What a nice Christmas we had this year...broken up nicely by my parents' visit and then a quick trip to N's parents' house a few hours north of here. We were home Friday afternoon so N could play in a wedding on Saturday (rehearsal was Friday pm), which meant that we had a lovely, no-stress, calm weekend at home with the dog. It was so nice just to spend time together over a long weekend.
Of course, today it's back to work. I'm trying to finish up some projects related to my dissertation. Finding it hard going sometimes...working on book chapter revisions but getting bogged down in editing what others have written. Need to submit abstracts for two meetings that are due in early January. And then there's the rest of our lives...endo follow up for me tomorrow...whole-house humidifier getting installed Weds...infertility follow up 1/12...
My incisions aren't healing as well as I would like. I guess it's time to bust out the antibiotic ointment, to see if that helps at all. I've also gotten frustrated trying to figure out why what we are doing isn't working. I was actually kind of happy with the hydrosalpinx diagnosis, because that helped explain why I wasn't getting pregnant. But without that, we're back to a questionable semen analysis and (I suppose) unexplained infertility.
That's something I think I will ask more about at the next appointment. I want more information on the semen analysis - it was kind of an afterthought at the initial appointment. And I want to know what they saw when they did my surgery. I have had weird cramps after sex the last few days (woo hoo, the 2 week ban was lifted!) and not sure what those are all about. I guess I just feel like hey, did they miss something? Becuase some mildly questionable sperm don't seem like they would be causing this much trouble. And if we go with IUI's...well...should we do the medicated ones? Unmedicated? Argh...
Monday, December 29, 2008
Sunday, December 21, 2008
Coming 'round the mountain...
My parents just left after what I think was a very nice four-day visit. They came in for my graduation - for my PhD that I defended successfully in September. It was so nice to have them here! They are fairly...anxious...travelers, so the fact that we are having lovely winter weather here in flyover country was enough to send them into a tizzy. But they knew they would see us, and meet their grand-dog, and also meet our friends. So I am pretty sure they were excited to be here.
And we had a lovely visit. They arrived on Thursday afternoon, pretty much on-time, considering the weather and the fact that they had to fly through the dreaded ORD. I picked them up (N was working) and we headed to Target to pick up a few things for the party on Friday...paper plates/napkins and plasticware. We also picked up a timer for my mom's friend and a g.c. for N for iTunes...he loooves his iTunes. It was weird being with my father in Target - I'm usually in those places with my mom only - but they were very helpful.
We had a lovely dinner Thursday night and then they spent some time looking around the house - my dad videotaped a 'tour' of it to show back home - and playing with the dog. We never had a dog growing up - and I wasn't sure whether they would enjoy meeting their grand-dog. But they did, and my mother even kissed him (on the head, you know, where you kiss dogs) before they left. So, whew. It helps that the dog is well-behaved and awfully cute.
Friday, the weather was awful awful awful. We had ice Thursday night, mixed with rain and snow. Bleah. Bleah. Bleah. So N went out to snowblow and hack at the ice, and put down some ice melt. It was a mess. And because I was still post op, I couldn't help. Ergh. So my parents - who are 60 and 64 - went out to help. Talk about feeling useless. Completely useless. They got the driveway pretty well cleaned up, then we took N to work and went to run a few errands around town. N called while we were picking up the cake - his parents weren't going to make it, they'd had a foot (a FOOT) of snow. Bummer bummer bummer. So, back we went to the grocery store to get a few more things to stand in for what his mother was going to bring. Bummer. My parents finished clearing the driveway and I went to get N mid-afternoon. Fortunately his work has this thing where if you are salaried and show up for at least part of the day, you don't have to use leave if you leave early/come in late. Since he gets less vacation time than anyone I know, this is a good thing.
Friday night was our open house/hey my parents are in town/oh, look! Annabelle's graduating party. It was lovely. A few people couldn't make it because of the weather, and one person never showed up, never called, and never emailed. But everyone else seemed to have a good time. It was fun to have my parents meet friends of ours that they had never met before, and it was really fun to have people over at our house. A couple of friends stayed pretty late, chatting with us and my parents.
