A Few Words

My thoughts and prayers go out to all of the residents of the Gulf Coast, who have been affected by the devastaing impact of Hurricane Katrina. I hope that all will safely reunite with their families, friends and neighbors and begin the process of rebuilding their lives.

David and I will, of course, not be taking our scheduled Labor Day trip to New Orleans. Instead, we will be traveling to Texas to visit David's family, as a close relative has recently suffered a stroke. Sadly, family and doctors are not optimistic of the prospects for her recovery. Please keep her in your thoughts.

Finally, thanks for all of your words of encouragement. It is with your support that I am able to continue this journey.

"Get thee to the RE for IVF -- ASAP!!!!"

"Why are you still sitting here? Didn't you hear what I just said? Go - right now! I mean, right now!"

OK, those weren't the exact words that Dr. NHB used today during the post game wrap-up, errr I'm mean, post op appointment. But they are pretty darn close. I mean VERY close.

David and I arrived at Dr. NHB's office this morning at 10am. He directed us into an exam room where he examined the sites of my incisions and seemed very pleased with his handywork and informed us that I was healing well. We then sat in his office where he explained the photos he'd taken during the laparoscopy and answered all of our questions related to the procedure. I had over 30 questions, many were compound questions but his answers were basically the following --

1) My uterus looks good now! As do my ovaries, although the endometrioma will likely return.

2) My pelvic organs were pretty much glued together. My appendix was covered with endo, was enlarged, and attached to my uterus and ovaries. He believes that, had it not been removed, it would have ruptured eventually.

3) He attempted to remove as much endo as he could, although he could not give us any type of percentage or estimation of how much was removed.

4) He removed the right tube with the hydrosalpinx.

5) He freed my left tube (blocked) and ovary from the left pelvic wall and freed the right ovary from the right pelvic wall. He removed the endometrioma from my ovaries. He explained that this was all in an attempt to prepare us for IVF.

6) I asked about unblocking the remaining tube. He said there was no point in taking this action as the endo may return at any time.

7) One fibroid was removed but the other intramural fibroids were left inside.

8) All of the tissue that was removed was biopsied and "benign" endo/fibroids were confirmed.

9) He could not give me any sense of how long we have before the endo will return but he suggested that with stage 4 endo, coupled with my age, we should quickly begin IVF. As. soon. as. possible. I mean like NOW!

We assured him that our appointment with the RE is in 2-3 weeks (we've decided to just return to Dr. L, given that the consensus is -- in a large practice we'll see all of the doctors anyway and they consult on each others cases.) So since Dr. L is nice enough, save some unresponsiveness (maybe attributable to his former nurse?), we'll stick with him. Dr. NHB was happy to learn that we'd made an appointment to return to Ginormous Fertility Clinic and that we were aggressively pursing treatment.

Of course, Dr. NHB could give us no definitive cause for endo only theories, which is consistent with my research, nor could he make any recommendations about diet or other methods of controlling endo (not that I really expected answers). He suggested that Lupron would help (obviously, not advisable outside of an IVF protocol) and that another lap may be necessary at some point, depending on my symptoms. He also suggested that fertility meds would likely accelerate the development of endo but pregnancy (a veritable panacea) would stave it off.

He also informed us that I could resume all normal activity, including exercise, but should expect soreness as this was a major, albeit laprascopic, procedure. He hopes that my menstral cramps will be less painful now. Finally, he confirmed David's observation that the procedure took nearly 3 hours.

So here we are.

Here we are.

I recently spoke with two fellow crusaders. One whom I'd met during a meditation class a few weeks ago, Cathy, and another woman, (I'll call her Gail), whom I met at a local get-together of Resolve bulletin board posters. Both have been through multiple IVF cycles. Cathy got pregnant from her last IVF cycle and is now about six weeks along. Gail is currently awaiting ET. Both spoke positively about their IVF experiences, assuring me that yes - WE CAN DO IT! They both informed me that the injections weren't so bad, even the IM injections. I was happy to speak with such positive women, who both suggested that IVF cycles would be fine, despite my reservations.

