Successful Surgery

Well, we arrived at the same day surgery area of the hospital around 7:45 a.m. I got my wrist band and then headed up to the second floor - Same Day Surgery area.  Once I got checked in, the nurse took me to a room where I got to change from my comfy clothes to the most stylish hospital gown - LOL.  The best part was while sitting in the chair she brought me one of those lovely heated/warmed blankets - oh, so nice and toasty!!  She took my vitals, which I have to admit I was a little worried about my blood pressure.

At my consultation last week it was 160/80, which I guess the top number was a little high, but it didn't cause any red flags.  There's something about going to the doctor's office, I'm fine until they call my name to go back and then I can feel my heart racing.  It's funny because I don't think I'm worried or anxious about doctor visits, but when they say my name it becomes a different story.  I know when I phoned Same Day Surgery on Friday to find out what time to arrive, she said they have patients arrive early enough to check vitals especially blood pressure. 

So, all vitals were fine - no fever, negative pregnancy test, pulse good, and blood pressure 142/70.  After a brief discussion with the nurse then we waited.  We waited a little over an hour before I finally was taken (walked over through the catwalk) over to pre-op.  Once I was in pre-op they got the IV going and gave me two meds in the IV - one for nausea and then the other to relax me.  I remember going into the OR, moving onto the operating table, and talking with one nurse about my freckles while the anesthetize nurse had me breath deeply through the oxygen mask.  The next thing I knew I was waking up in the recovery room.  After a few minutes, they moved me back to my initial room where I started the morning & Jay was waiting for me there. 

Jay said the doctor said the surgery went well.  The lining was a little thinner, still thicker than normal, and there were no polyps, but as protocol it gets sent to pathology.  If there's anything concerning we will know by Monday or early next week. 

Evidentlly to get to go home there were a couple of things I had to do before they would discharge me:
1.  eliminate - tinkle, pass fluids
2.  eat & drink without getting sick

Once I arrived back in my room, I had to use the potty - YAY!! one down and one to go before I can go home.  The nurse came in and took my vitals - all good.  I was so relaxed my blood pressure was 124/55.  Then she brought me some saltine crackers, graham crackers, Sprite, and water.  I ate my gramham crackers and drank the Sprite with no adverse effects. YAY!! two down now I can go home.  Another nurse came in, removed my IV, and walked with me down to the first floor (took elevator, but she left me there in the waiting area for Jay to return from getting the van).  I walked out on my own to the van. 

I was a little groggy during the ride home.  We got home a little after noon and when I got my coat off and talked with the kids a little bit I was pretty awake AND hungry.  So, I had a bowl of homemade chicken noodle soup, string cheese, some pretzels, and two cookies - OH, and a glass of water.   Then I was tired, so I went and slept for a little while.  I'm starting to feel a little tired again, but I think I'll just wait till bed time.

I feel okay.  They gave me an intravenous pain med that was suppose to last 6 hours, so I think that wore off about an hour ago, but I feel no pain.  YAY!!  They said it might feel like really bad menstrual cramps, but I explained to them I hae a very HIGH tolerance of pain.  So, if I become uncomfortable I'm suppose to take Ibuprofen. 

My follow-up appointment is in three weeks.  I'm not sure if any of those "that's for another day" conversations will be had then or if it will just be regarding the surgery.  So, we'll see. 

On a personal note,  the kids were taken care of by their lovely big sister - THANK YOU, Cassie.  When I got home, Zack & Mackenzie had my bed ready and a bell for me to ring.  Plus they had made me some really cool get well cards.  I love my kids!!

Tomorrow's the Day

Tomorrow is "surgery day."  At least I will get a good night's rest before going in.  Today was our last morning of getting up at 4:00 a.m. to deliver papers.  So that means I'll actually get a full night's rest before going in for surgery. 

I'm hoping for an uneventful & quick surgery.  I anticipate I'll probably be tired tomorrow and sleeping while the anesthesia wears off.  Who knows, maybe I won't be as drowsy afterwards since the surgery is only anticipated to take less than 30 minutes.  Apparently, I will spend more time in the morning in pre-op waiting for surgery than I will in surgery and post-op combined. 

Surgery scheduled

Well, Jay & I went Monday for my surgery consultation, pre-op appointment, and surgery registration.  The doctor of course had to review my medical history, so that entailed discussing my crazy menstrual cycle, the seven miscarriages over the last nine years, and our intentions to conceive again . . . perferably on our own.  All of which, she seemed to find intriguing, but would have to be discussed in greater detail at a later date and time because the D & C is here and now.

