Friday, (In)Fertility, Finallys...

• I had a full FP clinic Friday morning (yay! No dinkas!)-- my first patient showed up late, but I was running around from that point on. Since my last patient left around 11:15, the nurses even asked me if I could see another one, to which I responded, "Sure, why not?" I like patients and clinic a lot :). I really just need to get faster, though-- I was finishing up my notes well after I got home Friday evening!
• That half-day, I got to do some well woman exams as well as some routine medical exams.... on 19-22 year-old males. I could only talk one of them into getting (from me) a testicular and hernia exam... I will have to keep working on my persuasiveness in this department :)
• Friday afternoon, I was again working with Dr. W (the most adorable Asian man ever!) in the infertility clinic, which I find really fascinating. We see some complicated stuff. Actually yesterday, some of his exact words to me were, "After doing this for so long, honestly, it amazes me that people actually do get pregnant and have children." There are just so many things that need to come together, not only before pregnancy, but in maintaining it. I would actually really like to do fertility treatments in my practice someday, which Dr. W said is definitely possible. Among the patients I have seen and things I have learned recently:
• A 30-year old woman who stopped the pill in the hopes of starting to try to conceive with her husband but who does not have cycles. Despite a normal BMI, the consensus is that she likely has "hypothalamic" and exericse-induced anovluation and that, unless she gained some weight, she would be unlikely to get pregnant. I completely sympathized with her pain as she walked away saying, "So what happens if I gain some weight and still have this problem? Then I will be fat, have no periods, and still not be pregnant."
• A 40-year old woman who had been trying to conceive for about 8 years. She had pretty significant uterine fibroids requiring uterine artery embolization, as well as extensive endometriosis (with a history of umbilical bleeding, terrible pain, as well as sanguinous pleural effusions developing during her menses causing shortness of breath). She and her husband have to weigh the options of trying to pursue fertility treatments (which, at her age, don't have a good success rate), or, because of her condition, consider a hysterectomy. Yikes.
• A woman with an elevated prolactin, likely causing a luteal phase defect with low progesterone that is likely responsible for her infertility. She was referred for MRI to rule out a pituitary adenoma and was nervous about possibly having a "brain tumor" (although pituitary lesions act altogether differently and adenomas, particularly microadenomas, are generally quite easily treated).
• A couple in whom the male had about the lowest sperm count ("rare," not even quantifyable or analyzable) you could have in a sample. Short of a miracle, there is really no possible way that that couple could create a biological child and would have to instead investigate seeking out male donors, which I've learned is not that uncommon. Apparently you can pick all kinds of characteristics out, including blood type, height, eye color, etc., to decide on an anonymous donor (who has to go through rigorous screening to start with).
• Dr. Wei explained that egg-freezing will never be a viable option (i.e. for women a bit slow to hit the marriage/child-bearing wagon, doing career stuff, etc.). It just doesn't work. Dang.

Okay, enough of that.

• I finally got my license plates for my car!
• I finally cooked a meal (Laura's famous caribbean-jerk wraps... does that count?). This was a big accomplishment for me. In fact, I'm currently cooking my second meal -- a veggie/pasta dish Laura also sent me the recipe for (I'm relying on her completely to motivate me :)) for a bbq tonight at Kate's.
• Kyla is finally back in town and tonight I will finally meet her boyfriend, Ben, who is moving here to work at Kaiser.
• I finally invited a friend over to my apartment! Amy, one of my FP classmates, was the first guest. We watched Blood Diamond yesterday evening and enjoyed some Yellowtail wine:).
• Finances: Spent some time this morning getting all my bills in order, setting up autopays, etc. While I don't like "managing/investing" stuff, I don't mind making spreadsheets, balancing checkbooks, and those little things. I'm thinking about downloading this program called Quicken, but I'm still on the fence whether I should fork over money so that I can manage things. Maybe I'll just do it the old-fashioned way. Thank you so far to everyone for the financial tips, esp. Tony "the advisor" who called me this morning--I surely need them! :)
• Forgetfulness: My upstairs neighbor, Banafsheh, knocked on my door yesterday evening to tell me that my keys, hanging on their cord, caribeaner, and all, were in the lock outside my door. Duh. I guess I'd forgotten to remove them as I was busy wheeling my bike into my living room :) Anyway, I hadn't gotten to the point where I needed them to go anywhere, so it could have been a while before I realized they were missing! The sad thing is that this was not very surprising to me. I have done this tons of times in the last few years, at various dwelling-places.
• Finished: A Thousand Splendid Suns. While I didn't like it as much as I did Kite Runner, it was thoughtful, moving, and very well-written.
• Frisbee 'fraidiness (okay, fear, whatever-- but I like making up words): This morning, I ventured out to Curtis Park, where there reportedly is pick-up Ultimate on Saturdays. I hung out reading for a bit since I didn't see anyone else there yet, but then when a few guys showed up who looked very athletic and serious, I chickened out and left to go grocery shopping. How lame is that?! I think I need to bring a buddy with me next time for moral support :).
• Future fear: I work tomorrow on L&D and am afraid it will take me like 3 hours to round on postpartum patients I don't know, so I'm thinking of going in around 5 a.m. That might be extreme though. I hope I dodge the discharge frustration I experienced last call.