it's amazing how quickly the first part of my cycle goes when i'm not giving myself injections every day. i barely even noticed, and suddenly i'm pre-ovulatory. i went to the doctor this morning and i have one nice, big, fat follicle about ready to go, so we're doing IUI tomorrow. they gave me the trigger shot before i left, which is also great because that's the worst injection of all (it hurts and makes me sore afterwards) so i didn't have to worry about doing it myself OR having a sore leg because they give me the shots in my arm. the doc said because of the timing we will only do one insemination this cycle, which is fine by me. and i love that it's happening on a saturday... much less stress and i can go home and back to bed afterwards!
in related news, i've really been enjoying acupuncture. and no, not just because the guy is a hottie. it is such a completely different experience than the fertility stuff that is happening at the doctor... it seems incredible that they both can be intended to serve the same purpose. the divide between eastern and western medicine has never been so clear to me. frank, my acupuncturist, was upset by the fact that the head honcho doctor said, "time is of the essence" at my last appointment. well, he was as upset as a buddhist can get. which isn't really upset. but he had a lot of things to say about it. he said anyone who would say that to a patient doesn't understand the mind-body connection: what he thinks is the most important aspect of it all. not that he doesn't see truth in the fact that older women tend to struggle with fertility more often. but he won't generalize just on the basis of statistics when there are so many unknown factors about each individual situation. he told me he hadn't even met his wife yet when she was 35 -- and they have one child and another on the way -- so basing something on age isn't an effective measure of success.
so he talked to me a lot about different perspectives and ways to think about this from a more spiritual way, very much from buddhist ideals which are familiar and comfortable to me. we talked about attachment and impermanence, and how my mindset can and does affect this whole situation. he said i should think of myself already on a parenting journey, and that that journey began the moment i decided that i wanted to try to become a parent and turned my body over to the possibility. he said everyone's experience is different, and this is mine. it may include me getting pregnant and giving birth, or it may take another path. but i should stop thinking that i'm waiting for the experience to begin, because i'm already in it.
accepting that there are endless possible outcomes to this adventure is actually very comforting to me. i thought that idea might make me anxious, but it had the opposite effect. there are many ways to build a family and to give back to the world, and i will find a way to do it one way or another. i'm not going to let this crush me. we're doing what we can with a lot of medical assistance -- miraculous stuff that i'm so happy they can do. but it's not the be-all and end-all. these next few months will determine a lot, and then this phase of our journey will be over... no one can know what will come next.
Showing posts with label "infertility". Show all posts
Showing posts with label "infertility". Show all posts
Friday, October 7, 2011
Friday, July 8, 2011
phase 2, cycle 2 limbo and logistics
today is day 23 of my cycle. my period should arrive monday-ish. and i'm completely in limbo. if i do get my period, then the IUI protocol begins right away. i have to call the fertility doc ASAP and let them know, because on Day 3 of my cycle i will have to start the injections for ovulation induction. they'll also do bloodwork then to make sure my hormones are doing what they're supposed to do. i will give myself injections for 4 or 5 days, then when the monitor says i'm ovulating, i will go in for an ultrasound to make sure it's for real, and the next morning we'll go in for the insemination. i know there are other drugs and tests and procedures other than that, but they've been good about only telling me what i need to know for the immediate future and not overwhelming me with all of the next steps. in fact, i know i will be receiving five drugs, i think the nurse said, but i only know what the heck i'll be doing with the one. so really... much of this is going to be the great unknown.
my insurance will cover $5k per calendar year of treatments, although they've told me the medications aren't covered. i haven't yet been able to determine if that's because all of my prescriptions are covered by a different benefit plan, or if that means i'm going to have to pay out of pocket for them. the nurses and receptionists at the fertility institute have been -- as always -- amazingly helpful and on top of things, and i have been assured that the meds were ordered and they did have my prescription plan info. the medications will be delivered to me by a specialty pharmacy. from what i've been told, they will have to be refrigerated, so i think i'll have them sent directly to work to make sure nothing happens to them. and then i'll just have to figure out how the heck to give myself an injection. i'm not squeamish, but i've never done that before. and the hubby is certainly not a candidate for helping out. squeamish is an understatement for his reaction to anything related to needles.
i've been on the phone with someone from the fertility institute or from my insurance company every day for the past week. I had to be "authorized" to begin receiving the fertility assistance benefits provided under my plan, which consisted of me being read what i'm allowed and required to do: making sure my doctor was in their good graces, instructing me that i must have at least three rounds of insemination before they'll cover IVF, etc. it also consisted of me answering a whole bunch of questions (about 15 minutes' worth) about my medical and fertility history and getting a lot of detailed instructions about what i have to do and what i have to have the doctor's office do. have them call to get the authorization code, call them with the bloodwork results on day 3, call the second i know i'm pregnant... it all feels very artificial (no pun intended) and weird, weird, weird. but mostly just stressful. there are so many logistics to keep straight.
but at last, finally, i think every last detail is in order. but still... i can't know for sure what's going to happen. it's really bizarre to think that it's possible that we've taken all of these steps and set this whole chain of events into motion and that it might not even be necessary. my therapist asked me if i have any feelings about my possible pregnancy... do i have a hunch? a gut sensation? and the truth is i don't. i have stopped dwelling on symptoms, i have stopped paying attention and freaking out. i've been better about coffee (for general healthy reasons) but have had several glasses of wine and sangria over the past few weeks. I feel like i'm making an effort to live my life as if i'm not pregnant, rather than in the state of constant insane wondering in which i lived for many months. so for now i'm mostly just waiting. but as the end of my cycle gets closer i find it harder to keep my hope quiet. but we shall see, very soon indeed.
my insurance will cover $5k per calendar year of treatments, although they've told me the medications aren't covered. i haven't yet been able to determine if that's because all of my prescriptions are covered by a different benefit plan, or if that means i'm going to have to pay out of pocket for them. the nurses and receptionists at the fertility institute have been -- as always -- amazingly helpful and on top of things, and i have been assured that the meds were ordered and they did have my prescription plan info. the medications will be delivered to me by a specialty pharmacy. from what i've been told, they will have to be refrigerated, so i think i'll have them sent directly to work to make sure nothing happens to them. and then i'll just have to figure out how the heck to give myself an injection. i'm not squeamish, but i've never done that before. and the hubby is certainly not a candidate for helping out. squeamish is an understatement for his reaction to anything related to needles.
i've been on the phone with someone from the fertility institute or from my insurance company every day for the past week. I had to be "authorized" to begin receiving the fertility assistance benefits provided under my plan, which consisted of me being read what i'm allowed and required to do: making sure my doctor was in their good graces, instructing me that i must have at least three rounds of insemination before they'll cover IVF, etc. it also consisted of me answering a whole bunch of questions (about 15 minutes' worth) about my medical and fertility history and getting a lot of detailed instructions about what i have to do and what i have to have the doctor's office do. have them call to get the authorization code, call them with the bloodwork results on day 3, call the second i know i'm pregnant... it all feels very artificial (no pun intended) and weird, weird, weird. but mostly just stressful. there are so many logistics to keep straight.
but at last, finally, i think every last detail is in order. but still... i can't know for sure what's going to happen. it's really bizarre to think that it's possible that we've taken all of these steps and set this whole chain of events into motion and that it might not even be necessary. my therapist asked me if i have any feelings about my possible pregnancy... do i have a hunch? a gut sensation? and the truth is i don't. i have stopped dwelling on symptoms, i have stopped paying attention and freaking out. i've been better about coffee (for general healthy reasons) but have had several glasses of wine and sangria over the past few weeks. I feel like i'm making an effort to live my life as if i'm not pregnant, rather than in the state of constant insane wondering in which i lived for many months. so for now i'm mostly just waiting. but as the end of my cycle gets closer i find it harder to keep my hope quiet. but we shall see, very soon indeed.
Tuesday, May 17, 2011
Post-Op: The Plan
Today the hubby and I had our follow-up appointment with the doc to discuss the surgery results and to make a plan for next steps. I feel like it's taken an eternity for today to arrive; perhaps it's just because work has been so busy, but the surgery already feels lightyears back in history and I am so ready to move on.
First he showed us the photos from the surgery, which were really cool to see. It's amazing -- first of all -- that there were cameras INSIDE MY BODY! and, secondly, that they took this amazingly clear photos. It was like looking at space telescope photos, with all the bright colors and contrast and odd shapes that you can't quite identify. He showed us glamour shots of everything, from my cervix and birth canal and uterus (which all look Hollywood gorgeous... according to the expert) to the actual endometriosis.
Our doc said that while there was a bunch of it, it wasn't what he would call a serious case of endometriosis because it hadn't advanced past Stage 1 or 2 (out of 4 stages: http://womenshealth.about.com/cs/endometriosis/a/endotreatdiagsu_2.htm). My understanding is that that means it hadn't progressed enough to cause any major physical problems. But, as I already knew, the doctor reminded us that when it comes to endometriosis, it doesn't matter how much you have, because even a tiny spot creates whatever kind of autoimmune or chemical reaction that inhibits pregnancy (they still don't really know the exact connection).
So, as we saw in our endometriosis photo gallery, I had a bunch of lesions that just look like little black spots, and also some scar tissue, which looks more gross... like big fleshy growths. The worst of it was on my left ovary (which, I learned today, is defined by the doctor's view looking AT your body. So it's what I've always thought of as my right ovary, make sense?). There was some scar tissue on the ovary, and around the tube on that side. But it's all gone now, and both of my ovaries and tubes look healthy and functional.
The doctor said that, all things considered, he is very confident and optimistic that this may solve our "infertility" issues. He said sometimes the endometriosis comes back, and sometimes it doesn't; however, the earliest that it will come back is usually in six months post-surgery. Thus, the next six months are our target range... when our chances of conceiving are highest. His advice was for us to try to conceive on our own for a couple of months, and if we're not successful then we will move to Step 2: IUI (intrauterine insemination) with hormone injections to increase my egg production. He wasn't keen on jumping to that right away, although he said it was totally up to us. Of course the hubby is totally relaxed about the whole thing and just wants to see how things go, but I don't want to take our time too much.
Our compromise is to try on our own for two cycles. If it's unsuccessful, we'll move to Step 2. The timing of this works well for me, because it'll be summer vacation by the time we hit Step 2 (if we do), making it vastly easier for me to get to the doctor for hormone injections and insemination. And, while the doctor says I absolutely should NOT be thinking about how my pregnancy fits in with my work life, I'm not really able to ignore that entirely... and if I am pregnant before the end of the summer, I will still be on track for my ideal plan of having the baby before the end of next school year.
All in all, good stuff today. And how fun will it be to start trying again with a hope that it will actually be successful? Heck, in these long weeks post-surgery, how fun will it be to just have sex again?
First he showed us the photos from the surgery, which were really cool to see. It's amazing -- first of all -- that there were cameras INSIDE MY BODY! and, secondly, that they took this amazingly clear photos. It was like looking at space telescope photos, with all the bright colors and contrast and odd shapes that you can't quite identify. He showed us glamour shots of everything, from my cervix and birth canal and uterus (which all look Hollywood gorgeous... according to the expert) to the actual endometriosis.
