just hours after arriving home from a whirlwind international trip, i found myself back at the hospital -- this time in the cardiology department. thanks to my doctor's direct call to the cardiologist, i was easily able to schedule the pre-op procedures he wanted me to have done as soon as i arrived home, and they promised he would get the results the following day, which means i can schedule my surgery as soon as possible.
i had an EKG, which i've had done before... no big deal. it takes all of two minutes to print out the wavy lines that somehow indicate how your heart works once they stick the little thingies all over your body to attach the electrical wires to. the EKG looks for abnormal rhythms in the heart. i also had an echocardiogram, which i don't think i've had done before. that one took a bit longer. it's sort of just a sonogram, with the wand and the gel, but you also have to be hooked up to some of the electrical connections like with the EKG. the doctor asked me to do a lot of different breathing activities while she took about 50 different pictures of my heart. i could see it beating on the screen, and there were a lot of colors overlaid that i think indicated the flow of blood. this procedure obviously looks for physical issues with the heart and with the flow of the blood. it took about 20 minutes or so.
after i wandered around barnes & noble for awhile, i went back for my appointment with the cardiologist, to go over the results. (same day results -- i told you i had superstar service!) the doctor said that the two procedures showed that everything seems to be working fine with my heart, and that there's no reason to worry in terms of the surgery. which is good! but... there's still something up with my heart.
the cardiologist seemed more fascinated with the situation than concerned, so i am not worried. basically he just kept saying that my heartbeat has an irregular sound, and nothing in the echo indicated any reasons for that. in fact, he seemed to think i was misdiagnosed as a kid, when the pediatric cardiology department at the world-renowned hospital in my hometown told my parents that the tricuspid valve of my heart was actually a bicuspid, causing an incomplete seal when it closed and leading to an odd heartbeat. he said that the echo showed that all of my valves are normal and that my heart is contracting normally, but there is still a "strange" sound that he can't explain. so he wants me to have a cardiac MRI so that we can learn more. he specifically instructed the scheduling desk to make sure he was able to be present for the procedure, so it seems like he's really interested in my freak heart. i had to call the hospital in my hometown and request my records... from 1987. crazy.
but in any case, it seems like i'm good to go for the surgery. my ovulation monitor did not much enjoy me traveling to another time zone, and it didn't actually give me a reading this cycle. i'm not sure exactly wen i ovulated... for once i wasn't paying attention! but today is day 22, so i expect to get my period sometime in the next five days or so regardless. that means the surgery will be the end of april or beginning of may. yippee. i emailed my choir director today to tell her that i'm not sure i can continue performing with the group this semester, since our concerts are the first two weeks of may. sucks. but what can you do? in the end, i hope it will all be worth it.
Friday, March 25, 2011
Wednesday, March 9, 2011
and now, what you've all been waiting for: the results
we had our appointment with the fertility doc today to go over the zillion and one results from all of the procedures and tests. and, i have to say, the outcome is probably ideal. i honestly would have been miserable if he'd said, "you're perfect in every way and we have no idea why you're not getting pregnant! just go home and keep trying!" but, obviously, i didn't want to get terrible news about my health. thus, my perfect scenario was realized: there are some things going on that could very likely be impacting our fertility, BUT they should be easy to fix.
we were there for 45 minutes and i still love the doctor so much. he went through every single test result in detail, including each and every blood test that they ran with the huge vat of my blood they collected over three visits. he had looked over everything, including the records sent from my regular doc, and prepared a huge detailed and organized file with multi-colored tabs to document everything. it was very satisfying.
