More surprises. And confusion.

So the other day, I got my NK cells results and wanted immediately to go see Dra Velez to get an interpretation. Recall that as of my first visit to her, I was still lacking my NK panel results. So, when I got them the other day, I sent her the results via email and texted her to see if I can meet her that day. I quite liked her during our first meeting, so I was hopeful to get the same reception and same level of care. More than that, I was hopeful that my results meant I don't have to deal with NK issues, as they are the mother-fucker of fertility immunology conditions and are SO expensive to hurdle.

Lo and behold, she told me that judging from my results, I would need intralipid infusion therapy, hereby defined as: "Intralipid infusion therapy is a treatment, which is administered through an IV drip in the arm made from soya bean oil, egg yolk, glycerin and water. Intralipid Infusion therapy provides the body with essential fatty acids that help to lower the activity of Natural Killer (NK) cells." I started to worry, first about what this means for our IVF attempts then secondly about what it means financially. Each infusion costs a pretty significant 5-digit figure each time, and from what I know, I'll need several rounds to keep the NK cells from acting up. She said that a certain CD36 level was high, so I needed these treatments to stabilize them. I didn't quite understand. The text was short and didn't really provide enough explanation.

So I texted her back and asked if I could see her. I also called her landline to ask the nurse if I can get squeezed in. At this point, there was a good hour before her appointment schedule was over for the day.

Then I got brushed off - she essentially asked me to ask my LIT doctor about it since she may also perform it anyway. Whuuuut?! Is this because I chose not to get my LIT injections through her clinic, which was charging a good 8-9k MORE than the clinic in Katipunan?! Is this politics at work?! OMG.

Anyhow, I decided to ignore her and made a plan to see a different doctor - Dra Aleta, who held clinic in RAI Center in SLukes. Incidentally, this is also the doctor who gave me the LIT injections and who I think owns the Katipunan blood lab. Her appointment schedule was that same afternoon, so I figured I'll just go to her to get the results explained. I couldn't wait another day before getting the interpretations and the implications.

This is when I started getting really confused. Dra Aleta basically had opposite interpretations and recommendations as Dr Velez, save for the LIT which they both agree I needed. Dra Aleta told me that she is concerned about my TSH (thyroid stimulating hormone) levels because while they are normal for an average adult who is not trying to get pregnant, the levels are also way beyond the maximum of 2.0 that is optimal for those who do want to get pregnant. So she recommended that I took thyroid hormones to lower this level of TSH so I can reach the optimum level before I restart IVF. She also told me I didn't need intralipid infusions because the NK cells level result I have is within range. She also asked me to do 2 more tests, because all the paperwork I showed her still lacked 2 more tests to complete the fertility immunology workup.

I was stumped. How can two doctors say exactly the opposite things when looking at the same sheets of paper!?

I then turned to Dr Google - aka the repository of knowledge when one is stumped and has no one (at least no living, breathing person) to turn to.

So far, my research has supported Dra Aleta's assertions. My TSH level is indeed below fertility-optimal levels. I also read that the NK cells level she was reading seems to be within normal range. So so far, Dr Google affirmed Aleta's reading and not Velez's. I don't know what to make of this.

Even my husband, who is a biology major, is stumped. He doesn't want me taking hormones until the recommendation is validated by a 2nd opinion. So I made an appointment with another immunologist, who is actually my sister-in-law's immunologist, to get his reading on the matter. Hopefully he aligns with Aleta too so that I can move forward with her recommendations, because I am sick of just standing in place! Part of me wants to get moving already with our embryos and start trying again. But the other part does understand that I need to sort out these immunology stuff to better optimize my system to receive my embryos. But waiting sucks! This third doctor, Dr Gloria, is apparently super duper busy and is only available next Wed. Next Wed! A full week from now. A full week wasted. Grrr. The OC in me is not pleased.

But Dennis is adamant that I get his opinion first. So wait is all I can do for now. And research.

Hay.  Waiting sucks. Being confused sucks.

:-S