In coversation she did inquire if they had ever checked me for a chromosomal disorder or an anitbody because the fact that I can get pregnant and miscarry early are usually indicators of one or the other.  Which I have to say, I'm not sure if that avenue has ever been traveled, so she said we'll discuss that at a later time.  She also inquired about what avenues of fertility we had used and I explained several cycles of clomid over several years, but in '07 we did three cycles with clomid, the HCG to stimulate ovulation and then IUI's.  She was very curious why the IUI, especially since Jay's swimmers are "super swimmers."  We told her we weren't too sure other than to increase the odds of conception. 

Then I explained the doctor had recommended after those three cycles, it was time to be aggressive, and move on to the next level of ovulatory medications (daily shots) to increase the odds of conception.  I explained to her that I wasn't ready for that then or now so we haven't pursued any other fertility specialist assistance.  She agreed too that she wasn't even ready for me to move to the next level because I could get pregnant but just wasn't staying pregnant.  So, that was comforting.  However, because of my history of miscarriages she said if we get to the point where we would like medical information about conception she would refer/recommend us to a reproductive endrocronologist that comes in from Fargo once every other week. 

Now back to the surgery.  The D & C is scheduled for Mon., Feb. 8, 2010.  She went over the surgery, the recovery, and the possible side effects.  She also said that possibly, just cleaning/thinning the uterine lining may help with my fertility, and hopefully help regulate my menstrual cycle.  Wouldn't that be awesome if it were that easy!! 

Consultation Rescheduled

Well, Jay & I were suppose to go for my surgery consultation tomorrow, January 27, 2010.  The automated system even called me last night to confirm and remind me of my upcoming appointment and also explained if I needed to reschedule to phone the office during office hours. 

No. I don't need to reschedule.  I want to get this done and over with so I have a healthier reproductive system/monthly cycle, get rid of those nasty bad (could turn into cancerous) cells.  Then hopefully make some progress on conceiving another child.  We're good.  Jay was suppose to be at a three day retreat returning in time for my consultation, got permission from the bishop to leave early - as if he really needs permission.  Then because of the winter storm, turn into blizzard, the retreat was postponed till next week, Mon., Feb. 1st - Wed., Feb. 3rd.  Which could present a conundrum because I was originally told the surgery would be Feb. 1st or 8th. 

I was also trying to figure out if I could postpone the surgery till the 15th because I was suppose to be delivering papers till the 12th.  Well, I got excellent news yesterday that they have found a replacement carrier that wants to start Feb. 1st.  Great.  If need be I can have my surgery on Feb. 1st if the doctor has an opening. 

Then the phone rang this morning.  It was my doctor's secretary/receptionist.  Apparently, my doctor needs to reschedule my consultation.  To be honest, I was a little upset, but she was originally on vacation this week and had to get some appointments in.  Well, apparently her surgery schedule is light on Feb. 1st so she is moving some of her appointments to, yes you guessed it Mon., Feb. 1st.  You know when my husband is suppose to be at a retreat 3 1/2 hours away.  They moved my appointment to Feb. 1st at 2:00 p.m. I asked if she had any other times, but of course not for a few weeks, and she would like to see me sooner than later. 

So, either Jay is not meant to go to this retreat and leave his family for three days or he's not meant to go to the consultation.  It's a sign, a sign of what I'm not sure.  And now I have to wait to discuss what options will be available and what the doctor recommends until Mon., Feb. 1st.  I'm hoping she will be supportive and understand why I am not ready to give up on having another child.  I miss my OB/GYN back home.

Why share now??

One might ask, "Why now? Why share your struggle?"  You see we have been stuck between these two worlds ever since 1996, but it has really been evident since 2001, and there is always a trigger, a reminder, of our struggle.  When those triggers arise, there is a waterfall of emotions.  Sadness. Anger. Frustration. Heartache. Loneliness. Such triggers include the arrival of the monthly visitor, an announcement of an expectant parent, annual doctor's visits, our kids talking about wanting another sibling, and most recently a medical diagnosis.