RESULTS
overall, i am in very good health. the results were negative for all of the bad genetic stuff like sickle cell anemia and cystic fibrosis as well as for all of the infections and STDs and whatnot; not only do i not have any of them now, i never have. that was the most interesting thing i learned from the conversation, actually, that your blood is a record of your body throughout your life. it showed that i had chicken pox, and that i have been immunized against hepatitis B, and also that i had parvo (fifths disease) at some point in my life, although neither i nor my parents realized it. fascinating stuff.
but i digress. in addition to being clear of nasty stuff i also had normal results for the hormone tests. my ovaries have lots of healthy eggs and are producing them normally, and my estrogen and testosterone levels and whatever else are rising and falling as they should throughout my cycle. i am also totally normal in most of my other body functions, such as liver, thyroid, etc. my cholesterol was slightly high but nothing terrible (and i didn't fast before the test, so it may not even be accurate). the only thing that came out of the blood tests that is important to note is that i carry two genetic mutations that have to do with blood clotting. for normal, healthy nonchild-bearing folks, this is mostly irrelevant and doesn't impact their lives in any way. for normal, healthy pregnant women, they just need to take medication to make sure they don't develop blood clots. but it may be a bigger deal for me... more to follow.
the other thing that the tests showed was that there is something not quite right with my uterine lining. there are two parts of the lining (endometrium): the glandular lining and the endometrial stroma, which is connective tissue. these two parts have to be formed together in a particular way in order for a fertilized egg to implant and thrive. right now, mine probably won't allow that to happen. the doc said that even if an egg did manage to implant, this condition causes repeated spontaneous abortions. but he also said that scraping out the lining and letting it start from scratch will hopefully fix that, and also remove any polyps that are there. he said the one we saw in the sonogram photo may or may not actually be a polyp, but if it is one it needs to go. so that's something that will need to be done.
the third thing that the doc shared with us is that he's pretty convinced that i have endometriosis, which is a condition in which endometrial-type cells develop in other parts of the body, usually around the ovaries, causing lesions and sometimes scar tissue. these cells respond to hormonal changes as the regular endometrium does, which can wreak havoc with your periods and fertility. if it's bad enough, there's a chance that the tubes can actually become deformed from scar tissue so that the eggs don't ever make it out. the doc said that almost always when he sees a woman under 35 with otherwise normal test results, awful periods (which i have developed over the past couple of years), and a partner with decent sperm counts (which he insists the hubby's are) that endometriosis is the cause of the infertility. once they remove the cells, pregnancy is often very simple.
but in order to do that they have to do a surgical procedure. it's called a laparoscopy, and it consists of inserting a scope through my belly button and something else through the bottom of my pelvic region in order to get a closer look at what's happening down there. this allows them to see around and behind the ovaries and tubes to really be certain that everything is working correctly. while they're in there, they can laser away any endometriosis that they find. they can also, in my case, scrape out the uterine lining. it's like two surgeries for the price of one! aren't i lucky.
but before any of this happens, i have to see a cardiologist. when i was younger, my pediatrician discovered an abnormality in my heart that they kept a very close eye on throughout my teenage years. one of the valves that is supposed to be a tri-cuspid (meaning it has three flaps to let blood through) is only a bi-cuspid. for years they thought this might cause me problems, but eventually they stopped monitoring it because it seemed to be rather harmless. however, in pregnancy when the demands on the body increase tremendously, this could be an issue. add to that the blood test results that showed i may have issues with blood clotting, and we could have a serious problem. the doc insisted that i see a cardiologist before we take any other steps, to make sure that i'm healthy enough to handle a) surgery and b) a possible pregnancy. in fact, he called a reputable one at the hospital and talked to him this afternoon, so all i need to do is call and make an appointment.
NEXT STEPS
so, to recap concisely, here are the issues at hand:
1) blood clotting/possible heart issue
2) uterine lining problem
3) possible endometriosis
the first thing i need to do is see the cardiologist. as soon as he clears me for surgery (assuming he does), i schedule the laparoscopy. the doc wants this to happen in the beginning of my cycle, after my period has stopped but before ovulation -- so i'll need to look at my calendar and figure out how that works. after the surgery (and the 5 days or so he says i'll need to recover) we will hopefully be good to go. as long as the surgery doesn't reveal any bizarro issues with my tubes, the doc said he'd probably advise us to keep trying on our own for a couple months, possibly with the aid of injections that would up my ovulation rate (giving us a better chance of conceiving). if that's still unsuccessful, we'd probably try IUI. but, again, this assumes that my tubes are totally functional.