And then Saturday was graduation! N wasn't feeling so hot - he'd had a cold for a few days - but he powered through and was feeling better when we finally got to the ceremony. There was a reception beforehand, that the Grad College hosted. It was very nice - my adviser was there and had her ear talked off by my mother. I am so, so glad that I went through the graduation. There is something about having that hood placed over your head that just brings it all home. My adviser did the hooding - they said all of my names right - and it was just one of those moments where everything seems right.
We came home to save the dog from the torture of the crate and get ready for dinner. It snowed most of the day and was bitter, bitter cold, so going out to dinner didn't seem like such a fab idea. Of course we went -reservations and Italian food, hello - but holy God was it cold walking from the parking ramp to the restaurant. We had yummy Italian food, a little too much wine (well, mom and I did - N and my dad were fine) - and then came home to have champagne and leftover cake. Mmmm....
And then Sunday they left. Oh, what an ordeal. 40 mph winds, ground blizzards, delayed flights, nearly missed connections, etc. etc. etc. And of course their bags didn't make it. But they did! I'll have to hear about how we are two plane flights away for the rest of my natural life, but that seems a small price to pay for having them here for a few days.
Life has calmed down a bit now. We are back from N's parents' house, where we spent Christmas Eve and Day. It was very very quiet without our niece and nephew around to raise the noise level to earsplitting...I took several naps...and the Dog got spoiled rotten by his paternal grandparents.
I couldn't help but think how nice it would have been to have a baby this Christmas. New house, new dog...new baby would have rounded it out nicely. And I kept thinking how last Christmas, I was hoping to be able to tell our parents that we were expecting a baby. No dice. And not this Christmas either. And now that they know I had surgery, they also know that we have a follow up appointment in January. And I really don't want to have them asking me about what we're doing, or when I might get pregnant, or really any of the details of this whole ordeal. I just wish that I could surprise them when I do get pregnant. Maybe they'll forget about the follow up appointment...maybe I just won't say anything and they won't bother to ask...but what I really DON'T want is to be sharing details of our IUI's with our parents. Call me petty and small and controlling, but...I just don't want to. So we'll see how that shapes up.
Follow up with the endocrinologist next week. I'm interested to see what he wants to do. I've been munching (in a restrained way, of course) on cookies and crackers and cheese and mmm....Christmas snacks...but my sugars haven't really budged. So, we'll see.
Boy, what a rambling, pointless post.
And we had a lovely visit. They arrived on Thursday afternoon, pretty much on-time, considering the weather and the fact that they had to fly through the dreaded ORD. I picked them up (N was working) and we headed to Target to pick up a few things for the party on Friday...paper plates/napkins and plasticware. We also picked up a timer for my mom's friend and a g.c. for N for iTunes...he loooves his iTunes. It was weird being with my father in Target - I'm usually in those places with my mom only - but they were very helpful.
We had a lovely dinner Thursday night and then they spent some time looking around the house - my dad videotaped a 'tour' of it to show back home - and playing with the dog. We never had a dog growing up - and I wasn't sure whether they would enjoy meeting their grand-dog. But they did, and my mother even kissed him (on the head, you know, where you kiss dogs) before they left. So, whew. It helps that the dog is well-behaved and awfully cute.
Friday, the weather was awful awful awful. We had ice Thursday night, mixed with rain and snow. Bleah. Bleah. Bleah. So N went out to snowblow and hack at the ice, and put down some ice melt. It was a mess. And because I was still post op, I couldn't help. Ergh. So my parents - who are 60 and 64 - went out to help. Talk about feeling useless. Completely useless. They got the driveway pretty well cleaned up, then we took N to work and went to run a few errands around town. N called while we were picking up the cake - his parents weren't going to make it, they'd had a foot (a FOOT) of snow. Bummer bummer bummer. So, back we went to the grocery store to get a few more things to stand in for what his mother was going to bring. Bummer. My parents finished clearing the driveway and I went to get N mid-afternoon. Fortunately his work has this thing where if you are salaried and show up for at least part of the day, you don't have to use leave if you leave early/come in late. Since he gets less vacation time than anyone I know, this is a good thing.
