Would You Like a Hysteroscopy With That?

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Not having to be conscious during unpleasant medical procedures makes me deliciously happy. Why, yes, I would in fact enjoy a nice dose of anesthesia while having my lady bits poked and prodded with frightening medical instruments, thankyouverymuch! So, in that sense, it’s a dream come true for my pain threshold. Confused? Read on: this is a quicky post.

I don’t actually expect my readers of this lil’ blog (all 98 of you awesome people…still shocked that nearly 100 people find this stuff remotely interesting. Mwuah!) to remember what I’m talking about. I’m kind of an infrequent blogger, although one my new year’s resolutions is to fix that.

So, quick recap: I was supposed to have a combination hysteroscopy/D&C/uterine biopsy with my RE, Dr. C, earlier this month to investigate my last six months of continuous unexplained bleeding. After that procedure, I was supposed to have a laparoscopy cleanup surgery for endometriosis with my other doctor, Dr. Din, in early February. Pleasant ways to start off a new year, eh?  j/k. I’m actually grateful to be in the hands of such good doctors and to have God’s blessings of finances to pay for this medical care.

After I’d already scheduled my hysteroscopy/D&C/biopsy with his clinic, Dr. C suggested that, instead, Dr. Din could do these procedures while he was already operating on me… Which came down to a real “duh” moment for me: Why would I want to have two unpleasant procedures spaced out over the course of a month when I could just have them both done at once (and—bonus— while not having to feel the actual procedures while they were happening!)?

I saw Dr. Din again last week. He was extremely cool about adding these extras to my surgery.

We also scheduled my surgery while I was at his office. I picked the first available date. It all goes down on Wednesday, February 1, 2017:

  • Laparoscopy for endometriosis removal. This includes checking my bowels, abdomen, uterus, ovary, fallopian tube, cervix, pelvic cavity, and bladder for endo and/or adhesions.
  • Hysteropscopy to see why the heck I keep on bleeding and bleeding (including as I type this on cycle day 24) like a crazy woman between periods.
  • D&C to empty out whatever mystery intruders might have taken up residency in my uterus, possibly causing the bleeding.
  • Uterine biopsy to make sure nothing more sinister is lurking in my cells.
  • Correction of one of my previous surgical scars (post to follow) that looks….well…not like it should.

I’m pretty chill about the surgery itself. This is not my first rodeo, so I’m fully aware of what to expect afterward.

It seems like I’ve been writing on this blog for months now about having another surgery. Literally, months. You must all be bored to tears reading about something that never seems to actually happen! It’s a great feeling to finally have a set date, rather than just a looming possibility hanging in perpetuity in the general future.

Next up: all about surgical scars. I promise it will be nice and gory.

Peace. 🙂

 

The Long-Awaited Surgical Consult

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Guys, seriously. It actually happened! After like a zillion false starts and so much stupidity, I fina-freak-ing-ly had my surgical consult for endometriosis cleanup! That only took six months. But, praise God, He made a way this time!

I returned to see my latest surgery prospect, Dr. Din*, two days ago. I’m glad I gave him a second chance after the epic fail that was my original consult. Dr. Din ended up being extremely thorough and knowledgeable, and patiently answered all 1,000 of my questions. I’m so pleased that my first impression about his practice was changed for the better.

This time around there were no other patients in the waiting room, nor were there any ridiculous delays. I waited maybe 10 minutes in reception and an additional 15 minutes or so in the exam room; I think that’s pretty standard for a doctor’s office.

As I was hoping, I didn’t have to change into a gown or have an exam, or any other such nonsense. I remained in my regular clothes and Dr. Din didn’t press me to have an exam. I believe when you meet a doctor for the first time that it’s always better to be fully dressed. When you’re wearing only a thin paper gown and feeling virtually naked, it automatically puts all authority and power in the patient/doctor relationship in the doctor’s court. So I appreciated being able to keep my pants on.

