Background check

I thought it might be appropriate, since I spend so much time obsessing over my mental health, to make sure my body is sound before I get too far into this project.  My therapist seemed to think the same thing, as she suggested at our first meeting that I get my hormone levels checked, to make sure that my decreased libido didn’t have some undetected physical cause (other than my scapegoat, Mirena).  And since work is pretty much paying us to get physicals anyway, I went.

I elected to see a nurse practitioner, since I find them to be easier to talk to, less stressed/busy, and generally more human than actual doctors.  And while no one can compare to my NP in Seattle, who was quick to prescribe both massage therapy and sleeping pills along with my anti-depressants, the new one did not disappoint me.  After her assistant had sort of bumbled her way through taking my height, weight, blood pressure, and medical history – and I say “bumbled” because, moments after asking about my past surgeries and writing down “D&C,” she asked, “No miscarriages or abortions?” – the NP came into the room and lighted immediately on the book I had sitting on top of my pile of clothes.  I’d been debating between bringing Middlesex by Jeffrey Eugenides, which I’d just borrowed from a coworker, and Broken Open: How Difficult Times Can Help Us Grow by Elizabeth Lesser, which had been recommended to me by a friend for the purpose of this project; I’d settled on the latter.

“You’ll have to excuse me for a moment,” she said, picking it up and studying the back cover.  “I’m not a big self-help-book person like my sister is, but I’m pretty broken, and I feel like I might want to read this.”

We went through the rituals of a physical/pelvic exam, and I got a chance to ask her some of my questions about my post-traumatic, post-pregnancy body.  In her estimation, she said, the problems with my sex drive aren’t IUD-related.  And they probably aren’t hormone-related either, although she would give me the tests I was requesting.  Which means, and we left this part unsaid, that they are psycho-somatic problems, my damaged mind taking out its aggressions on my healthy body. 

“Your weight and energy are consistent?” she asked.

“Consistent, yes.”  I’d like a little more of each, please.  “I know I’m underweight.  People point it out to me all the time, but…”

“But it is what it is,” she said, waving away the concerns of these nameless people.  In other words, it’s the body I’ve got, and it seems to be working just fine, end of story.

That was a few days ago.  This morning, she called to tell me my labs were all normal.  Blood pressure: normal.  Cholesterol: normal.  Triglycerides: normal.  Glucose: normal.  Hormones…  normal? 

Forget that this means my therapist and I now officially have our work cut out for us.  “So I don’t have PCOS anymore?” I asked.

“I didn’t say that.  In order to find that out, we’d have to ultrasound your ovaries, to see if there’s a bunch of little cysts growing on them.”

“Okay, but last time I had my hormones tested a few years ago, the doctor said I was a classic case for PCOS.  The last time I had an ovarian ultrasound, I was 18.  I don’t remember what they did or didn’t see.”

“Which hormones were they looking at that they could come to that conclusion?”  She seemed genuinely taken aback.  “Your estrogen and progesterone levels will be different depending on where you are in your cycle.”

“Oh.  I don’t cycle.”  But I left it.

What I should have said:  “Can we ultrasound my ovaries?”

What I should have said:  “Will you take out my IUD?”

But I said neither of these things.  The first seemed crazy and paranoid – like, why are we looking into the causes of my infertility now, if I’m not even planning to have kids for another few years, and we haven’t even taken the time to see whether I’m infertile in the first place?*  And the second…  To be honest, I didn’t even think of it until I was out of the office, parked at my complex, and walking up to the front door of my apartment.  Which I guess is a sign of strength.

*I’m not infertile, and I know it.  PCOS can make it hard for a woman to get pregnant, but I’ve never heard (or believed, even in my most delirious crazy-person moments) that it makes it impossible.  Also, I’ve successfully gotten pregnant once, which is a pretty good nod toward fertility, even if the pregnancy didn’t stick.

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