You see, prior to our first miscarriage, in October of 2001, my monthly visitor arrived like clock work every 28 days, but after our loss there was no rhyme or reason to her arrival.  Which made (makes) trying to conceive more complicated. Of course, not one doctor can pinpoint the cause.  They can rule out reasons, but can't explain the difficulty of getting pregnant nor the cause of the seven miscarriages.  At one point, I was told, "Well, you can get pregnant, but you can't stay pregnant."  Keep in mind, getting pregnant didn't come easy or quickly though.  What might typically work for one couple actually seems to make our infertility worse.  Clomid & progesterone treatments actually had adverse effects on my ovulation rather than helping.  Doing nothing gets us no where, but trying something seems to work against us, too.

With our recent move to North Dakota and with my medical history I thought it be best to establish care and at least have an annual done since it had been almost two years.  You see, the females on my mother's side of the family seem to have issues to with their female health and with that family history I want to stay on top of things.  In 2003, my mother was diagnosed with Complex Hyperplasia with Atypia of the endometrial lining and had to have a hysterectomy.  I never even thought about it.  All of my doctors know my medical history and I thought I had shared my mother's because typically we inherit our mother's ailments. 

At my annual visit, in November '09, the physician's assistant asked the typical questions and did the exam.  Well, after the exam she recommended an ultrasound to evaluate my endometrial lining because of my sporadic cycles and heavy bleeding.  She explained to me that my symptoms could be an indication of a condition known as hyperplasia. Oh yeah, my mom had that. : (  Well, based on my age, being over 35, this condition is common especially with my given symptoms. 

Sure enough, the ultrasound indicated that my endometrial lining was at least three times as thick as it needs or should be.  So, in early December I had to go in for an endometrial biopsy.  Of course, the week I waited for the results all I could think about was my mom and how she had to have a hysterectomy.  What if I had it too?  What if I have to have a hysterectomy at the young age of 37?  We still want to have another baby, if I have what my mom had then that will never happen and it won't be my choice. 

Well, I went in for the results and found out I have Simple Hyperplasia without Atypia of the endometrial lining.  What does that mean?  Hyperplasia occurs when the cells of the endometrial lining grow abnormally and thicken the lining, and some kinds can lead to uterine cancer.  There are four stages and I have the earliest stage, where as my mother, by the time she was diagnosed, was at the final stage before the cancer.  As with any disease, early detection and treatment is the best defense. 

Well, the first approach of treatment, especially since we want to preserve my fertility (LOL) is a few months of hormone treatment, progesterone specifically, to try and thin the endometrial lining, naturally - if you will.  The PA explained the progesterone would/should thin the lining and while on the meds, I would not have a menstrual cycle.  Now keep in mind none of this made any sense. Number one, if the lining is suppose to thin, where's it going to go if I'm not menstruated. Number two, over the years I had been put on progesterone the last half of my cycle to help sustain a viable pregnancy - yeah, it never worked either.

Of course, I'm not the typical patient.  Six days after starting the meds, I started spotting then bleeding and after two weeks of bleeding I phoned the doctor's office.  The doctor on call reviewed my file and said it was find my body was just adjusting to the meds.  Well, another week went by, so now I had been bleeding for three weeks, so I phoned the office again to inquire because it wasn't letting up, it was getting heavier.  The next day I had to go in for an ultrasound to see what was going on and see if the meds were doing what they were suppose to be doing. 

Remember, I'm not typical.  The meds were not working like they should have been.  So, now the doctor has recommended a D & C (Dilationa and Curettage) to clean out the abnormally thick lining and cells.  Jay & I go Wed., January 27, 2010, for the surgery consultation, pre-op, and registration.  Of course, the PA said the doctor's recommendation is to go on a low-dose birth control after the procedure to prevent the lining from developing the hyperplasia again.  I reminded her we are still hopeful of conceiving another child. So she said she would leave that for us to discuss with the doctor at our consult. 

The assistance of an Infertility Specialist

As we have one foot in the world of parenthood and one foot in the world of infertility, we have tried, and are still trying, to find a balance.  I keep thinking the time will come when my heart will be lightened and I will be content and no longer longing to be pregnant, to feel life within, and to call a baby mine.  But until that time comes, we still try to find a way to make it happen. 

As I mentioned earlier, from Aug. 2006 to March of 2007 I focused on my health and losing some weight in hopes that would be enough to jump start my reproductive system.  Unfortunately, it wasn't enough.  So, from March 2007 - May 2007 my OB/GYN had me do three cycles of Clomid with Metformin to see if we could achieve a viable pregnancy.  No. Nothing. So it was time to be aggressive and she referred us back to the infertility specialist.