Friday night was our open house/hey my parents are in town/oh, look! Annabelle's graduating party. It was lovely. A few people couldn't make it because of the weather, and one person never showed up, never called, and never emailed. But everyone else seemed to have a good time. It was fun to have my parents meet friends of ours that they had never met before, and it was really fun to have people over at our house. A couple of friends stayed pretty late, chatting with us and my parents.
And then Saturday was graduation! N wasn't feeling so hot - he'd had a cold for a few days - but he powered through and was feeling better when we finally got to the ceremony. There was a reception beforehand, that the Grad College hosted. It was very nice - my adviser was there and had her ear talked off by my mother. I am so, so glad that I went through the graduation. There is something about having that hood placed over your head that just brings it all home. My adviser did the hooding - they said all of my names right - and it was just one of those moments where everything seems right.
We came home to save the dog from the torture of the crate and get ready for dinner. It snowed most of the day and was bitter, bitter cold, so going out to dinner didn't seem like such a fab idea. Of course we went -reservations and Italian food, hello - but holy God was it cold walking from the parking ramp to the restaurant. We had yummy Italian food, a little too much wine (well, mom and I did - N and my dad were fine) - and then came home to have champagne and leftover cake. Mmmm....
And then Sunday they left. Oh, what an ordeal. 40 mph winds, ground blizzards, delayed flights, nearly missed connections, etc. etc. etc. And of course their bags didn't make it. But they did! I'll have to hear about how we are two plane flights away for the rest of my natural life, but that seems a small price to pay for having them here for a few days.
Life has calmed down a bit now. We are back from N's parents' house, where we spent Christmas Eve and Day. It was very very quiet without our niece and nephew around to raise the noise level to earsplitting...I took several naps...and the Dog got spoiled rotten by his paternal grandparents.
I couldn't help but think how nice it would have been to have a baby this Christmas. New house, new dog...new baby would have rounded it out nicely. And I kept thinking how last Christmas, I was hoping to be able to tell our parents that we were expecting a baby. No dice. And not this Christmas either. And now that they know I had surgery, they also know that we have a follow up appointment in January. And I really don't want to have them asking me about what we're doing, or when I might get pregnant, or really any of the details of this whole ordeal. I just wish that I could surprise them when I do get pregnant. Maybe they'll forget about the follow up appointment...maybe I just won't say anything and they won't bother to ask...but what I really DON'T want is to be sharing details of our IUI's with our parents. Call me petty and small and controlling, but...I just don't want to. So we'll see how that shapes up.
Follow up with the endocrinologist next week. I'm interested to see what he wants to do. I've been munching (in a restrained way, of course) on cookies and crackers and cheese and mmm....Christmas snacks...but my sugars haven't really budged. So, we'll see.
Boy, what a rambling, pointless post.
Monday, December 15, 2008
Bleah
I just want to say that I really, really hate feeling bleah. And I know this surgery was not a major event - really, it wasn't. But I intensely dislike the feeling of...not feeling 100%. Twinges in my tummy, dizziness, general fatigue...I have a feeling I would be a not-very-good sick person.
I also think I overdid it on Saturday when I was being more indulgent with the pain medication. Now that I'm not taking as much, I'm definitely feeling it more. But we have visitors coming this weekend, and a party on Friday night to get ready for, and I don't want to overload my husband, and... Yeah. I'll probably still have to lie down for a bit this afternoon. *sigh* Here's hoping I feel better soon. Even though I know this could be a whole lot worse.
I also think I overdid it on Saturday when I was being more indulgent with the pain medication. Now that I'm not taking as much, I'm definitely feeling it more. But we have visitors coming this weekend, and a party on Friday night to get ready for, and I don't want to overload my husband, and... Yeah. I'll probably still have to lie down for a bit this afternoon. *sigh* Here's hoping I feel better soon. Even though I know this could be a whole lot worse.
Anticlimactic
So, had my surgery on Friday, and after all that, they found....nothing. Yep, nothing. Didn't have to remove a tube (or both tubes), didn't have to clean anything out. Because there was nothing there. And I was right at the start of my cycle, so they would have seen something if it had been there. Weird, very weird. They flushed out my tubes - told me they're a bit dilated but at the upper end of normal - and said that we can go ahead with IUI's instead of IVF.
