The Infertility Process

The Perinatal Diabetic Clinic

Because of my PCOS, insulin resistance and my poor eating habits (fine! I said it), I had to be referred to the Perinatal Diabetic Clinic (PDC) so they could follow my blood sugars during fertility treatments (and possible pregnancies).  The nurse at the fertility clinic told me over the phone that I had this referral pending and to expect a call.

I don’t remember how long it took but I eventually got a call from a medical assistant in the PDC telling me that I needed to attend a class so I scheduled it for the soonest possible date. I show up and the room is FULL of pregnant women – most of them look well into their third trimester.  For those who haven’t experienced the fear of not being able to get pregnant, it may not be obvious that there is a problem so let me explain. Putting a person who is having trouble getting pregnant (even if it’s only been 6-12 months) in a room FULL of nothing but pregnant women is cruel. It’s like someone saying to you, “You need to go to this class because you’re overweight and the room is full of women who are a size 2.”  Bottom line, it sucked and I felt like shit.

The class starts and the instructor states we will need to change our diet which was totally understandable.  She goes over healthy choices and things to avoid. All great reminders. But, then she talked about having to eat every 2-3 hours.  And I’m thinking, “Huh?” For the non-nurses, there are shifts where I don’t have time to pee much less eat so I’m wondering how this is going to work.  But, it has to, so I figure I will work it out.

Next, a nurse comes in and starts telling us about our glucometer – the home machine that checks blood sugars.  And now, I was like, “Wait just one second – I’m doing what now?” Just imagine being in a room full of strangers (pregnant strangers) and being told for the very first time you will have to completely change your life: checking blood sugars 8 times a day, keep a tracker of all blood sugars, keep a tracker of all meals and snacks, and change your diet.  I WAS FURIOUS!!!

Maybe because I am a nurse so I have higher expectations of medical care or maybe I don’t like to be told sucky news in front of strangers but it was information that should’ve been shared in a private setting – I would’ve settled for over the phone (Hell! I would’ve preferred a generic, templated email that I could’ve read in the comfort of my own home).

When the instructor asked if we had any questions, I asked if I could get help figuring out what to do when I transition from days to nights or nights to days.  I was told, “You’ll figure it out.” Uh, ok.

So, I went home angry and frustrated but I focused on the task at hand.  I made a schedule of what my life would be like when I was up during the day, when I was working at night and the days I transitioned.  Andrew and I planned meals and snacks. I made charts (no pie charts because I didn’t need reminders of pie), calendars, used post-it notes, searched recipes…

Then it came down to implementation.  Have you ever tried eating every 2-3 hours?  Here I was trying not to think about food because what I really wanted was a cheeseburger, fries and a beer but I was forced to think about it CONSTANTLY.  What am I going to eat for breakfast, lunch, dinner and my 3 snacks? This was tricky because I also happen to be somewhat of a picky eater (I didn’t think I was until it came time to meal prep).  Are they healthy meals and do they have the right amount of protein and carbohydrates? And by the time I was done eating, I was thinking about when I would have my next snack or meal. To top it all off, I had to time all my sugar checks in my day.

I know at this point I sound whiny.  I get it. You may be thinking that diabetics have to do this all the time.  But remember, I’m not a diabetic. I didn’t have high enough blood sugars for a prediabetic diagnosis.  Anyways…

I was doing ok in the process until I started sending in my blood sugars.  This nurse called me (we will call her Jody) a couple weeks in and told me in a very exasperated tone there were sugars missing on some days.  I explained that those were the days I transitioned from days to nights or vice versa. She still was not happy about it and I further explained I was told to “figure it out”, that’s the best I could come up with, and that if she could come up with a better solution, by all means, let me know.  She huffed, puffed and made feel like crap some more and she finally agreed to let it go (but with a “I need to try harder”}.

Over the next couple of months, I had little critiques.  I guess they got used to me missing some sugars here and there. Then, Jody stuck again.

It was time for a new cycle to start and I needed approval sent from the PDC office over to the infertility clinic to proceed.  I sent in my previous week’s tracker in on a Friday morning expecting a clearance in a couple of hours (like usual) – I needed it by that afternoon so they could schedule my ultrasound on Monday which was the last day they could do it.  The approval didn’t come. I get a call from Jody saying I would need to get a fasting glucose and HgbA1C drawn before they approved it. Oh, and all the PDC doctors have left for the day so there was no one to order the labs. SOOOOOO, she was telling me that I couldn’t go ahead with my treatment that month because they didn’t order the labs in a timely fashion.  To make matters worse, she was unbelievably rude (if I had heard a coworker speak to a patient or family member the way Jody spoke to me, I would have written them up). She kept saying it wasn’t her fault and there was nothing she could do….which I later found out to be untrue.

My first trip to member services: I went. I cried. I somehow got out through the tears what was going on.  They assigned a caseworker. Not much, if anything, was done.

After almost a year of this mess, we decided to take a break from fertility treatments – I believe 2ish months.  During this time, I decided to not be so diligent in checking my sugars or sending in my trackers but when I finally let them know we would start up again, I spoke with a nurse (not Jody) who came up with a different plan.  The plan consisted of me being able to check sugars on the days I wasn’t transitioning to or from being a vampire BUT I would have to submit at least 4 days a week. Also, she cut the checks from 8 down to 4 times a day. Maybe it’s silly of me to assume this but I thought she would’ve put our little pact in my chart somewhere where it was easy to see….but, nope.

I start sending in my trackers and all was well at first.  Then guess what? Jody gets a hold of my trackers and calls me.  She tells me what a piss poor job I am doing and she can’t see how anybody had been approving me to proceed with cycles.  I try to explain the situation but she kept interrupting me, huffing and saying things like “na-huh” (because that’s what professional nurses say).  By the time I hung up, I was again in tears.

I again went to member services but I also called the manager of the department.  I explained the situation and all she could come up with was, “I’ve never heard a complaint about Jody.”  Well, what I heard was “no one has ever complained about Jody (because we hold your cycles hostage so everyone is too afraid to complain) so I am not going to believe your complaint.”

I was so furious and frustrated.  They didn’t support me at all even when I asked for help. And this Jody chick was completely unprofessional and ill-mannered – a total disgrace to the nursing profession.

Shortly after that incident, we changed course and went the in vitro fertilization (IVF) route.  The nicest part about that transition…no Perinatal Diabetic Clinic.

(Just for some validation: I’ve spoken with several people who have had to use the PDC either for fertility treatment approvals or during pregnancy and not one person said they were happy with the service for one reason or another.)

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