Saturday, September 18, 2004

great expectations

I don't know why I was so disappointed when I got the phone call from my husband yesterday afternoon to report on his visit to the urologist. I suppose that in my mind, I had built up the importance of this consult. Believed that the new uro would provide us with answers, clarity, direction.

He did none of that. If anything, we're more confused than ever and are ready to pack it in at our clinic in DC and head up to Cornell to meet with the microdissection guru there.

I wasn't there, of course, but based on what my husband told me- the new uro was anything but helpful. My husband had to wait an hour to see him. And when he finally got into to Dr. Blecch's office, Blecch asked him "So, what can I do for you?" Apparently, our RE hadn't sent over any of our information. Luckily, my husband was armed with all of our medical records and test results.

My husband explained the problem, got a brief exam. Was told that he has his vas deferens (phew!) and that his testicles are normal sized (not often the case with non-obstructive azoospermic men), and that his varicocele is pretty large. Blecch recommended the biopsy, said it was a simple procedure, and that we he couldn't predict how to proceed until we got the results. That's fair, but when my husband asked about hypothetical situations: what if it's sertoli cell only? what if its maturation arrest? will you do microdissection? Dr. Blecch was only willing to say that we'd have to wait and see. Oh, and that if it's sertoli cell only, there'd only be a 15% chance of finding sperm through microdissection and he'd recommend going with donor sperm.


Now I know that a 15% chance of finding sperm is low. But I'll be damned if I give up on having my husband's biological child that easily. I can see trying the surgery and hoping that they find something, but in case they don't having donor sperm on-hand as back-up. But I can't see throwing in the towel if there's any chance at all that they might find something. Maybe I'm being irrational and naive, but its how I feel at the moment. At this point, I'm willing to try anything to have my husband's biological child. Anything.

There's a recommended three month wait between surgeries which means that if my husband has his biopsy in November (the earliest possible time for him because of work stuff), we'd be looking at an IVF start date of February or March. And that's if the biopsy results give us any hope at all. Otherwise, it'd be IUI with donor sperm. A possibility I've thought about in the past, but the more it becomes a potential reality, the more I hate to imagine it.

The thing is, Dr. Blecch really didn't tell my husband anything that we didn't already know, hadn't already read. My husband's biggest problem with him (and mine by proxy) was that he was so hurried, didn't want to answer the long list of questions that my husband had brought with him, snapped at my husband when he asked for clarification on one point.

My in-laws called from China last night to find out how the consult had gone and I told them what happened. My father-in-law told me that that's how uros are. "They're surgeons, not doctors," he said. When I reported that back to my husband this morning on the phone, he told me that a doctor friend he'd had dinner with last night had told him the same thing. I'm not sure exactly what it means, but I think we shouldn't expect any hand-holding from Dr. Blecch. That is, if we decide to stay with him at all.

So, we have some decisions to make. Do we leave Dr. Hope and Dr. Blecch behind for the Cornell doc of my fantasies? Do we stick with Blecch's treatment plan? Do we have the biopsy here in Mexico or up in the States? Do we ask Dr. Hope to recommend another uro that works with his practice and hope that the newest uro has a slightly less prickly bedside manner?

I pondered these questions last night over a bottle of wine and a half-pack of cigarettes. (obviously, I'm feeling over my cold). And I didn't come up with anything useful. As is often the case in life- every scenario has its pros and its cons. Every option has its limits.

I know we're not exactly back to square one, but it feels like it in a way. I should never have let myself believe that Dr. Blecch would have the answers to my prayers. I should never have pinned so much hope on one meeting with a doctor. I've learned my lesson. My expectations have fallen. Hard.


Blogger amanda said...

I'm so sorry that the new Dr. didn't live up to your expectations. It's so hard when you're trying to find "the" answer.

A couple of things from our experience. My husband's urologist was an awesome surgeon and an awesome dr. He answered every one of my insane questions. Not all surgeons are pricks. Also, my husband only had to wait 2 months between surgeries. It might be different in your husband's case- I don't know.

I'm sorry this new doctor ended up bringing more questions to the table than answers. Good luck in deciding the next step. It's so hard.

Oh, and I don't think you're naive at all for wanting to try everything possible. Just keep at it. I know that with your determination, you'll find the answers that you're searching for one way or another.

8:48 AM  
Blogger la gringa said...

thanks amanda. the more i think about it, and the more i read about cornell, the more i think its the best option for us. i can't believe that ALL surgeons are assholes and i want my docs to be the kind of people who take time with us and make us feel like real people, not just numbers for their stats. i'm glad to know that your uro was one of those.

8:53 AM  
Blogger Indigo Wolf said...

I don't know if this is even in your realm of possibilty, but what if you got a second opinion? It's always difficutl dealing with doctors who don't want to be forthcoming with information. Ideally a doctor will tell honestly all of your options based on the avaialble information without just saying let's wait and see. Some doctors can be pompous asses but some will tell you what they kow in the best way they can. You're better off with a docotor like that if you can find one.

11:56 PM  

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