I have to say, while I'm happy to have all of my parts, I'm still a bit baffled. If everything looks okay, is it really just the male factor stuff that's keeping us from getting pregnant? Are the IUI's going to work? We have a follow up appointment on 1/12, so we'll get to find out then. I am hoping they do medicated IUI's to up our chances of conceiving. They weren't going to before, but I would really prefer that. So we'll see what they say when we meet with them. Of course, 1 month = probably day 3 or so of my cycle. So I suspect that we'll have to do an unmedicated cycle for our first IUI and then add Clomid if they think that would be helpful.
I'm still having some pain and not feeling quite like myself - not sure exactly what it is. I have these weird periods where I feel completely awful - happened yesterday am and today, too. I wonder if it's the pain medicine? Percocet will do that to you, I suspect...So I'm going to try to take only the ibuprofen, and maybe the percocet for one more night.
More later, especially the details of Friday, but for now, a few more things that make me go hm...
I have to say, while I'm happy to have all of my parts, I'm still a bit baffled. If everything looks okay, is it really just the male factor stuff that's keeping us from getting pregnant? Are the IUI's going to work? We have a follow up appointment on 1/12, so we'll get to find out then. I am hoping they do medicated IUI's to up our chances of conceiving. They weren't going to before, but I would really prefer that. So we'll see what they say when we meet with them. Of course, 1 month = probably day 3 or so of my cycle. So I suspect that we'll have to do an unmedicated cycle for our first IUI and then add Clomid if they think that would be helpful.
I'm still having some pain and not feeling quite like myself - not sure exactly what it is. I have these weird periods where I feel completely awful - happened yesterday am and today, too. I wonder if it's the pain medicine? Percocet will do that to you, I suspect...So I'm going to try to take only the ibuprofen, and maybe the percocet for one more night.
More later, especially the details of Friday, but for now, a few more things that make me go hm...
- The v8 "weekly pack", which has 6 small cans of v8. Um. 6? That would be an almost-weekly pack, since there are, you know, 7 days in a week. At least, there were the last time I checked.
- Ads for special shows (home shows, furniture shows) that don't give the location of said show. N noticed this on Saturday, too - it was the local home show, advertising in the paper. No location. I think there was a date, though. Um, thanks for that.
- People who are published on widely read websites with egregious spelling and grammar errors. I know that blogs are generally "looser" than standard articles, but some copyediting would be okay. Right?
Tuesday, December 9, 2008
Things that make me go hm...
I should be cleaning the bathrooms, but it's icy here in flyover country and N is home from work (he couldn't even get out to the main road, so he's staying home). And so, a random list of things that have made me go "hm" recently...
- Stinky people at the gym...as in, people who let out toots in a room full of exercisers. I mean, I know, sometimes one slips out...but seriously? every day?
- Barefoot dude, also at the gym. It was +12 here the other morning, and he exited the gym in front of me. Shorts, t-shirt, bare feet. Walked to his car that way. Um, good for you?
- The grocery store on a Monday morning. No bags, no pepperoni, no soy cheese? I know Sundays are really busy, but maybe they could bring in extra staff on Sunday night to restock?? Instead, there they are restocking on Monday morning. Weird.
- The girl who was biting off her split ends on the bus last week. 'nuff said.
- My sleep patterns...last week I was exhausted, this week I am having trouble sleeping. Argh. I just want to sleep on a regular schedule and feel rested. That's all.
- Solved the case of the missing undies! They were apparently left in the washer, and showed up with this morning's sheet load. Thank goodness I'd washed them before - red undies + ivory sheets could = disaster.
Thursday, December 4, 2008
Onward
I should really write about things other than our journey through infertility, although it is what is taking up most of the space in my brain these days. Really, I do other things! I interact with people! But I want to get this all out so I don't forget it...hopefully when we do have a baby of our own, I will be able to look back at all of this and remember what it took to get us there.
So, telling my parents was really hard. They didn't even know we had been trying, because honestly I think that is our business, not theirs. A few friends knew we were trying, which helped - I could talk about it with them - but I didn't want my parents all worked up when things weren't going right. So when they called the other week to chat - they do this about once a week, and they both get on the phone, which is both endearing and slightly irritating - I waited until a lull in the conversation and then jumped in with "So, I am going to have surgery on December 12th". Um, probably not the best way to bring it up, now that I think about it!
