We had our first telephone consult with the infamous Dr. Braverman today. And it went… okay.
We waited 40 minutes past our appointment time. And despite being told that I had to complete his 14-page questionnaire, he had neither received it (I was told it went directly to him for privacy reasons) nor read it. If I had not known this doctor practiced in NY, I would have been annoyed by this point. Instead, the LP and I just exchanged eye rolls at opportune moments during the teleconference and at one point I wrote down “NYer” on my notepad and the LP nodded and rolled his eyes.
At the end of the call he had promised to transfer us to someone who would confirm that the person who collects the blood samples for the immunological testing is in his lab next week Thursday for our appointment. Instead, he hung up hastily after saying he needed to take another call. Oops. No big deal, I called back and confirmed (for a second time) that all was in place. I’ve read many complaints about the staff at this clinic but so far apart from a long wait to have my initial calls returned, the staff I’ve dealt with have been very helpful and mostly attentive.
The jury is still out on Dr. Braverman, but I went into this knowing I do not need to like this man, I just need to see if I can trust him. Unlike many of the wonderful women I have encountered online who are [now pregnant or with living children despite immune issues and RPL histories not unlike my own] patients or former patients of Dr. B, I cannot say I am in love. At least not yet. I am skeptical that I ever will be. I think the cynicism that came from having defended doctors when they got into legal troubles and from being onto our third reproductive specialist, 100% out-of-pocket, in 18 months might make me a “tough customer” as the kids on Arthur would say (I never watched that show before I had the MT, who has it downloaded on an iPad… yes, I let my toddler watch tv shows on an iPad. Sue me.).
Enough mockery and negativity. On to what was said.
First, Dr. B. thinks I have “an implantation problem” (not because he read the 14 pages of history that it took me two and a half hours to complete, but because I can now, in my vast experience yapping with specialists, narrow the essential evidence down to a very short synopsis and some key facts). Okay, I mean it this time, enough negativity about him being completely unprepared to talk with us today.
Second, Dr. B does not think much of the high IgE levels other than to say I may have hyper-IgE syndrome which involves an excessive histamine release, which can lead to implantation problems. He agreed when I said it’s hard to know whether there is a causal connection or a correlation. He said that women need some histamine to permit implantation but too much can be a problem. Unfortunately, there is no way to test for histamine (???). He also said we can use stronger drugs than steroids (???). He kind of meandered after this and mentioned two types of immune issues, being TH2 or antibody-based and TH1 or cellular-based, and suggested that hyper-IgE would suggest the former.
Third, he affirmed my decision not to do any more embryo transfers until we have a diagnosis. In his view without a diagnosis you’re basically guessing and cannot make a meaningful prognosis or effective plan (my words, not his).
I’m not sure that is true for anyone who does not have some kind of immune issue happening. I don’t even know if my issues are immunological or just look that way, by which I mean I’m not sure which is the chicken and which is the egg or if they are apples and oranges and just seem to both look like pears at the moment. I’m not sure I’m convinced that all of the immunological testing he will have us do is of real value. But I am doing it. One foot in front of the other. There is something to be learned here and learning is what Azulito has sent me forth to do. So do it I shall.
Fourth, the plan is to do all of the testing he prescribes, plan a protocol, do my next FET at his clinic and hope for a positive outcome. If that happens the next plan is either for me to find an ObGyn in my city who will work with me to have monitoring and/or prescribing done (that, I can safely say, is not going to be easy and may prove impossible) or for me to return to New York at 6 weeks and 10 weeks so he can do my monitoring and prescribe me meds accordingly (New York state law requires patients be physically present for Dr. B. to write them scripts).
So much for my retirement plan. Oh yeah, what retirement plan?
Finally, I asked about what blood tests I might ask my doctor to do here. He suggested fasting glucose, fasting insulin and hemoglobin C. In addition to that my TCM/Acupuncturist suggested I ask my doctor to test my liver enzyme levels (ALT and CRP) and Parasite testing. As an aside, she also suggested I consider stopping the Singulair. I did. No more dizziness – yay! It wasn’t doing anything as far as I could tell anyway and never did last time I was prescribed it, either.
All in all, I do not care if the LP and I are not enamoured with Dr. Braverman as many other patients are. And I am sure he would not give it a nanosecond’s thought (nor should he). If he can help us get and stay pregnant, I will pledge allegiance. And say only nice things. I promise.
Okay, I may still make the odd crack about him being very much a New Yorker. Who can resist? (I apologize to all of you New Yorkers, some of whom I am deeply fond. I say all of this affectionately, as does the LP. You can poke fun at me in return. Go on, ask me to say “about” and then snicker at how you think it sounds as though I am talking about a small sea vessel.)