Here’s how it went down, bullet style

  • Dr. Din reviewed the ginormous packet of records I’d brought. Specifically, he took time to read my last two post-op reports.
  • After reading my records, he looked up at me and said, “Boy. You’ve got a real mess going on in there.” This didn’t faze me or upset me at all like it used to. He’s certainly not the first (or second, or even third) doctor to say that to me: I already know my endo is way bad. Like, if they counted past Stage 4, I’d probably be a Stage 6.
  • Dr. Din was concerned about my colon. I’d forgotten this, but apparently in surgery #4—but not in previous surgeries—I had significant endo on my colon and bowel/rectum area (forgive me if these are not in the same neighborhood of the body. My anatomy knowledge is sparse).
    • Option A: Because of the colon thing, Dr. Din gave me the option of referring me to a reproductive oncologist (an “RO”) to do my surgery; ROs apparently frequently work within the colon area. My experience from a previous surgery with an RO is that they’re quite scissor-happy. I do not want another laparotomy. Period. I do not like Option A.
    • Option B. Dr. Din often work in tandem with a colorectal surgeon. This means that, during my surgery, Dr. Din will do all the work (well, the Da Vinci robot will, actually) as far as removing endo, but a colorectal surgeon will be the surgical suite too. If Dr. Din sees endo on my colon/bowel/rectum areas, his colorectal colleague will take over the Da Vinci robot to remove endo from those areas. I am a fan of Option B.
  • My endo will be fully excised. The only time Dr. Din would burn it away is if there were “very small spots” (his words) that would be too small to bother excising. I’m okay with this.
  • Dr. Din is buddies with Dr. C (my RE). Apparently the two of them frequently exchange patients: Dr. C does IVF, but not obstetrics. Dr. Din does not do IVF, but he’s an OB who often follows post-IVF pregnancies. I was pleased to know that, between the two docs, I’d be in good hands.
  • Dr. Din examined the myriad of surgical scars on my abdomen (seriously, there’s so many). He pointed out where he would make incisions over top of my existing scars. I was happy to know that I’m only adding 1 tiny new scar to the collection.

I am to send Dr. Din a copy of the report following my upcoming hysteroscopy. If he has any questions about it—or about my history in general—he will touch base with Dr. C. In the meantime, Dr. Din promised to thoroughly review my plethora of records.

After the hysteroscopy, I’ll schedule a second appointment with Dr. Din. I imagine he’ll go over my procedure, order some blood tests, and schedule my pre-op stuff and the surgery itself. Time frame = end of January/early February.

Here’s to pain relief, to finally freeing my ovary from a tangle of adhesions, and being one step closer to restoring my fertility for natural TTC!

 

 

*Nope, not his real name; just a pseudonym to keep up my privacy in the blog world.

Much Ado About Nothing

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Just a little rant-y post here today, because it seems I’m perpetually taking one step forward and two steps back in the Land of All Things Infertility. I’ve had a heck of a time finding a doctor for surgery, and I’m getting weary of the runaround. I just want answers.

Today was supposed to be my surgical consult for endo cleanup. I mentioned in my last post that my previous consult didn’t work out due to distance, traffic, and my anxiety. After that consult fell through, I made a consult with a different doctor, which was scheduled for today.

This morning I drove the 50 minutes to the doctor’s office and arrived ten minutes early. My first impression of the place was that it was one of those “cattle mill” medical practices: you know, the kind where they churn out patients like so much chattel, overscheduling their books, always with a packed waiting room, and where their bottom line is all about getting more patients in than the doctor has time to see. This particular practice touts itself as being “OB/GYN/Infertility,” although they do not perform IVF… Meaning lots of pregnant women were in the waiting room. It never bodes well for the infertility patient to be staring at big pregnant bellies while awaiting an appointment. But, I digress. Regardless, I decided to give the place the benefit of the doubt. I checked in and sat in the waiting room. Where I waited… And waited… And waited some more! Five women who’d arrived after me were called in, and still it wasn’t my turn.

After waiting 40 minutes, I asked the receptionist when I could expect to see the doctor. Her reply? “Oh, it’s going to be at least another 45 minutes. The doctor is very behind today.” For realz? An hour and a half wait? I went out of my way to get to my appointment on time, and they didn’t even have the courtesy to phone me and let me know I could’ve come at 1:00 instead of 11:30! Unfortunately, my job is very demanding and I don’t have the luxury of spending 3 hours at a doctor’s appointment, in addition to nearly 2 hours travel time there and back. I made the call to leave without being seen. They rescheduled my consult for Tuesday, December 13. I’ll give this place another shot, though I’m not expecting much.

