All Napro Doctors are NOT Alike-slightly Updated

I struggled thinking about this post.  I want a happy ending.  Then I decided that maybe this post would launch discussion and that your comments would help complete the picture.  I am genuinely interested in your thoughts.

I often recommend that folks chart using the CrMS and take advantage of Naprotechnology.  I believe in the methods with all my heart-for those who are Catholic and those who aren't.  For those who struggle with IF and those that don't.  I put my stamp of approval on it.  Some people have asked my opinion and respected it enough to learn to chart and seek out a medical consultant.  On some level I am so happy about this.  But at some extent, I cringe because for those that really could benefit most from it, my advice often leads them to the same place.  Omaha.  And sometimes Omaha, though the best possible option, isn't an option at all.  It can be expensive, obviously, if the insurance coverage isn't there.  It can be time consuming if you have to be there for 2 weeks like I was (usually worst case scenario, just waiting and waiting for you to ovulate).  Some people simply can't take off work or don't have the money.  I know this.  And it makes my heart ache.

Now, I firmly believe with all my heart that even if one was to pay cash to see Dr. Hilgers, it would be worth it.  He saves time.  Lots of it.  And by being so quick, he often saves money (a big chunk spent now or a little here and there for a very long time).  But that is easy for me to say-afterall, my insurance covered him (miraculously)-both the one before I was married and the one I have now.  Some very good and discerning Catholic friends have drawn lines about how far they will go to treat their IF.  They will not basically mortgage their home, etc.  I respect that.  We all have to have boundaries or IF would lead us all off the deep end, financially and emotionally. 

So is it wrong that I suggest Napro and CrMS to these folks?  I have justified it saying it is always best to give them all the information so they can decide for themselves what is best.  It isn't for me to decide, but if I know something that might help, I have the responsibility to share it.  But I have seen, in some cases, my suggestion lead to heartache.  And that hurts me too. 

What I want is for Dr. Hilgers' network of doctors to be just that.  I want for folks to have someone nearer to them, more accessible financially and physically, that they can count on to deliver Dr. Hilgers' tried and true methods.  But I am increasingly discouraged at what is being delivered.  What I can't help but describe as Dr. Hilgers LITE (this is relatively limited experience, granted; I live in an area with 3 Napro docs that are all primary care physicians-none have received hard core training; I have listened to other's experiences as well online, through emails and discussion boards).  When I see folks given large (greater than 50 mg) doses of Clomid right off the bat or otherwise hyperstimulated.  When I see folks given progesterone that isn't progesterone in oil.  When I see folks getting blood drawn and run at local labs instead of shipped to Omaha.  When I see pregnant girls being told their placenta will take over production of the progesterone after 12-14 weeks and thus taken off their supplements without data.    I GET FRUSTRATED!   And I know I have read TCIE get frustrated about the Tamox situation which I don't know enough to comment on . 

I know Dr. Hilgers must get frustrated too.  I say this because I have friends who have had laps and ultrasound series done locally with someone who said trained in Napro.  These show no problems, yet these girls try for years to become pregnant unsuccessfully.  Finally, they send their charts in to Dr. Hilgers and what does he recommend?   An ultrasound series, a hormone series, a lab-with him in Omaha.  Clearly he thinks the way he does things is different.  And that is where you receive the benefit.  He does everything the best and he does it all at once-"one stop shopping" I consistently say.  But what about the folks that don't want to go Omaha?  Can't?  I struggle with this.

Systems change is a big part of my field.  We do trainer of trainers and try to spread "our methods" to others.  I must tell you, it often fails.  It is watered down.  Folks don't have the resources to devote to receive the training we have and to implement it with the same fidelity.  It seems so many things have to be aligned just so.  And so it fails.  It is a hard field to be in, certainly not for the faint of heart.  More like the eternal optimist.

I know that Dr. Hilgers doesn't desire to have the monopoly on IF treatment.  He is not at all that type of man.  He wants others to learn from him, to carry it out.  His actions have shown that.  After all he isn't going to live forever.  It seems the only person he can truly vouch for is Dr. Keefe in his office.  I imagine the amount of time and money that would go into the oversight to ensure that this network of professionals are truly carrying out his methods in the purest fashion would be too great.  He is only one man, after all.  But there is some responsibility.  They are respresenting his brainchild when they use the name Napro medical consultant.

I have an email out to Fertility Care regarding their medical consultants list on the website.  It has questions such as, why don't Dr. Stegman and others of that calebar share a special distinction that is noted on the site.  And what does it take to get the current distinction?  And to keep it?  I noticed one of the doctors locally that I have criticized in the past has been removed from the site.  I want to know why.  And why my current doctor (primary care) is not on there.  If they are not current, Fertility Care practioners should at least receive an email updating them to who has been removed and why in their area.  That seems like a simple step that may help?

I am not writing this post to attack any Napro medical consultant in particular and my experience is a mix of local and national.  I am not trying to make anyone feel bad or put anyone on the defensive.  My goal is to use our experience to educate each other.  I want everyone to be able to discern for themselves if they are getting care in a manner that Dr. Hilgers would give, if that is what they want.  If they are getting different, they should know about it.  I mean, even "local" medical consultants can be a good distance away.  And like me, maybe you are globally recommending something where all Napro medical consultants are not alike.  And then we are putting our name behind something.  I think I can answer some questions pretty well about "would Dr. Hilgers do this?" related to the experiences I have had, but there are also a lot of new things going on that are outside of my experience.  Certainly with all our experiences combined we can answer this with some certainty though?   And help each other discern?

Thank you for reading a post that is very close to my heart. It is only one person's perspective and therefore incomplete until you respond.  I want to hear from you.  I want to know your thoughts and reactions.  I want to know if you know if you are getting Dr. Hilgers lite or not.  Or would you know if you are?  I want to know about your bad experiences and with who so other's don't experience the same.  I want to know who are the big names in Napro and where they are located.  How did you learn of them?  They don't seem to be listed on the site any differently.  Does anyone know what criteria it takes to get on the list?  Is there monitoring to stay on the list (I have an email out to find this out from the source).  Do you agree with my list of criticisms?  Or do you think it is okay if doctor's who are Napro do these things?  Maybe they don't matter?  Maybe you don't want your blood sent out?  Do you want to add anything that isn't Napro or is Napro lite?

Part of my goal with this blog is to share my experience-how I was able to VERY quickly and inexpensively find out the problem and treat it successfully by going directly to Dr. Hilgers.  (And my case was not easy, not at all open and shut).  I want to document my effective experience so if you are not getting similarly quick and effective care, then you question why and figure out how it can happen differently for you; you can discern if your doctor is the best doctor for you.  (And I know the answer for everyone can't be-go directly to Omaha).

Update: I am so frustrated I didn't update this earlier to include the response I received. It did explains levels of training, recognize that there is a problem, and that it is being worked on. Unfortunately, I no longer have access to that email. I apologize. If anyone asks Omaha and gets a response, please let me know and I will post it here.