Our doc said that while there was a bunch of it, it wasn't what he would call a serious case of endometriosis because it hadn't advanced past Stage 1 or 2 (out of 4 stages: http://womenshealth.about.com/cs/endometriosis/a/endotreatdiagsu_2.htm). My understanding is that that means it hadn't progressed enough to cause any major physical problems. But, as I already knew, the doctor reminded us that when it comes to endometriosis, it doesn't matter how much you have, because even a tiny spot creates whatever kind of autoimmune or chemical reaction that inhibits pregnancy (they still don't really know the exact connection).
So, as we saw in our endometriosis photo gallery, I had a bunch of lesions that just look like little black spots, and also some scar tissue, which looks more gross... like big fleshy growths. The worst of it was on my left ovary (which, I learned today, is defined by the doctor's view looking AT your body. So it's what I've always thought of as my right ovary, make sense?). There was some scar tissue on the ovary, and around the tube on that side. But it's all gone now, and both of my ovaries and tubes look healthy and functional.
The doctor said that, all things considered, he is very confident and optimistic that this may solve our "infertility" issues. He said sometimes the endometriosis comes back, and sometimes it doesn't; however, the earliest that it will come back is usually in six months post-surgery. Thus, the next six months are our target range... when our chances of conceiving are highest. His advice was for us to try to conceive on our own for a couple of months, and if we're not successful then we will move to Step 2: IUI (intrauterine insemination) with hormone injections to increase my egg production. He wasn't keen on jumping to that right away, although he said it was totally up to us. Of course the hubby is totally relaxed about the whole thing and just wants to see how things go, but I don't want to take our time too much.
Our compromise is to try on our own for two cycles. If it's unsuccessful, we'll move to Step 2. The timing of this works well for me, because it'll be summer vacation by the time we hit Step 2 (if we do), making it vastly easier for me to get to the doctor for hormone injections and insemination. And, while the doctor says I absolutely should NOT be thinking about how my pregnancy fits in with my work life, I'm not really able to ignore that entirely... and if I am pregnant before the end of the summer, I will still be on track for my ideal plan of having the baby before the end of next school year.
All in all, good stuff today. And how fun will it be to start trying again with a hope that it will actually be successful? Heck, in these long weeks post-surgery, how fun will it be to just have sex again?
Tuesday, May 10, 2011
one week post-op
it's been a long week, but finally today i went back to work. a half-day, but still. it felt good to be back in the real world, though i'm definitely not back to normal yet.
a quick recap of my days post-surgery:
- the gas pains and overall exhaustion and discomfort lasted until friday.
- i watched a whole heckuva lot of tv and movies and was waited on hand and foot by my mom and hubby. that part was ok.
- friday morning i thought i was ok to take the dog for a walk. a half-block later i realized i was wrong.
- my mom left friday afternoon.
- by the weekend i had developed some serious cramps. i'm guessing this was more from the d&c than the surgery. they basically felt like period cramps, but instead of being isolated in one spot or another it was my whole uterus contracting all at once. not fun. i also started spotting more than i had the first couple of days.
- then i got a cold. suh-weet. i figured if i was going to be home doing nothing anyway, it wasn't a bad time to get sick.
- saturday i went out for coffee with a friend, walked a total of about 10 blocks round trip, and it wrecked me for the rest of the day. so sad. i didn't do anything else. back to the couch.
- sunday i took a couple of short walks, which felt ok. i just needed to be back on the couch for awhile afterwards to recover.
- i walk really slow.
- i am SO SICK of my living room and my couch.
- monday i decided to stay home from school because of both my cold and the fact that i still wasn't able to get around very well. i will still spotting, most noticeably when i moved around a lot. i knew my hour-long subway commute was likely more than i could handle. but i worked from home most of the day, took another nice walk to the store, and did some laundry. which felt ok at the time.
- mostly i felt normal, except for my belly button. that incision seems to be the most sensitive, which makes total sense. bending over is still very uncomfortable.
that brings us to today. i had my first post-op appointment at the fertility institute, to check my incisions out and make sure that everything looks ok, at 10 this morning. so i slept in a bit and then planned to go to the appointment and then to school. when i got out of the shower, i saw that there was blood all around my belly button.
uh oh.
sure enough, the incision in my belly button was bleeding. i figured this wasn't a great thing. i took my sweet time getting to the hospital for my appointment (i still walk really slow), and when the nurse took a look at it her reaction was the same as mine. "oh!" she immediately left the room and brought back a doctor to check it out.
but the doctor didn't seem alarmed. she poked around in there with a q-tip and drew out some fresh blood. not a ton, though. she cleaned it out with betadine and said that some of the dermabond is coming off and that's why it's bloody. she said it shouldn't be coming off yet and warned me about picking at it (i haven't been) or getting it too wet (i MAY take excessive showers. sigh). but she slapped some gauze on it and said it should be fine, so i'm taking her word for it.
i went to work and did a pretty decent job with a half day of school. my principal sent me home before our after-school meeting, so that helped matters. i'm a bit sore in the middle but the spotting has really decreased. my belly button seems to have stopped bleeding after this morning, but i'm nervous about what will happen when i shower tomorrow. i guess i will try not to get it too wet. i cannot underestimate how GROSS it looks now. it was gross before, but now... blech.
i plan to work the rest of the week, assuming i continue to feel a little better each day. and of course if the bleeding doesn't stop i will give the office a call and see what they think. but it doesn't seem to be anything to worry about. a week from today the hubby and i go for our big follow-up with the doc... can't wait!
a quick recap of my days post-surgery:
- the gas pains and overall exhaustion and discomfort lasted until friday.
- i watched a whole heckuva lot of tv and movies and was waited on hand and foot by my mom and hubby. that part was ok.
- friday morning i thought i was ok to take the dog for a walk. a half-block later i realized i was wrong.
- my mom left friday afternoon.
- by the weekend i had developed some serious cramps. i'm guessing this was more from the d&c than the surgery. they basically felt like period cramps, but instead of being isolated in one spot or another it was my whole uterus contracting all at once. not fun. i also started spotting more than i had the first couple of days.
- then i got a cold. suh-weet. i figured if i was going to be home doing nothing anyway, it wasn't a bad time to get sick.
- saturday i went out for coffee with a friend, walked a total of about 10 blocks round trip, and it wrecked me for the rest of the day. so sad. i didn't do anything else. back to the couch.
- sunday i took a couple of short walks, which felt ok. i just needed to be back on the couch for awhile afterwards to recover.
- i walk really slow.
- i am SO SICK of my living room and my couch.
- monday i decided to stay home from school because of both my cold and the fact that i still wasn't able to get around very well. i will still spotting, most noticeably when i moved around a lot. i knew my hour-long subway commute was likely more than i could handle. but i worked from home most of the day, took another nice walk to the store, and did some laundry. which felt ok at the time.
- mostly i felt normal, except for my belly button. that incision seems to be the most sensitive, which makes total sense. bending over is still very uncomfortable.
that brings us to today. i had my first post-op appointment at the fertility institute, to check my incisions out and make sure that everything looks ok, at 10 this morning. so i slept in a bit and then planned to go to the appointment and then to school. when i got out of the shower, i saw that there was blood all around my belly button.
uh oh.
sure enough, the incision in my belly button was bleeding. i figured this wasn't a great thing. i took my sweet time getting to the hospital for my appointment (i still walk really slow), and when the nurse took a look at it her reaction was the same as mine. "oh!" she immediately left the room and brought back a doctor to check it out.
but the doctor didn't seem alarmed. she poked around in there with a q-tip and drew out some fresh blood. not a ton, though. she cleaned it out with betadine and said that some of the dermabond is coming off and that's why it's bloody. she said it shouldn't be coming off yet and warned me about picking at it (i haven't been) or getting it too wet (i MAY take excessive showers. sigh). but she slapped some gauze on it and said it should be fine, so i'm taking her word for it.
i went to work and did a pretty decent job with a half day of school. my principal sent me home before our after-school meeting, so that helped matters. i'm a bit sore in the middle but the spotting has really decreased. my belly button seems to have stopped bleeding after this morning, but i'm nervous about what will happen when i shower tomorrow. i guess i will try not to get it too wet. i cannot underestimate how GROSS it looks now. it was gross before, but now... blech.
i plan to work the rest of the week, assuming i continue to feel a little better each day. and of course if the bleeding doesn't stop i will give the office a call and see what they think. but it doesn't seem to be anything to worry about. a week from today the hubby and i go for our big follow-up with the doc... can't wait!
Wednesday, May 4, 2011
laparoscopy, hysteroscopy, and d&c
one of the things i hate most about cooking is that the actual event -- the meal -- is so much of a blip compared to the preparation and the follow-up. eating what you cook takes all of 15 minutes, when the shopping, chopping, stirring, and whatever you do to make the food as well as the cleaning up and the washing dishes that follow are such huge time and effort sucks. turns out that surgery is much the same.
i had my surgery yesterday, and i can't believe how fast it was over and how relatively simple it was for me. but of course, the prep and now the recovery are much more substantial. here's how it went down...
i followed the liquid diet on monday, the day before the surgery, as planned. it wasn't awful until that evening, when the hunger had given way to a general feeling of wooziness. i stayed up as late as possible to drink water, since i knew i couldn't have any the next morning. i actually woke up briefly at ten minutes after midnight and took an illegal sip from my water bottle... just to hold me over.
7:30am woke up, showered and got dressed to go. i couldn't wear any kind of lotion or cosmetics at all, or my contact lenses, but i did put on some deodorant. c'mon, it was going to be nearly 80 degrees. i have some standards.
8:30am my mom and i walked to the hospital. it was a lovely walk on a lovely morning, and i soaked it up, knowing i probably wouldn't get much more exercise or outside time this week. i was supposed to be there at 9, and we got there a few minutes early.
9-11am in the surgical prep area, they took all my vitals and i had to pee in a cup (difficult since i had hardly any liquid in me). they gave me a gas pill and a pain pill (and i got to drink a tiny bit of water with them! glorious.). they put in the IV and explained how everything would go down. they said the surgery would likely take between an hour and an hour and a half. i spoke with the anesthesiologist and her assistant (who warned me that i'd get a breathing tube down my throat), as well as a couple of nurses who would be helping with the surgery, and signed a bunch of paperwork. they put me in a ridiculous purple gown and pants and socks, and mostly my mom and i sat around waiting. i really wasn't nervous, though... just so anxious to have it over with.
11am i walked with the nurse into the operating room, which was pretty cool. it was huge and looked just like in the movies, with the huge round bright lights above the table and all kinds of tables and trays with instruments all around. there were about six people in the room when i got there, including the doctors and nurses i'd met so far, and the doctor who would be doing the surgery. they got me up on the table and situated correctly (my butt had to be in a hole, which made me giggle) and then they took my glasses off and the nurse delivered them to my mom, who was waiting outside.
they hooked up my IV and wrapped that arm tightly to my side with my thumb in one of those pulse monitors. my other arm was stretched out on a little board next to the table. they told me that they were going to start my IV with some medicine to "relax" me, and then they'd put on a mask to start the general anesthesia. once i was really under, they'd put the breathing tube down my throat. i'd probably wake up as they were removing the tube, and the whole thing would be over. the anesthesiologist specifically said, "we'll tell you when we're starting the anesthesia, because it works really quickly." so i thought i knew exactly what to expect.
so i have no idea what actually happened, because the last thing i remember was them starting the IV, which was just supposed to get things started. the assistant anesthesiologist said, "you're probably starting to feel a little relaxed, which is fine..." and then... i was out.
they did three things during the surgery: one was the laparoscopy, when they looked for endometriosis to remove; the second was the hysteroscopy, when they looked into my uterus to make sure things looked normal; and the last was the D&C (dilation and curettage) when they removed the lining of my uterus since it a) had at least one polyp, and b) wasn't properly formed to support a pregnancy. i knew nothing of any of this while it was going down, thankfully.
