The Blood Test Drama

Well I never did write the post that was to be my rant against the Ontario health care system on Friday, or yesterday. Instead, I ran out of time, and out of steam. I’ll try to do a quick summary of the ordeal that getting my pregnancy test results was, and then I’ll move on.

In case, there’s any doubt, my negative pregnancy result was confirmed via bloodwork. I got the confirmation on Friday, but it was quite the production.

When I had my transfer, my clinic had warned me that the lab in Ontario may not accept the requisition they wrote for the pregnancy test, in which case I would have to go to a walk-in clinic to get a requisition from a Dr. here. Sure enought, that ended up being the case, so after going to the lab, I went to the closest walk-in clinic, got the requisition and figured it would be smooth sailing from there. Wrong!

I had written on the requisition that test results should be copied to my RE (in my old province). However, the woman in the lab told me that they couldn’t send results to my Dr., as they were only authorized to send results to Dr.s in Ontario. It would be up to the Dr. here to forward my results on, but she warned me that it was totally up to his discretion, and that he may not do it! I was absolutely shocked at this. I understand that the lab has rules they have to play by, but for a Dr. to withhold test results from the medical professional who had ordered them in the first place (simply because they practiced in another province) seemed unfathomable to me.

But, it got worse. I was then told that results would not be available for 24 hours, and therefore I would have to wait another day for confirmation. I was once again shocked, as I was used to same day results, and had never considered I may not get them here. I was in Canada’s largest city, getting routine bloodwork done minutes away from the largest concentration of hospitals and medical facilities in Canada (and I’m sure sure one of the largest in North America), and I had to wait 24 hours for my results?? Meanwhile, I just wanted to get closure on this cycle so I could start to move on and plan next steps.

I was so upset by all this that I started tearing up as the lab tech was taking my blood. She noticed I was upset, which somehow made it worse, and I ended up flat out bawling. She saw how upset I was, and said that I could call the clinic to see if they would provide a new requisition that was marked “urgent”, in which case the results would be ready in three hours.

I considered this, but decided that at this point I needed the path of least resistance, and so would just wait until tomorrow for my results (especially as I didn’t think I would be able to get two words out to the clinic without crying). However, the lab tech somehow convinced me to call, promising that the receptionist at the clinic would be able to help me, and I wouldn’t have to drag myself in to see the Dr. again.

I called the clinic, and ended up speaking to the Dr. who informed me that they do not do “urgent” requests for pregnancy blood test results unless it’s a suspected ectopic as it would unnecessarily tie up resources. I told him fair enough, but the reason I was requesting it was because I was used to same day results in my old province and that the lab tech had suggested I request an “urgent” rating in order to get that. The Dr. finally relented and said that while he couldn’t code my requisition “urgent”, he could do an “ASAP”, in which case results may be ready earlier.

I then asked if he would send the hard copy results to my RE for his file, and the Dr. here said he wouldn’t (again, something about wasting resources). I was flabbergasted, but stayed calm and explained that my RE would require written confirmation of the test results over and above my verbal confirmation that the cycle was negative, and how would I go about making sure he got that confirmation?

The answer to this was that I would have to go back into the clinic on Saturday to get a copy of my results, which I could then fax to my Dr. myself. Again, this was incredibly frustrating. Not only would this be another painful step for me, and take up my time, it also meant that other patients with legitimate medical concerns would have to wait while the clinic served me again.

The Dr. ended up speaking to the lab tech directly, and when she hung up, she assured me I would have results that day. I was not convinced, but called the clinic just before they closed and got my confirmation. I dragged myself back to the clinic on Saturday, asked reception for a copy of my test results, was told they weren’t signed off by a Dr. yet, so I would have to see a Dr. before I got them. I then waited half an hour in the overflowing waiting room to see a Dr. for one minute so he could sign off on the results and give me a copy. I then went to a Grand and Toy down the street and faxed the results to my clinic.

Finally, over 24 hours after first going to the lab for bloodwork, my fertility clinic had the results.

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Peeling Back a (Small) Layer of Anonymity

I am back from my pregnancy blood test, and may or may not get results today. That said, the results are just a formality, as I already know what they will say. I took my last pregnancy test today just to confirm the earlier negative results. I am 11 days post a 5 day transfer, so even with late implantation, etc. if I had a viable pregnancy, my First Response Early Response pregnancy test would show a positive.

