Jamie and I are going for the follow-up SHG this Friday.
*crossing our fingers and hoping for good news*
Everything with this cycle is still looking REALLY good, so I feel myself getting my hopes up that maybe we won't have surgery again. Almost sounds a bit too good to be true, but you never know!
I never realized that all the terrible cramping that I used to have was probably due to AS. I have had literally almost NO cramping with this cycle. I've felt a small twinge here and there, but nothing more. It's amazing!
And now for an embarrassing confession. I actually sat down today and figured out what my due date would be if I got a good report from Dr. Dunn on Friday and got pregnant this cycle.
October 5, 2008.
An October baby! Another Libra! Okay, yes, my hopes are officially high now. Hopefully I am not setting myself up for disappointment.
Monday, December 31, 2007
Sunday, December 30, 2007
Results in 5-10 days
Okay, here we go! I just went to the restroom and discovered that today is the start of a new cycle. It's SO different...I have ZERO cramps. This is so promising! For the past few years my cramps have been so intense that I've needed 4 advil just to take the edge off. Today I don't feel a thing!
I'm getting excited to call the doctor and set up the SHG. I am going to call first thing tomorrow morning and try to get an appointment for Friday. That would be cycle day 6. If we don't get in on Friday, then we will have to go on Monday or Tuesday of the following week since the test has to be done between cycle day 5 and 10.
It's time to get some results!!!
I'm getting excited to call the doctor and set up the SHG. I am going to call first thing tomorrow morning and try to get an appointment for Friday. That would be cycle day 6. If we don't get in on Friday, then we will have to go on Monday or Tuesday of the following week since the test has to be done between cycle day 5 and 10.
It's time to get some results!!!
Thursday, December 13, 2007
All fired up and no one to call!
A few weeks ago I received a bill for my surgery. I already paid out of pocket $1,083 to the surgical facility and $193 to Dr. Dunn. For those who are keeping track that is $1,276 for surgery AFTER insurance. I was already pissed about that. We are shelling out over $400 a month for insurance, and I think it's a bunch of bullshit that it doesn't pay more towards treatment.
ANYWAY...when I got this additional bill I just about went through the roof. I started to get really angry, but then I decided to wait to receive my explanation of benefits from the insurance company before getting too excited.
I got that in the mail today. I am an accountant and it took me nearly an hour of sitting and comparing the statements to make sense of them, so I think a regular person would be completely out of luck. It really infuriates me that insurance companies make things so difficult to understand. The whole system is designed to screw over the average person. Luckily for me, I am not average.
A close examination of the situation indicates to me that I am owed somewhere around $230 back from the surgical facility and I owe somewhere around an additional $425 to Dr. Dunn. I'm already annoyed as hell and it's too late to call and bitch at anyone tonight. Now I am just working myself up for the battle that I will have to fight tomorrow that will no doubt involve at least an hour on the phone with United Healthcare and the surgical facility trying to convince someone to send me the refund I am owed so that I can put that towards the balance due to the doctor.
I can't wait.
ANYWAY...when I got this additional bill I just about went through the roof. I started to get really angry, but then I decided to wait to receive my explanation of benefits from the insurance company before getting too excited.
I got that in the mail today. I am an accountant and it took me nearly an hour of sitting and comparing the statements to make sense of them, so I think a regular person would be completely out of luck. It really infuriates me that insurance companies make things so difficult to understand. The whole system is designed to screw over the average person. Luckily for me, I am not average.
A close examination of the situation indicates to me that I am owed somewhere around $230 back from the surgical facility and I owe somewhere around an additional $425 to Dr. Dunn. I'm already annoyed as hell and it's too late to call and bitch at anyone tonight. Now I am just working myself up for the battle that I will have to fight tomorrow that will no doubt involve at least an hour on the phone with United Healthcare and the surgical facility trying to convince someone to send me the refund I am owed so that I can put that towards the balance due to the doctor.
I can't wait.
Wednesday, December 12, 2007
Oops
Well, my efforts to chart are not going very well so far! Jamie bought me an electric blanket, which I LOVE, but I think it is really messing with my ability to get accurate basal body temps. I haven't even tried to take my temp on the mornings when I'm using the electric blanket.
I've been telling myself that I need to start turning it off before I go to sleep, but with the cold front headed this way, I don't know if that is going to happen or not!
I've been telling myself that I need to start turning it off before I go to sleep, but with the cold front headed this way, I don't know if that is going to happen or not!
Thursday, December 6, 2007
No more estrogen!!!
At least for now!
I just took my last estrogen pill. It is hard to believe that it has already been 4 weeks since surgery. I'm beginning to get nervous and excited. Mostly nervous, though.
Dr. Dunn said once I discontinue the estrogen, it may take a few weeks for my body to gear up again and realize it needs to do its thing. Based on what he said, I should expect a period anywhere in the next 4-6 weeks. I think the quality of that period will tell me a lot about how successful the surgery was.
I will just be waiting...and waiting...and waiting.
When my period arrives, I am instructed to call the office immediately to schedule another SHG. It has to be done between cycle day 5 and 10. That will be the definitive answer to how my body has healed.
I feel so incredibly excited when I consider the possibility that in just 4-6 weeks I could be completely released to my regular ob/gyn and actively trying to conceive again. But it scares me at the same time, because I know how disappointed I am going to be if Dr. Dunn tells me that I haven't healed well enough to get pregnant.
I will still have recourse if that is the case - another laparoscopy/hysteroscopy. But I am soooo hoping that it won't be necessary. I have butterflies in my stomach just thinking about it.
I've decided to start a new chart tomorrow and pretend that it is the first day of a new cycle. We are under STRICT orders to be sure to be very careful and prevent pregnancy (on the off chance that I could actually conceive while on the estrogen), so I know for sure I won't get pregnant this first cycle. It's been a real pain, but Dr. Dunn feels strongly that he doesn't want us to get pregnant until he is certain that all is well due to a higher risk of possible miscarriage if I still have scar tissue.
I still want to chart so I can tell if and when I ovulate, because that will let me know when to expect a period and keep my obsessing to a minimum (maybe).
I just took my last estrogen pill. It is hard to believe that it has already been 4 weeks since surgery. I'm beginning to get nervous and excited. Mostly nervous, though.
Dr. Dunn said once I discontinue the estrogen, it may take a few weeks for my body to gear up again and realize it needs to do its thing. Based on what he said, I should expect a period anywhere in the next 4-6 weeks. I think the quality of that period will tell me a lot about how successful the surgery was.
I will just be waiting...and waiting...and waiting.
When my period arrives, I am instructed to call the office immediately to schedule another SHG. It has to be done between cycle day 5 and 10. That will be the definitive answer to how my body has healed.
I feel so incredibly excited when I consider the possibility that in just 4-6 weeks I could be completely released to my regular ob/gyn and actively trying to conceive again. But it scares me at the same time, because I know how disappointed I am going to be if Dr. Dunn tells me that I haven't healed well enough to get pregnant.
I will still have recourse if that is the case - another laparoscopy/hysteroscopy. But I am soooo hoping that it won't be necessary. I have butterflies in my stomach just thinking about it.
I've decided to start a new chart tomorrow and pretend that it is the first day of a new cycle. We are under STRICT orders to be sure to be very careful and prevent pregnancy (on the off chance that I could actually conceive while on the estrogen), so I know for sure I won't get pregnant this first cycle. It's been a real pain, but Dr. Dunn feels strongly that he doesn't want us to get pregnant until he is certain that all is well due to a higher risk of possible miscarriage if I still have scar tissue.
I still want to chart so I can tell if and when I ovulate, because that will let me know when to expect a period and keep my obsessing to a minimum (maybe).
Sunday, December 2, 2007
Surgery Pics
Okay, I finally got around to playing with my camera, and I think I actually was able to edit these and make them look decent. I think these pictures are amazing. It's remarkable what doctors can do these days and the precision of the tiny tools they use is hard to believe.
I only have 4 more days on the estrogen left...and then we shall see...
This is my liver. It has nothing to do with my Asherman's, but I thought it was a really pretty liver, so I am sharing! I was pleased to see that it survived my college years unharmed (kidding...sort of...). Hey, you have to keep a good sense of humor!
This next shot is my appendix (I think):
And now to the good stuff - here is my right fallopian tube opening as seen from the inside of my uterus. It's a really nice, open tube! You can also see some of the healthy endometrium. It appears as the red area. The white areas are scar tissue and/or areas where the endometrium has never grown back. In a perfectly healthy uterus, you would see that reddish lining all over.
In contrast to the right side, this next photo is a picture of the left side. You can see the tube opening, but it is quite blocked by a lot of scar tissue. Also, you can tell that there is basically no healthy endometrium on this side in contrast to what you see on the right side.
Obviously the right side is much better looking than the left.
Here is a picture of one of my fallopian tubes from the outside. It's hard to see, but you can see a dark spot at the bottom of the tube. This spot is where the dye ran through and spilled out from the other side...this is a great sign, because it means that the tube is not obstructed. Dr. Dunn got the same result on both sides, so we know that left tube is open even though it looks pretty bad in the picture.
When all was said and done, all of the scar tissue was removed. It seems hard to believe that is possible! I still look at these pictures in amazement at what can be accomplished in this day and age. Hopefully that little bit of healthy lining has been thriving on the estrogen and has multiplied and spread throughout the cavity over the last few weeks.
I only have 4 more days on the estrogen left...and then we shall see...
Tuesday, November 27, 2007
That was encouraging...I think...
**Warning: This post contains a little bit of "TMI". If you don't want any details or get grossed out by talk of blood, you might want to skip it! I've had a baby, so just about nothing can gross me out anymore.**
It's funny how the timing of things works out sometimes. When we were in Dr. Dunn's office he was saying that I might experience a little bit of breakthrough bleeding while on the estrogen. I assured him that I hadn't had any bleeding at all since 3 days after surgery. I asked him if I could expect to see any withdrawl bleeding when I discontinue the estrogen. He said maybe, and if I did, he would take that as a good sign. But he also said that I might not, and that was not necessarily a bad sign either. Gee that is helpful! Doesn't he know I need something to obsess over??
