Change of Plans

Well, I had my follow up appointment this week. And with the follow up another change in plans. Instead of Clomid and Decadron, which he says I don’t need (my androgen levels came back normal on my most recent blood panel), we proceeded to a repeat HSG this month. I guess he was concerned that the surgery could have damaged my right tube, so he wanted to be sure it was clear. So Wednesday I went back for the repeat HSG. The plus with a test like this, especially when it is your RE doing it, at his office, with just one of his nurses is that I not only get to watch, I get my news immediately.

My right tube is still completely clear and spilling. It was all done so quickly now that my misguided and bratty left tube is gone, Bill said I should get a discount for using less dye and having fewer xrays taken. Of course, this bit of good news was also followed up with the doom and gloom of the fact that I could still have damage around that ovary, etc, etc.

So, plan now is that I go back next Monday or Tuesday. Given my regular cycle, I should be close to ovulation. RE wants to verify which side I will O on and will proceed to tell us to go home and screw like, as Bill put it, “rabid howler monkeys”, or he may suggest an unmedicated IUI. Only downside to this plan is that even if I O on my bad side, that will be my marching orders.

From there, I don’t know. HSG supposedly makes you more fertile for the first 3 months after. I am all aboard that train of course given that we conceived my doomed pregnancy (also my only pregnancy ever in 7 years) the 3rd month after my last HSG. My only real worry is that my stupid right tube looks like it may have been open this entire time, so there could be unviewable damage to it. But, I’m trying to think positively. Maybe it was backed up with mucus or something all these years and we just got unlucky that I had a good O from the left side before the right.

We’ll see. RE still wants me to do IUI with injectables, but said IVF is of course our best option. And of course when I told him yes, I understand, but IVF will take me a couple years to save for I got reminded of how old I already am and that 2 years could be the difference between my currently awesome egg status, to a poor egg status.

Like I needed that reminder? I know my time is running out, but I:

  • Don’t have the credit to take out a loan.
  • Don’t have anyone who can cosign a loan for me.
  • Do not have family I can borrow the money from to pay back.

And let’s not forget that the cost of IVF and meds is basically half my yearly salary right now.

BUT.

On the plus side.

If things go well and I am still were I am now 2 years from now (praying to every god in existence on this one), he did say I am an ideal candidate. On my ultrasound this week at only CD 5, I have around 8-9 follicles on each ovary, which he said he has seen on every ultrasound he has done on me. So he thinks that if I have to go through IVF, when he goes to stim me I should produce a bunch of high quality follicles, which means we should get a bunch of eggs (say 20-ish he thinks?). He also said my egg quantity is good, especially for my age. So if we end up on that road there are some plus’s to keep in mind.

So now I wait. Like I do every month. It’s a nasty vicious cycle. Period, wait to ovulate, wait to test, BFN, period, wait to ovulate, wait to test, BFN, period. Rinse and repeat. Over and over. And don’t forget all the crying and obsessing and worrying, as those are all large parts of this process as well. All in the hopes that I might be lucky enough to experience something biology has programmed me to want above all other things.

Maybe some day.

The Results & The Plan

So I’ve had the follow up with both my OB/surgeon and my RE now and the results are all in.

The OB removed my left tube due to severe endometriosis damage. He said it was only large enough for the sperm to get through, but physically impossible for a fertilized egg to make it back out. So he removed it for my health and fertility. The tube was also positive for a pregnancy, so I did have an ectopic.

Right ovarian cyst was related to the pregnancy hormones. Labwork came back benign. He drained and removed the cyst and I got to keep my ovary intact!

The rest of the lap showed that I had some pretty severe scarring on my left side from endometriosis activity, but that my right side is completely healthy looking. No currently active endometriosis was visible in my abdomen. He said there may be some, but I was too swollen for it to be clearly visible and it would be minimal in that case.

Miscarriage bloodwork showed I have homozygous MTHFR A1298C. This is a fancy way of saying I have a clotting disorder in my DNA that I got from both parents. It means I don’t metabolize folic acid, b12, or b6 properly as well. So I got put on a synthetic high-dose version that my body should be able to metabolize, and I have to take that as well as baby aspirin everyday for the rest of my life pretty much.

So, because of my previous fertility problems, that are now compounded by only having one tube, he thinks my overall best bet is IVF obviously. But, while we save up for it ($12-14,000 depending on medication protocol, cryopreservation, and what my insurance will cover) he is going to try a few things. First is clomid & decadron with monitored cycles, then maybe something else. Turns out my insurance doesn’t cover injectables at all, so that is out. He thinks I may have a chance as long as we can get my right ovary to produce. So fingers crossed I start saving up IVF money for no reason.

The Results & The Plan

So I’ve had the follow up with both my OB/surgeon and my RE now and the results are all in.

The OB removed my left tube due to severe endometriosis damage. He said it was only large enough for the sperm to get through, but physically impossible for a fertilized egg to make it back out. So he removed it for my health and fertility. The tube was also positive for a pregnancy, so I did have an ectopic.

Right ovarian cyst was related to the pregnancy hormones. Labwork came back benign. He drained and removed the cyst and I got to keep my ovary intact!

The rest of the lap showed that I had some pretty severe scarring on my left side from endometriosis activity, but that my right side is completely healthy looking. No currently active endometriosis was visible in my abdomen. He said there may be some, but I was too swollen for it to be clearly visible and it would be minimal in that case.

Miscarriage bloodwork showed I have homozygous MTHFR A1298C. This is a fancy way of saying I have a clotting disorder in my DNA that I got from both parents. It means I don’t metabolize folic acid, b12, or b6 properly as well. So I got put on a synthetic high-dose version that my body should be able to metabolize, and I have to take that as well as baby aspirin everyday for the rest of my life pretty much.

