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Archive for December, 2011

Pre-op appt

Today was my pre-op for my laposcopic surgery on Jan. 4. I have a large 6 cm endometrioma on my right ovary, and very probably some more endometriosis. I left the appointment feeling very grumpy.

The nurse weighed me and took my blood pressure. My blood pressure was a bit higher than normal, and she noticed right away, and thought it was a bit off for me. It’s crazy that I’ve been to this doctor enough times that they know what my blood pressure should be.

Then I had my consult with the resident. It’s the same resident that I didn’t feel confident in at my ultrasound, and that someone else here hasn’t had good experiences with. He went through the pre-op stuff, but got all messed up when he was trying to explain that the endo might be so bad that they might have to make a call to remove an ovary and/or tube, or leave the endometrioma (his preference). And he wanted me to make a decision right then about what I would want. But he didn’t really give me much more detail, so after some pressure I said I would leave it to their best judgement. We went through the rest of the pre-op stuff… they’re just going to cauterize the endo that they do find. And he said the day before I can have a regular day, including eating dinner, but no food or drink after midnight. When I asked about the synthroid, he said it was ok to take in the morning, but then seemed surprised that I take it on an empty stomach. That’s standard. Taking it with food blocks the absorption. He also thought I might need to take some progesterone to hold off my AF since the surgery would be around that time.

Then the doctor came in (I get tired of having the same conversation twice, especially since the resident’s comments are often changed by the doctor). He explained the whole ovary/tube removal much clearer. Basically, if things are so bad that they’d have to take out an organ, it would be much more invasive surgery (lapratomy), and the steps that follow it would be much different than a regular laproscopy. They would do what they could laproscopically, but leave the endometrioma and talk with me post-op about more invasive surgery, and the possibility of IVF after the surgery. But he gives a 95% chance that this won’t be the case. He also said I didn’t need to worry about AF because it’s not a problem to do this surgery during AF.

After talking with the doctor I have two concerns. I mentioned that I think I have some endo on my bladder, and asked if they could check it out. I feel like they kind of brushed this concern off and told me that even if I did have it, there’s nothing they could do about it. Also, as I mentioned, they’re cauterizing the endo. I know that more complete endo removal involves cutting. But they can’t cauterize anything on the bladder, which is why they brushed my concern off. So, I’m worried that they’re not doing enough. I worry that another surgery might be in my future, and I’m not really comfortable with all of this medical stuff. I even sent a text to my DH later that said that if this doesn’t work adoption might be a better option than continuing down this rabbit hole. Straight Face

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Cycle #17

AF is starting today, marking the start of cycle #17. I have almost no hope for a successful cycle #17.

Cycle #16 was huge emotionally, although nothing new happened physically. When AF started I thought it was a failed clomid/IUI cycle, but I’d be doing another one. I went in for a CD3 ultrasound to look for cysts from the clomid, and they found a huge cyst on my right ovary (60mm), so I was told no clomid, and to come back in 2 weeks to see if it would shrink. I went home and researched cysts, and came to the conclusion that it most likely was a functional cyst, and I might have to wait a cycle or two until another round of clomid. I also researched natural remedies for ovarian cysts and found one that involved beet juice, aloe juice, and molasses. I made the drink, and it was nasty! It was so bad that I decided I’d rather have surgery to remove the cyst, if necessary, instead of drink that stuff twice a day for several weeks. And the thought of surgery scares me, so that should be some indication of how bad it was.

I went in for my follow-up appointment, and happened to have an LH surge the day before, so it was my O day. Unfortunately the cyst hadn’t shrunk at all, and the doctor told me it was most likely an endometrioma, and I’d need surgery to remove it. They’d also do a dye test during the lap to see if my tubes were clear, and look around for more endometriosis, and clean it up if it was there. On the positive side, the ultrasound showed that my left ovary had a nice 19mm follicle, and my lining looked good for where I was in my cycle.

For the past two weeks I’ve been learning everything I can about laproscopic surgery, endometriomas, and endometriosis. The thought of surgery scares me. I’ve never had anything more extreme than wisdom teeth surgery, and I really hate medical procedures. My research on endo has also caused lots of anxiety for me. I found that my cyst is definitely on the larger side for an endometrioma. I also read that endometriomas are generally found in women with severe (stage 3-4) endometriosis. I talked to my mom about everything, and found out that her sister had a total hysterectomy for severe endometriosis. My reading has also shown me that endometriosis can be bad news for TTC. Surgery may not fix whatever problem I’m having, and I actually might not ever be able to have kids. For the first time in this journey, I’m beginning to wonder “if” and not “when”.

So DH and I sat down and had a real discussion about options. He said that there are so many ways of having babies, but I reminded him that although the possibilities seem unlimited, the reality is that our money is very limited. I’ve never seen myself as childless, so it’s important to me that we end up with a baby, even if it’s not genetically related. Luckily, I had a wonderful DH and he didn’t care about it being genetically related either. And since he already has two DSS, I was worried about him feeling weird about having full custody of a non-biological child, with limited custody of his own sons. But he didn’t seem to worry at all about it.

So my current map through this horrible disease is as follows (our problems are endo and male subfertility): lap surgery on Jan. 4. December and January cycles are basically out. Feb we’ll just try timed intercourse to let my body heal. Then I’ll try a few natural IUIs, followed by a few IUIs with clomid or femara. Then I might try a round or two of injectables with IUI, depending on my RE. But if that fails, instead of jumping into IVF I’m really interested in FET with donated embryos. And if that fails, after I come to terms with it, I think it will be time to move on to adoption. DH and I agreed that if we don’t have a child by the time we turn 38 we’ll move our efforts into adoption of an infant.

Wow. What a month it’s been.

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