They, of course, had a ton of questions. Why, and for what, and why, and why, and why...I told them that we had been trying to get pregnant for over a year, and it wasn't working, so they want to make sure there isn't anything structural going on. I didn't tell them the specifics of the hydrosalpinx - that will just make them worry more. I did tell them that it will be an outpatient surgery, unless they have to open me up for some reason, and that I should be fine by the time they get here the next week for graduation. Mom wanted to know who was doing the surgery - had I met him? Was he good? I had to remind her that this is a huge academic medical center, and you get the surgeon of the day. I'm sure he's good, I just can't vet him myself. There was lots of sighing on their end, but in the end I answered all (or most) of their questions.
Telling N's parents was a bit anticlimactic - I wound up only telling his mother, since his father was in the basement (as per usual, it's a little strange there sometimes). And she didn't ask any questions at all, just offered to bring food to graduation and the party we are having the night before. So that was fine.
This is really stupid, but I keep thinking that I brought this on myself. I started reading infertility-related blogs last summer (as in, about when we started trying) when someone linked to Julia's blog in their own blog. And from there, I read blogs on her blogroll, and blogs on those people's blogrolls, and pretty soon I was reading all about the world of infertility. So, it's dumb, but I do wonder whether I brought this on myself.
I also worry about what they are going to find when they go in there...I mean, the endometriosis option is the only reasonable option. But...but...but...What if? What if it's cancer? Or a previously undetected infection? Or...I know I can't do anything about this now, and they are going to look in there, which is the best possible option, but...it still worries me.
So, telling my parents was really hard. They didn't even know we had been trying, because honestly I think that is our business, not theirs. A few friends knew we were trying, which helped - I could talk about it with them - but I didn't want my parents all worked up when things weren't going right. So when they called the other week to chat - they do this about once a week, and they both get on the phone, which is both endearing and slightly irritating - I waited until a lull in the conversation and then jumped in with "So, I am going to have surgery on December 12th". Um, probably not the best way to bring it up, now that I think about it!
They, of course, had a ton of questions. Why, and for what, and why, and why, and why...I told them that we had been trying to get pregnant for over a year, and it wasn't working, so they want to make sure there isn't anything structural going on. I didn't tell them the specifics of the hydrosalpinx - that will just make them worry more. I did tell them that it will be an outpatient surgery, unless they have to open me up for some reason, and that I should be fine by the time they get here the next week for graduation. Mom wanted to know who was doing the surgery - had I met him? Was he good? I had to remind her that this is a huge academic medical center, and you get the surgeon of the day. I'm sure he's good, I just can't vet him myself. There was lots of sighing on their end, but in the end I answered all (or most) of their questions.
Telling N's parents was a bit anticlimactic - I wound up only telling his mother, since his father was in the basement (as per usual, it's a little strange there sometimes). And she didn't ask any questions at all, just offered to bring food to graduation and the party we are having the night before. So that was fine.
This is really stupid, but I keep thinking that I brought this on myself. I started reading infertility-related blogs last summer (as in, about when we started trying) when someone linked to Julia's blog in their own blog. And from there, I read blogs on her blogroll, and blogs on those people's blogrolls, and pretty soon I was reading all about the world of infertility. So, it's dumb, but I do wonder whether I brought this on myself.
I also worry about what they are going to find when they go in there...I mean, the endometriosis option is the only reasonable option. But...but...but...What if? What if it's cancer? Or a previously undetected infection? Or...I know I can't do anything about this now, and they are going to look in there, which is the best possible option, but...it still worries me.
Friday, November 28, 2008
Decisions
So...I waited for a bit (but not long) for the PA who had given me the bad news the day before. I'm not entirely sure how this clinic works as far as deciding who you see for any given appointment - it's an academic medical center, so usually it's a resident/medical student + an attending at each clinic appointment. But the PA was the one who took my appointment on Thursday. She came in and said that they weren't able to get a good look at whether I had a septum during the HSG - that the position of my uterus wasn't conducive to getting the views that the previous doc had requested. But ultrasound had an open room right then, and was I okay with having another one? I said yes, of course, because in my mind, more information is always better. She asked how I was after the procedure the day before and I told her I was still having twinging pains, mostly on the left. She thought that was weird, since the hydrosalpinx is on the right. I told her it wasn't enough that I needed to take anything for it - but I definitely noticed it.