Anyway, of course the very next day I started to have bleeding (that is what I get for insisting that I didn't have any). I got all excited - strange, I know. You would be amazed at the things that make me happy these days. But this was bleeding that is comparable to a *normal* period...something that I haven't had since Elise was conceived. Actual healthy, red bleeding instead of just brown spotting here and there. I needed a tampon! It's been YEARS. It lasted for 3 days and went away. So, I am thinking that might be a good sign! There must be substantially more lining now than I had before...right?? It's driving me nuts to have no idea what is going on in there. I can't envision a scenario where bleeding would be a bad thing, though (as long as it's not hemorrhaging, of course), given that a lack of bleeding was the main symptom that led me to get tested in the first place.
In other news, the estrogen is still kicking my butt. But don't feel sorry for me...you should direct all sympathy towards Jamie!
I wanted to try to post some of the pics from surgery here, but I don't have access to a scanner. I might try to take a picture of a picture and see if the quality is good enough to share here. If this post grossed you out, you definitely will want to miss that one!
It's funny how the timing of things works out sometimes. When we were in Dr. Dunn's office he was saying that I might experience a little bit of breakthrough bleeding while on the estrogen. I assured him that I hadn't had any bleeding at all since 3 days after surgery. I asked him if I could expect to see any withdrawl bleeding when I discontinue the estrogen. He said maybe, and if I did, he would take that as a good sign. But he also said that I might not, and that was not necessarily a bad sign either. Gee that is helpful! Doesn't he know I need something to obsess over??
Anyway, of course the very next day I started to have bleeding (that is what I get for insisting that I didn't have any). I got all excited - strange, I know. You would be amazed at the things that make me happy these days. But this was bleeding that is comparable to a *normal* period...something that I haven't had since Elise was conceived. Actual healthy, red bleeding instead of just brown spotting here and there. I needed a tampon! It's been YEARS. It lasted for 3 days and went away. So, I am thinking that might be a good sign! There must be substantially more lining now than I had before...right?? It's driving me nuts to have no idea what is going on in there. I can't envision a scenario where bleeding would be a bad thing, though (as long as it's not hemorrhaging, of course), given that a lack of bleeding was the main symptom that led me to get tested in the first place.
In other news, the estrogen is still kicking my butt. But don't feel sorry for me...you should direct all sympathy towards Jamie!
I wanted to try to post some of the pics from surgery here, but I don't have access to a scanner. I might try to take a picture of a picture and see if the quality is good enough to share here. If this post grossed you out, you definitely will want to miss that one!
Wednesday, November 21, 2007
Post-operative follow-up visit
Well, I am in good spirits today!
Yesterday I hadn't gotten my reminder phone call from the doctor's office, so I called to ask them if they still had me on the schedule. I am glad I called, because they did not have a record of my appointment. It made me briefly question myself, because I was kind of drugged at the time I made the appointment, but I am almost positive that I did! I even had the time written down. Anyway, they were very nice and worked things out to get us in today.
We had to wait over an hour once we arrived. I was (again) so impressed with Dr. Dunn's office staff. They kept coming in giving us status updates. Dr. Dunn got pulled out for a moment to do an IVF transfer and it had thrown his day off a bit. It was no big deal.
I was really happy with our meeting. Dr. Dunn gave us 24 pictures that were taken during my surgery. He had some pictures of my bladder, liver, and appendix! Most of the pictures were taken inside the uterus, though (of course). I could see both fallopian tube openings, which was really neat. You could tell a huge difference between the right and left sides of my uterus. There was actually some healthy lining on the right side, whereas the left side was completely white (scar tissue). So we are just hoping the estrogen is doing its job and helping that healthy portion spread to the rest of the cavity.
I asked him if it was even a remote possibility that we wouldn't have to do another surgery. He said that it is possible, but it's also very possible that we will need to go in once more. But for now at least I have a small bit of hope that this first surgery did the trick.
I was also curious if I would be put on progesterone once I completed the 4 weeks on estrogen. He said that he is not planning on prescribing anything to bring on a cycle. He said that he prefers to wait and let my body realize that it's time to ovulate again on its own. He said that will take around 2-4 weeks once I stop the estrogen. This means that I can expect a period again in approximately 4-6 weeks. Once I do get a period, we are hoping to see some heavier flow. That would be a good sign that the lining is rebuilding and has more to shed. I am supposed to call him on the first day of my next cycle to schedule the SHG. I hadn't realized that we would wait for a period first, so we will not be doing the test in 2 weeks. It will probably be sometime in January before my period will return. So the waiting continues.
Dr. Dunn's parting words to us were very encouraging. He said that when you first go into a situation like this, you try to be very realistic. He does not like to create false hope for couples. But he said that at this point, he is now comfortable saying that he is very optimistic. We may need another surgery - but he thinks the final outcome is going to be not only a good enough uterine cavity to conceive, but a uterine cavity that is very close to being completely normal.
At this point, I think that is the best possible news we can get. The only thing that would make it better is if we don't have to go through another surgery in January.
Yesterday I hadn't gotten my reminder phone call from the doctor's office, so I called to ask them if they still had me on the schedule. I am glad I called, because they did not have a record of my appointment. It made me briefly question myself, because I was kind of drugged at the time I made the appointment, but I am almost positive that I did! I even had the time written down. Anyway, they were very nice and worked things out to get us in today.
We had to wait over an hour once we arrived. I was (again) so impressed with Dr. Dunn's office staff. They kept coming in giving us status updates. Dr. Dunn got pulled out for a moment to do an IVF transfer and it had thrown his day off a bit. It was no big deal.
I was really happy with our meeting. Dr. Dunn gave us 24 pictures that were taken during my surgery. He had some pictures of my bladder, liver, and appendix! Most of the pictures were taken inside the uterus, though (of course). I could see both fallopian tube openings, which was really neat. You could tell a huge difference between the right and left sides of my uterus. There was actually some healthy lining on the right side, whereas the left side was completely white (scar tissue). So we are just hoping the estrogen is doing its job and helping that healthy portion spread to the rest of the cavity.
I asked him if it was even a remote possibility that we wouldn't have to do another surgery. He said that it is possible, but it's also very possible that we will need to go in once more. But for now at least I have a small bit of hope that this first surgery did the trick.
I was also curious if I would be put on progesterone once I completed the 4 weeks on estrogen. He said that he is not planning on prescribing anything to bring on a cycle. He said that he prefers to wait and let my body realize that it's time to ovulate again on its own. He said that will take around 2-4 weeks once I stop the estrogen. This means that I can expect a period again in approximately 4-6 weeks. Once I do get a period, we are hoping to see some heavier flow. That would be a good sign that the lining is rebuilding and has more to shed. I am supposed to call him on the first day of my next cycle to schedule the SHG. I hadn't realized that we would wait for a period first, so we will not be doing the test in 2 weeks. It will probably be sometime in January before my period will return. So the waiting continues.
Dr. Dunn's parting words to us were very encouraging. He said that when you first go into a situation like this, you try to be very realistic. He does not like to create false hope for couples. But he said that at this point, he is now comfortable saying that he is very optimistic. We may need another surgery - but he thinks the final outcome is going to be not only a good enough uterine cavity to conceive, but a uterine cavity that is very close to being completely normal.
At this point, I think that is the best possible news we can get. The only thing that would make it better is if we don't have to go through another surgery in January.
Saturday, November 17, 2007
I've become the person who...
...people avoid when the subject of pregnancy comes up in conversation.
I really never wanted to be "that person".
I am so sad right now. Jamie and I took Elise to a birthday party at our friends Mark & Erin's house today. We met them through another mutual friend, and they are great people. Their son Ethan *loves* Elise and they are friends. Ethan turned 3 today, so we were really excited to take Elise to the party.
When I walked in, I thought Erin looked pregnant. She is starting to show. But of course, I didn't want to say anything just in case she had just put on some weight. She is not a tiny woman anyway, and a few extra pounds could make her appear pregnant even if she is not. So, we came in and the guys started hanging out and talking sports and such while the ladies played with the kids and chatted. I glanced at her refridgerator and saw an ultrasound photo. Now I felt pretty darn sure that Erin is pregnant...but still no one said anything, so I didn't either.
After we were there for a bit, I started noticing the other women going over to her quietly whispering about the fact that she is expecting. Jamie also overheard some of the guys talking to Mark about it. It began to become obvious that everyone else at the party knew...and still no one said anything to us. I felt so incredibly awkward and on the verge of tears. Was I supposed to just act like I didn't notice? Should I pretend that I can't hear people whispering? Do I tell her congratulations, even though she did not share her happy news with us? I didn't know what to do, so I just went outside with the kids and tried to enjoy the party. What I wanted to do was leave...right away. I was so hurt, and I didn't know what on earth to do. But Elise was having a great time and really wanted to stay to see Ethan open his presents and eat some cake. I couldn't leave without letting her enjoy the party first. Plus, it was Ethan's day, and he really wanted Elise to be there. So I did my very best to suck it up.
I knew that they were shielding me out of concern for my feelings. They are all such kind people, they really are. But what they did to us hurt my feelings so badly I can't even begin to explain it. I know we are going through a lot right now. Trust me, all I have to do is look down at my swollen, scarred belly button to remember. But I am still genuinely happy for Erin. She is a wonderful mother, and I am so glad that she is expecting another baby. It hurts so badly that she didn't think she could share it with me.
I acted as normally as I could, and the second we got out to the car I started crying. This is the most hurt I've felt since all of this began. I think it hurts extra badly because my friends feel uncomfortable talking to me now. It's hard enough struggling to conceive, but now I feel the relationships in my life changing too. Sometimes it even feels like Jamie doesn't know what to say to me or how to act around me. I just want people to treat me the same as always.
I really never wanted to be "that person".
I am so sad right now. Jamie and I took Elise to a birthday party at our friends Mark & Erin's house today. We met them through another mutual friend, and they are great people. Their son Ethan *loves* Elise and they are friends. Ethan turned 3 today, so we were really excited to take Elise to the party.
When I walked in, I thought Erin looked pregnant. She is starting to show. But of course, I didn't want to say anything just in case she had just put on some weight. She is not a tiny woman anyway, and a few extra pounds could make her appear pregnant even if she is not. So, we came in and the guys started hanging out and talking sports and such while the ladies played with the kids and chatted. I glanced at her refridgerator and saw an ultrasound photo. Now I felt pretty darn sure that Erin is pregnant...but still no one said anything, so I didn't either.
