A Dr. KK Update

     Welp, I finally had my follow-up telephone consult with Dr. Kwak-Kim. It's not that I waited long, it's just that I'm impatient. All-in-all, the follow-up went really well!

      It's a bit difficult to understand her at times due to her accent, and the fact that we were communicating over the phone. She also didn't really explain things well. It was a bit difficult to follow along with what she was explaining, and particularly, to understand what lab values of mine were off or normal. My only real complaint was that she didn't seem to know me from a hole in the wall as she was speaking to me...I could hear papers rustling as she was speaking to me, so I kind of got the impression that she was viewing my results for the first time as she mentioned to me I should have a thyroid scan done, but I did have one done at her office, but she didn't see the notes until I pointed it out. Also, whenever their was an elevated value, she didn't quantify it, so I don't know how "off" it was. To be fair, I didn't ask.

    First things first, my TSH came back at 2.66. This has been pretty consistent over the last year, except for a reading I just had in December where it was 1.25. None of my REs have been concerned with it, but she would prefer it to be under 2, so she prescribed 25mcg of Synthroid daily.

    Second, and what I already knew, blood flow to my uterus isn't great, so she prescribed lovenox injections for transfer. We have planned for a freeze-all for this IVF in anticipation of this, so I'll begin taking it at some point before that. However, a curve ball was thrown...I need to fly back to Chicago for another ultrasound to see if my blood flow has improved once I start taking it. It makes sense, but damn, I wasn't anticipating that.

    Finally, she said my T Helper Cells were elevated, I think. She may have been referring to my Th1/Th2 Cytokine Ratio or they may all be the same thing. I can't tell and this is where I got the most confused during our conversation. She's prescribing Prednisone to begin a few weeks before my next stim cycle. I'm actually already in my next stim cycle, but Dr. Wang already prescribed me Prednisone for my high normal Th1/Th2 so I started that when I began my protocol as well instead of having started it a few weeks ago like KK would have preferred.

   She did mention that if the Prednisone didn't work, I would have to do IVIG, but I'm pretty sure that is where we draw the line. It's super expensive, and even if it is covered by insurance, I don't know that I'm comfortable with using a blood product if it isn't absolutely required. In any event, she's running it through my insurance because coverage, if applicable, can take a while.

   Mostly, I'm overwhelmed with the amount of blood work required. I have to go back in two weeks to re-do my TSH and see if my Synthroid needs to be altered, as well as my free insulin level (which was normal, but she said it was higher than it should be for my age...so, maybe that's because of the 20lbs I've gained, or my crazy sweet tooth..) and two weeks after that.

    My plan is to e-mail her NP to explain that I'm stimming already so they know where I am in the process and can  view my lab results with that in mind. When I wind up having my FET, I'll follow her protocol fully. It's overwhelming adding a third provider to the mix, but I'm happy we went this route and can add a few more things to my protocol and hopefully find some success.