We went up to the front desk so the administrative person could put the request for the u/s in. The PA went back to the u/s room to let the tech know we were coming back - then they both came to the front desk and told the admin not to bother, they were just going to squeeze me in and not charge me for it (very nice!). We went back to the room, and I did the usual empty-the-bladder, take-off-the-pants, replace-with-this-sheet dance. Of course, I always wrap myself up like a burrito, and then they have to partially unwrap me to get the scan. Whoops.
She started scanning, and said that she couldn't see the hydrosalpinx on the right. Great, but it was definitely visible on the HSG the day before. Then she said something like "Whoa, I've never seen THAT before!" Um, okay. Not what you want to hear when someone is looking at your baby making parts with an ultrasound wand! She had the PA come around the end of the table, and she said the same thing. Apparently I have a very anterior cervix, but a very posterior uterus. Which is why the HSG hurt so much - they were trying to yank my uterus so that it flipped forward, so they could get a better shot of it on the x-ray. No dice - my uterus refused to move. So that, plus the pain of the dye going through the hydrosalpinx, was why the HSG hurt so, so, much.
The tech asked the PA to get the other tech, who had done my initial ultrasound (the one where they debated fibroids vs. septum vs. arcuate uterus) to "come and see this". So I had three people staring at the pictures of my apparently oddly placed and shaped uterus. She did, finally, get a view of the septum, and they decided that it was just a bit of a dent in the wall. It measured at less than 1 cm, which is the cut off for having to do something about it.
After that, we went back to the exam room, and the PA pulled up the HSG pictures on the computer. I was curious as to whether the hydrosalpinx was really on the right, since I was having so much pain on the left. Sure enough, it was -they had labeled it wrong during the scan, but it was definitely my right side. She showed it to me again, and then said that they typically recommend laparascopic surgery to examine the diseased tube, and likely take it ou, and also to take a look at the other tube, in case it is also diseased. She said that they think I probably have endometriosis. I think that's very strange - not impossible, but strange - because I have friends with endometriosis and my cycles and cramps were never as bad as theirs. My college roommate had it bad enough that she had two surgeries, one just after high school and one while we were in college. I gave her Lupron shots to try to keep the growth down during the year that she had surgery. Me? I never had cramps that were that bad that I had to skip school, or that made me sick. Sure, I have to take anti-inflammatories around the clock on the first day of my period, but that didn't seem that unusual to me. I did pass out from cramps when I was in high school- that was fun - but overall? It is really strange to me that this would be bad enough to cause this much tubal disease, but that I wouldn't have that much pain. Hm.
I talked with the PA about what I had read -about how the diseased tube can cause problems for pregnancy, and how I wanted to know as much as possible about what was going on. She said that this would allow them to remove that tube, and maybe the other one if it, too, was diseased. If that happens, we would definitely have to move on to IVF if I were ever to get pregnant. If they left the other tube in, then we could do monitored IUIs with ultrasound - to make sure I am ovulating on the correct side. But most likely we're looking at IVF. Not a place that I really wanted to go - what if I get pregnant with twins? What will that do to my career plans? And N's career plans? One baby is what we had agreed on - we both thought that one child would fit in well with the life we had planned for ourselves. But since we won't be able to get pregnant without help, well...I guess we have to reconsider all of this. We haven't made a decision about IVF yet - we want more information - but it does look like that is what we will be doing.
So we talked about the surgery - the risks, the benefits - and I told her that I thought it was a reasonable next step. Particularly since removing the tube would presumably help me to carry a pregnancy to term - that was one of the major arguments in favor of the surgery. She told me that their clinic numbers indicate that younger women (< 35) with hydrosalpinx who do not have the tube removed have a lower rate of successful pregnancy even with IVF. The numbers come close to those women without tube disease if the tube is removed. So. I made the decision that surgery was the next best step. I felt kind of bad that I didn't directly consult N about this, but we had talked about it the night before, and I had told him that I thought that would be a good step before trying anything else as far as conception goes.
