Sunday, December 16, 2012

Can I get a PRL STAT?


The fact that I want a baby is not a secret.  If you talked to me around the time that my best friend gave birth to the most perfect little boy in the entire world, then you know I want a baby.  If you have read my previous blog posts about how excited we all were to be welcoming baby Bella or how bitter I was about my younger sister and her growing family, then you know I want a baby.  If you follow me on Pinterest... well, then it's embarrassing just how much you know that I want a baby. I am already a homebody.  I am just ready to settle down and spend my time planning for a baby, my baby, the start of my family with Brandon.  I want to pick out a nursery theme (ok fine – you got me – I have had one picked-out since I knew that one day I would get to be pregnant and have a baby and be a mom... so since I was like 10), I want to read baby books and parenting books and obsessively go through and baby proof my house and re-baby proof my house after Hank destroys all of my hard work.  

Given where I work, I have plenty of time to think about it and dwell on it and over-analyze every cycle, every weird pain, every weird thing, every day late period, every three day late period, every nine day late period, and every negative pregnancy test - and I have taken and gotten plenty of negative pregnancy tests.

Something we do at Shady Grove Fertility (and really, OB-GYN offices will do them too so we’re not a beautiful and unique snowflake when it comes to this) is day three blood work.  On the third day of a patient’s cycle we test the estrodiol (e2) levels, follicle stimulating hormone (FSH) levels, thyroid stimulating hormone (TSH) levels, luteinizing hormone (LH) levels and prolactin (PRL) levels.  (I know, that last sentence really made me sound smart, it's just the hormones).  This information, hopefully, lets us know that the woman in question is producing the hormones at normal levels.  If, let’s say, a patient’s FSH level is high, that means she may have a diminished ovarian reserve – a possible hello to early menopause or even poor quality eggs.  If maybe her TSH is high, then there may be an underlying issue with the thyroid.  For several months, I had played with the idea of having day three blood work done.  It’s a quick way to find out maybe why I am not getting pregnant. I talked to my co-workers about it, I talked to my family about it, I talked to the physicians I work with about it, I talked to my OB-GYN about it, I talked to my dogs about it. I talked about this with just about anyone who would listen.  Finally – I got the nerve to say “screw it – might as well find out”.

So I asked if I could have lab slip for the blood work and on a lovely fall Saturday I went to the LabCorp location near our house to have blood work done and then I waited. I waited and waited and waited.  I logged into my LabCorp account for work from home and obsessively checked for results.  I checked all afternoon on Saturday, all day on Sunday and then Monday at work – I checked some more.  Finally, I just called LabCorp and said that I was calling from the physician’s office looking for results.  What? A girl has got to do, what a girl has got to do.  LabCorp faxed over my results and everything looked good – except my prolactin level was high.  The range for prolactin levels that we want to see is between 4.8 – 23.3.  My prolactin level was 36.1. 

I immediately ran up to the stairs to the fourth floor to Dr. Levy’s office.  I paced and waited for him to finish his meeting.  I stalked Dr. O’Brien in the OR hoping maybe I could catch her between cases and she could read my results.  I went back and forth, from outside the OR to outside Dr. Levy’s office.  I patiently stood outside the door to the office of the newest SG physician, Dr. Doyle, but decided I didn't want to scare him with my insanity and went back to pacing outside Dr. Levy's office.  This girl needed answers.  Finally, I got bold and just called Dr. Levy and interrupted his meeting.  What? I was desperate.  He was happy I did it.  He said things looked good and I had a great FSH level, but I needed to repeat the prolactin blood work, but this time, I needed to fast.  Seriously? I only had two cookies before I went to have the blood work drawn the first time.  Ok fine – I will fast before the next blood draw.

The following day, a Tuesday, I repeated the blood work.  This time I was smart.  I wrote the order to be done STAT.  Take that LabCorp, this girl was not going to pace and worry all day like a lunatic.  Around lunchtime I got the results back.  It was definitely not what I was hoping for.  My prolactin level was higher – 39.9.  Bingo my friends – we now had a possible explanation of why I haven’t been able to get pregnant: elevated prolactin levels.  Hallelujah! …Now what? 

Now... now, this girl needs to have an MRI done of her brain and Team Wilkinson needs to sit down with Dr. Michael Levy.