1:15pm the next thing i remember, i was being wheeled out of the room, and the assistant anesthesiologist was over my head, saying something. i thought i had accidentally passed out before the surgery even started, and i said, "i'm sorry, i think i fell asleep for a few minutes," and she laughed and said, "yes, you fell asleep. you're all done now." i had NO clue. it's still a little baffling that so much happened to my body without me even being aware of it.
at that moment i was mostly aware of my throat, which was super sore from the tube, and i was so dehydrated. i was also super groggy from the anesthesia still. they pushed me into a station in the recovery room, and after a little bit my mom could come in and say hi for a couple of minutes. she said she was starting to get a little worried, since i was in surgery for over two hours, which was longer than we were told. the nurses were checking in, making sure i was waking up and feeling ok. they brought my some water, which was fantastic, but i think i drank it too fast and then i got nauseous. when i tried to get up the first time, i was super shaky and couldn't even sit up. i was also pretty sure i was going to throw up, though i never did. but i ended up being in the recovery room for about two hours, because they needed to rehook me to an IV to give me some sugar water.
the nurse went over the post-surgical instructions with us (which my mom had a sign as a "responsible adult" since i was still under the influence). basically i knew all of the directions: take it easy for a few days, start off easy on food and move onto more solid and heavy things, "nothing in the vagina" for four weeks, expect some bleeding and cramping and soreness.
3:15pm eventually, the nurse and my mom helped me get dressed and took out my IV and all, and i stumbled my way to the elevator and downstairs (i said no to the wheelchair... i wanted to pretend i wasn't a total invalid) where the hubby was waiting in our friend's car to take us home. i was still pretty dopey at this point, and having trouble swallowing. i spent most of the car ride home thinking i was going to throw up. but again, i didn't.
when i got home, it was straight to the couch where i dozed and watched TV mindlessly all evening. i made myself stop dozing after awhile because the "dreams" i was having when i passed out were vivid -- almost psychadelic -- and frightening. i was definitely still feeling the effects of the anesthesia. the biggest physical side effects were my incredibly sore throat and the burping! they had to pump my abdomen full of gas during the surgery so it was still working its way out, which made my chest and shoulders/neck sore (weird) and made me burp like crazy. i actually drank a whole can of soda (which i never do) to help me with the burping. it was like in charlie and the chocolate factory where they have to burp to float back down from the ceiling... burping felt so good. i also had trouble peeing at first, which i didn't expect, but i guess was from the anesthesia. i wanted desperately to eat, but my throat was too sore to tolerate anything other than tea and yogurt. even my mom's homemade vegetable soup was too much, so i just drank the broth.
7pm the doctor who did the surgery called to check in, since they were so busy at the hospital that we weren't able to talk to her in the recovery room. the good news is that they found a LOT of endometriosis during the surgery ("extensive," was the doctor's word), which is why it took longer than expected! she said that everything went smoothly during the surgery and that both of my tubes are open and healthy. that means that my doctor was right, and that this really could be all we needed to do to conceive. what a relief!
10pm by bedtime i was just starting to get a little sore around my incisions. i have three incisions: one in my belly button, one a little further down on my left side, and one right at the top of my pubic hair on the right side. unfortunately, this soreness made sleeping difficult. i could really only lay on my back because of the soreness, but the gas pains were making me really uncomfortable. i did a lot of tossing and turning.
DAY 2
today is much better overall. the anesthesia has definitely worn off and my throat is less sore so i can eat most normally, but the soreness of the incisions has increased. i am fine when i sit or lay or stand still, but moving between those positions is not fun. i took a shower, and that was a huge undertaking. i had to ask the hubby to dry off my legs and feet because i can't really bend over. my abdomen is still bloated, and the area around the incisions is bruised. the belly button one is the worst. but i am feeling much more human, and trying to move around and do some stuff as best i can. but, in truth, i have spent most of my time on the couch not doing much of anything. which i think is fine.
the doctor's office called to check in again, and said that even though i have dermabond (skin glue!) instead of sutures on the incisions that i should still keep my one-week appointment so that they can see how things look. and now it's just more of the same. hopefully the gas and the bloating will continue to decrease, and the soreness doesn't get worse before it gets better. my mom and my hubby are both taking really good care of me, so i can't complain. i am just so glad it's over, and that the results were positive... i can't wait until we can try again and really cross our fingers for success!
i had my surgery yesterday, and i can't believe how fast it was over and how relatively simple it was for me. but of course, the prep and now the recovery are much more substantial. here's how it went down...
i followed the liquid diet on monday, the day before the surgery, as planned. it wasn't awful until that evening, when the hunger had given way to a general feeling of wooziness. i stayed up as late as possible to drink water, since i knew i couldn't have any the next morning. i actually woke up briefly at ten minutes after midnight and took an illegal sip from my water bottle... just to hold me over.
7:30am woke up, showered and got dressed to go. i couldn't wear any kind of lotion or cosmetics at all, or my contact lenses, but i did put on some deodorant. c'mon, it was going to be nearly 80 degrees. i have some standards.
8:30am my mom and i walked to the hospital. it was a lovely walk on a lovely morning, and i soaked it up, knowing i probably wouldn't get much more exercise or outside time this week. i was supposed to be there at 9, and we got there a few minutes early.
9-11am in the surgical prep area, they took all my vitals and i had to pee in a cup (difficult since i had hardly any liquid in me). they gave me a gas pill and a pain pill (and i got to drink a tiny bit of water with them! glorious.). they put in the IV and explained how everything would go down. they said the surgery would likely take between an hour and an hour and a half. i spoke with the anesthesiologist and her assistant (who warned me that i'd get a breathing tube down my throat), as well as a couple of nurses who would be helping with the surgery, and signed a bunch of paperwork. they put me in a ridiculous purple gown and pants and socks, and mostly my mom and i sat around waiting. i really wasn't nervous, though... just so anxious to have it over with.
11am i walked with the nurse into the operating room, which was pretty cool. it was huge and looked just like in the movies, with the huge round bright lights above the table and all kinds of tables and trays with instruments all around. there were about six people in the room when i got there, including the doctors and nurses i'd met so far, and the doctor who would be doing the surgery. they got me up on the table and situated correctly (my butt had to be in a hole, which made me giggle) and then they took my glasses off and the nurse delivered them to my mom, who was waiting outside.
they hooked up my IV and wrapped that arm tightly to my side with my thumb in one of those pulse monitors. my other arm was stretched out on a little board next to the table. they told me that they were going to start my IV with some medicine to "relax" me, and then they'd put on a mask to start the general anesthesia. once i was really under, they'd put the breathing tube down my throat. i'd probably wake up as they were removing the tube, and the whole thing would be over. the anesthesiologist specifically said, "we'll tell you when we're starting the anesthesia, because it works really quickly." so i thought i knew exactly what to expect.
so i have no idea what actually happened, because the last thing i remember was them starting the IV, which was just supposed to get things started. the assistant anesthesiologist said, "you're probably starting to feel a little relaxed, which is fine..." and then... i was out.
they did three things during the surgery: one was the laparoscopy, when they looked for endometriosis to remove; the second was the hysteroscopy, when they looked into my uterus to make sure things looked normal; and the last was the D&C (dilation and curettage) when they removed the lining of my uterus since it a) had at least one polyp, and b) wasn't properly formed to support a pregnancy. i knew nothing of any of this while it was going down, thankfully.
1:15pm the next thing i remember, i was being wheeled out of the room, and the assistant anesthesiologist was over my head, saying something. i thought i had accidentally passed out before the surgery even started, and i said, "i'm sorry, i think i fell asleep for a few minutes," and she laughed and said, "yes, you fell asleep. you're all done now." i had NO clue. it's still a little baffling that so much happened to my body without me even being aware of it.
at that moment i was mostly aware of my throat, which was super sore from the tube, and i was so dehydrated. i was also super groggy from the anesthesia still. they pushed me into a station in the recovery room, and after a little bit my mom could come in and say hi for a couple of minutes. she said she was starting to get a little worried, since i was in surgery for over two hours, which was longer than we were told. the nurses were checking in, making sure i was waking up and feeling ok. they brought my some water, which was fantastic, but i think i drank it too fast and then i got nauseous. when i tried to get up the first time, i was super shaky and couldn't even sit up. i was also pretty sure i was going to throw up, though i never did. but i ended up being in the recovery room for about two hours, because they needed to rehook me to an IV to give me some sugar water.
the nurse went over the post-surgical instructions with us (which my mom had a sign as a "responsible adult" since i was still under the influence). basically i knew all of the directions: take it easy for a few days, start off easy on food and move onto more solid and heavy things, "nothing in the vagina" for four weeks, expect some bleeding and cramping and soreness.
3:15pm eventually, the nurse and my mom helped me get dressed and took out my IV and all, and i stumbled my way to the elevator and downstairs (i said no to the wheelchair... i wanted to pretend i wasn't a total invalid) where the hubby was waiting in our friend's car to take us home. i was still pretty dopey at this point, and having trouble swallowing. i spent most of the car ride home thinking i was going to throw up. but again, i didn't.
when i got home, it was straight to the couch where i dozed and watched TV mindlessly all evening. i made myself stop dozing after awhile because the "dreams" i was having when i passed out were vivid -- almost psychadelic -- and frightening. i was definitely still feeling the effects of the anesthesia. the biggest physical side effects were my incredibly sore throat and the burping! they had to pump my abdomen full of gas during the surgery so it was still working its way out, which made my chest and shoulders/neck sore (weird) and made me burp like crazy. i actually drank a whole can of soda (which i never do) to help me with the burping. it was like in charlie and the chocolate factory where they have to burp to float back down from the ceiling... burping felt so good. i also had trouble peeing at first, which i didn't expect, but i guess was from the anesthesia. i wanted desperately to eat, but my throat was too sore to tolerate anything other than tea and yogurt. even my mom's homemade vegetable soup was too much, so i just drank the broth.
7pm the doctor who did the surgery called to check in, since they were so busy at the hospital that we weren't able to talk to her in the recovery room. the good news is that they found a LOT of endometriosis during the surgery ("extensive," was the doctor's word), which is why it took longer than expected! she said that everything went smoothly during the surgery and that both of my tubes are open and healthy. that means that my doctor was right, and that this really could be all we needed to do to conceive. what a relief!
10pm by bedtime i was just starting to get a little sore around my incisions. i have three incisions: one in my belly button, one a little further down on my left side, and one right at the top of my pubic hair on the right side. unfortunately, this soreness made sleeping difficult. i could really only lay on my back because of the soreness, but the gas pains were making me really uncomfortable. i did a lot of tossing and turning.