In other news, my intermenstrual bleeding is baaaaaack! I didn’t have the bleeding in October/November, probably because I was still in the throes of the Longest Cycle Ever and hadn’t ovulated in forever. Today I’m on cycle day 15 and have been bleeding since CD11. I ovulated right on time on CD14, so there’s some silver lining amongst the clouds.

Last time I had IM bleeding, my RE, Dr. C, told me to call the clinic if the bleeding returned. I called my clinic’s nurse today and she relayed my situation to my RE. Dr. C wants to do a hysteroscopy (this will be my third h/s) and [possibly] a D&C, as well as a biopsy and general vag exam. I’m to call back with the start of my next cycle so I can schedule the procedure. Unlike Cattle Mill Place above, Dr. C’s office is on the money: they answer their phones promptly, return calls quickly, and I can always get an appointment in no time at all. I wish Dr. C could do my surgery! He refuses though (I believe his exact words when I first met him were “No surgeon would touch you with a 10-foot pole.” How comforting), so onward the search continues.

So overall, today was just a bad day in the trenches. I have faith it will get better. It has to.

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An Actual Cycle and Other Random Updates

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Errrm…. sorry for the crickets over here. Life has been crazy busy and I keep meaning to blog, but then I think my “updates” are kind of lame and non-updatey, so it never really happens.

Work/business has been crazy, plus we relocated our office to the ‘burbs, and I’m frantically working on creating our website, so—whew! Then, just when I planned to post an update, all the election insanity hijacked the blogosphere. I wanted to wait for that to calm down in my feed before posting. This is a (in)fertility blog and I intend to keep it that way, so have no fear of interposing political views here! There’s plenty of other places to get your politix fix. All I will say on the matter is that I continue to pray for the ever-widening gulf which is so bitterly dividing our great country to be repaired. *end of non-fertility talk*

In the meantime, I have been following everyone else’s blogs on my feed. Please know that I grieve with those of you who’ve recently experienced losses. I celebrate with those of you who’ve gotten your miracle babies or that long-awaited BFP. And I completely identify a million percent with those still of you (well, “us”) still stuck in the trenches. It’s a tough, tough place to live.

The most exciting thing fertility-wise that I have to report is that I finally—after 4 months—had/am having an honest-to-God regular cycle! Sounds like kind of ho-hum news, right? But so far 2016 is going down in history as The Year of Stupid Cycles. I’ve had three (possibly four) bona fide, full cycles complete with ovulation this year. Miscarriage #2 really threw my body for a loop. This was after it took so.many.years to even have regular cycles to begin with. So having my body back on track feels pretty fantastic.

As the holidays draw near, I’m feeling just a tad desperate to end this year on a high note (read: pregnant) and time is a-tickin’. AF is due next week, and I’m praying and doing all the right things. Yep, it’s all pineapple core and brazil nuts and 24/7 sock-wearing around Marixsa’s crib these days. Even though I’m more than five years into this thing and I should know better by now, here I am on cycle day 26 symptom-spotting and chock full of hope. Or maybe naiveté. Or insanity.

Oh yeah. And that whole surgery thing? I never did have my surgical consult back in October that I was so excited about, though not for lack of trying. See, this past year my long-buried anxiety disorder has made a full-out reappearance. This dramatically affects my ability to drive—even though I take medication—without having a panic attack. More on that another post. The solution was to take an Uber to my consult, but it didn’t quite work out. For no particular reason the day of my consult, traffic was backed up 20X more than usual. I spent an hour in the backseat of some Uber driver’s car in dismay staring at a sea of brake lights. In that time, we managed to go four whole miles. There was no way I was making it to the appointment on time. Unfortunately, that surgeon’s office is unrealistically far for me. I never rescheduled the appointment.

Never one to easily give in to defeat, I found a new surgeon! This new doctor is also an hour away, but in an area that is all back roads and near the town I grew up in. Okay: doable. Well, doable with an extra dose of anxiety meds. He uses the Da Vinci robotic method, which I’ve had in a prior surgery and am a fan of. My surgical consult is scheduled for December 9. Surgery #5 will hopefully be in the early part of 2017.