After we were there for a bit, I started noticing the other women going over to her quietly whispering about the fact that she is expecting. Jamie also overheard some of the guys talking to Mark about it. It began to become obvious that everyone else at the party knew...and still no one said anything to us. I felt so incredibly awkward and on the verge of tears. Was I supposed to just act like I didn't notice? Should I pretend that I can't hear people whispering? Do I tell her congratulations, even though she did not share her happy news with us? I didn't know what to do, so I just went outside with the kids and tried to enjoy the party. What I wanted to do was leave...right away. I was so hurt, and I didn't know what on earth to do. But Elise was having a great time and really wanted to stay to see Ethan open his presents and eat some cake. I couldn't leave without letting her enjoy the party first. Plus, it was Ethan's day, and he really wanted Elise to be there. So I did my very best to suck it up.
I knew that they were shielding me out of concern for my feelings. They are all such kind people, they really are. But what they did to us hurt my feelings so badly I can't even begin to explain it. I know we are going through a lot right now. Trust me, all I have to do is look down at my swollen, scarred belly button to remember. But I am still genuinely happy for Erin. She is a wonderful mother, and I am so glad that she is expecting another baby. It hurts so badly that she didn't think she could share it with me.
I acted as normally as I could, and the second we got out to the car I started crying. This is the most hurt I've felt since all of this began. I think it hurts extra badly because my friends feel uncomfortable talking to me now. It's hard enough struggling to conceive, but now I feel the relationships in my life changing too. Sometimes it even feels like Jamie doesn't know what to say to me or how to act around me. I just want people to treat me the same as always.
Friday, November 16, 2007
Bloated and Emotional!
That pretty much sums up what it's like to take estrogen. I still have some swelling that I am sure is related to the surgery, and I think that is part of the issue and should improve sometime in the near future (I hope). I started crying in my closet last night, because I can't button ANY of my work pants. I have a few pair of really casual pants that I can wear on weekends, but I am really in a bind for work. I don't think this would normally make me cry, so I am going to blame that on the estrogen as well.
I don't know what to do, because I am not sure how long I will be swollen like this. I *really* dont' want to go out and spend money on bigger pants - especially not while we are paying for the surgery, Jamie's tuition for grad school, and trying to do Elise's Christmas shopping. I have 2 skirts that I can wear since they have stretchy waists and one pair of black pants that are normally too big. Otherwise, I am completely out of luck. I found a pair of jeans that are baggy and that is what I am wearing today (luckily we have casual Fridays at work). So I am really hopeful that some of this will go down by Monday. If not, my coworkers are going to get pretty tired of those 2 skirts and black pants. At least I have something that I can wear, though.
My bandages came off yesterday since the doctor said I could remove them after one week. I really, really regret that! If anyone else ever has a laparoscopy...leave the bandages on!!! I was so incredibly grossed out by what I saw when I removed them. The incisions were not stitched, so it was just the steri-strips that were holding them together, and they are not entirely healed yet. I got a little bit lightheaded when I looked down at them. Luckily they have dried out pretty well and are looking a bit better today. But man, I am really bruised and the cuts are not looking very nice right now. I'm thinking they will leave scars, but that is okay. One will be inside my belly button and probably won't be very noticable at all once fully healed.
I'm moving around normally again now, and last night was the first night that I could roll over in bed comfortably. It was great to get a full night's rest without having to wake up to roll over. My instructions said I could resume exercise after one week, but I still don't feel up to doing anything too strenuous. I could not run right now. It's good to know that I can resume exercise once I feel up to it, though.
Jamie and I will go see Dr. Dunn next Wednesday for our follow-up visit. They will not do another SHG yet, but he will show us some pictures of the surgery and discuss in more detail how things went and what he saw inside. I have a few more questions that I've thought of since surgery, so it will be good to have the opportunity to ask next week.
We should be able to schedule the SHG for sometime during the first week in December. It needs to be 4 weeks post-op. I am going to try to get in on the 6th, I think. I am assuming it will work the same way as the last one, and we will get the results and meet with Dr. Dunn immediately following the procedure. That is what I am hoping for, because the wait is already killing me! I am so anxious to know how it's healing in there. I've been really watching what I eat (with the exception of pizza on Tuesday night) and religiously taking my vitamins and estrogen. I figure every little bit might help.
Jamie is now afraid to touch me. Poor guy! He is afraid he's going to hurt me. He's so funny...now when he wants a hug, he just holds out his hands and I have to go to him. I'll be glad when he can relax more and not have to worry about all of that.
I also felt sorry for him last night when I was having my meltdown over my pants not fitting. I actually went upstairs and drug out some maternity pants and put them on. They fit well through my stomach, but were too big in the butt area. I was trying them on, and I said, "Well, at least my ass doesn't look pregnant." He started laughing, which was NOT the right thing to do at that moment. I snapped at him, and for the rest of the evening, I think he was scared to say anything at all. Of course, now I can see the humor in it as well.
Hey, the good news is that I only have 3 more weeks on the estrogen...
I don't know what to do, because I am not sure how long I will be swollen like this. I *really* dont' want to go out and spend money on bigger pants - especially not while we are paying for the surgery, Jamie's tuition for grad school, and trying to do Elise's Christmas shopping. I have 2 skirts that I can wear since they have stretchy waists and one pair of black pants that are normally too big. Otherwise, I am completely out of luck. I found a pair of jeans that are baggy and that is what I am wearing today (luckily we have casual Fridays at work). So I am really hopeful that some of this will go down by Monday. If not, my coworkers are going to get pretty tired of those 2 skirts and black pants. At least I have something that I can wear, though.
My bandages came off yesterday since the doctor said I could remove them after one week. I really, really regret that! If anyone else ever has a laparoscopy...leave the bandages on!!! I was so incredibly grossed out by what I saw when I removed them. The incisions were not stitched, so it was just the steri-strips that were holding them together, and they are not entirely healed yet. I got a little bit lightheaded when I looked down at them. Luckily they have dried out pretty well and are looking a bit better today. But man, I am really bruised and the cuts are not looking very nice right now. I'm thinking they will leave scars, but that is okay. One will be inside my belly button and probably won't be very noticable at all once fully healed.
I'm moving around normally again now, and last night was the first night that I could roll over in bed comfortably. It was great to get a full night's rest without having to wake up to roll over. My instructions said I could resume exercise after one week, but I still don't feel up to doing anything too strenuous. I could not run right now. It's good to know that I can resume exercise once I feel up to it, though.
Jamie and I will go see Dr. Dunn next Wednesday for our follow-up visit. They will not do another SHG yet, but he will show us some pictures of the surgery and discuss in more detail how things went and what he saw inside. I have a few more questions that I've thought of since surgery, so it will be good to have the opportunity to ask next week.
We should be able to schedule the SHG for sometime during the first week in December. It needs to be 4 weeks post-op. I am going to try to get in on the 6th, I think. I am assuming it will work the same way as the last one, and we will get the results and meet with Dr. Dunn immediately following the procedure. That is what I am hoping for, because the wait is already killing me! I am so anxious to know how it's healing in there. I've been really watching what I eat (with the exception of pizza on Tuesday night) and religiously taking my vitamins and estrogen. I figure every little bit might help.
Jamie is now afraid to touch me. Poor guy! He is afraid he's going to hurt me. He's so funny...now when he wants a hug, he just holds out his hands and I have to go to him. I'll be glad when he can relax more and not have to worry about all of that.
I also felt sorry for him last night when I was having my meltdown over my pants not fitting. I actually went upstairs and drug out some maternity pants and put them on. They fit well through my stomach, but were too big in the butt area. I was trying them on, and I said, "Well, at least my ass doesn't look pregnant." He started laughing, which was NOT the right thing to do at that moment. I snapped at him, and for the rest of the evening, I think he was scared to say anything at all. Of course, now I can see the humor in it as well.
Hey, the good news is that I only have 3 more weeks on the estrogen...
Saturday, November 10, 2007
Feeling better
I woke up this morning feeling considerably better than I did last night. It's a huge relief. I think the worst is over. It's a good thing too, because I hate not being able to help more around the house. Poor Jamie was out until nearly 11:00pm last night coaching the last football game of the season. We got to bed around midnight, and Elise was up bright and early at 6:30am today. She is still adjusting to the time change and has been waking early all week. Jamie got up so quickly that I didn't even hear her. I woke up around 10:00am. I can tell that he is completely exhausted and I feel so guilty! I am able to be up a lot more today, so I told him that once Elise goes down for her nap later, I will take the baby monitor into the living room and chill on the couch and he can get at least a 2 hour nap.
He has been keeping her entertained all morning. They were coloring pictures when I got up. I don't know how he was able to keep her so quiet all morning! I got up and ate so I could take my estrogen pill, and now I am sitting up in bed with Elise beside me watching a Diego video. I miss her so much! I haven't been able to actively care for her since Wednesday. I'm glad that she's willing to sit with me for a while this morning.
I was just thinking this morning that without such a supportive partner there is no way I could have done this. I am reminded constantly of how wonderful Jamie is, and I am so incredibly thankful for him. Just knowing that he is 100% committed to this journey with me makes such a huge difference. I don't have to do this on my own. Of course, my family and friends have been wonderful support as well.
When we sit down to Thanksgiving dinner in less than 2 weeks, I will have no trouble identifying what I am thankful for this year.
He has been keeping her entertained all morning. They were coloring pictures when I got up. I don't know how he was able to keep her so quiet all morning! I got up and ate so I could take my estrogen pill, and now I am sitting up in bed with Elise beside me watching a Diego video. I miss her so much! I haven't been able to actively care for her since Wednesday. I'm glad that she's willing to sit with me for a while this morning.
I was just thinking this morning that without such a supportive partner there is no way I could have done this. I am reminded constantly of how wonderful Jamie is, and I am so incredibly thankful for him. Just knowing that he is 100% committed to this journey with me makes such a huge difference. I don't have to do this on my own. Of course, my family and friends have been wonderful support as well.