DAY 2
today is much better overall. the anesthesia has definitely worn off and my throat is less sore so i can eat most normally, but the soreness of the incisions has increased. i am fine when i sit or lay or stand still, but moving between those positions is not fun. i took a shower, and that was a huge undertaking. i had to ask the hubby to dry off my legs and feet because i can't really bend over. my abdomen is still bloated, and the area around the incisions is bruised. the belly button one is the worst. but i am feeling much more human, and trying to move around and do some stuff as best i can. but, in truth, i have spent most of my time on the couch not doing much of anything. which i think is fine.
the doctor's office called to check in again, and said that even though i have dermabond (skin glue!) instead of sutures on the incisions that i should still keep my one-week appointment so that they can see how things look. and now it's just more of the same. hopefully the gas and the bloating will continue to decrease, and the soreness doesn't get worse before it gets better. my mom and my hubby are both taking really good care of me, so i can't complain. i am just so glad it's over, and that the results were positive... i can't wait until we can try again and really cross our fingers for success!
Sunday, May 1, 2011
pre-surgery
as my surgery approaches, my anxiety and anticipation are both increasing. of course i'm worried about the surgery itself, about being unable to lead my normal life for a few days, about missing almost a week of work, etc. but i am also excited in a way... to be moving forward in our journey and to have this over and done with.
last week i had my pre-surgery appointment, at which they took some blood, got all of my vitals charted, and gave me more details about the things i needed to do in the couple of days beforehand and on the day of the procedure. today was the first day that i needed to do anything to prep, which was altering my diet. as best as i can figure, they're trying to go easy on my digestion over these next couple of days, perhaps to make it less stressful for my body to be under anesthesia, and also to limit my gas production. apparently lifting and moving around all of my inside parts is made easier when there is not a lot of gas. i have a prescription for a gas-reducing drug that i will take all day tomorrow.
but for today, it was all carbs. which doesn't sound that bad when you first think of it... bread! pasta! but i also couldn't have any dairy products or protein, OR fresh fruits or vegetables (canned/jarred were okay). so it wasn't a glorious eating day. but it wasn't so bad -- i had a bagel with strawberry preserves, some crackers, and pasta with tomato sauce and canned corn for dinner. my favorite part was dessert: canned peaches. tomorrow is all liquids, which is a lot less fun. but luckily it's a work day, so i will keep myself busy. i made some jello tonight in preparation, and bought some juice. and... that will be it for tomorrow. the worst part, though, might be the "nothing at all after midnight" tomorrow. i'm not so worried about being hungry, but i drink a lot of water. imagining waking up tuesday morning and not being able to drink any at all doesn't seem like much fun at all.
but of course... i'll deal with it.
my mom arrives tomorrow, and will be helping out all week. she's even going to cook to give the hubby a break from his usual duties. the hospital will call me tomorrow afternoon to tell me exactly what time on tuesday i should report there on tuesday morning (i'm hoping for as early as possible). i can't bring anything with me or wear any kind of lotion, makeup, nailpolish, jewelry, contact lenses... nothing. but once i get there i shouldn't notice anything at all until i wake up a few hours later.
so that's that -- one more day. one day closer to hopefully being able to conceive a baby! or at least knowing our fate. either way, i'm ready.
last week i had my pre-surgery appointment, at which they took some blood, got all of my vitals charted, and gave me more details about the things i needed to do in the couple of days beforehand and on the day of the procedure. today was the first day that i needed to do anything to prep, which was altering my diet. as best as i can figure, they're trying to go easy on my digestion over these next couple of days, perhaps to make it less stressful for my body to be under anesthesia, and also to limit my gas production. apparently lifting and moving around all of my inside parts is made easier when there is not a lot of gas. i have a prescription for a gas-reducing drug that i will take all day tomorrow.
but for today, it was all carbs. which doesn't sound that bad when you first think of it... bread! pasta! but i also couldn't have any dairy products or protein, OR fresh fruits or vegetables (canned/jarred were okay). so it wasn't a glorious eating day. but it wasn't so bad -- i had a bagel with strawberry preserves, some crackers, and pasta with tomato sauce and canned corn for dinner. my favorite part was dessert: canned peaches. tomorrow is all liquids, which is a lot less fun. but luckily it's a work day, so i will keep myself busy. i made some jello tonight in preparation, and bought some juice. and... that will be it for tomorrow. the worst part, though, might be the "nothing at all after midnight" tomorrow. i'm not so worried about being hungry, but i drink a lot of water. imagining waking up tuesday morning and not being able to drink any at all doesn't seem like much fun at all.
but of course... i'll deal with it.
my mom arrives tomorrow, and will be helping out all week. she's even going to cook to give the hubby a break from his usual duties. the hospital will call me tomorrow afternoon to tell me exactly what time on tuesday i should report there on tuesday morning (i'm hoping for as early as possible). i can't bring anything with me or wear any kind of lotion, makeup, nailpolish, jewelry, contact lenses... nothing. but once i get there i shouldn't notice anything at all until i wake up a few hours later.
so that's that -- one more day. one day closer to hopefully being able to conceive a baby! or at least knowing our fate. either way, i'm ready.
Wednesday, April 20, 2011
this isn't directly related to fertility, i suppose, but since i'm providing such helpful medical information on this blog i figured i'd also describe my afternoon getting a cardiac MRI.
it sucked.
i've had one MRI before, for both of my knees a few years ago when i blew them out with too much exercise. (i now maintain a much safer regimen of anti-exercise.) i went to a "stand-up MRI" place for that one, and essentially i dozed off while comfortably propped up in a piece of machinery akin to a heavy-duty plastic recliner. 45 minutes later, it was over. today was not so a) comfortable, b) easy, or c) short.
to refresh your memory, due to my childhood history of funny heart issues, the fertility doc sent me to a cardiologist to make sure that my ticker is all set for both the upcoming surgery and, potentially, pregnancy and childbirth. i had an echocardiogram and an EKG about a month ago, both of which revealed nothing. however, the cardiologist maintains that i have an irregular heartbeat, and since neither of those standard procedures showed any reason for this, he wanted me to have a cardiac MRI to see if we could learn anything more.
turns out that cardiac MRI technology is fairly new -- really only in use in the past five years or so -- and that my cardiologist is some sort of a leader in the field. they are still doing studies on the procedure and its results, which i am now a part of. the cardiologist insisted that he be present for the procedure today, and he was... along with two other doctors, a technician, a nurse, and possibly a couple of other people that i couldn't see because i was inside a huge tube.
so, yeah. the huge tube. it's like you've seen on TV (and like the photo i've included above, from karachidigest.com). you lay down, they push you inside, and they put headphones on you so that the whirring and whooshing and thumping noises that the crazyass giant magnet machine makes don't make you deaf. i expected all of that. what i didn't know was exactly how long it takes to get images of all of the valves of one's heart (since he couldn't isolate which ones might be problematic) and also that i would have an IV that would be shooting contrast dye into my system so that they could see better. oh, i also didn't realize it would be about 40 degrees in the room while i laid there in just a hospital gown for TWO HOURS.
the technician could have been the brother of Top Chef's Mike Isabella. seriously, his voice was identical. and he was a big italian guy from brooklyn who laughed way too loud at his own jokes and bragged about his skills. ("i've been here since the place opened. i know the deal here. these residents... we get a new crop every year." rolls eyes) this was all very comforting to me somehow. he gave me the rundown of the procedure beforehand, and it was he who looked close enough at my file to realize, "oh... 'evaluate ALL valves!' oh, this'll be a long one." i was happy for the heads-up, but he still told me the "long" side was an hour and a half. this was not true.
in the beginning it wasn't that bad. the nurse put the IV in my arm and then they stuck me into the tube. the room had a huge skylight and the tube was open at both the top and bottom, so it wasn't dark and it wasn't too terribly cramped in there. the doctor gave me directions in the headphones: "take a deep breath," "hold your breath," "breathe normally," etc. in between commands i was dozing off... it was such a nice quiet little cave. while i was still comfortable.
then i started losing track of time. it's hard to keep on top of that sort of thing when you're staring at nothing and mindlessly following doctor's orders in between little naps. but eventually i started to get really cold, which eliminated the possibility of napping. i was SO cold that i was shaking, which isn't okay when you're having an MRI. you have to stay super still. staying still was also problematic because i starting losing feeling in my limbs. that began with my right arm, the arm with the IV in it. they warned me when they were injecting the dye through the IV and said my arm would probably feel cold. in fact, i could feel the liquid going into my veins (or at least i imagined i could) and my whole arm started tingling. and yes, got cold. very cold. anyway, by the end i was getting delirious, trying not to cry, and was convinced i'd never be able to move my limbs again. eventually they pulled me out, and i saw the smiling face of a lovely russian nurse who helped me sit up and took out the IV. then she gave me some advice:
nurse: you should drink lots of water to flush out the dye.
me: ok.
nurse: or whatever you like to drink.
me: ok. how long does it take?
nurse: it take 48 hours. just drink a lot. but you drink too much, you'll spit it up. (a pause.) but that's ok, too. just flush it out.
comforting advice.
the doctors and technician -- the many voices i had heard in the background over the headphones -- were gone... they'd all disappeared into an adjacent screening room where they were poring over the many photos of my heart. the nurse said the results would be ready in 3-5 days. i'm not sure what to think about the fact that i had a marathon session, even longer than the longest estimate Top Technician All-Star given me. maybe they found something weird. or maybe they didn't find anything, so they kept taking more pictures to try to find something. who knows.
i felt super light-headed and a bit woozy for awhile afterwards, but i walked home slowly and picked up a smoothie on the way. this was followed by several glasses of wine with dinner, to continue the flushing process. and i feel fine now.
next week i have a pre-surgery appointment for bloodwork and whatnot. and, assuming all is normal, that's the last hurdle before the surgery. i can't wait for it to be over. i have spent far too much time in a hospital these past couple of months.
