Wise Words

As many of you suggested, including David, I opted to cancel the laparoscopy on July 15th with Dr. Patience. I would not have been able to forgive myself if, despite the fact that this is a routine procedure, something went horribly wrong. I have done my research and I am confident in my choice. Now I'll just have to call next Tuesday morning (as soon as the office opens) and schedule the early morning (7am) lap appointment with Dr. NHB on August 16th.

In other IF news of the week, I contacted Ann, via email, about my suspicions (and briefly shared our story). She responded that I was, in fact, correct about her IF and suggested that we talk on the phone or get together sometime for lunch. It feels good to have made contact with her, so whether we develop a long term friendship or just talk every now and again, I am happy to know she's out there. I'll be pulling for her.

Also, I was invited to attend my first Resolve Peer Group dinner this weekend! One of the women that I first "met" on the Resolve message board and later met in person with a group of local "message board" gals for brunch, has invited David and I to join her regular Peer Group meeting. I feel like a very busy infertile.

Finally, thanks Ladies for all of your words of wisdom. And thanks David -- I appreciate all of your love and support.

A bird in the hand? Fear of the future? Or mindless babble?

Yesterday afternoon, I received a call from Dr. Patience's office informing me that my lap with Dr. Patience had been scheduled for July 13th. Hmmm, I hadn't realized that they would just schedule it without first contacting me . . . And of course, they are not completely aware of our seeking a second opinion.

As you may recall, David and I sought and received a second opinion from Dr. NHB. We decided that we'd have Dr. NHB perform the laparoscopy (perhaps b/c of his winning personality). Unfortunately, when I called Dr. NHB, he advised me that he would not be available to perform my lap until August 16th (mere days before my 35th birthday). To make matters worse, I can't actually schedule the lap until July 5th (he only schedules appointments 6 weeks in advance).

So here I am. Do I settle for Dr. Patience and get this whole laparoscopy thing behind us in less than a month or do we wait for Dr. NHB in August? If we are sticking with Dr. NHB, we'll have to inform Dr. Patience of our decision very soon, so that someone else will be able to take my appointment time. Decisions, decisions . . .

My biggest fear is that during the lap, the doctor (whichever doctor) will discover that both of my tubes are damaged and have to be removed. Of course, we will be sent straight to IVF land. Assuming I do have endometriosis (I know what happens when you assume), plus the odd assortment of cysts, fibroids, scar tissue, tube damage, etc. and will be 35, it is very likely that they will recommend moving straight to IVF anyway. And then what? Do we move forward?

IVF terrifies me and I'm not sure why. I don't know if it's the stims, needles, monitoring, etc. or if it's the fear that if it doesn't work, we are (I am) fresh out of options for a biological child. It almost feels like the end of the road and it just makes me want to cry. I know it's too early to assume the worst and of course, thousands of IVF babies are borne each year and I think I have the strength to do it, regardless of my fear of the outcome, but I just don't know . . .

I made it through the wilderness . . .

No -- not the wilderness of infertility (you haven't missed any posts, I'm still firmly planted in that jungle), the baby shower for Uber! You may recall, dear readers, that I thought I was off the hook with any involvement, (other than as guest) in my dear friend Uber's shower. How wrong I was! Other than purchasing, printing and mailing the invitations, I was enlisted to provide a few items for the event.

So last Saturday morning/afternoon, I raced around the baby store (yes, I entered the domain of the preggos), and bought a gift (it's so non-baby, that I probably should have purchased something else.) What is it? OK -- you dragged it out of me -- it's a rocking chair cushion and hey, they registered for it! It was in the furniture department. I simply couldn't do the cuties clothing/toy thing. Just being in the store made me a bit queasy. And yes, I know that I could (and should) have ordered a gift online but I kept procrastinating and finally had to buy something or show up empty-handed. Well, I guess I wouldn't have been empty-handed.

From the baby store, I went to a few grocery stores, the party supply store and a large discount store and purchased paper and plasticware, ice, cakes, cookies, garbage bags, foil, etc. I finally arrived at the shower an hour late and more than a bit frantic and out of breath. Fortunately, when I got there only 2-3 of the guests were present. (And the hosts had some paper plates/utensils - so no one was sitting around hungry, waiting for me).

