Post-op

It's been almost three weeks since my surgery. The actual procedure went smoothly, no complications. When my doctor came to speak with me right before the actual surgery, she asked what I would want her to do if when she got in there, she found my right tube to be damaged as well. Did we want her to take that one too? I honestly had never even considered this, but reluctantly said yes, knowing full well it would completely alter our fertility plans for the future. Thankfully, that right tube ended up looking fine and the left tube is gone forever. Thank goodness.

The recovery has been okay. Just in the past couple of days, I have started feeling like myself again. One of my incisions is pretty much healed, the other two not so much yet. I surprisingly got my period this week and that was excruciatingly painful since I'm still healing. I knew I was getting ready to ovulate right before surgery, but really thought having the procedure would have told my body to put that on hold for now. Since I was all drugged up and in pain anyway, I clearly never felt the actual ovulation pain right after the surgery. But I must have because exactly two weeks later, there was my period. Silly body trying to act all "normal" despite so much trouble.

I had my follow-up appointment with my doctor this week. They had sent home some pictures from my surgery that my husband and mother had tried their best to explain to me based on what they had been told after the procedure. But my doctor carefully went through it all with me and gave me even more pictures and a copy of the operative and pathology reports too. She removed a little bit of endometriosis, but that didn't really seem to be an issue. She did find and remove two fibroids in my uterus. Not all that surprising either. But she did say when they sent these fibroids for testing, it showed abnormal thickening of the lining of my uterus. Not cancer, less that 1% chance of becoming cancerous, but still not ideal for a pregnancy. It's called simple hyperplasia and mine is the best type to have as it's nonatypical. So yet another diagnosis. And as frustrating as it is to have yet another thing wrong with me, it is also another reason to be thankful that I chose to go back to the fertility doctor and was able to have this surgery. We never would have known about this and could have simply tried again with just the same sad result.

No wonder I've had so many failed pregnancies. So many reasons that lead to losses, it's amazing I've never really had trouble getting pregnant despite all this.

So our next course of treatment is four months of progesterone therapy. She was going to simply put me on birth control for these four months, but it's nearly impossible for me to take an effective birth control pill with my Factor V Leiden since I can't have estrogen. So she opted for the progesterone pills. Each month, after I know I've ovulated, I will take the pills for 10-14 days. This should help thin out and improve the lining of my uterus without completely throwing off my cycle. We still want me to continue ovulating and having a period in the meantime, but not to try to get pregnant at all during these four months. After the four months, my doctor will do an endometrial biopsy (thankfully an in-office procedure rather than surgery again.) And then we'll know whether we can start trying again at that point.

Part of me was sad we can't start trying again right away. I mean, I'm not getting any younger and I never imagined wanting to have my children so many years apart. But then again, it's freeing to know that at least for the next four months, we can kind of relax and just enjoy our life as it is. No worrying about possible pregnancies or losses. We can appreciate our little family the way it is and be thankful in that.

Pre-op

I'm finally having surgery tomorrow to remove my left Fallopian tube. Finally. Nearly seven years have passed since my first pregnancy, the first ectopic that began this rollercoaster. I'd be lying if I said I wasn't nervous. It's actual surgery with full anesthesia that's going to leave me in pain, recovering and unable to work or really care for my daughter for at least a week. But truly, this is a good thing. Something I've hoped for and wanted for a long time. Maybe this can finally lead to a successful pregnancy. But even if not, I will be glad to be finished with this stupid tube once and for all. Glad to not have the almost daily pain. Glad to not feel like I'm carrying around this bad part of me that is such a reminder of dark times.

New plan

This past week was the week of doctors' appointments. I met with my endocrinologist and found out my TSH has dropped back down to 2.7. Not quite as good as it was several months ago, but at least headed back in the right direction. He upped my thyroid dosage and told me to come back in two months. He asked what's happening with trying to get pregnant. I told him I was waiting to find out my TSH level and to talk to my fertility doctor before trying again. He said we didn't need to wait and to go ahead and try now. I do like this doctor, but it's frustrating when they just jump to conclusions without taking the whole big picture into account. It's not "just trying" to me anymore. Five losses later, I need to be more careful about this.

Which takes us to our fertility doctor appointment the next day. Shannon agreed to go. Thank goodness he's willing to be involved even if this is not his first choice. This appointment was to find out the results of all the millions of tests they've done over the past several months and to hear the doctor's plan for going forward. The results were nothing new or shocking to me. I have Factor V Leiden (blood clotting disorder), but now I know that I only have one copy of the gene, making it less likely that this will ever be a problem for me, pregnant or not. They were not able to get any DNA information from the slides from the babies they should have had on file at the hospital, so we weren't able to find out anything about those babies (a disappointment, for sure.) My HSG showed significant blockage in my left tube. She called it a hydrosalpinx. The one piece of new information is how much this hydrosalpinx could be affecting my fertility. Not only does it make it more likely I'll have yet another ectopic pregnancy, it could also negatively affect a properly implanted fetus by leaking toxic fluid into my uterus. Toxic fluid?? She said these can be so serious that almost no doctor would agree to doing IVF if you have a hydrosalpinx because research shows it causes such a high rate of loss. Well, that's news to me. I'm trying not to feel frustrated that we never knew this before. I've had HSG's in the past where we saw the blockage. I've complained of pain in the area for the past six years. But no one was willing to do anything about it until now.