if the laparoscopy reveals problems with my tubes, in vitro will be our only option. the doc said -- in light of our financial concerns about dropping the $10k this costs and the fact that my insurance only gives us $5k per calendar year toward any fertility assistance procedures -- that we'd be sure to save that whole $5k to put toward in vitro, if that's the case, rather than wasting time with IUI when it won't be useful. but we're hoping it won't come to that. (although my inlaws have already offered to pick up the tab for the $5k our insurance wouldn't cover if that's the only way they'll get a grandchild.)
so for right now, it's the cardiologist and then hopefully the surgery. and then we'll know even more and will be able to plan for the next (and hopefully last) step. the doc is very optimistic. he said his job is made easier by people in our situation. and so i am also optimistic. this is the best i've felt about this matter in months, even though i'm staring down a not-so-fun surgery. if it leads to us finally having a baby, it will be worth far more than that discomfort.
and the best part? there's absolutely nothing i can do until i get back from my trip in two weeks. i can't even wonder or worry right now, really. so i can hop on a plane and leave the stupid ovulation monitor at home (i can't figure out how to deal with the time zone change anyway) and just enjoy life and love and vacation for awhile. won't that be grand?
we were there for 45 minutes and i still love the doctor so much. he went through every single test result in detail, including each and every blood test that they ran with the huge vat of my blood they collected over three visits. he had looked over everything, including the records sent from my regular doc, and prepared a huge detailed and organized file with multi-colored tabs to document everything. it was very satisfying.
RESULTS
overall, i am in very good health. the results were negative for all of the bad genetic stuff like sickle cell anemia and cystic fibrosis as well as for all of the infections and STDs and whatnot; not only do i not have any of them now, i never have. that was the most interesting thing i learned from the conversation, actually, that your blood is a record of your body throughout your life. it showed that i had chicken pox, and that i have been immunized against hepatitis B, and also that i had parvo (fifths disease) at some point in my life, although neither i nor my parents realized it. fascinating stuff.
but i digress. in addition to being clear of nasty stuff i also had normal results for the hormone tests. my ovaries have lots of healthy eggs and are producing them normally, and my estrogen and testosterone levels and whatever else are rising and falling as they should throughout my cycle. i am also totally normal in most of my other body functions, such as liver, thyroid, etc. my cholesterol was slightly high but nothing terrible (and i didn't fast before the test, so it may not even be accurate). the only thing that came out of the blood tests that is important to note is that i carry two genetic mutations that have to do with blood clotting. for normal, healthy nonchild-bearing folks, this is mostly irrelevant and doesn't impact their lives in any way. for normal, healthy pregnant women, they just need to take medication to make sure they don't develop blood clots. but it may be a bigger deal for me... more to follow.
the other thing that the tests showed was that there is something not quite right with my uterine lining. there are two parts of the lining (endometrium): the glandular lining and the endometrial stroma, which is connective tissue. these two parts have to be formed together in a particular way in order for a fertilized egg to implant and thrive. right now, mine probably won't allow that to happen. the doc said that even if an egg did manage to implant, this condition causes repeated spontaneous abortions. but he also said that scraping out the lining and letting it start from scratch will hopefully fix that, and also remove any polyps that are there. he said the one we saw in the sonogram photo may or may not actually be a polyp, but if it is one it needs to go. so that's something that will need to be done.
the third thing that the doc shared with us is that he's pretty convinced that i have endometriosis, which is a condition in which endometrial-type cells develop in other parts of the body, usually around the ovaries, causing lesions and sometimes scar tissue. these cells respond to hormonal changes as the regular endometrium does, which can wreak havoc with your periods and fertility. if it's bad enough, there's a chance that the tubes can actually become deformed from scar tissue so that the eggs don't ever make it out. the doc said that almost always when he sees a woman under 35 with otherwise normal test results, awful periods (which i have developed over the past couple of years), and a partner with decent sperm counts (which he insists the hubby's are) that endometriosis is the cause of the infertility. once they remove the cells, pregnancy is often very simple.