So, the PA sent the nurse in to do the pre-op education. Hilarious, since I used to work in the recovery room. It's the usual stuff. Oh, we scheduled it for 12/12, which is a Friday, a week before my parents and in-laws are coming to town for my graduation. They will try to do the surgery laparascopically, but they might have to open me up if there is endometrium/disease that they cannot access through the surgical openings. I will definitely be up and around by the next week - so that is why I chose to go ahead before graduation. Even if I have to stay in the hospital over the weekend (which I really, really hope doesn't happen). So anyway - preop education was fine, the nurse was nice and didn't make me watch the video (seriously? a video? I think I have it down, thanks...). They have to do a computer-based questionnaire to evaluate your risk for anesthesia - I came in at low risk, despite the diabetes. Woo hoo. So I don't need to have a pre-op appointment in anesthesia clinic, just a phone call the day before surgery and then a day-of check in with the anesthetist.
The person doing my surgery is the head of the Infertility clinic and a gyn surgeon. So, not a bad person to be doing this! And the resident on that day is a third year. So, whew. I'd rather have someone who must have a bit of a clue by now. ;)
The PA came back in to do a physical and everything checked out fine. She couldn't feel anything - the hydrosalpinx, etc - on bimanual exam, which is why no one ever thought that something might be wrong. It has occurred to me since this appointment that the fact that I was on birth control pills for so long (7+ years) might also have limited the cramps and pain that I have each month - even on the pill, I needed to take anti-inflammatories round the clock on the first day of my period, or I was completely miserable.
So I am set for surgery - the appointment took forever, I don't think I left until almost 1 pm. They talked to the billing office - the surgery will be covered under my new insurance's infertility coverage. It should be about $7000, which isn't too bad. That still leaves enough that we could get in an IVF or two if we choose to go that route. I do have to call Monday -the first day of my new insurance - to see if I need to get preapproval/clearance for the surgery. She put it in as a diagnostic laparoscopy, with dysmenorrhea. We'll see - I'm sure there will be a co-pay, but as long as they cover the majority of it, that will be good. And, I get paid again starting Monday, so that is even better. We're cutting our spending a bit close since I haven't been paid in 2 months. Whew.
More in the next post re: telling the parents (NOT fun, since they didn't even know we were trying!), etc.
We went up to the front desk so the administrative person could put the request for the u/s in. The PA went back to the u/s room to let the tech know we were coming back - then they both came to the front desk and told the admin not to bother, they were just going to squeeze me in and not charge me for it (very nice!). We went back to the room, and I did the usual empty-the-bladder, take-off-the-pants, replace-with-this-sheet dance. Of course, I always wrap myself up like a burrito, and then they have to partially unwrap me to get the scan. Whoops.
She started scanning, and said that she couldn't see the hydrosalpinx on the right. Great, but it was definitely visible on the HSG the day before. Then she said something like "Whoa, I've never seen THAT before!" Um, okay. Not what you want to hear when someone is looking at your baby making parts with an ultrasound wand! She had the PA come around the end of the table, and she said the same thing. Apparently I have a very anterior cervix, but a very posterior uterus. Which is why the HSG hurt so much - they were trying to yank my uterus so that it flipped forward, so they could get a better shot of it on the x-ray. No dice - my uterus refused to move. So that, plus the pain of the dye going through the hydrosalpinx, was why the HSG hurt so, so, much.
The tech asked the PA to get the other tech, who had done my initial ultrasound (the one where they debated fibroids vs. septum vs. arcuate uterus) to "come and see this". So I had three people staring at the pictures of my apparently oddly placed and shaped uterus. She did, finally, get a view of the septum, and they decided that it was just a bit of a dent in the wall. It measured at less than 1 cm, which is the cut off for having to do something about it.
After that, we went back to the exam room, and the PA pulled up the HSG pictures on the computer. I was curious as to whether the hydrosalpinx was really on the right, since I was having so much pain on the left. Sure enough, it was -they had labeled it wrong during the scan, but it was definitely my right side. She showed it to me again, and then said that they typically recommend laparascopic surgery to examine the diseased tube, and likely take it ou, and also to take a look at the other tube, in case it is also diseased. She said that they think I probably have endometriosis. I think that's very strange - not impossible, but strange - because I have friends with endometriosis and my cycles and cramps were never as bad as theirs. My college roommate had it bad enough that she had two surgeries, one just after high school and one while we were in college. I gave her Lupron shots to try to keep the growth down during the year that she had surgery. Me? I never had cramps that were that bad that I had to skip school, or that made me sick. Sure, I have to take anti-inflammatories around the clock on the first day of my period, but that didn't seem that unusual to me. I did pass out from cramps when I was in high school- that was fun - but overall? It is really strange to me that this would be bad enough to cause this much tubal disease, but that I wouldn't have that much pain. Hm.