So, because of my previous fertility problems, that are now compounded by only having one tube, he thinks my overall best bet is IVF obviously. But, while we save up for it ($12-14,000 depending on medication protocol, cryopreservation, and what my insurance will cover) he is going to try a few things. First is clomid & decadron with monitored cycles, then maybe something else. Turns out my insurance doesn’t cover injectables at all, so that is out. He thinks I may have a chance as long as we can get my right ovary to produce. So fingers crossed I start saving up IVF money for no reason.

Ninty Five Percent

Just over a week since my surgery and I am physically about 95%. The spotting from the D&C had stopped by the 2nd day, the bruising is starting to fade around my incisions, the glue closing them is starting to peel off, the random bouts of pain from the gas, and the cramping is all dying down. Physically I feel pretty good. I no longer feel pregnant. My breasts don’t hurt anymore, the bloating is gone (my pants fit again!), and my skin is back to normal.

Mentally I am battered and trying to process everything. Before things got out of control I made an appointment with my regular doctor. I wanted him to know what happened and to prescribe me something for the anxiety/panic and depression so I didn’t do something stupid like start smoking again. So he gave me a scrip for Zoloft and Ativan. The Zoloft is for daily use, the Ativan as needed for panic and to sleep.

I’m doing okay. I’m sad. But I’m not as sad today as I was yesterday, or the day before that. It’s just hard to process.

The nurses called from my OB with my lab results on Thursday. The cyst was benign and the tube they removed was positive for an ectopic pregnancy. I wanted to say “No shit?! Can you tell me something useful?”. All I did was say okay and hang up. I’ve found it’s pretty much pointless to try and get answers over the phone and I’m just trying to remember to write down every question I want an answer to for my follow up appointment on the 30th.

I then have a follow up with my RE on the 3rd.

I want to know what the game plan is. I want to beat the fear and dread I have that I tried to get pregnant for 5 years, for my only chance to end in an ectopic at 5 and a half weeks.

I need to know for sure if we can try naturally using the right side, or if we need to live like paupers for the next year and beg everyone we know to help so we can afford IVF. And if my only choice is IVF, I need an absolute cost breakdown.

I just have to remember the good things. After 5 years of nothing, not only did I get pregnant, I did it on my own. This means I can in fact get pregnant. That puts us a lot further then we were before.

Now it’s just having a good plan and hopefully things will fall into place. I just hope they do quickly, to fill the hole I have in my heart right now.

Outpatient Surgery

It’s done. I am no longer pregnant. And I don’t know when I will be again.

On Friday, I had 2 appointments. First with my RE at 9 am for another HCG, ultrasound, and an endometrial biopsy. Then at 2 with an OB about a probable ectopic.

Bill took the day off work to drive me around due to the biopsy. I went to my RE appointment in the morning, had my blood draw, then my ultrasound, and then the biopsy. I read online about the biopsy, as I wanted to know pain wise where it would fall. I read in several places where it was like a bad menstrual cramp. Well, let me tell you, they are full of fucking shit. That biopsy was without a doubt among the top most painful things I have ever had done to me. It took everything in my power not to thrust off of the table while he was doing it, and I just about started to cry.

I then had to wait out for my biopsy results and blood test to see if my HCG was falling. Finally got the results back about everything around noon and my HCG had risen to 365. The biopsy came back as negative for a pregnancy.

So my RE went over my options. At this point he was basically certain I had an ectopic we just couldn’t see. He said my options were going to be the shot, or to have a lap and a D&C and also have the cyst drained. He told me my best option was going to be the surgery and I agreed with him.

Went to the OB for another opinion, and he agreed with what my RE thought.

The OB also happened to be the doctor on call at Akron General that night, so he was the one who performed my operation. I arrived at the hospital around 4, got registered and checked in and taken back to outpatient surgery. Bill got to sit with me until I was wheeled back to the operating room. Not going to lie, I mostly sat and cried. The OB was fairly certain I would lose my right ovary due to the size of the cyst, and that terrified me.

I finally got wheeled back to the surgery room around 6:15 and cried the entire time I was back there until they put me out.

Woke up around 9 pm-ish? and I was in SO MUCH PAIN. After 2 more doses of painkillers  and a rectal anti nausea med, I was pushed into my clothes and wheeled out the door with instructions to make a follow up appointment with my OB in 2-3 weeks.

I ended up having a D&C with the materials from that sent for lab work. I then had laparoscopy  where they found an ectopic pregnancy in my mangled left fallopian tube. The tube was so damaged from endometriosis and scarring, that they removed the entire thing. They were able to save my right ovary though. He drained and excised the cyst and sent it for lab work as well.

So, now I’m home. No longer pregnant and having to wait until my follow up appointment on the 30th to find out exactly what happened and what the OB found. He did speak with my RE, and my RE said I need to start to seriously consider IVF, as it sounds like I have pretty extensive endometriosis in my abdomen, with a lot of scar tissue.

So, no idea where I’m going from here. But I guess the bonus is knowing for sure what is wrong now. I’m just curious to know how bad it was on my right side, and/or if it could potentially be fixable through another laparoscopy.

As far as how I feel? I’m feeling pretty much like shit. I’ve had a couple of episodes with the shoulder and upper back pain from the gas from the lap, but my lower abdomen hurts more then anything else, and the vicoden they gave me for it barely does anything to help. So we’ll see. I’m going back to work on Tuesday, so I am hoping I feel better by then. Fingers crossed?