Now she wants to take the tube out. Hallelujah! I've wanted this awful, bad tube out of my body for years. I know my OBGYN was trying to do me a favor by saving it we he did surgery the first time, but I always wished he hadn't. It's caused me nothing but pain and trouble, probably more trouble than I'd even known, it turns out. So now we wait. Wait for me to get my period in a couple of weeks to make sure I'm not pregnant when she does the surgery. I hope I'm not. At one point, I thought this might be a good month to start trying again and we weren't 100% careful, so there's always a chance, but I hope not. I really only think we can handle one more pregnancy, whatever the outcome. And I want to make our last chance our best chance possible.

I know the recovery from surgery won't be pleasant. I remember how painful and difficult it was when I had essentially the same laparoscopic procedure done to remove the ectopic years ago. And I didn't have a four-year-old who wants so much of my attention. Thankfully, my mom just lives down the road and will help a great deal with her. Maybe even my in-laws will help. I'll have to ask for and accept help and that's just the way it will have to be, even when I'd rather be tough and independent and do it the right way myself. Learning when and how to ask for help is a huge skill. I tell this to my clients all the time. Time for me to take my own advice.

The day of our fertility appointment was October 15th, National Pregnancy and Infant Loss Remembrance Day. And yes, the irony was not lost on me.

Craziness

I feel like I'm going crazy. I was convinced in the middle of the night last night that I was pregnant. Absolutely convinced. My period was due yesterday and never came. I've been having cramping and pain, but still not period and this is always how it's been with all my pregnancies. I usually ovulate earlier than expected, but my period arrives like clockwork exactly 2 weeks after I feel ovulation pain which I know for sure was 2 Wednesdays ago. I really didn't sleep much at all in the night, waiting until what I felt was a reasonable time to finally test. I was absolutely sure it would say I was pregnant, so I was shocked when the test read "Not Pregnant". I actually had to look back at it several times to believe it.

I wasn't heartbroken. A little disappointed, but nothing big. This was just our first month semi-trying again and I never expected it to happen so quickly. I told Shannon. He said sorry and asked if I was okay. I am.

So I went on about my day. I've continued to have pain and cramping off and on, but still no period. I had a routine appointment with my endocrinologist where I found out that my TSH has jumped up to 4.7 (!) again. It was .3 two months ago and the only thing we changed was to have me only take half a pill one day a week to help lessen the hyperthyroid symptoms I had been experiencing. I am shocked and disappointed it has risen so high so quickly. So my first thought again is I must be pregnant and that's what is making it go up now. And if I'm pregnant, it's already not looking good. First of all, a negative pregnancy test would show that the HCG levels are pretty low and they should not be that low 15 days after ovulation. Secondly, my TSH is already dangerously high for a pregnancy. So I stopped at a store on the way home and bought more pregnancy tests. This time, I got the ones that say how pregnant you are, like 1-2 weeks or 3+ weeks past ovulation. I figured these would have a lower range for testing and I could trust that. Still "Not Pregnant".

What in the world is going on with my body? In the middle of the night, in my absolutely sureness that I was indeed pregnant, I went ahead a used a progesterone suppository that I had left over from my last pregnancy and does not expire until next year. I know this could have confused my body and could delay my period, but shouldn't that have cleared out by now?

Honestly, at this point, I really don't want to be pregnant after all the worrying this has already caused me today. Last night, in the middle of the night, I welcomed the idea and tried to surround myself in positive thoughts. Today, I can't see that positivity so well anymore. I'm just ready for my period to show up now so I can move on and really try again the right way when my body is more ready.

Trying again

We discussed it and decided to go ahead and try starting this month. Originally I was going to wait since we were just getting started at the fertility doctor and hadn't even had all the tests or officially gotten a plan from the doctor yet. But what are all those tests and plans going to change? I know that most likely they're going to recommend IVF and that we don't want to do that. I'll admit that maybe, just maybe, I would consider it if we didn't have to pay for it. But really, it just doesn't feel right for us. I just want the chance to get pregnant as naturally as possible for me.

I kept hearing in my head that the HSG could help us get and stay pregnant for the next few months. Then the doctor called the next morning to say they saw evidence of swelling/irritation in my tube when she reviewed my HSG results. (Duh, I've told everyone all these years that it hurts there almost daily. No shocker to me.) So they're putting me on a course of antibiotics. I know I've heard of research showing that antibiotics can help your chances of getting and staying pregnant too. So I just couldn't pass up this shot to go ahead and try now. I don't think it will happen right away, but we might as well start now. I never asked the doctor if we should try this month or wait. I didn't want to hear her answer. I've been through this enough now to know I need to trust myself most in this process.