So our appointment with Dr. L is on September 16th. I am going to drop off the laparascopy photos and Dr. NHB's report at Ginormous Fertility Clinic either later today or tomorrow. We may attempt to speak with Dr. L or one of his nurses over the phone prior to the consult, so that we can hit the ground running on the 16th. Gail suggested that I inform Ginormous' financial advisers that we intend to pursue IVF, so they will begin working on the insurance approvals immediately. I think that's a great idea and I plan to speak with one of their financial advisers when I drop off the laparascopy materials.

Lastly, I guess I will make a decision about an acupuncturist, Eve or Frank , in the upcoming days.

And, of course, await our appointment with Dr. L.

And the countdown begins.

Happy Birthday to me

Today is my 35th birthday. I am extremely fortunate to have a great husband and a loving family. My mom flew into town last week to spend time with me. She has been cooking, cleaning, washing, ironing, folding, etc. ever since. Today mom and I are going out for a nice lunch in honor of my birthday. I also have many good friends, who have stopped by, called or emailed with well wishes. And of course, I have you, my cybersisters, who have sent warm wishes and words of love, encouragement and wisdom. I appreciate you all so much.

On the less than positive side, I have a work situation that, with two pretty high profile resignations, has seemed to become more tenuous over the course of the past few weeks. This may be one of those situations that ultimately leads to a positive result, by causing me to aggressively seek a more stable (and, actually, more fulfilling and enjoyable) employment arrangement, rather than remaining at my current job, which has gotten tedious and boring.

And, of course, there is the very significant fertility situation. With the severity of my endo (and, not to mention, my age), we obviously have a limited window to begin the IVF process. We will have to decide whether to stick with my current RE (Dr. L) or to change to another RE (Dr. Fabulous) in the same practice. I have met a few women through the Resolve Bulletin Board and a Resolve Peer Group potluck, who speak very highly of Dr. Fabulous. So I am interested in making a change. But I am not sure of the politics of making such a move at this point. Dr. NHB has offered to call an RE at Ginormous Fertility Clinic (presumably, Dr. L) and inform them of his assessment from the laparoscopy, but who will he call if we change REs now? Maybe we should visit Dr. Fabulous and then have Dr. NHB give him a call. Is a change within a practice (even a large one) awkward? In addition, we will require insurance approval, IVF injection training/orientation, etc. So, I am not sure how long it will take for us to get started.

Also, David and I have scheduled a much needed Labor Day trip to New Orleans. I am extremely excited to have a nice break from everything but I am concerned that this will postpone our treatment cycle by a month. This is not great. I am not sure what the lab cleaning schedule is at Ginormous and I don't know if a one month postponement may cause us to lose two months or more. I hope that we can get started soon and allow ourselves the possibility of, at least, two IVF cycles before another lap would be necessary.

So here we are - moving ahead . . . making a wish and blowing out a ton of the candles.

Did I mention appendectomy?

David and I arrived at the hospital at 6am on Tuesday morning. We checked in, signed the remaining waivers and financial payment documents. They recorded my insurance information, checked my id and gave me two hospital bracelets (one for each arm). I joked with David that perhaps they suspected that my arms might be separated and therefore, I required two bracelets. We were then sent up to the In and Out Surgery Ward.

From the Ward's nurses station, I was sent into what appeared to be a regular hospital room with four beds. Since the room was empty and I had my choice of beds, David suggested that we select the bed closest to the window. On my bed sat a plastic bag with a stylish hospital gown, hospital robe and socks. David suggested getting undressed and prepared for surgery. I declined to get undressed immediately in a vain attempt to delay the inevitable. But as it approached 7am, I knew that the room's other occupants would be arriving soon (along with my doctors) and I should just get undressed and prepared for my 7:30am procedure.

Shortly thereafter, a nurse arrived and asked me to verify the procedure I was having, took my temperature and blood pressure. She asked about allergies and questioned me about what drugs I had taken recently. She reviewed the recommendations for an outpatient procedure including the drugs to take, prohibitions on drinking and activities to avoid. Then the anesthesiologist showed up. She also asked what procedure I was having, asked more questions about allergies and made additional post surgerical recommendations. She then went through her role in the surgerical process. She checked my heartbeat and thyroid and told me that I had a heart murmur and that my thyroid seemed slightly enlarged. She then started an IV, which she advised me would sting a little and burn a little (right on both counts).