So I am expecting a flat out negative, but based on my previous chemical pregnancy where my beta hcg was only 11 (or too low to be picked up by a home pregnancy test) I realize there is also the possibility that my bloodwork could show a low positive.

Don’t get me wrong, I’m not holding out “hope”. When I had my chemical pregnancy, I did a ton of reading about starting out with really low hcg levels, and saw there was virtually no chance that starting out that low would result in a viable pregnancy. While I came across enough stories about “low” betas resulting in healthy, bouncing babies 9 months later, they were betas in the 20’s or 30’s, which of course my home pregnancy test would have picked up this morning.

The only reason I mention the possibility of a low positive scenario, is to provide context for why I am anxious to have the pregnancy results today; so I can officially get closure on this cycle, and know how it ends – whether it’s the likely BFN (Big Fat Negative), or the less likely, but still possible chemical pregnancy scenario. I want to know what my “stats” are, as I start to plan next steps and make a list of questions I will ask the Dr. at my follow up consult next week.

Assuming I still have the emotional energy, I am planning on writing my next post about the complete nightmare that the simple act of getting my blood drawn this morning ended up being. But in order to do that, I need to provide some additional context, which will be very difficult to provide if I continue with cloaked references to my “old city” and “new city”.

When I started this blog, I was very careful to leave out any details that would reveal my identity if someone who knew me happened to stumble across it. It was (and still is) very important to me that I could write what I want about who I want on here, and be comfortable sharing things I wouldn’t share in person with people I know, without worrying about someone I know reading it and connecting the dots.

So aside from the obvious things like not including my real name on this blog, or posting pictures of myself, I have taken the less obvious steps of connecting this blog with its own email address, instead of the one I normally use, and not even revealing where in Canada I lived. 

I really don’t get enough internet traffic to warrant this level of paranoia, but  it made me feel good knowing I had multiple layers of security in place to keep me safe from prying eyes. That said, having recently moved from a smaller city, to a bigger city, I had already been considering at least sharing where it is I now live, as millions of other people live here too, so I no longer feel like sharing that information would really reveal anything personal about me, and it’s easier to just share where I am instead of constantly saying “new city” or “where I live” etc. etc.

While many would argue that the place I moved from is large enough that sharing that location would likewise not be any sort of big reveal, over the years that I lived there, I experienced too many strange connections/coincidences to give me comfort that I could remain anonymous if I shared where it was. Despite being one of Canada’s major (or at the very least semi-major) cities, over and over again I came across situations which proved to me how small and tight social circles there could be. In many ways it felt like a much smaller town than the population would suggest.

Here is just a small sample of what I mean (this post has ended up ridiculously long – feel free to read only a few of the below coincidences):

1. Shortly after moving there, I started to cultivate a friendship with one of my coworkers. When we discussed where I live, it turned out that her husband’s ex-wife lived in the same 8 unit complex as us (2 doors down, I believe).

2. Around the same time, my husband connected online with someone who was putting together a band and looking for people to jam with. Soon enough, we found out that one of the singers in the 8 person band worked at my work (not the same office as me, but the other office in town). To make it more strange, just the week before I had bid on (and won) a United Way raffle item at my work which she had submitted, for 3 personal training sessions with her.

3. After buying our house, we were telling a friend (actually one of the band members referenced above) about the place we bought and how the old owners had moved to Belize. His wife perked up, and we soon made the connection that she worked with the woman we bought the house from until she moved away.

4. On another occasion, a friend of a friend was driving me home after a party, and when she pulled up at my house, she said “I’ve been here before.” After a few minutes of discussion, we confirmed that she also knew the old owners of our house.

5. Several years later, I was now working at a new job. The office was really small, with just three of us, and me and the guy I worked for were looking for someone to replace the third person as she was going on maternity leave. We hired a keen summer student as a temporary replacement, and when he found out where I used to work when I first moved, he asked if I knew his cousin who also worked there. It turns out I knew here quite well, as his cousin was the friend mentioned in point 1 above.

6. When we went away on sabbatical two years ago, we put our house up for rent. One of the people interested was a yoga instructor. When she showed up to see the house, we immediately recognized each other as she had just subbed in that week for a class I was taking at the new yoga studio I was trying out. She and her friend ended up signing a lease, but due to a last minute change in her friend’s circumstances, had to back out.

7. We ended up renting our house to three other people. One of the roommates was our main contact, however when we met the other two roommates, we discovered that we had another yoga instructor on our hands. This girl taught at the main yoga clinic that I attended, and I’d done many classes with her, so again she recognized me right away.