I talked with the PA about what I had read -about how the diseased tube can cause problems for pregnancy, and how I wanted to know as much as possible about what was going on. She said that this would allow them to remove that tube, and maybe the other one if it, too, was diseased. If that happens, we would definitely have to move on to IVF if I were ever to get pregnant. If they left the other tube in, then we could do monitored IUIs with ultrasound - to make sure I am ovulating on the correct side. But most likely we're looking at IVF. Not a place that I really wanted to go - what if I get pregnant with twins? What will that do to my career plans? And N's career plans? One baby is what we had agreed on - we both thought that one child would fit in well with the life we had planned for ourselves. But since we won't be able to get pregnant without help, well...I guess we have to reconsider all of this. We haven't made a decision about IVF yet - we want more information - but it does look like that is what we will be doing.
So we talked about the surgery - the risks, the benefits - and I told her that I thought it was a reasonable next step. Particularly since removing the tube would presumably help me to carry a pregnancy to term - that was one of the major arguments in favor of the surgery. She told me that their clinic numbers indicate that younger women (< 35) with hydrosalpinx who do not have the tube removed have a lower rate of successful pregnancy even with IVF. The numbers come close to those women without tube disease if the tube is removed. So. I made the decision that surgery was the next best step. I felt kind of bad that I didn't directly consult N about this, but we had talked about it the night before, and I had told him that I thought that would be a good step before trying anything else as far as conception goes.
So, the PA sent the nurse in to do the pre-op education. Hilarious, since I used to work in the recovery room. It's the usual stuff. Oh, we scheduled it for 12/12, which is a Friday, a week before my parents and in-laws are coming to town for my graduation. They will try to do the surgery laparascopically, but they might have to open me up if there is endometrium/disease that they cannot access through the surgical openings. I will definitely be up and around by the next week - so that is why I chose to go ahead before graduation. Even if I have to stay in the hospital over the weekend (which I really, really hope doesn't happen). So anyway - preop education was fine, the nurse was nice and didn't make me watch the video (seriously? a video? I think I have it down, thanks...). They have to do a computer-based questionnaire to evaluate your risk for anesthesia - I came in at low risk, despite the diabetes. Woo hoo. So I don't need to have a pre-op appointment in anesthesia clinic, just a phone call the day before surgery and then a day-of check in with the anesthetist.
The person doing my surgery is the head of the Infertility clinic and a gyn surgeon. So, not a bad person to be doing this! And the resident on that day is a third year. So, whew. I'd rather have someone who must have a bit of a clue by now. ;)
The PA came back in to do a physical and everything checked out fine. She couldn't feel anything - the hydrosalpinx, etc - on bimanual exam, which is why no one ever thought that something might be wrong. It has occurred to me since this appointment that the fact that I was on birth control pills for so long (7+ years) might also have limited the cramps and pain that I have each month - even on the pill, I needed to take anti-inflammatories round the clock on the first day of my period, or I was completely miserable.
So I am set for surgery - the appointment took forever, I don't think I left until almost 1 pm. They talked to the billing office - the surgery will be covered under my new insurance's infertility coverage. It should be about $7000, which isn't too bad. That still leaves enough that we could get in an IVF or two if we choose to go that route. I do have to call Monday -the first day of my new insurance - to see if I need to get preapproval/clearance for the surgery. She put it in as a diagnostic laparoscopy, with dysmenorrhea. We'll see - I'm sure there will be a co-pay, but as long as they cover the majority of it, that will be good. And, I get paid again starting Monday, so that is even better. We're cutting our spending a bit close since I haven't been paid in 2 months. Whew.
More in the next post re: telling the parents (NOT fun, since they didn't even know we were trying!), etc.
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