but in order to do that they have to do a surgical procedure. it's called a laparoscopy, and it consists of inserting a scope through my belly button and something else through the bottom of my pelvic region in order to get a closer look at what's happening down there. this allows them to see around and behind the ovaries and tubes to really be certain that everything is working correctly. while they're in there, they can laser away any endometriosis that they find. they can also, in my case, scrape out the uterine lining. it's like two surgeries for the price of one! aren't i lucky.
but before any of this happens, i have to see a cardiologist. when i was younger, my pediatrician discovered an abnormality in my heart that they kept a very close eye on throughout my teenage years. one of the valves that is supposed to be a tri-cuspid (meaning it has three flaps to let blood through) is only a bi-cuspid. for years they thought this might cause me problems, but eventually they stopped monitoring it because it seemed to be rather harmless. however, in pregnancy when the demands on the body increase tremendously, this could be an issue. add to that the blood test results that showed i may have issues with blood clotting, and we could have a serious problem. the doc insisted that i see a cardiologist before we take any other steps, to make sure that i'm healthy enough to handle a) surgery and b) a possible pregnancy. in fact, he called a reputable one at the hospital and talked to him this afternoon, so all i need to do is call and make an appointment.
NEXT STEPS
so, to recap concisely, here are the issues at hand:
1) blood clotting/possible heart issue
2) uterine lining problem
3) possible endometriosis
the first thing i need to do is see the cardiologist. as soon as he clears me for surgery (assuming he does), i schedule the laparoscopy. the doc wants this to happen in the beginning of my cycle, after my period has stopped but before ovulation -- so i'll need to look at my calendar and figure out how that works. after the surgery (and the 5 days or so he says i'll need to recover) we will hopefully be good to go. as long as the surgery doesn't reveal any bizarro issues with my tubes, the doc said he'd probably advise us to keep trying on our own for a couple months, possibly with the aid of injections that would up my ovulation rate (giving us a better chance of conceiving). if that's still unsuccessful, we'd probably try IUI. but, again, this assumes that my tubes are totally functional.
if the laparoscopy reveals problems with my tubes, in vitro will be our only option. the doc said -- in light of our financial concerns about dropping the $10k this costs and the fact that my insurance only gives us $5k per calendar year toward any fertility assistance procedures -- that we'd be sure to save that whole $5k to put toward in vitro, if that's the case, rather than wasting time with IUI when it won't be useful. but we're hoping it won't come to that. (although my inlaws have already offered to pick up the tab for the $5k our insurance wouldn't cover if that's the only way they'll get a grandchild.)
so for right now, it's the cardiologist and then hopefully the surgery. and then we'll know even more and will be able to plan for the next (and hopefully last) step. the doc is very optimistic. he said his job is made easier by people in our situation. and so i am also optimistic. this is the best i've felt about this matter in months, even though i'm staring down a not-so-fun surgery. if it leads to us finally having a baby, it will be worth far more than that discomfort.
and the best part? there's absolutely nothing i can do until i get back from my trip in two weeks. i can't even wonder or worry right now, really. so i can hop on a plane and leave the stupid ovulation monitor at home (i can't figure out how to deal with the time zone change anyway) and just enjoy life and love and vacation for awhile. won't that be grand?
