Tuesday, June 22, 2010

Getting a Second Opinion: It's Not Cheating

So, you've been on your infertility journey for a while under the care of an RE; you've tried a little of this and a little of that, and even received some "baby dust" virtually sprinkled by your friends... and still nothing to show for all this time you've spent agonizing over whether this month is finally your month. Well, it might be time to get a second opinion. A fresh pair of eyes on your case may just be what you've needed all along.

My fellow blogger The 2 Week Wait decided to "grab June by the balls" (her words!) and seek out a second opinion (she was supposed to be "on a break" from trying to conceive, but of course, there's never such a thing when you're dealing with IF). She expressed to me how she was a little hesitant about getting this second opinion as she had a nice rapport with her current doctor and felt that consulting with another RE would feel like cheating on her first. I could certainly relate to that feeling. After almost 2 years and more cycles than I could count on both hands, I had finally decided that it was time to get a second opinion at another highly respected clinic. (For ease of understanding, I'll call the first clinic/RE "A," and the second clinic/RE "B.") It took me a while to muster the courage to call, make an appointment and ask for a copy of my records. After timidly phoning my RE's assistant (praying that I won't have to confession the reason behind my request) and signing a waver for the release of my records, I was finally ready to make the jump.

It's always difficult to get an appointment, but if you can manage to coordinate the dates, try to get in before your next period starts, so that should RE "B" decide to run some Day3 blood work or do a minor surgery (Hystero or HSG) to cover all the bases, you won't have missed the window and waisted yet another month.

Armed with pages and pages of my long history of fruitless cycles, DH and I waited amongst the sea of other childless couples at Clinic B. After so many cycles at Clinic A, I knew the drill, but here, I was back to being a newbie -- suddenly unable to anticipate my next move or take comfort in the faces of the nurses whom I had gotten to know on a first name basis. Finally, we were ushered into the office of RE "B," which made the cheating-on-RE-A feeling that much more tangible. After some initial small talk, we got down to business: RE "B" reviewed my records, made some notes, followed by a few indiscernible sounds (Was he approving or disapproving of my prior protocols), he finally shared his thoughts...

REs, like all doctors, have very big egos. They take pride in their expertise and knowledge (as they should), so more than likely, RE "B" will have a few criticisms of your past protocols (you were triggered too late," "too much stims," etc.) But in the end, you will either leave this new place with a new and improved conception action plan or simply find yourselves back in the arms of your first RE (A one time use of the magic wand shouldn't count as cheating. After all, there were no feelings involved) . In the interest of keeping hope alive, I think it's somehow more desirable to hear RE "B" tell you how RE "A" messed up (either missed something or didn't follow the right protocol) than to hear that you're on the right track and "it's only a matter of time."

To the detriment of your emotional and physical state, having gone through a few cycles in another clinic could actually be a good thing when you're trying to move forward with a new RE -- your response to earlier protocols allows RE "B" to have a better picture of your medical history and possibly devise a more successful protocol. And perhaps, even if RE "B" doesn't have a revolutionary approach, sometimes you just need a change of scenery. Month after month of disappointments at Clinic A has probably left you with some PTSD. You may need a clean slate, a new start, heck, maybe you're just tired of getting calls from the same apologetic nurses ("I'm sorry, your Beta Hcg was negative.").

On your quest to finding your new RE, the same rules apply as your initial search. Find someone who is highly reputable and don't be shy to ask all of your questions. But having cycled a few times somewhere else, you now have the advantage of being more knowledgable about your situation, so with a little research you might find a clinic that has a strong success rate for your specific issue (i.e., high FSH, MFI, PCOS, etc.).

Most importantly, when it's time to finally break up with RE "A" don't feel guilty. Sure, you've gotten to know each other and you've probably looked up to him/her as your personal fertility-god. When we finally had our "What-The-Fuck?!" meeting with RE "A" before we decided to move on, I was heartbroken to discover that our special relationship wasn't that special at all. That I really was just "another patient." I walked in there expecting to softly break up with RE "A" only to leave his office feeling like I had been the one to get dumped. Should you not feel the need to face RE "A" then don't feel guilty to quietly walk away -- just slip out of the surgical chair, close the door behind you and no need to leave a Post-it note saying "Goodbye." This is the business of making babies. No one is doing this out of the kindness of their heart. You and your dreams come first so give yourself the freedom to play the field until you find doctor-right and not doctor-right-now. 


the2weekwait said...

Great (and important) post! You, my friend, were definitely part of the reason I decided to get a second opinion and I'm so glad I did. In retrospect, I don't know how I let emotions get in the way of something that makes all the sense in the world. I urge EVERYONE to get 2nd, 3rd, 4th opinions if they feel like it's needed. Thanks again. -- Jay

A City Girl in the Burbs said...

I am SO glad you posted on this issue- we were with our "RE A" for a year. After a surgery & three cycles- with some changes in the dosages of medication and nothing in the protocol- I started losing faith. And when the talk about donor eggs surfaced, that's when I knew it was time to shop around. I felt just as guilty as changing hair stylists, but when I started looking at the bigger picture- and even now- just as the2weekwait said, I realized that you should not let emotions get in your way. And, I am so glad that I reached out to "RE B"!
With all that said, I consider myself extremely lucky to have a very supportive friend, a true listener who guided me along the way. Thank you! I needed that extra "push" to make that call to "RE A" to get my records. (I think I almost talked in a whisper on the phone!!)

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