Wednesday, April 13, 2011
surgery deets
after a month or so of what feels like almost constant traveling, i am home for the foreseeable future and therefore finally went back to the doctor today to schedule the surgery. at first i was annoyed that i had to physically visit the office just to plan the procedure, but after spending a half hour with the doc and the nurse practitioner going over all the details, i understood why we couldn't just have a short phone chat.
i'm going in on tuesday, may 3, which works out well for a friend's wedding at the end of the month but not so much for my choir performances in early may. ah, well. priorities, i suppose. my mom has offered to fly down to stay and help out around the house, which i thought was overkill when she first offered... but after hearing the details today i think it will be a great help. the hubby is wonderful in many ways, but picking up the slack around the house when i'm incapacitated is not one of those ways.
since i'll be totally knocked out under general anesthesia, there is a lot of preparation. and since they will be making three incisions in my pelvic region AND they won't really know the situation down there until they get inside, it's hard to say how much pain and discomfort i will experience. the doc did tell me that i definitely won't be able to return to work that week after the surgery on tuesday. but hopefully by the following monday i'll be able to be up and around more normally.
about a week prior to the surgery, i'll have to go in for a pre-op check-in to make sure all of my bloodwork and everything is still normal. then two days before the surgery i have to eat an all-carbohydrate diet, eliminating fruits, veggies, proteins, and dairy. the day prior to the procedure i will be on an entirely liquid diet, with nothing at all (even water!) after midnight the night before. i also have a prescription pill to take four times per day the day before the surgery (simethicone) which will help to reduce bloating and gas. fun, fun.
i'll go into the hospital that morning (they'll call me the day before to go over details and tell me exactly what time to arrive) and will get knocked out so i don't have to know about any of the gory details until afterwards. basically, they will make three incisions, each about a centimeter long. one will be in my belly button, where they'll insert the laparascope to peek around in there and see what's going on. then there will be two other incisions somewhere along my pubic bone that will allow them to insert other tools like scissors and lasers and scrapers and who knows what else. they'll scrape out the uterine lining to get rid of the polyp(s) and the "dysynchrony" of its composition, and they'll move my tubes around to see what's going on behind and around them. if they find endometriosis, they'll zap it out as much as they can. then they'll either staple or glue me up.
i will have to hang out in recovery for a couple of hours afterwards to come out of the anesthesia and all, but then i can retire to the couch for some good (and hopefully not too agonizing) relaxing time. i should start thinking about movies and TV shows to watch that week... hmmm...
all in all, i feel ok (if a little nervous) and just want to get this over with. i am so grateful that i work with such supportive and understanding people, and that i will have friends and family here to lend a hand. it really shouldn't be a big deal at all, and hopefully the end result will be worth all of it!
i'm going in on tuesday, may 3, which works out well for a friend's wedding at the end of the month but not so much for my choir performances in early may. ah, well. priorities, i suppose. my mom has offered to fly down to stay and help out around the house, which i thought was overkill when she first offered... but after hearing the details today i think it will be a great help. the hubby is wonderful in many ways, but picking up the slack around the house when i'm incapacitated is not one of those ways.
since i'll be totally knocked out under general anesthesia, there is a lot of preparation. and since they will be making three incisions in my pelvic region AND they won't really know the situation down there until they get inside, it's hard to say how much pain and discomfort i will experience. the doc did tell me that i definitely won't be able to return to work that week after the surgery on tuesday. but hopefully by the following monday i'll be able to be up and around more normally.
about a week prior to the surgery, i'll have to go in for a pre-op check-in to make sure all of my bloodwork and everything is still normal. then two days before the surgery i have to eat an all-carbohydrate diet, eliminating fruits, veggies, proteins, and dairy. the day prior to the procedure i will be on an entirely liquid diet, with nothing at all (even water!) after midnight the night before. i also have a prescription pill to take four times per day the day before the surgery (simethicone) which will help to reduce bloating and gas. fun, fun.
i'll go into the hospital that morning (they'll call me the day before to go over details and tell me exactly what time to arrive) and will get knocked out so i don't have to know about any of the gory details until afterwards. basically, they will make three incisions, each about a centimeter long. one will be in my belly button, where they'll insert the laparascope to peek around in there and see what's going on. then there will be two other incisions somewhere along my pubic bone that will allow them to insert other tools like scissors and lasers and scrapers and who knows what else. they'll scrape out the uterine lining to get rid of the polyp(s) and the "dysynchrony" of its composition, and they'll move my tubes around to see what's going on behind and around them. if they find endometriosis, they'll zap it out as much as they can. then they'll either staple or glue me up.
i will have to hang out in recovery for a couple of hours afterwards to come out of the anesthesia and all, but then i can retire to the couch for some good (and hopefully not too agonizing) relaxing time. i should start thinking about movies and TV shows to watch that week... hmmm...
all in all, i feel ok (if a little nervous) and just want to get this over with. i am so grateful that i work with such supportive and understanding people, and that i will have friends and family here to lend a hand. it really shouldn't be a big deal at all, and hopefully the end result will be worth all of it!
Friday, March 25, 2011
my heart
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.
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.
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.
Friday, February 25, 2011
phase 2, part 4
this morning was the last test of the fertility workup: the endometrial biopsy. this is, as it sounds, a procedure that is done in order to examine a sample of the uterine lining for any abnormalities, cancerous cells, etc. i made the hubby come with me for this one, because i knew it would likely be the most uncomfortable part of the process. in actuality, it wasn't as bad as i expected. the cervical biopsies i've had in the past seem worse in my memory... but maybe i've just toughened up. :)
we had a different doctor again for this test, but she was great: an older russian woman with a great bedside manner. she first did a regular ultrasound to, once again, check things out in there and take more photos of my ovaries and whatever else. then she explained the procedure to me very simply: after inserting the speculum, she'd swab me with some betadine, then put in the catheter and use a tube to suck out some of the lining for 15 seconds. she told me those 15 seconds would be the worst part but that was it. i figured i can handle anything for 15 seconds. and it all happened so fast, i didn't even realize the 15 seconds were happening until she told me we were halfway done. she made me keep talking to her, and totally distracted me. excellent technique.
then the nurse took some more blood. you know, as if i have any left in my body after the past couple of weeks. they're going to check the hormone levels again to make sure they've dropped, now that it's a week after ovulation. i asked her to take it from right arm since my left one is still bruised... now i definitely looks like the reason i've missed so much school lately is due to my crack habit.
afterwards i stayed lying down for a few minutes until the cramping subsided. it hasn't been much of anything since then, though she did tell me i'd probably have some spotting for the next day or so, and NO SEX today or tomorrow. then we had to make our appointment for the results discussion with the doctor. we had a moment of panic when we thought we might not be able to schedule it prior to our trip to turkey in two weeks, but finally we were able to get an appointment for the wednesday before we leave, march 9. that still seems like a long time away to me, but by then at least i'll know for sure if i got pregnant this try, and we'll know what's up before our vacation... for better or worse.
then the hubby took me out for a lovely brooklyn diner breakfast, and now i'm spending the rest of this rainy day on the couch, catching up on work, reading, and probably napping. not a bad friday. and there's nothing else for me to think about or do at this point other than try to ignore the two-week wait. today is day 20, so in a week or so i'll either get my period... or not.
we had a different doctor again for this test, but she was great: an older russian woman with a great bedside manner. she first did a regular ultrasound to, once again, check things out in there and take more photos of my ovaries and whatever else. then she explained the procedure to me very simply: after inserting the speculum, she'd swab me with some betadine, then put in the catheter and use a tube to suck out some of the lining for 15 seconds. she told me those 15 seconds would be the worst part but that was it. i figured i can handle anything for 15 seconds. and it all happened so fast, i didn't even realize the 15 seconds were happening until she told me we were halfway done. she made me keep talking to her, and totally distracted me. excellent technique.
then the nurse took some more blood. you know, as if i have any left in my body after the past couple of weeks. they're going to check the hormone levels again to make sure they've dropped, now that it's a week after ovulation. i asked her to take it from right arm since my left one is still bruised... now i definitely looks like the reason i've missed so much school lately is due to my crack habit.
afterwards i stayed lying down for a few minutes until the cramping subsided. it hasn't been much of anything since then, though she did tell me i'd probably have some spotting for the next day or so, and NO SEX today or tomorrow. then we had to make our appointment for the results discussion with the doctor. we had a moment of panic when we thought we might not be able to schedule it prior to our trip to turkey in two weeks, but finally we were able to get an appointment for the wednesday before we leave, march 9. that still seems like a long time away to me, but by then at least i'll know for sure if i got pregnant this try, and we'll know what's up before our vacation... for better or worse.
then the hubby took me out for a lovely brooklyn diner breakfast, and now i'm spending the rest of this rainy day on the couch, catching up on work, reading, and probably napping. not a bad friday. and there's nothing else for me to think about or do at this point other than try to ignore the two-week wait. today is day 20, so in a week or so i'll either get my period... or not.
Friday, February 18, 2011
phase 2, part 3
if you want to know the secret to making sure that sex-on-demand happens as it needs to, i'll tell you: be sick for a week beforehand (coming off of your period) so your husband is severely deprived. we had no issues last night, other than him refusing to kiss me because i have been feeling so crappy and he didn't want to be exposed to more of my germs than necessary. also yesterday and today were my ovulation days, so we had double the incentive... hopefully i will be feeling well enough for the rest of the weekend to maximize these peak fertility days!
this morning i went in for the post-coital exam, which was the easiest part of this process yet. it was even less involved than a pap smear. all they needed to do was collect some mucus. speculum in, mucus sucked up, and done! for a pop culture reference on the subject, this is where things went wrong for charlotte on "sex and the city." her cervical mucus was attacking trey's sperm. hopefully this is not the case for me.
today's doctor was much more chatty and helpful than tuesday's, so i asked her something that i'd been wondering about about next week's biopsy. on the off-chance that i do get pregnant, would it be safe for them to be poking around in there and removing part of the uterine lining? she said that people ask that question a lot, but that yes, it is safe. she also told me that she had recently read a study that showed that in cases of early pregnancy when a biopsy is done it may actually cause the embryo to form an even stronger bond during implantation. go figure! she said that a lot of women end up getting pregnant during the fertility work-up, which i've heard and read before. who knows exactly why, but it's something to stay optimistic about, i suppose.
after that i went to a lab to have the additional bloodwork done. these were tests that have to be submitted as frozen samples for whatever reason, and the doctor's office doesn't have the technology to do that. i couldn't decipher anything on the form other than figuring out that one of the tests was for lupus. so i'm guessing these are just more of the same hormonal and genetic tests that they were collecting for last week. it was another 10 vials, not terrible.
so that's it until a week from today: the biopsy. that's the last stage of this process other than the results meeting with the doctor. hopefully we won't have to wait too long to schedule that. this has felt like a long process already.
this morning i went in for the post-coital exam, which was the easiest part of this process yet. it was even less involved than a pap smear. all they needed to do was collect some mucus. speculum in, mucus sucked up, and done! for a pop culture reference on the subject, this is where things went wrong for charlotte on "sex and the city." her cervical mucus was attacking trey's sperm. hopefully this is not the case for me.
today's doctor was much more chatty and helpful than tuesday's, so i asked her something that i'd been wondering about about next week's biopsy. on the off-chance that i do get pregnant, would it be safe for them to be poking around in there and removing part of the uterine lining? she said that people ask that question a lot, but that yes, it is safe. she also told me that she had recently read a study that showed that in cases of early pregnancy when a biopsy is done it may actually cause the embryo to form an even stronger bond during implantation. go figure! she said that a lot of women end up getting pregnant during the fertility work-up, which i've heard and read before. who knows exactly why, but it's something to stay optimistic about, i suppose.
after that i went to a lab to have the additional bloodwork done. these were tests that have to be submitted as frozen samples for whatever reason, and the doctor's office doesn't have the technology to do that. i couldn't decipher anything on the form other than figuring out that one of the tests was for lupus. so i'm guessing these are just more of the same hormonal and genetic tests that they were collecting for last week. it was another 10 vials, not terrible.
so that's it until a week from today: the biopsy. that's the last stage of this process other than the results meeting with the doctor. hopefully we won't have to wait too long to schedule that. this has felt like a long process already.