Finally, I am hosting Thanksgiving this year! I typically usually do host it, except for last year when I boycotted the holiday. Since then, it’s taken me a very long time to return to feeling like I want to do anything at all. Most of this past year I’ve been a complete homebody. Isolation and avoiding people were my specialties. Lately that cloud has been slowly lifting, and I am tentatively taking baby steps back into actual living. I have to admit, it’s nice to be back participating in my own life again, although I don’t feel like the same person anymore. In some ways, ongoing infertility and multiple miscarriages have changed and shaped me into a new person: a person who I’m slowly learning to live with. Thirteen family members, including the infamous Baby, will be descending upon my house in three days’ time. Living cautiously in case of pregnancy means I’ll be doing Thanksgiving sans wine, so, please, pray for me.

Peace.

 

Cycle Day 50 and Other Updates

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What?! “Cycle day 50?” you say. Word. fif.ty. Fiddy. The Big Five O.

You may recall that my blog as of late has basically been about my making innumerable, pointless visits to my RE’s office—coupled with taking frequent ‘scripts for Provera—to try taming my ongoing mystery bleeding. I spoke too soon last time I posted when I said that the bleeding was disappearing. Not a day later it returned with a vengeance. For those of you not familiar with Provera, it’s not supposed to make you bleed while taking it… Like, that’s the exact opposite effect of its purpose. But I did bleed on Provera… twice… and heavily. The eventually bleeding went away, long after the script ran out. The investigative h/s and D&C that Dr. C planned to do were both canceled for reasons unknown to me. I’ve made no effort to try to reschedule them. The whole thing still remains a mystery.

Dr. C’s office tells me that any bleeding I had while taking Provera did not count as a period, i.e. no unfertilized egg was passed. This means that today I’m either on cycle day 50 or cycle day 77. Pick your poison. Personally, I’m going with 50 because it sounds just slightly less insane.

In other fertility news, I [finally] am having my surgical consult on October 6. I don’t find that typing such a sentence warrants an exclamation mark, even though I am actually excited about it. Well, you know: not excited excited. But, post-surgery, certainly I’m looking forward to pain relief from Evil Endo and to having the same chances of natural conception that normal women have. Now that I am excited about! Two exclamation marks for natural TTC!!

It took a long time to find a surgeon. I hit several roadblocks and dead ends along the way, but eventually I found a stellar surgeon who’s only an hour from where I live. She received rave reviews online, and when I called her office to make the appointment her staff was friendly and efficient. Plus, the pre-visit forms I completed were ridic thorough. It took a full six weeks to get an opening with this surgeon, as she’s very in demand. All good things, right? I’m years overdue for another surgery: what’s six weeks to wait?

Otherwise, all’s been quiet on the TTC front. Jake and I ended up not even being able to try making any babies for about, oh, 6 full weeks (!). I was still have problems with painful intercourse and couldn’t, errrrm, do anything. For the record, celibacy during marriage is not fun. Because there’s been a less than zero chance of pregnancy, I’ve become incredibly lazy about taking my vitamins/supplements, charting BBTs, and avoiding too much coffee (c’mon, it’s pumpkin spice season, people!), plus all those other nutty things I do in the name of TTC. And you know what? Part of me doesn’t care. Part of me likes it.

We’ve recently had the one-year anniversary of our first embryo transfer, which was (and is) a tough pill to swallow when I remember back to a year ago and the promises I thought were in store from our second pregnancy. But we also recently celebrated our 13 year wedding anniversary, which is a lovely ray of sunshine busting through the dark and stormy clouds. We may not have our take-home baby yet, but we still have each other. And that alone is priceless.

I’ll end this post with a pic of our still-new-to-us kitty, Grumpy Cat, ‘cause, my goodness, he’s too cute not to be shared with the world.

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 p.s. Is anyone else’s WordPress acting wonky? Not showing draft posts, taking forever to load, not able to save drafts, etc.? Or is it just mine?

Reproductive Plans: The Next Chapter

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Okay, so I might have slightly misled you. I really don’t have a plan. In fact, I probably haven’t been very clear on this blog about what’s next for us in our Quest for Baby. Well, that mystery is about to be solved. ‘Cause here’s the answer: not much.

I have the deepest admiration for those of you who soldier through back-to-back ART cycles, and I wish that I could do the same. Such a feat is not possible for us right now, though it’s not for lack of wanting to. If I had infertility treatment insurance coverage then I’d be right there alongside you, my blogger friends, trying again and again and again. But, my plan has zilch coverage for such extravagantly “unnecessary” treatments, so here I am. Juuuust hanging out….waiting and trying… Blogging occasional random ruminations about all-things-fertility, while watching my biological tick-tock into infinity.