On a semi-related note, Shannon has a much younger brother who got married this summer. They're in their early twenties and still living at home with her parents (in a far away state from us). When we were there for the wedding, people inevitably asked when they were going to have kids and they said they definitely wanted to wait. Fast forward about a month. Surprise, surprise, she's already pregnant (another one from their honeymoon, no less.) I wanted to be happy for them. But really I wasn't. I thought they should wait, etc. But really I was jealous. I cringed at their announcement on Facebook and pictures they were posting of her little belly.

We recently found out that the pregnancy is not going well. Today I was told details that tell me this is definitely ending in miscarriage. It sounds like the doctor is still giving them hope. But I know better. No heartbeat at 11 weeks? It's not happening. There's no way your dates are that off. But I couldn't say that to them. They've reached out to us because they know we've been through it all too many times before. All I could honestly tell her was to hope for the best and prepare for the worst. And keep talking about it with people they know and trust.

It's sad that anyone has to go through this. And sad how scared and alone it makes you feel when in reality, they are so many of us who have experienced the very same thing. I'm thinking I really don't want to stay quiet about it all anymore. I may even share more with my real life friends about my current fertility experience, which I've barely done before. What's the point of staying quiet about it? It didn't help before and definitely didn't help when I was struggling through losses.

HSG

Just got back from my HSG test. It was much less painful than I remember it being years ago when I had it done before. It probably helped that I took two Aleve before I got there... The xray tech woman was very kind and walked me through every step of the procedure, both before and during the test. She even turned the screen so I could see what was happening as it was happening and explained it all to me (which I know she's not really supposed to do, but I so appreciated.) My uterus looked "beautiful", my right tube filled and spilled just like it was supposed to, and the left tube filled a little then nothing. No spilling, even when she had me move in different positions and she put more contrast dye in. So it's still blocked. No surprise.

I wish I could go back to six years ago when I had the first ectopic and had surgery to remove it. I would insist that my doctor take that whole stupid tube out too. I know he was trying to do me a favor, but it's just been nothing but trouble.

The woman that did my HSG today was trying to be helpful and tell me all about how this test can sometimes help you get and stay pregnant for 2-4 months after the test. Then she was explaining to me how your body ovulates from alternating ovaries each month and how she never knew that when she was trying to get pregnant. I had to just stop her there and explain how I already know entirely too much about ovulation and pregnancies, but I appreciated her effort.

Since we're so early in this process now again, I'm not sure how to feel about it all this time around. I want to be excited and hopeful, but honestly I'm just feeling bitter right now. I'm pissed that I even have to go through all this. I'm still mad when I see other women announcing their easy pregnancies on Facebook. I'm angry that I have to go to these crazy lengths just to have the tiniest of hope that I might be able to one day give birth to a baby. I want to get passed all these negative feelings, but for now it just feels like I've opened a big can of bitterness.

Doctor, revisited

Just got back from the fertility doctor. I still have mixed feelings about it all, but it went fine. I spent most of the time actually meeting with the doctor, going over my history and what we plan to do from here. I told her from the beginning that I really don't want to do IVF and she said we would table that discussion for now, but it may in fact be my best shot. I'm going to have another HSG done tomorrow to check my tubes. I remember having this done years ago and it was very painful, especially where the ectopic was. Heck, even the ultrasound she did today hurt when she pushed on that area. So not looking forward to the pain, but I expected this and do want to have the test done again.

Then we'll do more bloodwork next month. The biggest, newest thing we're going to do is she is going to try to go back to the records from the hospital when I had my ectopic pregnancy removed and when I had my D&C to try to test the chromosomes of those two babies. She said this is very new technology to be able to go back to these slides and get this sort of information. It can be difficult to do and may take awhile for them to even track down what they need, but that's the plan. That both excites and terrifies me. I've always had details I imagined about each of the babies, but I've never known anything at all for sure. If we find chromosomal abnormalities in these babies, that indicates a very different plan that almost certainly includes IVF.

It almost felt like an out-of-body experience being there. I've so blocked out so many things from those pregnancies and losses, it was weird to talk about them again. Even when I was filling out the new patient paperwork last week, I felt almost annoyed to have to list the details of each pregnancy again. I wouldn't say I necessarily feel hopeful at this point, but it felt like a positive experience overall. At least not a negative one. I felt like I was heard and respected and I didn't always feel like that by the end of my last fertility experience, to say the least.

I feel like I need to talk about all this to process it. But I'm not sure where to turn at this point. So I'm thankful I still have this blog to help me wrap my brain around it all. Here we go again...