Starting again

So, it's been nearly two weeks since I had my lap and as of tomorrow and, in my doctor's opinion, I'll be considered "fully recovered." Even though the incisions are still healing and there is still some bruising around each one, I do feel nearly healed and I'm ready to jump back into exercise and TTC.

I had my follow up with the RE last Tuesday and got the lowdown on what all he did during the surgery. I tried to outline what was done but it was based on the post anesthesia fog report that my husband gave me. My husband really tried to remember what the doc said when he showed him the pictures, but I didn't get the complete story until my follow up.

I had an exploratory laparoscopy and a hysteroscopy. They lasered all the endometriosis they found which was on both ovaries, some in a pocket on the right side of my uterus, and some on my left uteral-sacral ligament (it is because of this endometriosis on my uteral-sacral ligament that they knew I had endo due to the pain it caused with cervical manipulation). All of the endo was removed. They also found a para-tubal cyst on my right tube. This type of cyst can twist and wrap around the tube closing off the tube. When discovered, it was unwraped and untwisted, but it could have caused intermittent problems that I didn't even know about. The hysterscopy revealed a polyp in my left tube which was then removed. They repeated the HSG and found both tubes to be open and clear at the end of the surgery.

Knowing all of this, it is possible that I had both a toxic pelvic environment from the endo as well as blocked tubes (although I previously had a good HSG).

The doc gave us a 40% chance of getting pregnant naturally over the next 3 months. If not pregnant by October, we call him on CD1 of that cycle to start IUIs with injectables. With IUIs and TTC naturally, combined he gives us a 70% chance of getting pregnant. Since he plans to let us have 3 months of TTC naturally and 3 cycles of IUI, that means we have a 70% chance of conceiving before the end of 2012.

It really feels like I am starting all over again with TTC. You know the excitement you feel when you first start trying, how you are just so sure you are going to get pregnant right away and you question whether you are really ready for this? That's how I feel right now.

Laparoscopy...check! and then some

I had my Laparoscopy yesterday, and hysteroscopy, and HSG and polyp removal. Who knew I was going in for the whole shebang!

They found stage 2 endo and removed it, which makes me feel good and bad. I'm glad they found it. I'm glad that, since it was Stage 2, I had the procedure, but I sort of also wish they found nothing and that I didn't have it.  They gave me pictures as proof that they removed endo from an ovary and something else. Husband wasn't too clear on the details although he really tried to remember.

They had told me that if I wasn't under for too long they would also do a hysteroscopy, I'm glad they did decide to do this because they found a polyp at the entrance to one of my tubes, so although that tube was open during my HSG a few months ago, it likely has not been since.

After they did the hysteroscopy, they also did an HSG again to make sure that the tubes flushed clear. I assume that they did because I didn't hear anything about it.

I'm in no pain, I've taken no medication for pain or for nausea. But the laxative they made me take on Tuesday night has had long lasting effects, which I guess is better than the alternative.

I considered posting pictures of my insides, but decided against it (I thought it might be gross to some, but let me know), instead I will show you the before and after of the outside of my stomach. I was told that they would be leaving about 200 cc's of fluid behind to promote healing. I was told that I would look several months pregnant, but besides a slight sloshy feeling when I move around it's not been too bad.  3 incisions in total and bandaids covering them for the squeamish.

Before

Before

After

After

Finally some news

After some scrambling around, I went for our WTF (if you want to call it that) appointment yesterday. I had made this appointment 3 weeks ago after my initial consultation with the RE. I was unable to make it any sooner (as it turns out it probably wouldn't have mattered anyway because we have to wait until my next period to do anything).

I got a voicemail after I was in yoga class on Saturday morning that the office needed to change my appointment from 2:45 to 9:45. I ran over to the husband who was doing cardio and said that they had called him after being unable to get a hold of me and he told them that no way would I be able to go as I couldn't change my schedule that last minute. I called immediately back and said that I would figure it out, but had to leave that on their voicemail. I ran over to work and on a Saturday, called all of my patients for Monday and moved them from the morning to the afternoon and then hoped that I would actually be able to be seen.

