Wednesday, September 05, 2007

Finding the Right Doctor

Going back through some of the articles I've written over the years, I thought this one might be helpful to some:

Copyright © 2001, Jennifer Saake

"Patient refuses selective reduction." The words jumped off the page at me as I was reviewing some of my old medical records. My mind vividly flashed back to that long-ago day when I was interviewing a new RE ("Reproductive Endocrinologist" or infertility specialist) for the first time.
I had come to his office as a new patient in the sense that I had just moved to this state and needed to re-establish myself with a physician who could handle my infertility care. I was not, however, a "new patient" in the sense of inexperience. We had already been traveling down the long road of infertility for well over five years and had seen eight or nine previous doctors in our quest to build our family beyond the two of us.

As Christians I believe that God calls us to be responsible, informed, and clear about our options and limitations while battling through the jungle maze of infertility treatment. We are taught by society to trust our doctors and not to question that they know best. It is easy to become overwhelmed by the medical issues of reproduction and blinded by our desperation for children to the point where we let our doctors dictate the path first, then only check in with God after the course is set.

After my first referral from my family physician to an OB/GYN whose business card proudly announced his special interest in infertility, I felt great hope that we would soon be pregnant. His initial evaluation was that I simply was not ovulating and his claim was that this was the easiest kind of infertility issue to resolve. With a prescription for the fertility drug Clomid and reassurance that I should easily be pregnant within six months, I left his office very happy. Two years later, after much reading, personal research, and talking with other fertility patients, I finally realized that I had been receiving sub-standard and often inappropriate treatments. It was time for a change!

No doctor is the perfect fit for every patient. There is no law saying that you must stay with the first doctor you find. Give your doctor a fair chance, but if you are not satisfied with your care, let him know and give him a chance to fix things. Ask LOTS of questions and push for detailed answers until you feel you have a full understanding of the issues. Your doctor does not know everything. He is human, with human limitations (cannot read every new medical article published about your specific condition, has bad days, doesn't always do things right the first time) and human emotions of his own (pride, personal opinions of right and wrong, personality conflicts, stresses outside work, etc.).

HSG, HCG, IUI, IVF, post-coital, endometrial biopsy, luteal phase, follicles… The tests, treatments, and terms used can all become so confusing. In trying to understand what all these things mean it is even harder to understand what all the consequences may be! Again, ask questions and do your own research until you really understand what your doctor is talking about. Don't be afraid to bring other tests and treatments to his attention and find out his views on things you are not yet actively dealing with. As you gain a big picture of what your options are and where your treatment may be headed, take it all before God and ask Him for very clear direction. Write down your limits and share them with another couple that will hold you accountable; then you won’t be swayed by the emotions of the moment when your doctor proposes something outside your boundaries.

For my husband and I personally (and I am not saying these are the limits God will give your family, I'm just using our own experiences as an example), we felt convicted early on in our infertility journey that if we were to have a biological child it would need to come from my egg and my husband's sperm and be carried in my body, otherwise we would adopt. If we had to look at donor or surrogate issues, we felt that we would respond to the introduction of a third person in our marriage for the sake of conception as a form of adultery and that it could cause great harm to our marriage. My husband also had a very strong conviction against masturbation, causing much frustration when the issues of sperm collection for tests or insemination were important. We resolved this by having our doctor prescribe a special sterile "fertility condom" or "condom for insemination," allowing us to collect through the act of loving intercourse.

When I was seeing my new RE for that get-established visit and still far from being pregnant, why was my chart marked so prominently with words about refusing abortion of one of more babies in a multiple-birth scenario? It was another limit we were setting. I wanted this doctor to know from the outset that any time one of my eggs and one of my husband's sperm were united in conception, that from that moment on we would consider this our child, a unique person with value and soul. He was firmly instructed from the start to do everything in his power to keep me from getting into a compromising situation of being pregnant with more babies than he felt I could safely carry to term in any given pregnancy. Yes, we wanted children, but not so desperately as to put any of our babies' lives at risk because there were "too many."

It was a long journey, but by seeking God for wisdom with each step, becoming educated about our medical issues and options, setting firm limits within the convictions God gave to our family and persisting until we found the doctor that was right for us, we survived! Appreciating the amount of thought we had put into becoming informed and our honesty in setting strong limits, our doctor went out of his way to help us work for our goal. By God’s grace, within two years of that first consultation we were back in our RE's office to introduce him to our son!

"Consider it pure joy, my brothers, whenever you face trials of many kinds, because you know that the testing of your faith develops perseverance. Perseverance must finish its work so that you may be mature and complete, not lacking anything. If any of you lacks wisdom, he should ask God, who gives generously to all without reproach, and it will be given to him.” (James 1:2-5)