Tuesday, February 15, 2011
phase 2, part 2
this morning i went in for the hysterosonography, so that the docs could get some pictures of the inside of my uterus. it wasn't too bad. in terms of discomfort, it was about the same as the hysterosalpingogram (the test that made sure my fallopian tubes were open and the ovaries were working correctly), and even a little less weird than that one since there were no balloons involved. they did the procedure in a regular exam room. first the doctor did a regular sonogram to get the lay of the land, and then she used a speculum and a catheter to inject a bunch of iodine-saline solution into my uterus. that felt crampy and weird, but not awful. then she did another sonogram, after the solution made it easier to see the actual surface of the uterus. i tried to watch on the monitor but it made me a little queasy watching the liquid slosh around in there. she snapped some photos and that was that.
now, this was not the fertility doctor that we met with before, just another doctor that i didn't know until today. so i'll cut her a little slack, i guess... but she left just saying that they'd go over the results with me at our "results appointment" that happens once all of the tests and procedures are done. after she was gone, the nurse told me to lie down for a few minutes to make sure i felt okay, and pointed to the monitor to show me the polyp they'd found. why on earth the doctor didn't share that nugget of information with me, i have no idea. i asked the nurse what that meant and she said sometimes they like to take them out, so they might want to do that, but i'd have to wait to see what the doctor said at my follow-up. but heck, at least she mentioned it. she was also super nice and made sure i wasn't dizzy before i sat up. she even smirked a little when she reminded me about the procedures required for my post-coital test this friday, and said she'd see me then. i appreciated that.
so i've done a little reading about polyps and what i know is that the experts don't even know that much about them. they're growths of cells that are attached to the walls of the uterus, caused by an overgrowth of cells in the lining. any time i hear about cells overproducing of course i think cancer, and apparently it's normal to test them and make sure that they're not cancerous. i suppose the endometrial biopsy that i'm having next week will also test for this. it seems that polyps can be caused by hormone issues, usually only occur in women in the 40s and 50s (ha! or... sigh), and may or may not affect fertility. Some studies have shown that removing the polyps has led to increased fertility in some women, so that's a bonus. it seems there are a couple of ways to deal with them and it doesn't sound awful... my guess is that if there's any chance it might help us conceive i'll have it done. details here: http://www.mayoclinic.com/health/uterine-polyps/DS00699/DSECTION=tests-and-diagnosis
so now -- with the memory of the fertility doctor talking about the possibility of prematurely aging eggs -- i'm having visions of my prematurely aging body experiencing early menopausal hormonal shifts and rebelling against ever getting pregnant. but i suppose there's not much to do but wait and see once all the results are in and the doctor has a chance to look over everything and come to some conclusions.
oh, and i have to go for more bloodwork. apparently they need some "frozen" samples and the fertility place doesn't do frozen samples, so i have to go to a lab to have it done... another 10 vials. i think i will go on friday after the post-coital exam, since that doesn't seem like it will be anything much and i'm going to be late to work anyway. as for today, i'm now at work so should probably try to ignore the slight cramps and iodine-saline solution discharging from my body and get some stuff done.
Monday, February 7, 2011
Phase 2
today my Full Fertility Work-up officially began. yes, that means i -- once again -- am not pregnant. and i have to say that this one hit me harder than it has in awhile... possibly the worst yet. but after i spent a good portion of yesterday in a miserable state of mind, i had no choice but to switch gears into Phase 2 of our TTC saga. we tried it on our own, now we enlist the help of the experts. i hoped it wouldn't come to this. i know that's part of the reason i was so, so upset when i got my period yesterday. i didn't want to have to go through this next round of tests and procedures. i would rather not run the risk that we simply have "unexplained infertility" and that we aren't able to rectify the situation easily. but what choice do i have?
i dug out the paperwork we got from the fertility institute and read that if i got my period over the weekend they just wanted me to come in first thing monday morning, so i got myself there at 7am not exactly sure what to expect. i thought i might just schedule all of the upcoming appointments, but they said they could do the bloodwork today (normally done on Day 3 of the cycle). they took 17 vials of blood, which was a bit crazy but not as bad as i worried it might be. they were testing my hormone levels (details here: http://www.fertilityplus.org/faq/hormonelevels.html#female), as well as doing some genetic tests (cystic fibrosis, i think, and something else that has slipped my mind already), and a mandatory HIV test. which makes sense, and would probably terrify me if it was my first but luckily (or unluckily, i guess) i've been tested for HIV several times in my life already. i won't get any of these results back until we have our "discussion meeting" after this whole battery of tests is done and the doc presents us with our options.
after they sucked out my blood and i had some time to rest in the waiting room, they scheduled the remaining three visits that i need to make over the next couple of weeks. since they open at 7am, i won't have to miss too much school, i'll just come in late a couple of days. next tuesday i go in for the hysterosonography, which is a sonogram that examines the uterus for any weirdness. shouldn't be too terrible. next friday is the super embarrassing post-coital test, which is not at all intrusive other than the fact that the hubby and i MUST have sex the night before so that they can make sure things are doing what they should be in the aftermath, and that kind of pressure doesn't always work well for him. but that *should* be right around ovulation time anyway, so hopefully we'll be in the groove already. and then the following friday is the one thing that i know won't be at all fun... the endometrial biopsy. i've had enough biopsies (and many in the nether regions) to know about what to expect from that procedure, and since it's a parent-teacher conference day i will just stay home after that one's over, and will have the weekend to recover.
progress always feels good, to an extent. it's certainly a brighter day than yesterday. of course i'd rather be pregnant right now. but i'm still optimistic that it can happen, and that -- one way or another -- we will be fine. i don't think i'd be handling any of this so well if it wasn't for the support system that i have. my family, friends, and co-workers and their love and understanding mean the world to me. not only does it make life brighter in general and help me to realize that even if we can't have children our lives have so much meaning, but it also helps so much to know how many people out there care for us and are sending us love and positive energy as we deal with this.
i found out this morning that my boss and his wife went through the same struggles trying to have their two daughters, and he assured me that he completely understands and that, especially in our field, "kids come first." while it might seem counterintuitive, being surrounded by so many beautiful and amazing children every day does help me to focus on the big picture. i'm making a difference in the world already. and while the fact that i don't have my own children sometimes breaks my heart, the fact that it's the one thing in life that i can honestly say is eluding me is more of a proud and grateful realization than a downer. i couldn't have a better situation in which to deal with all of this. so bring it on.
i dug out the paperwork we got from the fertility institute and read that if i got my period over the weekend they just wanted me to come in first thing monday morning, so i got myself there at 7am not exactly sure what to expect. i thought i might just schedule all of the upcoming appointments, but they said they could do the bloodwork today (normally done on Day 3 of the cycle). they took 17 vials of blood, which was a bit crazy but not as bad as i worried it might be. they were testing my hormone levels (details here: http://www.fertilityplus.org/faq/hormonelevels.html#female), as well as doing some genetic tests (cystic fibrosis, i think, and something else that has slipped my mind already), and a mandatory HIV test. which makes sense, and would probably terrify me if it was my first but luckily (or unluckily, i guess) i've been tested for HIV several times in my life already. i won't get any of these results back until we have our "discussion meeting" after this whole battery of tests is done and the doc presents us with our options.
after they sucked out my blood and i had some time to rest in the waiting room, they scheduled the remaining three visits that i need to make over the next couple of weeks. since they open at 7am, i won't have to miss too much school, i'll just come in late a couple of days. next tuesday i go in for the hysterosonography, which is a sonogram that examines the uterus for any weirdness. shouldn't be too terrible. next friday is the super embarrassing post-coital test, which is not at all intrusive other than the fact that the hubby and i MUST have sex the night before so that they can make sure things are doing what they should be in the aftermath, and that kind of pressure doesn't always work well for him. but that *should* be right around ovulation time anyway, so hopefully we'll be in the groove already. and then the following friday is the one thing that i know won't be at all fun... the endometrial biopsy. i've had enough biopsies (and many in the nether regions) to know about what to expect from that procedure, and since it's a parent-teacher conference day i will just stay home after that one's over, and will have the weekend to recover.
progress always feels good, to an extent. it's certainly a brighter day than yesterday. of course i'd rather be pregnant right now. but i'm still optimistic that it can happen, and that -- one way or another -- we will be fine. i don't think i'd be handling any of this so well if it wasn't for the support system that i have. my family, friends, and co-workers and their love and understanding mean the world to me. not only does it make life brighter in general and help me to realize that even if we can't have children our lives have so much meaning, but it also helps so much to know how many people out there care for us and are sending us love and positive energy as we deal with this.
i found out this morning that my boss and his wife went through the same struggles trying to have their two daughters, and he assured me that he completely understands and that, especially in our field, "kids come first." while it might seem counterintuitive, being surrounded by so many beautiful and amazing children every day does help me to focus on the big picture. i'm making a difference in the world already. and while the fact that i don't have my own children sometimes breaks my heart, the fact that it's the one thing in life that i can honestly say is eluding me is more of a proud and grateful realization than a downer. i couldn't have a better situation in which to deal with all of this. so bring it on.
Tuesday, January 18, 2011
cycle 12, day 9: blessings from the medical profession
it's sad that i've forgotten that doctors are supposed to be helpful and a good use of our time rather than a necessary hassle. i have come to think of my ob/gyn as a freak of nature in the medical profession, but i was reminded today that this should be the norm.
i am so glad that we (i! let me give myself credit where credit is due.) decided to see a fertility doctor. our consultation was this morning, and i realized within the first five minutes how much i was rushing to make sure that i got to say everything i needed to say before i slowly started to see that this guy wasn't pushing us out the door. this was so unlike most of my interactions with doctors in the recent past. he engaged us in conversation for over a half hour, going over both of our medical histories and our lifestyles and how we've been TTC so far. he was so helpful, and so nice, and truly seemed to want to work with us rather than just checking off some boxes on a form and shuttling us off for mindless procedures.
we shared the results of the hubby's semen analysis, and he said that from his perspective he's not seeing why it should keep us from conceiving. it seems that my ob/gyn, not being an expert in the boy stuff, may have simply looked at the percentages when he went over the initial results and didn't take into account the fact that the total sperm count is way above average (which is pretty much what the urologist and our common sense said). the fertility doc said he feels the high concentration of sperm outweighs any negatives and that even though the morphology is on the low side, he doesn't think it should matter. he said by the end of our talk that he actually doesn't think it's "male factor" infertility at all, and he's curious to see what else may be going on with me. sigh.
so get this -- even though today was scheduled as a consultation, we got to do some initial tests! i was shocked by this. when he started talking about our next steps, I assumed I'd have to make another appointment to get things rolling, but we wasted no time. after our talk, we went into an exam room where he did an ultrasound to showed us my cervix, uterus, and ovaries and explained what everything was and how it was supposed to look. everything looked perfect. he said the ultrasound allowed him to see that there wasn't any obvious endometriosis, but that may be something we'd have to revisit later. he also did some cultures; i'm not exactly sure what they were all for, but i'm guessing they may have been STD-infection kind of tests. which i know i've been tested for in the past, but it doesn't hurt, i guess. and then he prescribed me some prenatal vitamins and folic acid, and wants me to get some other vitamins that will improve my egg quality. whew.
this week is ovulation, so he wants us to "try our best!" (obviously) and if we aren't successful, we start a "full fertility workup" when i get my period (probably around the beginning of february). the workup normally includes a couple of things we've already had done (the semen analysis and the hysterosalpingogram), so we won't repeat those. but we will do a bunch of other things. it looks like this:
1. 3rd day of period i have a blood test... a big one. 17 vials of blood, they said. yikes.