And I will admit that my responsibilities ended as soon as my carload of goodies was taken into the house. Mr. Uber did all of the bbqing. (Not bad). Others brought side dishes. The hosts of the party had a large deck/patio, which was perfect for entertaining (and considerably larger than our backyard/patio). In total, about 30 guests attended.

I declined to attend Uber's girly baby shower on the prior Saturday, using my responsibilities for the co-ed shower as my excuse. And I must admit, as far as showers go, this was the right one for me! There was no gift opening, no silly games, no decorations, nothing girly at all! Instead, this was a bbq, with a couple of preggos, where people happened to bring gifts. The weather was great! I saw some friends that I hadn't seen in a while, met some new folks and had a pretty good time.

In fact, I think I may have encountered "one of us" in their midsts. This particular person and her husband (I'll call them Ann and Bob) attend most of Uber's events. So I know both Ann and Bob but I wouldn't call them my friends. They have been married for a while (maybe 4 years) and have no children. (I know, I know, you think I'm jumping to conclusions.) But get this -- during the course of a conversation, Ann asked another couple if they had children, the couple responded that they don't. She then said something about "having children, God-willing" and looked pretty disconsolate. Watch out Sherlock Holmes, I'm the infertile detective!

I emailed Uber yesterday to find out if she knew whether Ann and Bob are having trouble conceiving or if I had simply been imagining things. She assured me that I had probably heard correctly (which was a relief - I don't want to become the person, who starts hearing mutterings of infertility during conversations when none are actually being made!) and that she knows that Ann and Bob have been trying for a while. Uber also informed me that during previous phone conversations, Bob has made statements indicating that he and Ann were having fertility issues but did not go into the specifics of their situation.

So I got Ann's phone number and email address from Uber and I think I will contact her. I am not sure what type of support system she has but I know how difficult this journey is and no one should have to go through it alone. I think I'll send her an email, that way if she doesn't feel comfortable discussing the issue, she can simply not respond. A phone call seems pretty bold and may not be well received.

What do you think? Would you welcome an email from an acquaintance sharing experiences about infertility or would it just weird you out? Hmmm, maybe that's a dumb question since we are all sharing infertility experiences with acquaintances/cybersisters online, but let me know what you think anyway.

"This fertility treatment stuff is all voodoo anyway"

On Friday, David and I met with Dr. Terrific. Following our meeting, I decided that he will more accurately be referred to as Dr. No Holds Barred. Dr. NHB first asked us what brought us to his office. I gave him a copy of my records from the IF clinic and my prior records from the GYN related to IF. I then talked him through the process that we'd been through up until now. Trying for nearly 2 years, one medicated IUI cycle, lap recommended, cysts, possible hydro blah, blah, blah.

Well Dr. NHB asked if I had a regular cycle. I informed him that I do, he then questioned why I was given Clomid. He believed that it was not necessary or useful since I ovulate on my own. I explained the logic of the medicated cycle, increasing the number of eggs, increasing our chances, etc. . . we all know the drill. He then said so "they give you meds, inject you with sperm and then wait." Yeah, that's it -- IUI in a nutshell. As he said he's "no schmo." He knows how this works.

He said that we have no way of knowing if any treatment is going to work since we haven't had a lap performed. I may have endo, scar tissue, the tubal issue etc. He asked why hadn't anyone performed a lap in the past? I don't know. I believe my RE felt there was no need for one up until now. He clearly thinks that the lap is an essential diagnostic tool, thereby questioning the wisdom of my prior doctors allowing this much time to go by without performing the lap. OK . . . there is some logic in that.

He then questioned the whole infertility treatment process. He said that this "fertility treatment stuff is all voodoo anyway." "RE's go into a room and come up with a number of different treatments and hope something works. But there is no control group, they don't really know what treatment will work to treat what condition" . . . So he critized the fertility treatment process in general. A lot of people are putting a lot of faith in the IF treatment process and it often works, so I understand that this is a relatively new area of medicine but I couldn't agree with the "voodoo" statement. But he said that someone at IF clinic could perform the lap. Hmmm . . . question the legitimacy of this area of medicine but then send me back to them to be CUT OPEN?

He then asked why I hadn't gone back to my Gyn for a second opinion on the lap. (The medical community in this area is small enough and he practices the same type of medicine as Gyn at the same hospital). I don't know. Dr. NHB came highly recommended by two very close friends and I decided to meet with him instead. He informed me that my Gyn could perform the lap, a fact that I am well aware of.