I’m pretty sure that another IVF is not in my reproductive future. The only way we’d be able to do another IVF round is if: (a) I won the lottery, or (b) we befriended a benefactor both rich and generous. Since I don’t even play the lottery, my odds seem pretty nil on that front. And, so far, no rich benefactors have come a’calling. Short of taking out a massive loan, the IVF ship seems to have sailed its final course.

We continue to try naturally, although the last two months have both been busts. In July I had all that weird bleeding, so I was out a month. Then this month I’m also having…yep, more mystery bleeding! I also didn’t ovulate this month, which I was surprised to learn is a common side effect from Provera. In fact, there’s only been a handful of months in 2016 that have been normal cycles for me complete with ovulation, so thus far 2016 hasn’t exactly been our year. Things could always turn around though, and I very much believe that I will eat these words come December 31st.

At least I’m not completely out of the game! I’ve been investigating another cleanup surgery (lap) for my incessant endometriosis. This would be my fifth surgery. Aside from drastically increasing my odds of conceiving naturally, the other big reason I want another surgery is that I am so over being in pain all the time…grrr. I literally never stop feeling my ovary, all day, every day. Whether it’s pulsing, throbbing, or outright screaming at me, this has.got.to.stop. Lately I can add weird random shooting pains near my uterus to my pain factor. They come out of nowhere, which means I could just be walking down the street or sitting on the train when—WHAM!—a pain will strike and double me over. Besides being embarrassing, this kind of pain is so not cool just in general. It also keeps me up at night diagnosing myself with all kinds of far-flung, worst-case-scenario maladies… Anxiety’s such a monster.

I won’t let just any old doctor perform my next surgery though. I’ve been down that road before and, just, no. It’s a challenge, because there’s very, very, VERY few doctors out there specializing in endometriosis. My personal experience has been that I tend to know more about this disease than the majority of doctors I’ve dealt with! That said, I did find one potential contender: He’s a gynecologic endoscopy specialist (fancy!) whose practice is located about two hours from where I live. This doctor seems to really know his stuff about endo and he has 4,000+ laparoscopic surgeries under his belt… well, so to speak, haha!  I haven’t called for an appointment yet, but he looks very promising. Fingers crossed!

Despite no real plan save the maybe-surgery, things could be much worse, reproductively speaking. There is always hope, and God still does the impossible! So until maybe-surgery time gets here, I do have some fun things coming up that I’m looking forward to:

  • A Joyce Meyer conference this weekend. Joyce is only in my state once a year and this year I WILL attend the conference, distance be damned! Seriously, every time I listen to/watch Joyce Meyer I wish that she was my mother. She rocks!
  • A Labor Day cookout in a few weeks. I freakin love Labor Day weekend. It’s still technically summer, but it also unofficially ushers in autumn, which is my favorite season.
  • A conference that my profession’s local association is hosting at the end of September. I have no real colleagues to speak of in my workplace, so I’m very much looking forward to a paid day of networking and a day free from Boss.
  • Sewing classes. My sister and I have signed up for sewing classes at Jo-Ann Fabrics. I’ve always wanted to learn to sew, but never got even the basics down. I mean, I struggle to sew buttons back on a shirt; the scrunchy I made in seventh grade home ec class was little more than a floppy, unwearable circular cloth. My first class is in mid-September and I’m excited for it, even if it might mean near-certain decimation of another innocent garmet.
  • Home Depot workshop. On the third Thursday of each month, my local Home Depot (and yours, too!) holds a free women-only workshop. We’ll be making “vintage wheelbarrows” at the workshop that I signed up for. I feel kind of silly admitting that I’m excited for this. But the truth is that I AM crazy looking forward to it, cause I totally heart making crafty décor.
  • Camping. Our annual family camping trip is only 7 weeks away! My entire family gets together, we bring our campers and tents plus a whole lot of grub, and spend the weekend camping at a quaint country campground. I usually begin looking forward to the next trip before the current trip has even ended. Jake and I bought a popup camper last year, so we’re always stoked for a chance to use it.
  • Bike ride.  The annual 19k organized bike ride that my dad and I participate in each year is only 2 weeks away! It’s a great ride for a great cause, and an added bonus is that most of the course runs along a scenic river canal. Oh yeah, did I mention that my dad is almost 72 years old and he does this ride like a boss? This is truly one of my favorite rides and I’m ridic excited for it.