2. soon thereafter: i have a hysterosonography, which checks the uterine lining for polyps and fibroids.
3. next: we have a post-coital test, which is an exam 9-12 hours after intercourse to see how my body is dealing with the sperm and such. (the hubby will likely feel a lot of pressure about that specific timeline... we might need some strategies there...)
4. when i ovulate again: i have an endometrial biopsy to check my the quality of my endometrial tissue.
5. when we have a discussion appointment to go over all of the results. all of this will happen within my next cycle... assuming we don't get pregnant this time.
but maybe we will! he was rather optimistic, which i suppose we should be. so we'll do our best this week... i should probably ovulate within the next few days. all in all, it just feels like the right thing to do to have this expert on our side and for us to stop jumping to conclusions that the internet or a pay-service lab suggests. all of these tests are totally covered by my insurance, so we can get as much information possible before we start making big decisions. maybe it will turn out that IUI is still a great option for us, but in the meantime i do not feel badly about taking our time with this most-important process. and now it's a week of "trying" to look forward to... woo hoo!
i am so glad that we (i! let me give myself credit where credit is due.) decided to see a fertility doctor. our consultation was this morning, and i realized within the first five minutes how much i was rushing to make sure that i got to say everything i needed to say before i slowly started to see that this guy wasn't pushing us out the door. this was so unlike most of my interactions with doctors in the recent past. he engaged us in conversation for over a half hour, going over both of our medical histories and our lifestyles and how we've been TTC so far. he was so helpful, and so nice, and truly seemed to want to work with us rather than just checking off some boxes on a form and shuttling us off for mindless procedures.
we shared the results of the hubby's semen analysis, and he said that from his perspective he's not seeing why it should keep us from conceiving. it seems that my ob/gyn, not being an expert in the boy stuff, may have simply looked at the percentages when he went over the initial results and didn't take into account the fact that the total sperm count is way above average (which is pretty much what the urologist and our common sense said). the fertility doc said he feels the high concentration of sperm outweighs any negatives and that even though the morphology is on the low side, he doesn't think it should matter. he said by the end of our talk that he actually doesn't think it's "male factor" infertility at all, and he's curious to see what else may be going on with me. sigh.
so get this -- even though today was scheduled as a consultation, we got to do some initial tests! i was shocked by this. when he started talking about our next steps, I assumed I'd have to make another appointment to get things rolling, but we wasted no time. after our talk, we went into an exam room where he did an ultrasound to showed us my cervix, uterus, and ovaries and explained what everything was and how it was supposed to look. everything looked perfect. he said the ultrasound allowed him to see that there wasn't any obvious endometriosis, but that may be something we'd have to revisit later. he also did some cultures; i'm not exactly sure what they were all for, but i'm guessing they may have been STD-infection kind of tests. which i know i've been tested for in the past, but it doesn't hurt, i guess. and then he prescribed me some prenatal vitamins and folic acid, and wants me to get some other vitamins that will improve my egg quality. whew.
this week is ovulation, so he wants us to "try our best!" (obviously) and if we aren't successful, we start a "full fertility workup" when i get my period (probably around the beginning of february). the workup normally includes a couple of things we've already had done (the semen analysis and the hysterosalpingogram), so we won't repeat those. but we will do a bunch of other things. it looks like this:
1. 3rd day of period i have a blood test... a big one. 17 vials of blood, they said. yikes.
2. soon thereafter: i have a hysterosonography, which checks the uterine lining for polyps and fibroids.
3. next: we have a post-coital test, which is an exam 9-12 hours after intercourse to see how my body is dealing with the sperm and such. (the hubby will likely feel a lot of pressure about that specific timeline... we might need some strategies there...)
4. when i ovulate again: i have an endometrial biopsy to check my the quality of my endometrial tissue.
5. when we have a discussion appointment to go over all of the results. all of this will happen within my next cycle... assuming we don't get pregnant this time.
but maybe we will! he was rather optimistic, which i suppose we should be. so we'll do our best this week... i should probably ovulate within the next few days. all in all, it just feels like the right thing to do to have this expert on our side and for us to stop jumping to conclusions that the internet or a pay-service lab suggests. all of these tests are totally covered by my insurance, so we can get as much information possible before we start making big decisions. maybe it will turn out that IUI is still a great option for us, but in the meantime i do not feel badly about taking our time with this most-important process. and now it's a week of "trying" to look forward to... woo hoo!
Tuesday, January 11, 2011
cycle 12, day 2... an update
after spending the past several days making a zillion phone calls between my ob/gyn's office and the lab to have records faxed and get details on IUI procedures, plus reading online and in books and talking to folks who have firsthand experience in such matters, it was the insurance company that finally pushed me to actually think about our current course of action. go figure.
i called aetna this morning to find out about our deductible for fertility assistance; i knew we have $5000 per calendar year once said deductible is paid, but i wanted to make sure the deductible itself wouldn't cause us to go broke. and the representative i spoke to on the phone not only spent way more time and effort than i expected in our conversation about deductibles, but also offered me some advice about the whole situation. he kept saying throughout, "i mean, i'm just telling you what i know from my position, but you can do whatever you think is best..." but, in the end, i'm listening to the insurance guy.
for those of you who have been following along, you may remember that in the fall my ob/gyn referred the hubby to this private lab that doesn't take insurance for his semen analysis. it was only $125, and my doc suggested them, so we went with it. when those results came back iffy, my doctor proceeded to refer us to a urologist for next steps. this guy also wasn't covered by insurance (not just our insurance... ANY insurance) and was considerably pricey for even a consult. at that point i looked online for urologists the hubby could see that might actually be covered, but found none. i kind of shrugged and figured that fertility stuff wasn't widely covered and that we'd just have to suck it up and do a lot of our own research. no biggie. we're good at research.
so we did. we read about the sperm dna test and knew that we wanted to have that done. since we already knew what we wanted, it made sense just to go back to the same lab. thus we've been dealing with this lab, with varied amounts of satisfaction, since then... and planned to go ahead with the IUI through them as well. this was based on one very rushed conversation that the hubby had with a urologist who works with the lab. that is the only actual medical advice we've had since the initial referral for semen analysis.
but again... i didn't think we had many other options. we knew once the deductible was paid the rest of the costs would be covered, and it just seemed like the easiest route. in truth, i wasn't thrilled about it... particularly because it felt like we were simply going about it on our own. they're a private business -- you tell them what you want and they do it. of course they have medical knowledge. i spoke to a nurse. (what she told me didn't agree with some things i'd read about IUI, but i was willing to let that slide.) but when i talked with a friend of mine who had (successful!) IUI, she mentioned some other possible issues that we might need to explore, and i started to think that having an actual doctor advising us would be really, really nice. but again, i didn't think we had that choice under my insurance plan.
i have to say now that it does seem ridiculous. i live in new york city and i have fancy university insurance. i mean... really.
which is pretty much what the aetna guy said to me today. when i asked him about the deductible, he told me that the out-of-network one was $575, which is what we'd pay going through the lab. but then he said, "i'm just curious... what's the benefit of using this lab rather than an in-network doctor?" when i told him i didn't think there were any and he asked for my zipcode, he replied, "oh... no way. you're in new york." in an instant he pulled up a list of 111 specialists covered by my medical plan all within 5 miles of my house that could provide us with the same services as the lab. 111, when i found zero! how could this be the case? well, because he knew the correct terminology to plug into the search bar for these sort of things: "reproductive endocrinology," of course. in a thousand years i never would have come up with that. THIS IS WHY I NEED MEDICAL PROFESSIONALS. even medical insurance guys know more than i do.
so in a split second of decision-making, i called one of the offices that had a website i liked and good reviews online (http://www.kofinasfertility.com/index.html), had a pleasant conversation with a woman on the phone, and scheduled a consultation for tuesday morning! the deductible for in-network doctors is only $150. AND they're real doctors! with offices in places like brooklyn, where i actually LIVE!
this means, most likely, that we won't do the insemination this cycle... because i will probably ovulate next week. but, in the end, the advantages of having a doctor to guide us through this AND saving a bunch of money will outweigh an extra month's wait time. i am feeling much more calm and confident about the whole thing now that we're not flying by the seat of our collective pants. i mean, i know we don't have all the time in the world. but we certainly have the time to be smart. right? right.
i called aetna this morning to find out about our deductible for fertility assistance; i knew we have $5000 per calendar year once said deductible is paid, but i wanted to make sure the deductible itself wouldn't cause us to go broke. and the representative i spoke to on the phone not only spent way more time and effort than i expected in our conversation about deductibles, but also offered me some advice about the whole situation. he kept saying throughout, "i mean, i'm just telling you what i know from my position, but you can do whatever you think is best..." but, in the end, i'm listening to the insurance guy.
for those of you who have been following along, you may remember that in the fall my ob/gyn referred the hubby to this private lab that doesn't take insurance for his semen analysis. it was only $125, and my doc suggested them, so we went with it. when those results came back iffy, my doctor proceeded to refer us to a urologist for next steps. this guy also wasn't covered by insurance (not just our insurance... ANY insurance) and was considerably pricey for even a consult. at that point i looked online for urologists the hubby could see that might actually be covered, but found none. i kind of shrugged and figured that fertility stuff wasn't widely covered and that we'd just have to suck it up and do a lot of our own research. no biggie. we're good at research.
so we did. we read about the sperm dna test and knew that we wanted to have that done. since we already knew what we wanted, it made sense just to go back to the same lab. thus we've been dealing with this lab, with varied amounts of satisfaction, since then... and planned to go ahead with the IUI through them as well. this was based on one very rushed conversation that the hubby had with a urologist who works with the lab. that is the only actual medical advice we've had since the initial referral for semen analysis.
but again... i didn't think we had many other options. we knew once the deductible was paid the rest of the costs would be covered, and it just seemed like the easiest route. in truth, i wasn't thrilled about it... particularly because it felt like we were simply going about it on our own. they're a private business -- you tell them what you want and they do it. of course they have medical knowledge. i spoke to a nurse. (what she told me didn't agree with some things i'd read about IUI, but i was willing to let that slide.) but when i talked with a friend of mine who had (successful!) IUI, she mentioned some other possible issues that we might need to explore, and i started to think that having an actual doctor advising us would be really, really nice. but again, i didn't think we had that choice under my insurance plan.
i have to say now that it does seem ridiculous. i live in new york city and i have fancy university insurance. i mean... really.
which is pretty much what the aetna guy said to me today. when i asked him about the deductible, he told me that the out-of-network one was $575, which is what we'd pay going through the lab. but then he said, "i'm just curious... what's the benefit of using this lab rather than an in-network doctor?" when i told him i didn't think there were any and he asked for my zipcode, he replied, "oh... no way. you're in new york." in an instant he pulled up a list of 111 specialists covered by my medical plan all within 5 miles of my house that could provide us with the same services as the lab. 111, when i found zero! how could this be the case? well, because he knew the correct terminology to plug into the search bar for these sort of things: "reproductive endocrinology," of course. in a thousand years i never would have come up with that. THIS IS WHY I NEED MEDICAL PROFESSIONALS. even medical insurance guys know more than i do.
so in a split second of decision-making, i called one of the offices that had a website i liked and good reviews online (http://www.kofinasfertility.com/index.html), had a pleasant conversation with a woman on the phone, and scheduled a consultation for tuesday morning! the deductible for in-network doctors is only $150. AND they're real doctors! with offices in places like brooklyn, where i actually LIVE!
this means, most likely, that we won't do the insemination this cycle... because i will probably ovulate next week. but, in the end, the advantages of having a doctor to guide us through this AND saving a bunch of money will outweigh an extra month's wait time. i am feeling much more calm and confident about the whole thing now that we're not flying by the seat of our collective pants. i mean, i know we don't have all the time in the world. but we certainly have the time to be smart. right? right.