Was he trying to get rid of us?

He then asked if my Gyn had given me antibiotics prior to performing the HSG. I told him that I didn't believe so. He said that if I had had an infection, the HSG could have aggravated that infection and caused the hydro. Also, he said that the hydro might not necessarily have shown up on the HSG, so there is no point in performing another one. OK. So he critizes my Gyn. But he said that my Gyn could perform my lap . . . hmmm . . . let Gyn perform the lap . . . at my own peril.

Dr. NHB said that he could perform the lap. He has performed many many laps. He would "clean everything out" -- remove the cysts, endo, possibly the fibroids (depending on their position/the feasibility of it), check the tubes, remove any scar tissue and have us try on our own for 3 months. But I am turning 35 in August, so he expressed concern about my age.

In the end, he said that the endo and hydro could impede implantation (I know) and therefore, if present, they'd have to go. David expressed concern about the removal of the tube (which David describes as "radical") and asked if there is anyway of repairing it. Dr. NHB said that the only real way to know what's going on in there is to take a look and make a judgment call. He assured us that there is no way he'd remove the tube if it looked normal. Unfortunately, if the tube is badly damaged and infected, it would not be useful to try to save it and the hydro would likely return. We talked about the fact that frequently your body compensates if you have only one tube and that our chances would not necessarily be reduced by 50%. He also said that a functioning left tube could "conceivably" (he, he) get an egg from the right ovary for fertilization.

So here we are. Do I personally like Dr. NHB better than Dr. Patience? Of course not. Dr. Patience was a very nice and I would be more likely to invite Dr. Patience to my home for dinner than Dr. NHB any day of the week. Is Dr. NHB a bit of a jerk? Probably more than a bit. Do I trust the skills of Dr. NHB more? Yes. He came highly recommended. My friend L received the recommendation from two of her doctors. (L has many doctors). One of whom told L that Dr. NHB was the only doctor that he would allow to perform his wife's procedure. And of course, he performed Ober's myomectomy and will be performing her c-section in a few weeks. So tomorrow we'll try to schedule the lap with Dr. NHB in either July or August.

If he can squeeze us in . . .

WHAT NEXT????

David and I met Surgeon B for a surgical consult. He was extremely nice and professional. He sat with us and answered all of our questions. We didn't feel rushed at all. I'll call him Dr. Patience. Dr. Patience knew that I have fibroids, in addition to the hemmoragic cysts, so he decided to do an impromptu u/s and SHG to review the landscape and confirm the location of the fibroids.

During the u/s, we saw the 4 cysts, 2 on each ovary. The two on the left ovary are most likely hemorragic and therefore they must be removed. They are characteristic of endo, so that will have to be removed too. Dr. Patience then examined my uterus. He assured us that the fibroids were not in my uterine cavity, therefore he recommended leaving them alone. At that point, there were no surprises.

And then Dr. Patience saw an elogated cloudy image on the u/s monitor.

He thinks it's a hydrosalpinx. And he recommended removing one of my fallopian tubes.

We were stunned.

My Gyn performed an HSG in Sept '04 and my tubes were both fine. How could I have a hydrosalpinx now?!?! How did we get here??? I know that if one of my tubes is removed during the lap, my regular RE will recommend that we move straight to IVF (I turn 35 in August). I just don't know what we'll do . . .

Tomorrow David and I meet with Dr. Terrific for a second opinion. We will just have to wait and see if his opinion differs from that of Dr. Patience. Will he recommend another HSG, even if he doesn't we should probably have one (thanks Kinneret) to see if the results are consistent with the u/s. Also, should we get a third opinion? I just don't know what will happen next.

Are we actually making progress???

On Sunday morning (7am!), I had my day 3 b/w and u/s and they confirmed what I already knew -- I still have four ovarian cysts. The technician, who performed the u/s suggested that at least one cyst appears to be a hemorragic cyst, which may be characteristic of endometriosis. We received a call on Sunday afternoon confirming that my estrogen level was elevated and that we will not be cycling (again) this month (big surprise!) and advised us to wait for a call from the RE or his nurse.

Well by Monday afternoon, we'd received no call. So David and I called and bugged both the RN and the receptionist to the point where they had no choice but to put the RE on the phone . . . himself . . . without an appointment! I was amazed. I must admit that all of the credit goes to David on this, I would have given up and merely scheduled a phone conference with RE at the next available appt time (in 2 weeks!). However, David persisted and persevered.