So now you guys are all caught up in our lack-of-a-plan plans, and I hope I haven’t put you to sleep cause I feel like I’ve said a whole lot of nothing here.

However, one of the best things about plans is that they’re always subject to change. And I wouldn’t mind if this one changed, like, a whole lot! Besides, who knows? While I’m busy looking one way for that mystery benefactor, God may have a much better plan in store for me coming from the opposite direction. I hope He does.

 

 

 

 

Intermenstrual Bleeding

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Last month I took 50 mg of Clomid, unmonitored, on cycle days 3 through 7. I didn’t exactly expect it to work, but I had an extra script lying around and figured, meh, why not? While the Clomid failed to help to get me pregnant, it did give me some seriously painful cysts. I then had a particularly hellish period and figured that was the end of it.

Except that it wasn’t the end of it. This current cycle that I’m in—the one following the failed Clomid attempt—I’ve had intermenstrual bleeding 13 out of the 19 days since my period ended. If you’re wondering what intermenstrual bleeding is, because I’d never heard of it until this week myself, it’s “Vaginal bleeding that occurs between a woman’s monthly menstrual periods.” The causes of it can range from the benign to the frightening (thank you, Dr. Google). Every website I visited on the topic said that IM bleeding should be evaluated ASAP.

{{TMI WARNING!}}  My IM bleeding ranged from both bright and deep red to various shades of brown to nearly black, and was accompanied by both small, dense clots and large, goopy clots. Yuck fest. I ovulated super early on CD 12, and then the IM bleeding picked up serious speed: as in, I just kept bleeding and bleeding and bleeding… but it was definitely not a period. The bleeding became like whoa heavier after sex. I eventually began to avoid sex altogether because, aside from Carrie-esque blood everywhere, intercourse was also painful. To top things off, the bleeding would intensify after—errrm—using the restroom, in which case streams of blood and clots would flow for hours afterward. Scary stuff for anyone, especially for a gal who’s had two ovarian cancer scares in the past. Okay, TMI session over.

Completely freaked out and not knowing who else to call, I emailed my RE, Dr. C. Within minutes of my email, the clinic called me to book a scan and blood work for the very next morning. Bonus awesomeness points to Dr. C! Not that he really needed any more awesomeness points: the man is a medical rock star.

Fortunately, my scan was overall normal. The cysts were gone. Dr. C did point out a couple pools of blood on the u/s screen that shouldn’t be there, but I never did get the location of where the blood was pooling. His take was that I either had a cervical infection or an ectopic pregnancy due in part to the Clomid. So, yeah: maybe something minor or maybe something completely terrifying! The results of my blood work would be what would solve this mystery. My blood was drawn and I was released to spend the rest of the day awaiting the results.

It’s been over 3 months since I’ve had the pleasure of awaiting an important results call from the clinic. Sheesh, did I ever not miss that feeling: carrying my cellphone everywhere, even to the bathroom, so I wouldn’t miss the call. Obsessively checking my phone for missed calls in case it magically turned itself to silent mode. Staring at—but not having any appetite for—lunch due to frayed nerves. You guys know what I’m talking about… I was a nervous wreck at work waiting for the clinic to call. Luckily I was able to wring my hands in relative privacy by closing my office door and only speaking to Boss when needed. Some days it pays to be queen, or, at least, female. Boss senses when I’m having medical girl issues and gives me a wide berth.

After what seemed like an eternity, the nurse called with my results. And much like the ultrasound, my blood work was also normal. So, no weird hormonal changes, no infection, and no ectopic. Confusing, right?

The consensus was that I should begin taking medroxyprogesterone, a/k/a Provera, to induce a [real] period.  I didn’t get much of an explanation about why I’m taking Provera, but I think it’s supposed to help reset my natural cycle. I’ve only just begun taking it and so I have no way of knowing yet how it will affect me, nor do I know if it’s supposed to make me start bleeding or stop bleeding. Does anyone have experience with this drug?