When we sit down to Thanksgiving dinner in less than 2 weeks, I will have no trouble identifying what I am thankful for this year.
Friday, November 9, 2007
Feeling sore
I am so sore today. I expected today to be the roughest day. I've been trying to limit my activity, but I really needed to get up a little bit today. I need to work this gas out of my system. They inflate your insides with gas during surgery so they can work better, and all of that has to come out. I wanted to encourage that process along, because this bloated feeling is quite uncomfortable.
I think I might have overdone things a bit. My bleeding has gotten a bit heavier, and after going through a massive hemorrhage once before, this is NOT something that I like to see. I'm sure it's not an alarming amount of blood, but ANY increase to me is scary. So, I am back in bed again typing this as I lay almost completely flat on my back. Ugh.
My parents are both here helping with Elise. I'm so thankful to have them, because I really wanted Jamie to go to the football game tonight. It is the last game of the season, and I know he wouldn't have gone if I were going to be here alone. I caught the halftime score on the radio and the game was tied at 14. I'm just trying to take my mind off of things. I'm watching a rerun of Friends, and that is helping. The only problem is that it's making me laugh, which really hurts!
I'm just anxious to be healed and on my feet again. But I know this is all for such a worthy cause, so I am keeping that in mind and counting my blessings.
I think I might have overdone things a bit. My bleeding has gotten a bit heavier, and after going through a massive hemorrhage once before, this is NOT something that I like to see. I'm sure it's not an alarming amount of blood, but ANY increase to me is scary. So, I am back in bed again typing this as I lay almost completely flat on my back. Ugh.
My parents are both here helping with Elise. I'm so thankful to have them, because I really wanted Jamie to go to the football game tonight. It is the last game of the season, and I know he wouldn't have gone if I were going to be here alone. I caught the halftime score on the radio and the game was tied at 14. I'm just trying to take my mind off of things. I'm watching a rerun of Friends, and that is helping. The only problem is that it's making me laugh, which really hurts!
I'm just anxious to be healed and on my feet again. But I know this is all for such a worthy cause, so I am keeping that in mind and counting my blessings.
Thursday, November 8, 2007
Finally some wonderful news!
I am still having a lot of soreness/faint feelings, but I am finally able to sit up in bed and give an update (thank goodness for wireless internet connections).
I am just *thrilled* to say that the doctor had a great report for us after taking a look inside. He was able to see the right side of my uterus pretty well and confirm that my right tube is completely open to the cavity. There was 70-75% scarring, mostly on the left side and towards the entrance to the uteran cavity. He was able to remove ALL of it today. Once he cleared my left side, he could see that the tube was open (it had just been blocked by the scar tissue previously). So, at this moment, I have a reconstructed cavity and 2 open tubes!!!!!!! I feel like this is a miracle. Dr. Dunn told my mom and Jamie that I was very lucky.
I will start estrogen supplementation tomorrow and will stay on that for 4 weeks. Our prayers will continue that my lining is able to rebuild (especially on the left side). We are in a waiting pattern now...some reoccurance of scarring is possible, but I am not going to even let that enter my mind. I feel like I need to stay 100% positive at this point, because I truly believe that the mind-body connection can be a powerful thing.
I will follow up with Dr. Dunn in 2 weeks. Once the estrogen supplementation ends in 4 weeks we will repeat the SHG and hopefully see that everything is still open. If this is a success, we could be on our road to trying to conceive around January or February.
I'm very, very sore today, but with such great news I cannot complain one single bit. I feel so incredibly blessed to have such a wonderful physician, husband, family, and friends. I truly believe that all the prayers have made a difference and I cannot thank everyone enough. Please keep them coming for the next 4 weeks.
I am just *thrilled* to say that the doctor had a great report for us after taking a look inside. He was able to see the right side of my uterus pretty well and confirm that my right tube is completely open to the cavity. There was 70-75% scarring, mostly on the left side and towards the entrance to the uteran cavity. He was able to remove ALL of it today. Once he cleared my left side, he could see that the tube was open (it had just been blocked by the scar tissue previously). So, at this moment, I have a reconstructed cavity and 2 open tubes!!!!!!! I feel like this is a miracle. Dr. Dunn told my mom and Jamie that I was very lucky.
I will start estrogen supplementation tomorrow and will stay on that for 4 weeks. Our prayers will continue that my lining is able to rebuild (especially on the left side). We are in a waiting pattern now...some reoccurance of scarring is possible, but I am not going to even let that enter my mind. I feel like I need to stay 100% positive at this point, because I truly believe that the mind-body connection can be a powerful thing.
I will follow up with Dr. Dunn in 2 weeks. Once the estrogen supplementation ends in 4 weeks we will repeat the SHG and hopefully see that everything is still open. If this is a success, we could be on our road to trying to conceive around January or February.
I'm very, very sore today, but with such great news I cannot complain one single bit. I feel so incredibly blessed to have such a wonderful physician, husband, family, and friends. I truly believe that all the prayers have made a difference and I cannot thank everyone enough. Please keep them coming for the next 4 weeks.
Wednesday, November 7, 2007
I'm starving!!!
I'm on a liquid only diet today since surgery is tomorrow. I am sooo hungry. I am allowed to have jello, so that was my dinner tonight along with some broth. Lovely combination, isn't it?
We took Elise to spend the night at my parents' house tonight, and she made me so sad. As we were leaving, she said that she wanted to go home with us. I feel so bad that she can't stay here tonight, but we have to leave in the morning before the daycare opens, so we didn't have a choice. I feel terrible that all of this has to affect her at all, but hopefully it will all be worthwhile.
I am feeling really nervous tonight. I'm not worried about the surgery itself, but I am really on edge thinking about what the doctor might tell us afterwards. I'm so afraid that he'll tell us that it's worse than he thought and he can't fix it. I didn't used to think this way, but after a few unlucky experiences, I find myself feeling much more vulnerable lately.
I guess we are all ready to go in the morning. I got my prescriptions filled earlier this week so I will have pain and nausea medicine ready at home in case I need it. I will post an update once I am feeling up to it.
We took Elise to spend the night at my parents' house tonight, and she made me so sad. As we were leaving, she said that she wanted to go home with us. I feel so bad that she can't stay here tonight, but we have to leave in the morning before the daycare opens, so we didn't have a choice. I feel terrible that all of this has to affect her at all, but hopefully it will all be worthwhile.
I am feeling really nervous tonight. I'm not worried about the surgery itself, but I am really on edge thinking about what the doctor might tell us afterwards. I'm so afraid that he'll tell us that it's worse than he thought and he can't fix it. I didn't used to think this way, but after a few unlucky experiences, I find myself feeling much more vulnerable lately.
I guess we are all ready to go in the morning. I got my prescriptions filled earlier this week so I will have pain and nausea medicine ready at home in case I need it. I will post an update once I am feeling up to it.
Friday, November 2, 2007
Thank You
I wanted to say thank you to everyone for all the support. It's overwhelming! I received so many nice PMs from my Mommy Zone friends as well as a really nice phone message from one of my Pitter Patter girls. It means so much to me! Thank you all!!!!!
I went to watch my old high school team in a volleyball playoff game tonight. We won and it was the perfect diversion.
I went to watch my old high school team in a volleyball playoff game tonight. We won and it was the perfect diversion.
SHG Results
I wish I were here to report good news, but unfortunately that is not the case. Before doing the actual procedure, Dr. Dunn did a baseline ultrasound to take a look at my lining. For a point of reference a normal, healthy lining should measure around 8-10mm. Mine measures right around 3mm. He told me right away that it was looking pretty thin.
Next he inserted the catheter and attempted to infuse my uterus with saline solution. I say "attempted" because my uterus didn't inflate the way it should. He was only able to use half of the solution, and even most of that didn't inflate my uterus and just ran back out onto the table. He could see a small portion near the cervix fill with water, but otherwise I was completely blocked. That fact, combined with my thin lining caused him to give me a diagnosis of "severe uterine adhesions".
Dr. Dunn has wonderful bedside manner. He explained what he was doing and seeing every step of the way. Jamie and I both were extremely impressed. When he finished the SHG, he had me get dressed and we met him in his office. I would love to say that there is a positive side to things, but right now I can't really find one. As I said, my condition is severe. The next step is surgery and it may require more than one procedure. There is no way to assess the true condition of things until he gets inside to take a better look. There will be an incision at the belly button and another somewhere around the pubic bone where he will insert cameras and other instruments to get a good view from above the uterus. He will also go in through the cervix. He will begin closest to the cervix and work his way back, attempting to break away and remove the scar tissue. Depending on the degree of scarring and the quality of what little lining remains, he may choose to stop at some point and go back in at a later date to continue working on it. In between surgeries I will be on estrogen (the dosage will depend on what he sees when he operates) to foster regrowth of the lining. If he were to remove too much all at once without quality lining in the surrounding areas, there is a high chance that the uterine walls would stick together and rescar. That is the reason that we may have several surgeries ahead of us to get it completely repaired. The doctor said that he's seen one case that required 4 operations - but the woman did end up having a baby.
He wasn't able to assess my tubes today, and he cannot guarantee that he would be able to see them during the first surgery either. There is a chance that the scarring extends into the tubes, and if this is the case, it would be very difficult to repair. That would leave us with no other option besides IVF to conceive if that is the case. I have to at least consider that it is a very real possibility with all my scarring.
I held myself together very well as I received the bad news, and I thought I was going to make it out of the office without tears...until we got up to leave. Dr. Dunn was so sincere and kind when he shook my hand. He told me that he knew this was not what I had hoped to hear, but not to lose hope. So, I started to cry. I *hate* crying in public. When I got out to the desk to check out, I couldn't find my stupid debit card. The staff was so very kind. They told us not to worry about paying. They said they could just bill the insurance and send me a separate billing for the copay. Then we talked about scheduling surgery. The nurse asked me if I wanted her to check his calendar for next week...I didn't even know what to say. I was just tongue-tied. I felt like I couldn't even digest all of this, much less make a rational decision regarding surgery. Jamie stepped in for me and I am so glad he did. They did some checking and said they could do the surgery next Thursday. We took the appointment. So I guess I am having surgery in less than one week. My pre-op appointment is on Monday afternoon.