Anyway, on the impromptu phone conference, RE explained his concerns about the cyst and suggested a laparoscopy with Surgeon A. During the course of the conversation, I inquired about the fibroids and RE's initial response was that it is only 4 cm and based on the size and location he wasn't concerned. After I persisted with my questions (I know that there is more than one fibroid), RE reviewed my medical records and recommended seeing a different surgeon, we'll call him Surgeon B, who has a great new technique for fibroid removal. Unfortunately, a new technique is not so reassuring when its MY BODY we are talking about. Also, even if his fibroid technique is fabulous, how is he on endo and cysts????? Tomorrow we will have an opportunity to have all of our questions answered, David and I meet with Surgeon B to discuss his opinion on my case.

I was interested in getting a second opinion and we were fortunate to get an appt on Friday with a local surgeon (Dr. Terrific), who has performed uterine surgeries on two of my friends. One of my friends (Uber) had Dr. Terrific perform her uterine surgery two years ago and it was a huge success (baby Uber is scheduled to make her debut on July 6th). Both Uber and L (a good friend who had Dr. Terrific perform her lap and remove cysts, polyps, endo) can't stop singing Dr. Terrific's praises.

So here we are. We will meet both doctors this week (and maybe even schedule a consult with a third, I'm not sure yet) and try to schedule the lap as soon as we can. Hopefully, we will be comfortable with one of these doctors and can move forward with the lap.

I am really looking forward to having the best possible chance of conceiving, because up until now, I don't think that my "landscape" was very baby friendly. . . we'll see . . .

And the two shall become four . . .

I finally received a voicemail from RE. Taking the advice of Kinneret, I left a message with the operator, who sent RE an internal email (she claims he doesn't have voicemail). A mere 36 hours later, RE called me (last night at 9:30pm) and unfortunately, I missed the call. He indicated on the voicemail that I, in fact, had FOUR cysts (not TWO as RN had indicated at last u/s, or so I thought) and he suspects that at least one may be an endometrioma. He suggests that if the cysts-gone-wild (and their children) are still present on day 3 of my cycle (Sunday), he would recommend that we do a laparascopy.

Finally! I believe that I probably should have had a laparascopy prior to doing IUI#1. I think I have had symptoms of endometriosis for about 20 years now, so it is time to take a look and see what's really going on in here. I know that the endometrioma and endometriosis are not the same thing but I also know that there is no way to diagnosis the presence of endometriosis without doing a lap. So I think the lap may kill two birds with one laser! Also, what's up with the fibroids? Can we do a total internal clean up job and get ready for action?!?!?

Anyhow, it looks like another cycle, without an IUI, may be underway but at least we can maybe make some progress . . .

Does anyone want to play Tag?

Internal Spring tagged me with these two memes:

TAG ONE:
Finish the four bookish statements and pass it on.

1) Total number of books owed - several hundred, too many to count.
2) Last book I bought (2) - The Infertility Cure and the Infertility Survival Handbook.
3) Last book I read (2) - I am currently reading the Infertility Survival Handbook and listening to The Skeleton Man in my car.
4) 5 books that mean a lot to me - To Kill a Mockingbird, Tar Baby, Angela's Ashes, Giovanni's Room and The Poisonwood Bible.

Pick five of the lives below and write about them. Then add one of your own and pass it on.

IF I COULD BE A POLITICIAN: I'd do everything in my power to make this country a more equitable place. I would support early childhood education programs, universal health care, aid to the poor and other liberal causes. I'd work to defeat corporate welfare and tax breaks to the wealthy.

IF I COULD BE A PHOTOGRAPHER: I'd photograph people. I'd try to capture their essence through my art. I'd seek out different types of people, in far-reaching parts of the world, particularly those who are rarely photographed, like the poor and the disenfranchised and bring their plight to the forefront.

IF I COULD BE A PSYCHOLOGIST: I'd help people deal with the struggles of daily life like depression, infertility and loss. I'd work with people who are seeking joy and peace in their daily lives.

IF I COULD BE A MUSICIAN: I would be a singer/rapper like Gwen Stefani or the woman in the Black Eyed Peas. I have always told my law school friends that if I had any musical talent at all, I would never have met them. I know this is really shallow but I think it would be cool to do music videos and wear cool outfits and have others around to do my hair and makeup.