I really want to blame all this craziness on the Clomid, but I can’t prove that it’s the cause of things. Either way, I’m staying faaaaar away from that stuff from now on. If the Provera resets my cycle and I have no more IM bleeding, then good. If the IM bleeding continues, I’ll need a referral from Dr. C for more comprehensive testing. Praying that this medicine will take care of things.

Update to follow.

 

 

 

The Meeting (and the due date)

About six weeks ago, Dr. C left me a voicemail: “I’m really disappointed to hear about how things went this cycle. Let’s chat,” he said. I’m pretty sure this was code for the fertility blogger’s infamous “WTH meeting” I read about from time to time (and that’s “What-The-Heck” in case you’re wondering. No swearing here!). I never wanted to go to one of those. So I did what I do best and put it off.

After several weeks of dragging my feet, I finally I got around to calling the clinic back. Even then I took my sweet time, scheduling the meeting out weeks in advance. I wasn’t alone in not wanting to go: Jake sure didn’t, either. He saw no point in meeting with Dr. C, and I understood his feelings. I had this mental image of us walking the walk of shame down the hallway to Dr. C’s office, passing by all the staff who would give us pitying looks because they knew why we were there.

Of course, it went nothing at all like that. Jake eventually warmed up too, and in the end he told me the meeting was actually worth having.

Even though we covered a lot of ground during our 30 minutes, it also felt like we didn’t really get anywhere. I asked Dr. C every single question I’d had during the past nine months. He graciously took the time to answer each and every one. Toward the end of the meeting Dr. C said that, even though I’d given him quite a workout, he appreciated patients like me who come in armed and ready. He also half-jokingly offered me a job in his practice.

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Stock photos lie. This is not how a WTH meeting looks.

Since you guys know how much I love lists, here’s the highlights:

AMH/DOR/Egg Quantity: My AMH was 0.62 a year ago. I had another AMH panel drawn during my WTH visit. The results will take several days to come in.  Last year, Dr. C conservatively figured that my low AMH could’ve been due to my having one ovary. This year he changed his opinion and said that my score wouldn’t have made a difference, because whether I had one, two, or three ovaries (who has 3 ovaries????), DOR is DOR is DOR.

Egg Quality: Besides my low egg reserve, there’s also a quality issue of my remaining eggs. I again declined Dr. C’s suggestion of using donor eggs. It’s important to me to be biologically related to our child, and using donor gametes goes against my beliefs. After the meeting, this whole egg quality thing had me feeling pretty bad about myself: Did my “bad eggs” make me directly responsible for all our losses? I’m only 34. Aren’t donor eggs something for older women? Why is this even something a doctor is talking to me about?

Pelvic Adhesive Disease: Dr. C kept throwing this term into my diagnoses until finally I had to ask what exactly pelvic adhesive disease is. Here’s the lowdown: Endo adheres your insides together. After surgery to remove the endo adhesions, new scar tissue forms from removal of the endo adhesions themselves. This new scar tissue adheres your insides together yet again, resulting in PAD. It’s like an ever-spinning wheel of adhesive insanity! Of course Dr. C couldn’t prove it diagnostically at our meeting, but the fact that my ovary hurts, oh I don’t know, ALL THE FREAKING TIME makes him think PAD is a culprit, along with recurring endo. Hooray.

Laparoscopy: It makes sense to me—and I said so, too, bluntly—that all this IVF/ART business is like putting a band-aid on a gunshot wound. As long we ignore the endometriosis factor then we’re not really treating my fertility issues, we’re just trying sneaky backdoor methods to get me knocked up. Since IVF is tabled for now (donations welcome!), Dr. C gave me a referral to a local gyn surgeon he highly recommended. This would be my fifth surgery and third laparoscopy. It might seem counterintuitive to have surgery because of the whole PAD thing, but surgery is the option I’m most in favor of. Jake and I have a lot of discussing to do before I make the final decision, since there’s a few things going on in our personal lives with work, school, moving, etc. that might make having a lap a bit tricky right now. We will see. And, of course, I’ll let you guys know!

IUI: I’d always been told that IUI for endo patients is a total waste of time and money. However, Dr. C feels that that’s not necessarily true if the IUI is done soon after a lap. In that case, the endo is gone so it’s no longer a factor. Until we’re able to do another IVF, Dr. C suggested Clomid IUIs with injectables following the lap. It seems like we’d be going backward to move from IUI to IVF back to IUI.  I’m 50/50 about this option, but leaning more toward “no.”