Jamie and I have full faith in this doctor. We believe that he can help us. At the same time, I cannot help but feel incredibly discouraged. I was really hoping this would be a more minor issue. And I don't know what we are going to do if my tubes are scarred. I don't think we can afford IVF. I don't know what I would be willing to do at this point.
For now at least we know that he will go in at least once and see what can be done.
Next he inserted the catheter and attempted to infuse my uterus with saline solution. I say "attempted" because my uterus didn't inflate the way it should. He was only able to use half of the solution, and even most of that didn't inflate my uterus and just ran back out onto the table. He could see a small portion near the cervix fill with water, but otherwise I was completely blocked. That fact, combined with my thin lining caused him to give me a diagnosis of "severe uterine adhesions".
Dr. Dunn has wonderful bedside manner. He explained what he was doing and seeing every step of the way. Jamie and I both were extremely impressed. When he finished the SHG, he had me get dressed and we met him in his office. I would love to say that there is a positive side to things, but right now I can't really find one. As I said, my condition is severe. The next step is surgery and it may require more than one procedure. There is no way to assess the true condition of things until he gets inside to take a better look. There will be an incision at the belly button and another somewhere around the pubic bone where he will insert cameras and other instruments to get a good view from above the uterus. He will also go in through the cervix. He will begin closest to the cervix and work his way back, attempting to break away and remove the scar tissue. Depending on the degree of scarring and the quality of what little lining remains, he may choose to stop at some point and go back in at a later date to continue working on it. In between surgeries I will be on estrogen (the dosage will depend on what he sees when he operates) to foster regrowth of the lining. If he were to remove too much all at once without quality lining in the surrounding areas, there is a high chance that the uterine walls would stick together and rescar. That is the reason that we may have several surgeries ahead of us to get it completely repaired. The doctor said that he's seen one case that required 4 operations - but the woman did end up having a baby.
He wasn't able to assess my tubes today, and he cannot guarantee that he would be able to see them during the first surgery either. There is a chance that the scarring extends into the tubes, and if this is the case, it would be very difficult to repair. That would leave us with no other option besides IVF to conceive if that is the case. I have to at least consider that it is a very real possibility with all my scarring.
I held myself together very well as I received the bad news, and I thought I was going to make it out of the office without tears...until we got up to leave. Dr. Dunn was so sincere and kind when he shook my hand. He told me that he knew this was not what I had hoped to hear, but not to lose hope. So, I started to cry. I *hate* crying in public. When I got out to the desk to check out, I couldn't find my stupid debit card. The staff was so very kind. They told us not to worry about paying. They said they could just bill the insurance and send me a separate billing for the copay. Then we talked about scheduling surgery. The nurse asked me if I wanted her to check his calendar for next week...I didn't even know what to say. I was just tongue-tied. I felt like I couldn't even digest all of this, much less make a rational decision regarding surgery. Jamie stepped in for me and I am so glad he did. They did some checking and said they could do the surgery next Thursday. We took the appointment. So I guess I am having surgery in less than one week. My pre-op appointment is on Monday afternoon.
Jamie and I have full faith in this doctor. We believe that he can help us. At the same time, I cannot help but feel incredibly discouraged. I was really hoping this would be a more minor issue. And I don't know what we are going to do if my tubes are scarred. I don't think we can afford IVF. I don't know what I would be willing to do at this point.
For now at least we know that he will go in at least once and see what can be done.
Thursday, November 1, 2007
Tomorrow is the day!
I've been waiting for months (literally) to find out what is going on and get an official diagnosis. I'm anxious, excited, and nervous...all rolled into one! I had to take an antibiotic tonight to prevent infection. Elise and I just ate and I took my pills. Jamie is coaching a JV football game tonight, but he took the day off tomorrow to go along with me to the test. The doctor will sit down with us afterwards and go over everything. I feel like I should prepare some questions again, because if I get surprised by the diagnosis I might freeze up and forget what I want to ask. I have been successful in putting this out of my mind for the last week, so I haven't thought about what I want to ask at all.
If he tells me that he doesn't see any scar tissue at all, then I am going to want an explanation for my symptoms.
If it's worse than I'm anticipating (severe scarring), then I am going to want some specifics on where the scarring is located and what the plan will be during surgery to remove it.
What I am expecting is for him to tell me that he sees some mild/moderate scarring. I'm very interested to hear where it's located. And of course I want to know a prognosis for treatment success.
But I feel like I'm missing something. I need to go do some checking around for additional questions to ask. I will do that once I have Elise tucked in for the night.
I'm getting up at the crack of dawn tomorrow (we are talking 5am) so I can work at my office for a few hours before having to leave for the day. This comes at a somewhat inopportune time for me as far as my work schedule goes. I'm going to juggle things and find a way to make it work, though.
If he tells me that he doesn't see any scar tissue at all, then I am going to want an explanation for my symptoms.
If it's worse than I'm anticipating (severe scarring), then I am going to want some specifics on where the scarring is located and what the plan will be during surgery to remove it.
What I am expecting is for him to tell me that he sees some mild/moderate scarring. I'm very interested to hear where it's located. And of course I want to know a prognosis for treatment success.
But I feel like I'm missing something. I need to go do some checking around for additional questions to ask. I will do that once I have Elise tucked in for the night.
I'm getting up at the crack of dawn tomorrow (we are talking 5am) so I can work at my office for a few hours before having to leave for the day. This comes at a somewhat inopportune time for me as far as my work schedule goes. I'm going to juggle things and find a way to make it work, though.
Monday, October 29, 2007
"The Only Child Syndrome"
When you hear the word syndrome, don't you think of something like...a disease?? An abnormality, perhaps? It really pisses me off that my daughter's step-mother (who happens to be one of NINE children and is 20 weeks pregnant with a child of her own) decided to use those words to describe Elise's behavior in her blog.
Gee, I am really sorry that not everyone can pop out insane numbers of children to ensure that their kids like to share with others. It's been my personal experience that most 3-yr olds don't like to share their toys regardless of whether they have siblings or not.
It's pretty unfortune timing that she should choose to call Elise out as one of those icky "only children" while I am in the midst of infertility testing.
Gee, I am really sorry that not everyone can pop out insane numbers of children to ensure that their kids like to share with others. It's been my personal experience that most 3-yr olds don't like to share their toys regardless of whether they have siblings or not.
It's pretty unfortune timing that she should choose to call Elise out as one of those icky "only children" while I am in the midst of infertility testing.
Friday, October 26, 2007
The First RE Appointment
My test was negative this morning...so moving on to the appointment...
I wasn't in the greatest mood this morning. I fully expected a negative test, but it still sucks to see it. While we were getting ready, Jamie was acting silly - dancing and singing in the shower, etc. He was trying to lighten the mood for me.
We arrived at the office 15 minutes early as requested and completed some additional forms. They had already collected a bunch of forms (mostly family history and my history with pregnancy and prior miscarriage, etc) via fax about a month ago when I made the appointment. They got us back pretty quickly, but it was still about an hour wait to see the doctor. That seems fairly standard these days (but it's annoying). The couple that went in right before us was just being released to their regular ob/gyn because their treatment had been successful and they were pregnant. They looked so happy...it was nice to see. There was another girl who looked to be around our age in the waiting room. I found myself wondering what was wrong with her.
Once we got called into the doctor's office we sat down and he went through our file. He had received all of my records from my previous doctors, and I could tell that he had studied them. He discussed the D&C that I had after Elise's birth and asked a few questions about that. He told me that with my history, I was definitely a prime candidate for scarring (that was not anything new to me). Then he began discussing the testing that he would recommend.
He prefers to do a sonohysterogram (SHG) first as opposed to a hysteroscopy. He explained that his reasoning is that the hysteroscopy is a 2-dimensional test, whereas with the sonohysterogram he can see a bit more. This is basically how the SHG will work: They will insert a small catheter into my cervix. Then they will insert sterile water into my uterus. By seeing where the water goes (or more importantly where it does not go), he will be able to tell where I have scarring and approximately how much scarring there is. This test is less painful and less invasive than the hysteroscopy. When he was explaining this to us it made perfect sense, but this goes against almost everything I've read which states the the hysteroscopy is the "gold standard" test for Asherman's Syndrome. This leaves me feeling a bit confused.
I asked some questions, which I had prepared ahead of time. I got a lot of advice regarding what to ask from my online support group.
Question 1: How many cases has he treated?
His Answer: He's been practicing for 20 years and has seen "scores" of women with scarring of some degree. He's only seen about 4 cases that were so severe that the entire uterus was completely obliterated with scar tissue.
Question 2: How successful has he been in treating the cases that he has seen?
His Answer: Out of the 4 very severe cases, 3 of them went on to become pregnant. He sees varying degrees of success depending on the location and severity of the scars.
Question 3: What instruments will he use to remove the scarring?
His Answer: He uses 3 different instruments. Which one he would choose would depend on the location and nature of the scarring.
1. Microscissors (This is what I wanted to hear.)
2. I forgot the name, but it's a precise tool that targets only one area and does not use heat, but it's kind of like a laser. (I hadn't heard of this, and now I am kicking myself for not writing it down.)
3. Laser (NOT what I wanted to hear, but he said if the scarring is at all vascular, this is the only option because the scissors would cause bleeding).
The reason I don't like the laser is because any introduction of heat can produce more scars.
Question 4: Would he insert a balloon after the procedure?
His Answer: Sometimes - but usually he would not. He said that the problem with the balloon is twofold. Introduction of a foreign object into the uterus raises the risk of infection post-op. The second reason is that the uterus tries to contract on the balloon and puts pressure on the walls. He feels that this makes it harder for the lining to regenerate in the area that is touching the balloon. This answer sounded appropriate to me. There are some A-List doctors who do not use the balloon, so I was not bothered by this.
Question 5: Would he prescribe hormone treatment following surgery to aid the uterine lining in regenerating?
His Answer: Almost always. That was good to hear.