Monday, November 22, 2010
cycle 10, day 5: sperm, always sperm
after a rather uneventful couple of weeks, we have some news and a slight update. well, i got my period last week so i am (obviously, again) not pregnant. but this was no surprise and no disappointment this time around. but in more significant news, we finally got the results back from the hubby's sperm dna test. we had quite a hassle trying to obtain this information; the lab had the results last wednesday, but gave him the runaround with return phone calls. finally this afternoon a urologist called him back to discuss the results.
the doc said that the dna results were fine. 2/3 of his sperm are normal, which apparently is... normal. so -- no big awfulness with the sperm, they just don't quite do what they're meant to. it was nice to have a pro look at the results of his first semen analysis also; this doc said that he wasn't really concerned at all about the motility, and that while the morphology percentage is bad, since the sperm count itself is high it's not as bad as it seems. he mentioned a couple of things that could be going on, things i've read a bit about on the internet -- varicose seals and whatnot, but the hubby is convinced all of this is just a plot to get him to come into this guy's office and spend a ton of money. bottom line is the doctor told him he should be taking male fertility supplements (he has been for a couple of weeks now) and that there's really no reason we shouldn't be able to conceive. he also suggested Interuterine Insemination (IUI), which i thought was interesting because from what i'd read online i didn't think it would be a helpful method for us with a morphology issue. but this guy said yes. i feel that i must use a direct quote from the hubby to describe the IUI process, because i just can't say it any better:
"He said that procedure is only a few hundred bucks and would involve me looking at a nudie mag, them "washing" the sperm, then shoving it up your yeehaw."
clearly we'll need to learn a bit more about it, but it sounds promising (and slightly terrifying).
but... i think we have a gameplan for the next couple of months. we'll keep trying as we have been this cycle and next, now that he's on the fertility supplement and we've read a bit of other pieces of advice: that i should lay down for at least 30 minutes after sex, that we should have sex in the morning whenever possible (a.m. sperm is better than nighttime sperm), that he should be exercising more and eating healthy (we'll see how far we get with that!). by january, after 12 tries on this crazy adventure, we'll consider trying IUI if it seems like a good plan.
i like plans.
oh, and we also read that he should be... ahem, expelling sperm every 48 hours or so consistently throughout the month to keep the sperm as fresh and healthy as possible. apparently if they sit around in there they get funky. i thought this could be the key to all of our problems, and told him that we needed to have sex a lot more often. he said, "no... that hasn't been the problem." i paused, knowing full when when we've been having sex and that there have been some big gaps in between my peak times. he repeated, "that hasn't been the problem," and smiled. so i guess he's been taking care of the sperm. sigh. well, he'll have to keep that up!
can you believe this silliness of all of this??? what a riot.
the doc said that the dna results were fine. 2/3 of his sperm are normal, which apparently is... normal. so -- no big awfulness with the sperm, they just don't quite do what they're meant to. it was nice to have a pro look at the results of his first semen analysis also; this doc said that he wasn't really concerned at all about the motility, and that while the morphology percentage is bad, since the sperm count itself is high it's not as bad as it seems. he mentioned a couple of things that could be going on, things i've read a bit about on the internet -- varicose seals and whatnot, but the hubby is convinced all of this is just a plot to get him to come into this guy's office and spend a ton of money. bottom line is the doctor told him he should be taking male fertility supplements (he has been for a couple of weeks now) and that there's really no reason we shouldn't be able to conceive. he also suggested Interuterine Insemination (IUI), which i thought was interesting because from what i'd read online i didn't think it would be a helpful method for us with a morphology issue. but this guy said yes. i feel that i must use a direct quote from the hubby to describe the IUI process, because i just can't say it any better:
"He said that procedure is only a few hundred bucks and would involve me looking at a nudie mag, them "washing" the sperm, then shoving it up your yeehaw."
clearly we'll need to learn a bit more about it, but it sounds promising (and slightly terrifying).
but... i think we have a gameplan for the next couple of months. we'll keep trying as we have been this cycle and next, now that he's on the fertility supplement and we've read a bit of other pieces of advice: that i should lay down for at least 30 minutes after sex, that we should have sex in the morning whenever possible (a.m. sperm is better than nighttime sperm), that he should be exercising more and eating healthy (we'll see how far we get with that!). by january, after 12 tries on this crazy adventure, we'll consider trying IUI if it seems like a good plan.
i like plans.
oh, and we also read that he should be... ahem, expelling sperm every 48 hours or so consistently throughout the month to keep the sperm as fresh and healthy as possible. apparently if they sit around in there they get funky. i thought this could be the key to all of our problems, and told him that we needed to have sex a lot more often. he said, "no... that hasn't been the problem." i paused, knowing full when when we've been having sex and that there have been some big gaps in between my peak times. he repeated, "that hasn't been the problem," and smiled. so i guess he's been taking care of the sperm. sigh. well, he'll have to keep that up!
can you believe this silliness of all of this??? what a riot.
Wednesday, November 10, 2010
mid-week update
finally talked to the doc today. life has been way too crazy lately... i completely forgot to call him when he was back in the office on monday and then i did not have a single free second yesterday. but, in the end, the conversation wasn't all that earth-shattering anyway. my hysterosalpingogram results were totally normal, everything seems to be working exactly as it should be as far as my body is concerned.
fancy that.
the hubby had the sperm dna fragmentation test yesterday, and we'll get the results next week. in the meantime, we received a copy of the semen analysis, mailed from my doc's office, and have been trying to decipher it. based on the percentages, his motility is "low" (40%, when it should be 50% or more) and his morphology is "poor" (16% when it should be 30% or more). the lab that did his analysis uses the traditional World Health Organization numbers, but my internet research shows me that there is little agreement these days on the morphology breakdown. it seems that all kinds of newer research in the past couple of decades indicates that a much lower percentage of "normal" sperm is still totally average and viable. in fact, some sites i've found say that normal morphology is 15%, and that most men rate much lower (around 5%!). but i'm not sure if what they're looking at or counting as "normal" is different under those conditions, so... it's a little confusing. we're not sure how to react to this information, exactly. could it be that he actually is "normal?" or is this new perception of "normal" just plain silly, as this doctor: http://infertilityblog.blogspot.com/2006/05/sperm-morphology-mythology.html thinks? i really don't know. his results do say that 72% of his sperm have "head defects," which doesn't sound promising, and from my completely non-medical opinion, morphology seems harder to overcome with fertility "assistance" measures than motility. if all we had to worry about was his little guys getting up to the egg, we could do some kind of insemination, i'd imagine... but if, once they get there, they still can't get the job done because their heads are messed up, well... that's not so hopeful.
so we're still at a standstill for the time being, but i am really enjoying the break from the obsession/insanity. next week we'll have more results, another new cycle of mine should start by the end of the week, and it'll be a brand new day! ... one way or another.
fancy that.
the hubby had the sperm dna fragmentation test yesterday, and we'll get the results next week. in the meantime, we received a copy of the semen analysis, mailed from my doc's office, and have been trying to decipher it. based on the percentages, his motility is "low" (40%, when it should be 50% or more) and his morphology is "poor" (16% when it should be 30% or more). the lab that did his analysis uses the traditional World Health Organization numbers, but my internet research shows me that there is little agreement these days on the morphology breakdown. it seems that all kinds of newer research in the past couple of decades indicates that a much lower percentage of "normal" sperm is still totally average and viable. in fact, some sites i've found say that normal morphology is 15%, and that most men rate much lower (around 5%!). but i'm not sure if what they're looking at or counting as "normal" is different under those conditions, so... it's a little confusing. we're not sure how to react to this information, exactly. could it be that he actually is "normal?" or is this new perception of "normal" just plain silly, as this doctor: http://infertilityblog.blogspot.com/2006/05/sperm-morphology-mythology.html thinks? i really don't know. his results do say that 72% of his sperm have "head defects," which doesn't sound promising, and from my completely non-medical opinion, morphology seems harder to overcome with fertility "assistance" measures than motility. if all we had to worry about was his little guys getting up to the egg, we could do some kind of insemination, i'd imagine... but if, once they get there, they still can't get the job done because their heads are messed up, well... that's not so hopeful.
so we're still at a standstill for the time being, but i am really enjoying the break from the obsession/insanity. next week we'll have more results, another new cycle of mine should start by the end of the week, and it'll be a brand new day! ... one way or another.
Sunday, November 7, 2010
a nonchalant Round 9! and other stuff.
so... we decided to TTC again this month. to heck with it, right? by the time the 24-hour waiting period following my procedure had ended, it was the night of my first peak fertility day, so we hit that day and the morning following my ovulation window. but i have to say that i don't think this was as much an attempt to TTC as it was just us... getting busy. our sex life has been constrained by rules lately, even more than usual. we had a mandatory abstinence period prior to his first semen analysis, and by then i had my period, and then we weren't allowed to in between when i got my period and the hysterosalpingogram. so... it had been awhile. i don't think this will be a tremendously hopeful cycle, since we're fairly confident now that this whole thing will be pretty damn difficult. but... as least we had some fun, right?
i've also done some non-researchy research about adoption the past few days. since we're in the information-collecting stage. i have a friend from high school who's in the process of adopting a four-year-old girl from russia, and a former colleague/friend from north carolina who adopted a newborn over the summer. both of them have been more than forthcoming about their experiences and have provided me with a lot of food for thought. much like conception has been for us, the reality of adoption is much less romantic than one thinks before learning something about it. of course it's a risk anytime someone decides to become a parent, but the risks with adoption scenarios are kind of terrifying. but. we're not there yet, so i'm just taking in some details and saving them for a time when i might need to process them further.
in the meantime, the hubby and i had a wonderful weekend setting up the house and just generally enjoying one another's company, which was so needed and so appreciated. i feel dramatically better than i did a week ago today, and for the moment am perfectly content to take things as they come and not get caught up in over-dramatizing, over-planning or over-thinking. for once.
i've also done some non-researchy research about adoption the past few days. since we're in the information-collecting stage. i have a friend from high school who's in the process of adopting a four-year-old girl from russia, and a former colleague/friend from north carolina who adopted a newborn over the summer. both of them have been more than forthcoming about their experiences and have provided me with a lot of food for thought. much like conception has been for us, the reality of adoption is much less romantic than one thinks before learning something about it. of course it's a risk anytime someone decides to become a parent, but the risks with adoption scenarios are kind of terrifying. but. we're not there yet, so i'm just taking in some details and saving them for a time when i might need to process them further.
in the meantime, the hubby and i had a wonderful weekend setting up the house and just generally enjoying one another's company, which was so needed and so appreciated. i feel dramatically better than i did a week ago today, and for the moment am perfectly content to take things as they come and not get caught up in over-dramatizing, over-planning or over-thinking. for once.
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