8. When we sold our house in June, we had another series of coincidences. My husband was trimming the plants at the back of our yard, and chatting with our neighbour in the yard behind us, when the neighbour told us that he met the guy who’d bought our house. Turns out they were at a stag party for a mutual friend, and ended up going back to our neighbour’s place after the party, where the new owner realized he was staring into his new backyard.

9. Several weeks later, we were talking to the girl who bought our place, and she mentioned off hand that her best friend was familiar with our house. She was telling her friend about the place she’d just purchased, and her friend started finishing her sentences. Turns out her best friend is the yoga instructor who almost rented our house when we went away (see point 6 above).

10. And if you’re not sick of the yoga references yet (hmm….perhaps the issue wasn’t where I lived, perhaps it was the fact that I did yoga 🙂 ), after buying our new house, we realized that we would have nowhere to put our hutch/china cabinet, so we listed it on Craigslist. We started getting requests for more information coming in, but nobody seemed interested anymore when we followed up. And then my husband got a hit from someone who wanted to come see the hutch in person. He forwarded the email to me, and I recognized it right away as my fertility yoga instructor’s. (And in case you’re wondering, for good karma, we ended up flat out giving it to her instead of charging her anything for it).

So if you’ve stuck with this post so far, hopefully you’ll appreciate that I’m not some nut for not wanting to reveal where I used to live! However, I am comfortable with sharing that as of last week, I live in Toronto, Canada’s largest city.

Pregnant: 2 weeks down, 38 to go

Today I am PUPO, which for the uninitiated means pregnant-until-proven-otherwise. Due to the quirkiness with how pregnancy is measured (i.e. measurement starts from the first day of your most recent period, rather than from ovulation), I am also two weeks pregnant.

What health class neglected to tell us (or if it did, most of us were not paying attention), is that not only are there just a few days each month when a woman can conceive; if she is in fact pregnant, she has to wait up to two weeks to find out. In this age of instant gratification, this feels like a ridiculously long time to wait for something, especially news as life-altering as a pregnancy. Therefore, for those trying to conceive, there is a window of approximately two weeks each month, when your part is done, but you do not know whether you are pregnant.

While a sperm needs to fertilize the egg within 24 to 48 hours of ovulation in order for pregnancy to be possible, the fertilized egg takes about 5 days to travel down the fallopian tube and into the uterus, where it can implant (implantation occurs 6 to 12 days after ovulation). Only once it implants, does it start to secrete the pregnancy hormone hcg, which is what is picked up by pregnancy tests.  While home pregnancy tests are getting more and more sensitive, and able to detect hcg in urine sooner than ever, given the mechanics of what happens when an egg gets fertilized, it’s impossible to cut the wait down any further. So we’re stuck waiting.

Many people find the two-week wait (as it’s commonly referred to) excruciating and painfully slow, however I’ve actually come to enjoy it over the last year.  When we first started trying for a baby, I was like most other people in that I couldn’t wait to find out whether things had worked or not, and took a pregnancy test the first possible chance I could. Of course, the test would always be negative, at which point the real mind games started.

The most sensitive pregnancy tests can detect hcg in your urine 5 days before your period is due. However, due to the  uncertainty around when the embryo implants, and therefore when it actually starts to secrete hcg, you may have had a successful cycle, yet testing early will still show a negative result. For example, the pregnancy test I use most often has stats something like this: detects 67% of pregnancies 4 days early, 78% 3 days early, 87% 2 days early, and 98% the day before your period is due. This means that today’s negative could be  tomorrow’s positive result. So you take another test the following day, and again it’s negative, but it is still early after all, and so on and so forth. After a few months on this rollercoaster, I found it was easier (not to mention cheaper!) just to wait things out until my period came. Then, for a long time, since I didn’t really expect things to work anyways, the two-week wait stopped having any meaning for me.

However in 2010, I discovered my love of the two-week wait while going through six intrauterine inseminations (IUI’s). Starting fertility treatments was difficult as it stemmed from a realization that we would need help to conceive, but it also brought back hope that pregnancy was possible. This time, I treasured those two weeks between the IUI and my pregnancy test date because until proven otherwise, I was pregnant. My last IUI was in December, however I am still recovering from the hangover of the possibilities that a two-week wait brings, so will embrace it and milk being PUPO for all it’s worth!