Always, Katie: Big Exciting Medical Update


Wednesday, December 18, 2013

Big Exciting Medical Update

During my little unintentional blogcation, I had THREE doctor's appointments that just filled me with giddy, bouncy relief :-)


Since my RE, Dr. G., thinks we're pretty close to being ready to start on IVF, he referred me to a maternal-fetal medicine specialist (MFM), who happens to be another Dr. G.  He wanted her to be familiar with our case and my history so she would be ready to jump in the minute I have a bun in the oven.  Our agenda was basically to figure out which of my doctors would be handling which part of my care (which I know sounds funny, but there is some overlap in the specialties)... we really liked the dietician (which is shocking - most of the ones I've seen have annoyed the daylights out of me) and LOVED the doctor!  

The most complicated (but probably most typical) plan would have been for Dr. G, the RE to do our IVF and monitor me for the first trimester before handing me off to my regular ob/gyn and the MFM who would kind of co-manage the rest of the pregancy, with the MFM taking the lead right up until delivery, which would be handled by the ob/gyn. In the meantime, between bouncing back and forth from the MFM and ob/gyn, I would also be having frequent appointments with the endocrinologist to keep my insulin pump settings fine-tuned.  That's a lotta docs.  But it turns out, the MFM is totally comfortable managing my diabetes (which is fairly common, but not what the RE made us think would happen at first)... and I'm not even her first type 1 with IVF!!  So, for 9ish months, I will get to skip the endo's office.  WooHoo!  But then the even awesomer news is... she is one of the very, very rare MFMs who ALSO DELIVERS HER PATIENTS' BABIES!!  So I can also avoid the redundant appointments with my general ob/gyn! 

THE ENDOCRINOLOGIST (aka... the doc diabetics dread).

I saw my new endocrinologist, Dr. K., for a one-month follow-up from my first appointment.  He downloaded the information from my insulin pump and was pretty pleased with what he saw.  He made some minor adjustments and was ready to send me on my way when he asked if I had any more questions.  I hesitantly asked if we could do another hemaglobin A1C test (A1C).  I told him I knew it was a three-month average, and that my previous laissez-faire management would still be reflected, but that I thought that if I could see it come down just a little bit, it might be the motivation I needed to keep pushing myself.  He kind of smiled indulgently and had the MA stick my finger for a test.

He came back in the exam room about five minutes later holding a sheet of paper and scowling at it.  He asked what I was hoping for, and I answered "7.8" which would have been a .5 reduction from the A1C of just a month ago, and .1 lower than my all-time record low.  His scowl started to crack and I realized he was pretty excited about my news when he said, "Well, it's not quite a 7.8... how about 6.8?"

Then I started crying and he told me not to dehydrate on him.  :-)  We had a fun little moment of celebrating in the office, and he gave Ethan and me the all-clear to get pregnant. I think he was shocked, but genuinely very, very happy for us. :-) Which is nice... it's nice to have a doctor who seems to be rooting for you.


My RE wanted to do an ultrasound to get a better look at the large cyst that was seen during my CT scan and HSG, before deciding on a surgery plan.  It turned out to have been a functional cyst that resolved on its own, and there were no others in the vicinity of my tubes.  Some of my hormones had come down just a little bit, too... enough that he didn't see any reason to rush into surgery.  So my tubes can stay where they are, and my ovaries can remain undrilled!  It's kind of silly... one of the (smaller) reasons I'm excited about this is that drilled ovaries are really, really ugly.  And I KNOW nobody would ever know the difference, but... somehow it still would've been sad and really scary to have parts of my ovaries destroyed! Plus, we're saving the time, cost, pain, and risk of surgery... wooHOO!!  

So... that's my medical update from the last couple of months, I think.  All in all, super-encouraging!!  With these couple of hurdles out of the way, IVF is now just a matter of scheduling and finances! :-)
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