After all of my questions were answered, he told me that he wanted to give me a bit of good news. He said that the fact that I do still cycle (even though it's extremely light) is a good sign that I'm probably not going to be an extremely severe case. In his experience, the worst cases cause a complete cessation of periods altogether. He asked me about my cyclical pain and cramping. I was telling him that my cramping has gotten much worse since going off the birth control pill. He feels that this is also a positive thing. He said that it is possible that my uterus still has lining to shed, but the scarring is near my cervix and prevents the lining from shedding. This causes additional cramping as the uterus tries harder to expel the lining. If the scarring were only in one spot and near the cervix that could mean that I still have a mostly good uterus with good lining and it's just been blocked. This is kind of the "best case" scenario. The third piece of good news is that I didn't run fever before or after my D&C. He said a fever would indicate infection and that would possibly worsen my scarring. The absence of fever should work in my favor.
I aksed him what he felt my prognosis would be. He wouldn't really say much and said we would have a better idea after the SHG. I liked the fact that he wasn't going to make any promises without the information he needed. I also showed him all of my BBT charts. He thought they were very nice looking and said that I obviously ovulate regularly. I already knew that, but it's good to hear that something is working as it should!
Overall, I left feeling pretty decent. Jamie was a little bit quiet. He said he was just digesting everything. I think he's been pretty resistant to accepting the idea that we probably have an issue. After talking with the doctor today, he realizes that we probably do have some things to work through. I think he might feel a little disappointed, but I know he feels optimistic. He said that he liked the doctor pretty well. He felt that he was experienced and was really good about addressing my questions. Even when I questioned his methods, he never became defensive. We both liked that a lot.
Since we were right in the neighborhood, we stopped at Cheesecake Factory for lunch. Jamie proposed to me there and we hadn't been back since then, so it was special to eat there together today. I even had a glass of wine!
So here is the plan: On the first day of my next cycle I am supposed to call and schedule the SHG. This must be done between CD 5 and 10. This means I am not going to have to wait another month! HOORAY! The doctor will meet with me immediately following to discuss the test results. Assuming that we find some scarring, we will schedule surgery for the next cycle. Tentatively I will be doing testing in early November and surgery in December. The timing is good, because football will be ending and Jamie is not coaching basketball this year.
Surgery will involve general anesthesia. I hadn't expected to hear that, but he wants to do a laproscopy along with an operative hysteroscopy. There will be a small incision through my belly button. I'm not too excited about that, but I'll do what it takes.
I think the best thing about today's appointment is that I now have a plan and a timeline. It should not be too much longer before I finally get some concrete answers.
I wasn't in the greatest mood this morning. I fully expected a negative test, but it still sucks to see it. While we were getting ready, Jamie was acting silly - dancing and singing in the shower, etc. He was trying to lighten the mood for me.
We arrived at the office 15 minutes early as requested and completed some additional forms. They had already collected a bunch of forms (mostly family history and my history with pregnancy and prior miscarriage, etc) via fax about a month ago when I made the appointment. They got us back pretty quickly, but it was still about an hour wait to see the doctor. That seems fairly standard these days (but it's annoying). The couple that went in right before us was just being released to their regular ob/gyn because their treatment had been successful and they were pregnant. They looked so happy...it was nice to see. There was another girl who looked to be around our age in the waiting room. I found myself wondering what was wrong with her.
Once we got called into the doctor's office we sat down and he went through our file. He had received all of my records from my previous doctors, and I could tell that he had studied them. He discussed the D&C that I had after Elise's birth and asked a few questions about that. He told me that with my history, I was definitely a prime candidate for scarring (that was not anything new to me). Then he began discussing the testing that he would recommend.
He prefers to do a sonohysterogram (SHG) first as opposed to a hysteroscopy. He explained that his reasoning is that the hysteroscopy is a 2-dimensional test, whereas with the sonohysterogram he can see a bit more. This is basically how the SHG will work: They will insert a small catheter into my cervix. Then they will insert sterile water into my uterus. By seeing where the water goes (or more importantly where it does not go), he will be able to tell where I have scarring and approximately how much scarring there is. This test is less painful and less invasive than the hysteroscopy. When he was explaining this to us it made perfect sense, but this goes against almost everything I've read which states the the hysteroscopy is the "gold standard" test for Asherman's Syndrome. This leaves me feeling a bit confused.
I asked some questions, which I had prepared ahead of time. I got a lot of advice regarding what to ask from my online support group.
Question 1: How many cases has he treated?
His Answer: He's been practicing for 20 years and has seen "scores" of women with scarring of some degree. He's only seen about 4 cases that were so severe that the entire uterus was completely obliterated with scar tissue.
Question 2: How successful has he been in treating the cases that he has seen?
His Answer: Out of the 4 very severe cases, 3 of them went on to become pregnant. He sees varying degrees of success depending on the location and severity of the scars.
Question 3: What instruments will he use to remove the scarring?
His Answer: He uses 3 different instruments. Which one he would choose would depend on the location and nature of the scarring.
1. Microscissors (This is what I wanted to hear.)
2. I forgot the name, but it's a precise tool that targets only one area and does not use heat, but it's kind of like a laser. (I hadn't heard of this, and now I am kicking myself for not writing it down.)
3. Laser (NOT what I wanted to hear, but he said if the scarring is at all vascular, this is the only option because the scissors would cause bleeding).
The reason I don't like the laser is because any introduction of heat can produce more scars.
Question 4: Would he insert a balloon after the procedure?
His Answer: Sometimes - but usually he would not. He said that the problem with the balloon is twofold. Introduction of a foreign object into the uterus raises the risk of infection post-op. The second reason is that the uterus tries to contract on the balloon and puts pressure on the walls. He feels that this makes it harder for the lining to regenerate in the area that is touching the balloon. This answer sounded appropriate to me. There are some A-List doctors who do not use the balloon, so I was not bothered by this.
Question 5: Would he prescribe hormone treatment following surgery to aid the uterine lining in regenerating?
His Answer: Almost always. That was good to hear.
After all of my questions were answered, he told me that he wanted to give me a bit of good news. He said that the fact that I do still cycle (even though it's extremely light) is a good sign that I'm probably not going to be an extremely severe case. In his experience, the worst cases cause a complete cessation of periods altogether. He asked me about my cyclical pain and cramping. I was telling him that my cramping has gotten much worse since going off the birth control pill. He feels that this is also a positive thing. He said that it is possible that my uterus still has lining to shed, but the scarring is near my cervix and prevents the lining from shedding. This causes additional cramping as the uterus tries harder to expel the lining. If the scarring were only in one spot and near the cervix that could mean that I still have a mostly good uterus with good lining and it's just been blocked. This is kind of the "best case" scenario. The third piece of good news is that I didn't run fever before or after my D&C. He said a fever would indicate infection and that would possibly worsen my scarring. The absence of fever should work in my favor.
I aksed him what he felt my prognosis would be. He wouldn't really say much and said we would have a better idea after the SHG. I liked the fact that he wasn't going to make any promises without the information he needed. I also showed him all of my BBT charts. He thought they were very nice looking and said that I obviously ovulate regularly. I already knew that, but it's good to hear that something is working as it should!
Overall, I left feeling pretty decent. Jamie was a little bit quiet. He said he was just digesting everything. I think he's been pretty resistant to accepting the idea that we probably have an issue. After talking with the doctor today, he realizes that we probably do have some things to work through. I think he might feel a little disappointed, but I know he feels optimistic. He said that he liked the doctor pretty well. He felt that he was experienced and was really good about addressing my questions. Even when I questioned his methods, he never became defensive. We both liked that a lot.
Since we were right in the neighborhood, we stopped at Cheesecake Factory for lunch. Jamie proposed to me there and we hadn't been back since then, so it was special to eat there together today. I even had a glass of wine!
So here is the plan: On the first day of my next cycle I am supposed to call and schedule the SHG. This must be done between CD 5 and 10. This means I am not going to have to wait another month! HOORAY! The doctor will meet with me immediately following to discuss the test results. Assuming that we find some scarring, we will schedule surgery for the next cycle. Tentatively I will be doing testing in early November and surgery in December. The timing is good, because football will be ending and Jamie is not coaching basketball this year.
Surgery will involve general anesthesia. I hadn't expected to hear that, but he wants to do a laproscopy along with an operative hysteroscopy. There will be a small incision through my belly button. I'm not too excited about that, but I'll do what it takes.
I think the best thing about today's appointment is that I now have a plan and a timeline. It should not be too much longer before I finally get some concrete answers.
Thursday, October 25, 2007
What if...
I really shouldn't even let myself think of all the what ifs.
I was on Mommy Zone tonight and I saw a picture posted. It was a photo of the 2 daughters of one of our members. The older daughter was holding her little sister. They were cheek to cheek, and it was precious. It was really a beautiful picture. I looked at it for a moment and tried to imagine Elise holding a younger sibling.
Then I realized...I may never get to witness that.
Her dad is having another child early next year. This will be his third child. He is a shitty father. I can't understand why he would be blessed with THREE babies. He hasn't participated in raising the first 2, and the jury is still out on the third. I supsect he will not be anymore instrumental in that child's life than he has been in the first 2. He lets a stripper raise his first child. Yes you read that correctly, and yes I am serious. He just had a shotgun wedding 2 weeks ago. Just the thought that he can procreate is such bullshit.
I'm all emotional today, so I must have PMS.
I was on Mommy Zone tonight and I saw a picture posted. It was a photo of the 2 daughters of one of our members. The older daughter was holding her little sister. They were cheek to cheek, and it was precious. It was really a beautiful picture. I looked at it for a moment and tried to imagine Elise holding a younger sibling.
Then I realized...I may never get to witness that.
Her dad is having another child early next year. This will be his third child. He is a shitty father. I can't understand why he would be blessed with THREE babies. He hasn't participated in raising the first 2, and the jury is still out on the third. I supsect he will not be anymore instrumental in that child's life than he has been in the first 2. He lets a stripper raise his first child. Yes you read that correctly, and yes I am serious. He just had a shotgun wedding 2 weeks ago. Just the thought that he can procreate is such bullshit.
I'm all emotional today, so I must have PMS.
Wednesday, October 24, 2007
Getting nervous
I am not sure why, but now that my appointment is only 2 days away, I am getting nervous! I have this wild dream that I'll turn out to be pregnant on my own and not need to go through any testing. I am 9dpo today, so I am planning on taking a test on Friday morning before the appointment.
I am somewhat dreading the hysteroscopy - both because I am not liking the idea of pain and because I am afraid of getting bad news. I wonder how long I will have to wait for the testing??