I called first thing in the morning (as we were already driving to El Paso) and confirmed that they did get my message and that I would be able to be seen. It turns out that they got it and things were OK.

Got there on time for my 9:45 appointment but we didn't actually see the doc until 11:00 and I had to leave by 11:30 in order to make it back to see my own patients.

He basically gave us the long and short of it in about 5 minutes.

Husbands sperm look OK, not great, but OK and slightly better than they did at any previous testing, so it turns out that the varicocelectomy did help even if only slightly.

That means that we aren't automatically moving to IVF because his numbers look OK. If they had been any poorer, our only option would be IVF.

He explained that he does believe that I have some degree of endometriosis and that the only way to diagnosis it is laparoscopy.

He laid the two choices in our hands:

Choice 1: Do IVF, it bypasses the toxic pelvic environment as well as the fair sperm counts, he gives us a 60-70% chance of success

Choice 2: Have laparoscopy to diagnose and treat endometriosis and sit that month out of the game, then try naturally for 2-3 months (because I do ovulate and there is sperm), then do injectable IUIs for up to 4 cycles. He gives this a 60% chance of success.  and if it doesn't work move on to IVF.

Regrettably, we have chosen choice 2 as it makes more financial sense at this time. If it doesn't work, it will be at maximum 8 months until we can do IVF and we will have the chance to save up some money and likely use next years tax return to pay for IVF.

So, for now, I wait for my period, call on the first day and schedule my laparoscopy for 1-2 weeks after my period starts.

In the meantime, while TTC is on hold, I'm going to work my butt off to get down to my goal weight. I've gone to the gym for the last 3 days in a row and everyone is commenting on how much weight I've lost in the last few weeks. I hate to break it to them, but the actual weight loss is 0 pounds! Trying desperately to lose 1 lb by tomorrow's weigh-in.

Side Note: Mary moved away, guess I need to start making new friends.

Second Side Note: I got to meet my friend Stephanie's twins, she finally brought them home (their technical due date is tomorrow), they are so small, but I got to hold and feed and burp them. Didn't have to change any dirty diapers though, nor did I get spit up on! I haven't asked if I can post any pictures, so that will have to wait.

RE conclusions

Well, I really meant to post this earlier because obviously all of you were on pins and needles waiting to hear.

I was able to visit the RE today, I was in the office from about 1:30 until nearly 4:00. I knew it might take a long time, but really?!?!?!

Anyway, we were able to come up with some solutions if not conclusions.

Here is the play by play.

1:30-arrive at clinic, I was forewarned that the clinic doesn't open it's doors after lunch until 1:30, however, I also knew that my appointment was scheduled at 1:30 so there was no way I was being seen upon arrival without filling out paperwork.

1:35-doors to clinic open, I'm first to sign in, but last to be called upon because I am the only new patient of the 4 or 5 women who are checking in at the same time

1:45-I'm finally given the new patient paperwork, it's not so bad, it's just personal information, not health information

1:50-turn in paperwork

2:15-I'm finally called back after everyone else in the waiting room is gone, not in back rooms, but checked out and left, meet with an MA who asks me questions, but doesn't really ask me to elaborate, they apparently have copies from my gyno (who has no idea what my other gyno who did IUIs, my rheumatologist, my endocrinologist and my GP had to say, or even did for that mater) I basically answer yes/no questions because she obviously doesn't care about the details

2:30-I am placed in a room that is very much like a small conference room with a large glass table and 9-10 chairs around it and find that I am facing a wall with about 10-15 plaques on it that say that this Dr. has been voted one of the best Dr's in Texas for the last...oh...10-15 years or so