Implantation Issues: This one’s a biggie. Since no one can see implantation happening (or not happening), it remains this mysterious, elusive, intangible thing for doctors. I  walked away from the meeting feeling like I didn’t get a lot of answers about possible implantation issues, as Dr. C couldn’t offer any real solutions. After three losses, Dr. C feels that implantation is definitely a factor to investigate… somehow. But there’s not much to be done diagnostically that I haven’t already done. Basically, the implantation issue went nowhere and I’m not thrilled about that. To be revisited.

MTHFR: Along those lines, we reviewed my RPL panel and Dr. C espoused how unremarkable it was. Here’s where I could use some serious input from you guys: When I asked Dr. C why he didn’t include testing for MTHFR on the panel, his response was (literally), “It doesn’t really make a difference.” This didn’t sit well with me. That can’t be true, right?! Anyone? I mean, there’s entire websites dedicated to MTHFR. I really, really wish that REs took RI more seriously. It’s to their patients’ detriment that they don’t.

Scratching the Itch: Last year I had asked for an endometrial scratch prior to starting IVF. Science is iffy about whether ES helps prime the uterus for an embryo, but it certainly doesn’t hurt (scratch that, it does hurt, physically, a lot. Pun intended) to have the procedure done anyway. He wasn’t opposed to it last year, but Dr. C eventually talked me out of having it done. During our meeting, though, he recommended I have an ES done prior to doing IVF again… You can’t even begin to know the depths of my frustration when I reminded him that I’d asked for an ES last year and we didn’t do one!

The Miscarriages/RPL:  All Dr. C could tell us was that m/c #2 was likely due to an abnormal embryo, and that m/c #3 could have been another abnormal embryo or an implantation issue alone or both. We did ICSI last time around, but not PGS. Dr. C recommends PGS for any future IVFs. I have reservations about the reliability of PGS and I don’t believe it doesn’t harm embryos (science says so, too!), plus I have moral issues about destroying embryos that don’t pass the PGS test. This is one thing I’m really firm on. Since I never had any miscarried embryos to biopsy, there’s no telling. Again, a more thorough RPL panel might have helped here… Maybe one that included MTHFR.

Okay, wow, now that I’ve written it all out it seems pretty clear to me that we need to get a second opinion (or a fourth, really). Dr. C is the third reproductive endocrinologist that I’ve treated with, but I’m not so dedicated to the practice that I won’t get another opinion. REs don’t know how a patient will respond to IVF the first time, and it can take a few cycles to get the right protocol down; I totally get that. I guess the whole purpose of a WTH meeting is to go over things, try to come up with what went wrong, and make plans to change what needs to be changed the next time around.

With that said, I’ve looked into RI treatment with Dr. Braverman. I even went so far as to start dialing his number for the free consultation. I mean, logistically it’s somewhat doable: Braverman’s office is only 2 hours away. Boss would even work with me for all the time I’d need to miss from work. There’s a semi-local clinic where I could be seen for non-NY appointments. But, it’s all so stupidly expensive and my insurance covers none of it. Another door closes.

With no real solutions, I feel I’ve basically said nothing this entire post up ’til now… except for a whole lot of “maybe’s” and “I don’t know.” Which is pretty much how I feel about things too: maybe this, maybe that, and I just don’t know.


 

Finally, it wouldn’t be right for me to end this post without making mention of my due date… well, one of them anyway. I’ve added the due date to all the other tough moments of being in the fertility trenches. I like to think of them as a collection of battle scars. As scars become layered on top of each other, they form a thick skin. And a thick skins helps us toughen up and soldier on, even when our insides are all soft and battle-weary.

June 9, 2016 would’ve should’ve been my due date for pregnancy #2. Instead of a baby on June 9, I got my period. Seriously. Jake sent me a beautiful bouquet of flowers at work that day to let me know he didn’t forget either, which meant so much to my heart. I think about it every single day and I will always hold a special place in my heart for the little person who should be here with us now, but is in Heaven instead. I love you, S.W., and You Are Missed.

In S.W.’s memory, this charm hangs from my rearview mirror, for when I look back while still moving forward.

mcheart

  Peace.