reindollar, was not our usual doctor. Usually, we see Dr. Porter. Or rather, I should say, usually we don’t see Dr. Porter, but nurses and other hospital staff let us know that she is keeping tabs on our case by telling us oh-so-encouraging things like, “Dr. Porter doesn’t mind if you switch from Clomid to Femara, but she doesn’t see the point.” (See my previous post on that subject, here.) Over the course of two years of fertility treatments and the conception of two babies, we’ve seen Dr. Porter in person three times: 1) She did a consult with us before Penelope began IVF; 2) She performed Penelope’s second IVF-transfer (she was on vacation during her first IVF cycle); and 3) She popped in to oversee my first ultrasound last month. On all three occasions, she spoke only to the patient, barely acknowledging the wife, and ducked in and out of the room as fast as she possibly could.
Penelope and I bitterly call Dr. Porter “Negative Nancy,” because she has a way of making even good news seem dire. She has a sort of pinched expression that comes across as judge-y, and a cagey, I-don’t-make-promises-I-can’t-keep style of studied noncommittal-ness — (I made up that word and don’t particularly like it: if you have a better suggestion, please leave a comment) — that means that even when she says something innocuous, like “Congratulations,” after my first ultrasound, what the patient hears is: “Yes, you’re pregnant now, but don’t get used to it: you’ll probably screw it up.”
By contrast, yesterday when Dr. Reindollar came into the ultrasound room, he walked right up to us, smiled in greeting (and the smile reached his eyes!), shook our hands and introduced himself to both of us, and said to me, “We spoke on the phone a few months ago,” — (about a genetic testing issue having to do with the donor sperm) — which I had totally forgotten. I don’t think I’ve ever in my life had a medical professional remember me when I did not remember him or her. How refreshing!He asked about my pregnancy symptoms so far and narrated the ultrasound. Afterwards, he had us meet him in a consult room down the hall, where he told us that at this point, I have a better than 90% chance of carrying this baby to term (yay!), but also told me that he was a little bit concerned that my thyroid might be under-active, since my bloodwork in January 2010 and in March 2012 had both showed my TSH (thyroid stimulating hormone) levels to be on the very high edge of the normal range. (This was the first I’d heard of this, even though they’d had these results since January 2010!) He ordered another round of bloodwork to check my TSH levels again, and assured us that if there is a problem, it can easily be treated through medication, and I will probably get some relief for my fatigue and find it easier in future to manage my weight. As we were waiting downstairs at the blood lab, Penelope and I marveled at what a difference bedside manner makes. Dr. Reindollar had told us about this potential medical issue in a way that gave us information, a plan for treatment, and which allayed our fears about how this thyroid condition (if it exists) will impact the pregnancy. We are sure that if Negative Nancy had been the doc on call for today’s ultrasound, she would have left us feeling like the sky was falling. It is ironic that our very last appointment with DHMC’s Reproductive Endocrinology clinic — (because as of yesterday, I am cleared to pursue ordinary prenatal care with our family practitioner, and because, dollars-to-donuts, this will be our last baby) — was by far our most positive. Our trying-to-conceive journey there, for both babies, has been fraught with bad and worse interactions with the treatment providers: poor guidance about timing of ovulation that made us waste many, many IUI cycles; several medication mistakes; inability to schedule diagnostic tests which forced us to miss cycles; questions answered with misinformation or at least incomplete information; providing the wrong sized needles for Penelope’s IVF-medication injections, which led to weeks of unnecessary pain and bruising; a series of truly nightmarish early ultrasounds during Penelope’s pregnancy with Hank (I am still too emotional at the memory to be able to do that story justice in the telling, but I gave a thumbnail sketch of it here); inadequate information-sharing between DHMC and Penelope’s prenatal care doc that literally endangered Penelope’s and Hank’s lives during her pregnancy and delivery; and so many other, pettier headaches at almost every visit. I am jealous of friends and Sister-Wives in bigger cities who have their pick of RE clinics, because if it were not the only game in town, we would never have gone back to DHMC after our first few months of trying, and we would certainly never recommend it to friends trying to conceive. But it is the only game in town, and Dr. Reindollar, who is new there, might be its redemption. -C.