2:45-A resident is sent in to further question me, but still is basing all of his questions off of the paperwork given by my regular gyno, he does however allow me to elaborate on my Hashimoto's and the husband's varicocele and repair, he cares nothing about the stack of paper's I've brought with me, but does acknowledge that I've done my homework and seem prepared

3:00-The Dr. Himself has been consulted by the resident and comes in to verify a few things and obviously plans to order more testing, only I'm one step ahead of him and am able to provide the necessary paperwork referencing the cystic fibrosis, rheubella, etc etc screenings I have already had done. He moves on to repeating day 3 and day 21 bloodwork, which I am also able to produce (in duplicate, from both February, 2011 and July, 2011). He also questions semen analysis, which has been done twice...but not 6 months after varicocele repair...FUCK...called out on a technicality. He indicated that we needed to have that repeated before we could make any decisions or come to any conclusions.

3:30-A fun unexpected pelvic exam along with a chlam.ydia and gon.orrhea swab...as part of the evaluation, he does cervical manipulation and re-questions me about pain during intercourse (insert red flag).

3:35-The most brief and succinct discussion of endometriosis ensues, which based on the 2 seconds he had his fingers in my vagina tells him that I have it, included in the *wealth* of information he gave me was a nod to the fact that I needed to be on a different form of folic acid since I have had to discontinue my pre-natal so that I don't overdose on vitamin D while supplementing it over the next 16 weeks.

3:40-I am re-dressed and sent to the waiting room for the front desk to schedule my husband a semen analysis and a 3 week follow up for me

4:00-I am finally called to the desk after watching 2 unattended 3-4 year olds chase each other around the waiting room (actually they were quite well behaved considering there was no obvious adult watching them) I check out, pay the co-pay and leave

Conclusions
-They think I have endometriosis and I am inclined to agree as no one else has been able to put their finger on it prior to now
-Sex shouldn't ever be painful, and neither should manual cervical manipulation, if it is, it means bad things
-Doctor's can give out homework, I was given a 20 page document on "Endometriosis, A guide for patients", but from what I have read so far I am sort of convinced, but that is a whole other post
-Front desk personnel can not multi-task if it takes them 20 minutes to check someone out
-Even if you think you're on top of your game, someone is bound to prove you wrong
-I think that my RE is more willing to help me because I was "so incredibly organized" according to him, which he must have said 3-4 times during our initial sit down

My opinions

First of all, does every RE really need to have a wall plastered by baby pictures somewhere in their office?

Up until now, I have only considered infertility merely an inconvenience. I simply thought of it as delaying pregnancy and having children rather than truly preventing it. I always thought that if someone could just determine the problem, there would be an easy fix. But things in life aren't always that easy. I really try hard not to complain too much, I'm just feeling a little broken.

Maybe this will end up being an easy fix, but my patience has run out. I don't know how I will make it through the next 3 weeks until my next appointment. I've just recently learned how to function respectably in 2 week time increments.

Is it worth inquiring about why I have to wait 3 weeks if my husband's semen analysis is scheduled one week from today? Should I have my husband try to move it up when he goes for the semen analysis? Is that being to forward/annoying/pushy?

*denotes extreme sarcasm

RE appointment is this afternoon

Finally, the day we've all been waiting for...errrrr....I've been waiting for!

My RE appointment is this afternoon.

I think I am prepared. I'm trusting no one else and I don't want to have to wait or have the Dr. trying to make decisions without all the information he needs, so I have collected all of my records to take with me.

Primary Care Privider...check
Regular OBGYN...check
OBGYN who did IUIs...check
Endocrinologist...check
Rheumatologist...check
Thyroid bloodwork...check
All other bloodwork...check
HSG results...check
Sperm Analysis results...check
BBT charts...check

Anything else I missed?

I have it in my mind that if I'm organized enough, that this may actually happen, that I might actually find someone who can help get me pregnant. Let's just hope he speaks English!

Here's hoping for the best!