Friday, March 4, 2011
perspective
while it was hard to pinpoint exactly when it started as i never stopped spotting after the biposy, i definitely have my period. and while i am, of course, disappointed, i am not surprised and also not very bothered by it this cycle. this was our 13th try, i think, though i'm losing count. it's a mere five days until our results appointment, and i'm really looking forward to hopefully hearing something definitive, something to change the course of the past year and my outlook on the future.
and in the meantime, i think i can honestly say that i've developed some perspective on this, finally. there has been so much stuff happening in lives parallel to mine that has made me think about how very lucky i am to be at this point of my life and to have almost everything i ever could have wanted. i know it sounds cliched, but it's really true. in the past year i got my doctorate, bought a house, and landed my dream job (which has, unbelievably, actually continued to be my dream job even after doing it for nearly a year). the hubby and i are happier than we've ever been. and yet, on the periphery of my rosy life, i have friends and acquaintances who can't find jobs, relatives going through divorces, friends fighting cancer, a friend whose mother is dying of cancer, a friend who has had a student die in recent weeks, and a fellow chorus member whose life partner suddenly passed away -- leaving her financially and legally very bad off. i recently learned that a colleague -- one of the people i'm closest to at work -- has been trying to get pregnant on her own for over a year. she's been inseminated 14 times and they can't figure out why it's not working. she's 37 and desperately wants kids so, although she's single, she finally triumphantly decided to go it alone and had every reason to believe it would happen easily... and here she is, shelling out big bucks for hormone meds and procedures every month, to no avail. she's spending her nest egg trying to make a baby and they can't figure out why it's not working and she just doesn't know what to do next.
i'm not going to say "it could be worse;" of course it could be, and that's not the important thing here. the important thing is that i am, in every other facet of my life aside from my un-parenthood, incredibly happy. and i'm not going to sacrifice that for want of this one elusive thing. i do want a baby... so much. so much that it makes me cry both in happiness when i imagine it and in misery when i think it won't ever happen. but no matter what we find out on wednesday, i think we're in good shape to deal with this with perspective. we know what we will and won't pursue in terms of fertility assistance, and any information we get will hopefully help us to make a plan going forward. if there's nothing conclusive, we'll give ourselves a time limit for how much longer we'll try before we switch routes. and that's that. i don't think we're going to let this crush us. i really don't. and while i've claimed that in the past, i am pretty sure now that i actually mean it.
and in the meantime, i think i can honestly say that i've developed some perspective on this, finally. there has been so much stuff happening in lives parallel to mine that has made me think about how very lucky i am to be at this point of my life and to have almost everything i ever could have wanted. i know it sounds cliched, but it's really true. in the past year i got my doctorate, bought a house, and landed my dream job (which has, unbelievably, actually continued to be my dream job even after doing it for nearly a year). the hubby and i are happier than we've ever been. and yet, on the periphery of my rosy life, i have friends and acquaintances who can't find jobs, relatives going through divorces, friends fighting cancer, a friend whose mother is dying of cancer, a friend who has had a student die in recent weeks, and a fellow chorus member whose life partner suddenly passed away -- leaving her financially and legally very bad off. i recently learned that a colleague -- one of the people i'm closest to at work -- has been trying to get pregnant on her own for over a year. she's been inseminated 14 times and they can't figure out why it's not working. she's 37 and desperately wants kids so, although she's single, she finally triumphantly decided to go it alone and had every reason to believe it would happen easily... and here she is, shelling out big bucks for hormone meds and procedures every month, to no avail. she's spending her nest egg trying to make a baby and they can't figure out why it's not working and she just doesn't know what to do next.
i'm not going to say "it could be worse;" of course it could be, and that's not the important thing here. the important thing is that i am, in every other facet of my life aside from my un-parenthood, incredibly happy. and i'm not going to sacrifice that for want of this one elusive thing. i do want a baby... so much. so much that it makes me cry both in happiness when i imagine it and in misery when i think it won't ever happen. but no matter what we find out on wednesday, i think we're in good shape to deal with this with perspective. we know what we will and won't pursue in terms of fertility assistance, and any information we get will hopefully help us to make a plan going forward. if there's nothing conclusive, we'll give ourselves a time limit for how much longer we'll try before we switch routes. and that's that. i don't think we're going to let this crush us. i really don't. and while i've claimed that in the past, i am pretty sure now that i actually mean it.
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