Well, we actually had insurance that covered parts of treatments - office visits and some medications, but not all meds and not other parts of treatment.  So Jay & I discussed it in great detail and we weren't sure how we could afford the parts that weren't covered.  We decided to meet with the doctor in June so we could discuss with the him our options.  The visit went well, but the statistics for an unassisted pregnancy based on my age (approaching 35) and history, especially the multiple miscarriages, were grim.  He stressed the importance of being aggressive if we wanted to achieve a viable pregnancy. 

We were aggravated because of all the losses we had and here we were being told that it was still going to be extremely difficult for us.  It didn't make sense, and to make it worse someone close to us was pregnant with twins - someone that wasn't even trying, was on birth control, and was content with her family size of two children when she found out she was pregnant.  It happens all the time around us, in the world, someone doesn't plan a pregnancy, doesn't want anymore kids, yet they are given this gift.  Then you have all those so-called parents that hurt their children -- WHY?? WHY have they been given such a gift that they don't want, don't long for with an aching heart, haven't prayed for, and don't take care of and rear in a loving home with discipline and guidance?? 

As we had explained to the doctor, we were only willing to go so far with his assistance because we felt blessed for the three children we have and we felt that certain procedures were reserved for those who still had empty arms.  He helped explain the financial aspect of our choices and wrote the orders for the first cycle.  We applied for a fertility loan to help cover the expenses that the insurance wouldn't cover and from June 2007 through October 2007 we were under his care.  We went through three cycles of oral meds, mid-cycle ultrasounds, a monthly injection, and IUIs to find out we finally achieved a pregnancy in October (the September cycle was a success) to only have it end in a miscarriage. 

The doctor's recommendation was with three failed cycles it was time to step up the next level of meds (daily injections); however, I wasn't ready.  So, we took three months off and then in February 2008 I requested that all unused funds be returned to our lender because I still wasn't ready to subject myself to fourteen days of shots and continue all the other invasive procedures.  I just wanted to get pregnant on my own. 

So, here we are in January of 2010 and we are still hopeful that it will happen.  However, now I am dealing with the latest diagnosis, one that has provoked an emotional roller coaster. 

Stuck between two worlds . . .

So, have you ever been stuck between two ideas or two places and didn't know which way to go or just felt like you didn't belong in either place?

On the outside, I look like a mother of three beautiful healthy children, which I am. So, I have three children which means I can't be suffering from infertility. WRONG!! When people see us out and about we look like the typical American family – husband, wife, and three kids. You know you don't know a family or a couple's story because they don't wear it. A friend best said it, when she stated, "I just assumed, maybe as many do, that you happily had three and decided that was your "number."  Our kids are older now, so when looking one might think we have completed our family. I don't wear a badge that says, "Mother of three here in this place, seven angels above, and still longing for one more here in this place."

So one foot is in the world of parenthood and the other is in the world of infertility. We didn't decide three was our number, we had a family plan and four was the number we wanted, still want. Even though we are stuck between two worlds, society doesn't or isn't sympathetic and dictates we are not part of the infertility world. We have had family and friends tell us we should be thankful for the three we have and leave it at that. What they don't realize is those words cut like a knife because we are thankful for our three children but we agonize over the loss - our loss.

Not just the loss of each pregnancy, but the loss of being pregnant and having another baby/child to raise as our own. I have come to the conclusion, unless you have experienced this loss, it is too hard to understand what a couple is going through. Please understand, I would never wish this loss, pain & suffering even on my worst enemy. I know I can't understand the pain and suffering a couple or a woman is going through that still has empty arms, but they can't understand the pain and suffering Jay and I have and are going through either. Every couple's journey to parenthood is their own and every couple's pain and suffering to get to parenthood, whether it be to the first child or the fourth child or the tenth child, is their own and doesn't lesson or isn't limited because they have entered the world of parenthood.

Every time we visited a fertility specialist we treaded lightly because we weren't sure if we belonged there, in the world of infertility. When I would sit in the waiting room, I remember feeling sadness for the other couples who sat there, too. Not knowing their individual story made my heart ache. I do have three beautiful children, but what if they still had empty arms, should I be there taking up the doctor's time???? We discussed these emotional feelings with the doctor on our initial consultation, and he reminded us infertility was infertility – primary was no different than secondary because they were caused by the same thing. We were all there for the same reason. We all desperately wanted to have a baby.

So, here we are with one foot in the world of parenthood and one foot in the world of infertility.