Then Dr. NHB entered the room. He also asked me what procedure I was having (which, after three inquiries, seemed a bit bizarre to me) but as the anesthesiologist explained to us, they are concerned that patients are agreeing to procedures that they don't completely understand. The anesthesiologist informed Dr. NHB that I had a slightly enlarged thyroid and asked about my hormone levels. I guess they don't typically work together (or maybe don't get along?) b/c he seemed to sort of brush off her concerns, telling her that the information should be in my files. She retorted that gynos normally keep these kinds of records and Dr. NHB responded that the information should be in the files.

Finally, another nurse showed up to wheel me into the OR. David grabbed my bag with my clothing, cd player, wallet, cell phone etc. and asked whether he could walk with me to the OR. The nurse advised him that he wouldn't be able to walk with us for very long but he was welcome to join us. After what seemed like only a few steps out of the room and down the hallway, David was told he could not accompany us any farther.

My throat caught and my eyes began to fill with tears. I felt alone and I finally started to panic.

The nurse advised me that I would be given a sedative to settle me down. She then began making small talk about my career. This distraction was helpful and by the time we arrived at the OR, I had begun settling in. The room seemed so large and bright and filled with metal objects and machines. The nurse introduced me to a couple of women (doctors, nurses?), who would be assisting in the procedure. I was told to untie my gown and slide onto the operating table. Then the anesthesiologist appeared out of nowhere said something about the meds and I was off to slomberville. I can't remember counting or anything.

When I awoke Dr. NHB was standing over me, saying something about my appendix, but I thought I was delirious. Later, I awoke in recovery and Dr. NHB and David were talking to me. Dr. NHB told me that I had had stage 4 endo, and that my tubes, ovaries etc. had been "cemented" together with scar tissue. One of my fallopian tubes had been removed due to a hydrosalphix and the other tube appeared blocked (but had been left in my body) and yes, my appendix had been enlarged and had therefore been removed. The inside of my cervix had also been narrowed by scar tissue. He had also removed one of my fibroids, which was near my cervix. He said that given the endo, tubal issue, scar tissue, fibroids, etc., there was no way that we would have gotten pregnant on our own. Then Dr. NHB told us what we'd feared hearing -- Mr. "Anti-Voodoo" recommended that we go back to Ginormous Fertility Center and pursue IVF. He told us that was the extent of our options.

Later, David told me the story from his perspective -- how nervous he'd become when the surgery was taking much longer than we'd been advised. How Dr. NHB hurriedly showed him the pictures of my insides and told him that "his wife's pelvis was in pretty bad shape." And then how Dr. NHB rushed off to his next procedure, which had been scheduled for 10:30 am. He told me that he'd talked to his mom about his fears and concerns, while waiting for me to return. It seemed pretty awful from both sides.

So here we are -- dealing with our new reality. I am glad that there wasn't anything more serious wrong with me. I had started to worry that the unexplained pain in my side would be diagnosed as ovarian cancer and that I would need an emergency hysterectomy. Neither was the case. This isn't so bad. Also, I am recovering pretty well. I am walking around the house on my own and could conceivably return to work by Monday or Tuesday.

On the other hand, after we meet with Dr. NHB for our post op visit in two weeks to have our final questions answered, we are down to our final option for having our own child.

IVF is it.

I am so intimated by IVF. Can we handle it? What if it doesn't work? Is it too much for us to take on? Are we "not meant to" have children of our own? What about adoption? How did we get here?

Oh God, how did we get here?

Today is the day!

We are off to the hospital now. The procedure is scheduled for 7:30am and our check-in is at 6am. Thanks for all of the well wishes. I really appreciate all of your advice, support and words of wisdom. I wouldn't be able to do it without you all!

Good luck to everyone. I will be checking in again soon.