I got a call from the nurse today to confirm the appointment.
We had free flu shots today at work, but I declined. After just being so sick on Monday I was a little afraid to get the shot today. Plus, I am in the 2 week wait...soooo...I passed up the opportunity. I will have another chance next week if I change my mind. I'm glad I'll have the opportunity to discuss it with the doctor beforehand. I know that the flu shot is not recommended in the first trimester and some ob's do not recommend it at all.
It's funny how trying to conceive complicates life, isn't it??
I will be back on Friday with an update from the appointment.
I am somewhat dreading the hysteroscopy - both because I am not liking the idea of pain and because I am afraid of getting bad news. I wonder how long I will have to wait for the testing??
I got a call from the nurse today to confirm the appointment.
We had free flu shots today at work, but I declined. After just being so sick on Monday I was a little afraid to get the shot today. Plus, I am in the 2 week wait...soooo...I passed up the opportunity. I will have another chance next week if I change my mind. I'm glad I'll have the opportunity to discuss it with the doctor beforehand. I know that the flu shot is not recommended in the first trimester and some ob's do not recommend it at all.
It's funny how trying to conceive complicates life, isn't it??
I will be back on Friday with an update from the appointment.
Thursday, October 18, 2007
Team Players
Since I am married to a coach, there are a lot of sports analogies used in our house. I've picked up on the lingo, and I have to give Jamie credit for being a team player. He told me today that he requested a substitute teacher to take his classes next Friday so that he can accompany me to the doctor for our consultation. I didn't even ask him to do that, because I know nothing much will actually happen at this first appointment with the RE...and I know how hard it is to miss school on a game day.
I love you so much for that, baby.
I love you so much for that, baby.
No more waiting
Well, Jamie and I have been planning a vacation for this coming summer in our minds for quite some time now. In anticipation of a possible pregnancy, I have been hesitant to actually book anything. Today I decided to heck with that! Life does not stop while we deal with all of this, and I am taking my baby to Disneyland! I booked the trip in the car on my way home from work today. It feels great to have something to look forward to!
Now, say I am pregnant this cycle...that would give me a July due date and force a cancellation of the vacation. I think this is the first time since all of this began that I actually hope I am not pregnant!
I just got tired of waiting.
Now, say I am pregnant this cycle...that would give me a July due date and force a cancellation of the vacation. I think this is the first time since all of this began that I actually hope I am not pregnant!
I just got tired of waiting.
Tuesday, October 16, 2007
It's a long story...
I've been blogging for a few months now, and I really enjoy it. I've been trying to keep my current blog (It Feels Like Today) pretty light. I like having a place to share pictures, give general updates, and focus on the good things in life. The one thing that has been bothering me is that I haven't felt like I wanted to share everything that is going on with me publicly, yet I really feel like I need an outlet for putting my thoughts in writing. I think it's somewhat therapeutic and it helps me to work through some of my feelings and thoughts. So, I decided to create this blog as well. It won't be viewable to the public, so if you are reading, you are someone that I wanted to share the more private side of my thoughts with.
I want to post a disclaimer: Some of the things I say here won't be polite. Some won't necessarily be rational. This is my way to get everything out and work through things. I sincerely hope I don't offend anyone, but if I do please accept my apologies in advance. It is not my intention. I hope I don't get any mean or insensitive comments (and I'm sure I wouldn't from anyone who I share this with)...but I just wanted to say that up front.
So now I suppose you are probably wondering what is on my mind!
It's a long story. It all began about 2 months ago. But I probably need to go back even further to when Jamie and I got engaged. We had a whirlwind romance, and after only a few months we knew that we wanted to be together for the rest of our lives. We talked about the future a lot, and naturally one of the things we discussed was having more children. Jamie is an amazing father. He blew me away from the very start. I remember vividly the first time he and Elise met. When we first began dating I would meet him out or drive to his apartment before our dates. If he picked me up, I didn't invite him inside. It was important to me that I didn't introduce anyone into Elise's life unless I was absolutely sure they were special. I had seen her father parade a variety of women through his home during her visits (even before our divorce was finalized), and it disturbed me. I vowed not to do the same thing. So when I decided to have Jamie and Elise meet, it was a big deal.
He was in the midst of baseball season and his schedule was crazy. By the time he would get home from baseball practice Elise would already be tucked in bed and sound asleep. Back then she was out by 7:00pm. He was coaching tournaments on the weekends for a few consecutive weeks, but he had Sunday afternoons free. His Sundays were precious, because it was his only down time. Based on my previous experience with Michael, I didn't expect that Jamie would sacrifice that free time to come hang out with me and my 18 month old. But I was wrong and very pleasantly surprised when he asked to come over one Sunday afternoon. I agreed and assumed he would drop by for 30 minutes or so just to say hello quickly and meet Elise. He arrived around noon just as my parents were heading out the door to run a bunch of errands (back then I was still living with them and trying to get back on my feet after the divorce). He came and and was introduced to Elise for the first time, and the 3 of us sat in the living room floor with her toys. I kept expecting him to get up and leave...but he didn't. He sat with us for 5 hours that afternoon. He sang songs. He played peek-a-boo. He read stories. Elise loved him from day one, and I was officially in love as well.
So when the discussion came up about adding to our family, naturally we both agreed it was something we wanted to do. Jamie told me about how much he's always wanted children. He was 32 when we married, and most of his friends were already settled down and had children of their own. He was often the only coach that didn't have a family to greet him on the field after games. He told me how he had always dreamed of having a child of his own to come running to him after the final minutes of the football games ticked off the clock. He was so excited the first time Elise and I attended a game and came to meet him at the end. It was a great feeling for him to see Elise sprinting towards him, anxious to jump into his arms. Over the last year and half, he's been such an amazing father to her. I cannot say enough good things about him. We truly have a 50/50 relationship and I feel beyond blessed to have such an involved partner in my life. I know first hand how it feels to do it all alone. I can honestly say that I never take Jamie for granted.
Once we had decided to have children, we began discussing the timing. Jamie was ready from day one, but I needed a little more time. Around the same time that we married we booked a dream vacation to Hawaii. I did not want to be pregnant during the trip and risk not getting to go if complications should arise given my history of pre-term labor with Elise. I convinced him to wait until we got home from the trip. So we agreed to wait a year and take our vacation. I enjoyed our first year of marriage so much. We've only grown closer as time has passed and I love that we had that first year with the 3 of us to settle in. We took our trip back in June and I went off the pill immediately. We thought we would be pregnant by now.
I won't go into graphic detail, but I could tell as my body weaned off the pill that something was not quite right. I am charting basal body temperature, so I know that I ovulate and have a nice strong luteal phase. I don't believe that I have any issues aside from the one big problem.
I began to do some research about my symptoms - I'd noticed them before but dismissed them as being caused by the pill. Once the pill was no longer a factor and the problem persisted, I began to get the nagging feeling that something was going on. That is when I ran across a description for Asherman's Syndrome online. I knew the instant that I read it. I began to read the stories of other women who have AS, and I felt like I was reading my own story. Here is a brief description of AS from http://www.ashermans.org/:
What is Asherman's Syndrome?
Asherman's Syndrome is an acquired uterine disease, characterized by the formation of adhesions (scar tissue) in the uterus. In many cases the front and back walls of the uterus stick to one another. In other cases, adhesions only occur in a small portion of the uterus. The extent of the adhesions defines whether the case is mild, moderate or severe. The adhesions can be thin or thick, can be spotty in location, or can be confluent. They are usually not vascular, an important attribute that helps in treatment.
Symptoms
Most patients with Asherman's have scanty or absent periods (amenorrhea) but some have normal periods. Some patients have no periods but feel pain at the time each month that their period would normally arrive. This pain may indicate that menstruation is occuring but the blood cannot exit the uterus because the cervix is blocked by adhesions. Recurrent miscarriage and infertility could also be considered as symptoms.
Causes
Most commonly, intrauterine adhesions occur after a D&C (dilatation and curettage) that was performed because of a miscarriage or because of retained placenta with or without hemorrhage after a delivery. Adhesions sometimes also occur in other situations, such as after an elective abortion, after a cesarean section, after uterine surgery (for example, after surgery to remove fibroids), or as a result of pelvic tuberculosis. The more D&Cs done after a delivery (and especially D&Cs done in the second to fourth week after delivery), the higher is the likeliness of developing adhesions. In one study of curettage after delivery the frequency of scarring was 25% when surgery was done during this time period. Each case of Asherman's Syndrome is different, and cause must be determined on a case-by-case basis. In some cases, Asherman's may have been caused by an "overly-aggressive" D&C.
There is a variant of Asherman's Syndrome that is more difficult to treat. This is a so-called "unstuck Asherman's" or endometrial sclerosis. In this condition, which may coexist with the presence of adhesions, the uterine walls are not stuck together. Instead, the endometrium has been denuded. Although curettage can cause this condition, it is more likely after uterine surgery, such as myomectomy. In these cases the endometrium, or at least its basal layer, has been removed or destroyed.
Some of you may know that in the weeks immediately following Elise's birth I had quite a few issues. I eventually hemorrhaged and was rushed in for an emergency D&C to remove retained placenta. I believe this is when I contracted AS. Armed with this information, I made an appointment to go in and speak with my ob/gyn, but I had to wait almost a month to get in. I met with her a few weeks ago and she confirmed a strong suspicion of AS. She wouldn't even touch me and referred me directly to a Reproductive Endocrinologist (an infertility specialist) who will do the official testing and staging. I am currently awaiting that appointment now. We had to fill out a bunch of paperwork about our histories and will be having a consultation on October 26. From there hopefully we will schedule the testing, which is an outpatient surgical procedure called a hysteroscopy.
I've been through a full range of emotions beginning with anger and transitioning into sadness. How can it be that a wonderful man & father like Jamie could end up never having the experience of a biological child?? Why would this be happening? I can't even remember what it felt like to be pregnant anymore, and I am terrified that I won't have another chance. I'm sad that I may never get to watch Elise grow up with a sibling. And it's not fair.