IF I COULD BE A CIRCUS PERFORMER: I'd be a trapeze artist. I'd fly through the air with the greatest of ease, performing death-defying stunts. I'd enjoy the roar of the crowd and the thrill of entertaining others.

The rest of the list for those who accept this mission is: SCIENTIST, FARMER, MUSICIAN, DOCTOR, PAINTER, GARDENER, MISSIONARY, CHEF, ARCHAEOLOGIST, ARCHITECT, LINGUIST, PSYCHOLOGIST, LIBRARIAN, ATHLETE, LAWYER, INNKEEPER, PROFESSOR, WRITER, LLAMA-RIDER, BONNIE PIRATE, SERVICE MEMBER, BUSINESS OWNER, ACTOR, AGENT, VIDEO GAME DESIGNER, PHOTOGRAPHER, CIRCUS PERFORMER, SPY, FASHION DESIGNER, HIGH SCHOOL STUDENT AGAIN, MODEL, POLITICIAN, SERIAL KILLER, HOSTAGE NEGOTIATOR, MOVIE PRODUCER OR ACUPUNCTURIST.

If there is anyone lurking out there, choose one or both tags and let me know a little bit about you! Also, I tag a few of my favorite bloggers to play along and give us their answers on their blogs -- the fabulous and pregnant Life's Bright Chaos and The Road, sports and Russell Crowe fan extraordinaire BabyQuest and finally any members of the The Grateful Distraction Book Club seeking additional distraction.

And I'm still standing still . . .

The wife of a colleague of mine just gave birth to their second child in less than a year and a half. I remember when their first daughter was borne, we'd only been trying for 6 mos. (Feb. 2004) and I assumed it would be just a matter of time before I'd be sharing our good news. Well here we are, it's June 2005, she's delivered number two and I'm still in the starting blocks. I know that I should just feel happy for them (and to a certain extent, I do) but I can't help the feeling that I am making no progress and that time is just passing me by . . .

We interrupt this program . . .

I realize that I promised a mini-series about the positive things that I have gained during the IF process. However, I am back to playing the role of sad and bitter infertile. You should have known that the Ms. Suzie Sunshine thing wouldn't last. I do hope to return to the wonderful prospective, wisdom and patience that I have gained during this process -- but not today.

I have begun spotting, which marks the impending arrival of AF (today is day 23 of a 26 day cycle). Therefore, another natural cycle goes bust. Will I look on the bright side -- by Sunday or Monday I should return to RE's office for a baseline u/s and b/w to begin another treatment cycle? Of course not! Since the cysts seem to be hanging on to my ovaries for dear life, I completely lack any optimism about doing another IUI. I honestly have no earthly idea what we will do if the cysts are still there this time around. I have not spoken with anyone at RE's office about our game plan and I'm pretty flipping pissed off! I am considering changing RE's, I know it's early in the process but I need more attention!

More later . . .

The Sisterhood

Rather than posting my typical complaints about my RE/RN/ friends/ cysts, etc, I thought it would be a good time to begin a mini-series on things that I am thankful for about infertility (IF). Yep, you read that right -- I have actually gained some really worthwhile and life changing experiences from IF and I am actually thankful for many of them.

The Sisterhood -- Yesterday, I was fortunate to join five remarkable women for brunch. They are intelligent, funny, strong, smart and brave women, who want nothing more than to be mothers. We met because we all frequent the Resolve online bulletin board and one of us organized a get-together in our area. (I had attended a similar gathering of Resolve women in my area a few months ago). It was refreshing to meet women from different walks of life, who are going through the same experiences as I am. (It's always nice to know that you are not only - not alone but that there are women out there, who will support other women whom they've never met just because they share a common bond.)

From a treatment perspective, we are all in different places. With my one failed IUI cycle, I have received the fewest treatments of any member of the group. But despite many failed cycles among us, everyone remained levelheaded, optimistic about family building (one way or another), good natured and self-assured. I have found that all of us possess a strength and fortitude that we never knew we had. I am thankful that IF has allowed me to offer and receive support and encouragement from such an incredible group of women, be they the sisters whom I've met in person or my many cybersisters across the country. IF is truly a life-altering experience and I am honored to be in such esteemed company.

I want to say a special thank you to the regular visitors to my little blog. It really warms my heart that you take the time to read my rantings. Good luck to you in your journey.