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!

5 comments:

Angie said...

*hugs* Melanie...

mmsd1410 said...

The two of you are great parents and I just know that you will be blessed with another child.
MD

coach said...

As i have said all along, we have a great, loving family... a complete family. I consider Elise my daughter... heart and soul. She may not have my genetics, but she has everything else i can offer. I love you both with 100% of my heart (no less). I do not know what i did to deserve it, but GOD entered not one... but TWO "loves" into my life. If he has put us on the path in which we can not add to our GREAT family, then my life is still EXCELLENT!!!.
You are my heart, my soul, my life, my world, MY UNIVERSE... You make me whole and give my life meaning. I am a better man because of you "my love."... the past is the past and we will take on the future together...
LOVE YOU!!!!!!

Laurie said...

Oh Melanie, I have tears in my eyes reading your blog and darn it if Coach didn't cause the tears to overflow. I'm praying for both of you to be blessed with another precious bundle. Please let me know how the dr's appointment goes.

I too am starting to think about the next baby, and I always get so worried that maybe next time won't be so easy.

NesrstaFamily said...

Oh my goodness, stunned would be a good word to use right now. I had no idea these things had happened to you and I am truly sorry; shouldn't happen to someone like you. But, I also know, as someone who was once your best friend, you shall get through this too. Luckily, you have a great partner on your team and a wonderful daughter to boot. I will keep you in my prayers Mel.