But there is a bright side as well. If the scarring is mild, then treatment is about 70-80% effective. Treatment consists of an operative hysteroscopy and cutting away of the scar tissue (to put it very briefly) followed by hormonal treatments to assist with the regenerating of the uterine lining. I will talk more about treatment options once I know exactly what I am dealing with. For now it's just been very hard to not know. I am a planner, and it kills me to not know. If I knew, I could focus on the plan.
The doctor told me that we could continue to try to conceive while I awaited the testing and diagnosis. We've been doing that somewhat half-heartedly. Part of me does not really see any point, but there is still a small part of me that hopes maybe I am wrong and I don't have Asherman's. Please let me be wrong.
Jamie has been wonderful - he is the eternal optimist of our marriage! I know he's dealt with me in some rather unpleasant moods since this all began. I told him that I felt guilty, because if he had known that I may never be able to give him a child, maybe he would not have wanted to marry me. Of course, he assures me that it doesn't matter to him. Elise is our daughter and he has a child. When we talk about it he is so sweet that he makes me cry. And I have cried on his shoulder several times. It is still just very hard to imagine that our family could be complete. I don't feel ready for that yet.
So this is the reason that I wanted a separate place to talk. I want to have an outlet for all of this, but I don't want it to take over my life. I am SO blessed in so many ways. I am making a big effort at not focusing on this hurdle. Some days I do better than others. I joined an online support group for AS sufferers and it has been an amazing resource. I've learned more than I probably wanted to know at this stage. But it is good to go into my appointment well-informed.
I hope that writing here will be a good thing for me. I already feel a little bit better just getting this first post out of the way. If you are still reading, then you must be a true friend! This was a long entry!
I want to post a disclaimer: Some of the things I say here won't be polite. Some won't necessarily be rational. This is my way to get everything out and work through things. I sincerely hope I don't offend anyone, but if I do please accept my apologies in advance. It is not my intention. I hope I don't get any mean or insensitive comments (and I'm sure I wouldn't from anyone who I share this with)...but I just wanted to say that up front.
So now I suppose you are probably wondering what is on my mind!
It's a long story. It all began about 2 months ago. But I probably need to go back even further to when Jamie and I got engaged. We had a whirlwind romance, and after only a few months we knew that we wanted to be together for the rest of our lives. We talked about the future a lot, and naturally one of the things we discussed was having more children. Jamie is an amazing father. He blew me away from the very start. I remember vividly the first time he and Elise met. When we first began dating I would meet him out or drive to his apartment before our dates. If he picked me up, I didn't invite him inside. It was important to me that I didn't introduce anyone into Elise's life unless I was absolutely sure they were special. I had seen her father parade a variety of women through his home during her visits (even before our divorce was finalized), and it disturbed me. I vowed not to do the same thing. So when I decided to have Jamie and Elise meet, it was a big deal.
He was in the midst of baseball season and his schedule was crazy. By the time he would get home from baseball practice Elise would already be tucked in bed and sound asleep. Back then she was out by 7:00pm. He was coaching tournaments on the weekends for a few consecutive weeks, but he had Sunday afternoons free. His Sundays were precious, because it was his only down time. Based on my previous experience with Michael, I didn't expect that Jamie would sacrifice that free time to come hang out with me and my 18 month old. But I was wrong and very pleasantly surprised when he asked to come over one Sunday afternoon. I agreed and assumed he would drop by for 30 minutes or so just to say hello quickly and meet Elise. He arrived around noon just as my parents were heading out the door to run a bunch of errands (back then I was still living with them and trying to get back on my feet after the divorce). He came and and was introduced to Elise for the first time, and the 3 of us sat in the living room floor with her toys. I kept expecting him to get up and leave...but he didn't. He sat with us for 5 hours that afternoon. He sang songs. He played peek-a-boo. He read stories. Elise loved him from day one, and I was officially in love as well.
So when the discussion came up about adding to our family, naturally we both agreed it was something we wanted to do. Jamie told me about how much he's always wanted children. He was 32 when we married, and most of his friends were already settled down and had children of their own. He was often the only coach that didn't have a family to greet him on the field after games. He told me how he had always dreamed of having a child of his own to come running to him after the final minutes of the football games ticked off the clock. He was so excited the first time Elise and I attended a game and came to meet him at the end. It was a great feeling for him to see Elise sprinting towards him, anxious to jump into his arms. Over the last year and half, he's been such an amazing father to her. I cannot say enough good things about him. We truly have a 50/50 relationship and I feel beyond blessed to have such an involved partner in my life. I know first hand how it feels to do it all alone. I can honestly say that I never take Jamie for granted.
Once we had decided to have children, we began discussing the timing. Jamie was ready from day one, but I needed a little more time. Around the same time that we married we booked a dream vacation to Hawaii. I did not want to be pregnant during the trip and risk not getting to go if complications should arise given my history of pre-term labor with Elise. I convinced him to wait until we got home from the trip. So we agreed to wait a year and take our vacation. I enjoyed our first year of marriage so much. We've only grown closer as time has passed and I love that we had that first year with the 3 of us to settle in. We took our trip back in June and I went off the pill immediately. We thought we would be pregnant by now.
I won't go into graphic detail, but I could tell as my body weaned off the pill that something was not quite right. I am charting basal body temperature, so I know that I ovulate and have a nice strong luteal phase. I don't believe that I have any issues aside from the one big problem.
I began to do some research about my symptoms - I'd noticed them before but dismissed them as being caused by the pill. Once the pill was no longer a factor and the problem persisted, I began to get the nagging feeling that something was going on. That is when I ran across a description for Asherman's Syndrome online. I knew the instant that I read it. I began to read the stories of other women who have AS, and I felt like I was reading my own story. Here is a brief description of AS from http://www.ashermans.org/:
What is Asherman's Syndrome?
Asherman's Syndrome is an acquired uterine disease, characterized by the formation of adhesions (scar tissue) in the uterus. In many cases the front and back walls of the uterus stick to one another. In other cases, adhesions only occur in a small portion of the uterus. The extent of the adhesions defines whether the case is mild, moderate or severe. The adhesions can be thin or thick, can be spotty in location, or can be confluent. They are usually not vascular, an important attribute that helps in treatment.
Symptoms
Most patients with Asherman's have scanty or absent periods (amenorrhea) but some have normal periods. Some patients have no periods but feel pain at the time each month that their period would normally arrive. This pain may indicate that menstruation is occuring but the blood cannot exit the uterus because the cervix is blocked by adhesions. Recurrent miscarriage and infertility could also be considered as symptoms.
Causes
Most commonly, intrauterine adhesions occur after a D&C (dilatation and curettage) that was performed because of a miscarriage or because of retained placenta with or without hemorrhage after a delivery. Adhesions sometimes also occur in other situations, such as after an elective abortion, after a cesarean section, after uterine surgery (for example, after surgery to remove fibroids), or as a result of pelvic tuberculosis. The more D&Cs done after a delivery (and especially D&Cs done in the second to fourth week after delivery), the higher is the likeliness of developing adhesions. In one study of curettage after delivery the frequency of scarring was 25% when surgery was done during this time period. Each case of Asherman's Syndrome is different, and cause must be determined on a case-by-case basis. In some cases, Asherman's may have been caused by an "overly-aggressive" D&C.
There is a variant of Asherman's Syndrome that is more difficult to treat. This is a so-called "unstuck Asherman's" or endometrial sclerosis. In this condition, which may coexist with the presence of adhesions, the uterine walls are not stuck together. Instead, the endometrium has been denuded. Although curettage can cause this condition, it is more likely after uterine surgery, such as myomectomy. In these cases the endometrium, or at least its basal layer, has been removed or destroyed.
Some of you may know that in the weeks immediately following Elise's birth I had quite a few issues. I eventually hemorrhaged and was rushed in for an emergency D&C to remove retained placenta. I believe this is when I contracted AS. Armed with this information, I made an appointment to go in and speak with my ob/gyn, but I had to wait almost a month to get in. I met with her a few weeks ago and she confirmed a strong suspicion of AS. She wouldn't even touch me and referred me directly to a Reproductive Endocrinologist (an infertility specialist) who will do the official testing and staging. I am currently awaiting that appointment now. We had to fill out a bunch of paperwork about our histories and will be having a consultation on October 26. From there hopefully we will schedule the testing, which is an outpatient surgical procedure called a hysteroscopy.
I've been through a full range of emotions beginning with anger and transitioning into sadness. How can it be that a wonderful man & father like Jamie could end up never having the experience of a biological child?? Why would this be happening? I can't even remember what it felt like to be pregnant anymore, and I am terrified that I won't have another chance. I'm sad that I may never get to watch Elise grow up with a sibling. And it's not fair.
But there is a bright side as well. If the scarring is mild, then treatment is about 70-80% effective. Treatment consists of an operative hysteroscopy and cutting away of the scar tissue (to put it very briefly) followed by hormonal treatments to assist with the regenerating of the uterine lining. I will talk more about treatment options once I know exactly what I am dealing with. For now it's just been very hard to not know. I am a planner, and it kills me to not know. If I knew, I could focus on the plan.
The doctor told me that we could continue to try to conceive while I awaited the testing and diagnosis. We've been doing that somewhat half-heartedly. Part of me does not really see any point, but there is still a small part of me that hopes maybe I am wrong and I don't have Asherman's. Please let me be wrong.
Jamie has been wonderful - he is the eternal optimist of our marriage! I know he's dealt with me in some rather unpleasant moods since this all began. I told him that I felt guilty, because if he had known that I may never be able to give him a child, maybe he would not have wanted to marry me. Of course, he assures me that it doesn't matter to him. Elise is our daughter and he has a child. When we talk about it he is so sweet that he makes me cry. And I have cried on his shoulder several times. It is still just very hard to imagine that our family could be complete. I don't feel ready for that yet.
So this is the reason that I wanted a separate place to talk. I want to have an outlet for all of this, but I don't want it to take over my life. I am SO blessed in so many ways. I am making a big effort at not focusing on this hurdle. Some days I do better than others. I joined an online support group for AS sufferers and it has been an amazing resource. I've learned more than I probably wanted to know at this stage. But it is good to go into my appointment well-informed.
I hope that writing here will be a good thing for me. I already feel a little bit better just getting this first post out of the way. If you are still reading, then you must be a true friend! This was a long entry!
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