Like Old Home Week

I had my annual appointment with Dr. Terrific today, and it was like going home after a long time away.  Crazy enough, it was good to see everyone.  It had been so long!  Dr. T and Nurse Excellent were there but Nurse Amazing had the day off.  I'm sure she'll be sad she missed us (me & my ute).  Dr. T was his typical goofy self, talking half the time in some bastardized version of English/Irish he made up on the fly.  You just learn not to ask . . .  :)

I went in with my typical barrage of questions and concerns and need for Rx refills, and as always, everything was addressed.  My main concern was that my periods have become almost unbearable since our failed IVF.  Because you know I love TMI, my periods have lasted a week with massive bleeding and clotting and hellish cramps.  A super plus tampon is lucky to survive two hours during the three-day heavy part of my cycle.

Therefore, we are looking at a hysterectomy.  Since the Englishman doctor knows I don't need my uterus anymore, it's a good option because things will only get worse from here.  I'm doing my research, but a laparoscopic hysterectomy is most likely going to be the best solution.  A full hysterectomy that takes my uterus and ovaries but leaves the cervix intact.  Done by Dr. T and maybe a robot (who better not be English or Irish!).  And I'm okay with it.  Get rid of the bad shit and avoid ovarian cancer while rubbing on hormone cream or wearing a patch to get me fixed..  Considering my hormones are out of whack, why not?

I just thought this pic was great & wanted to include it!

After a short time with the "dick stick", aka vaginal u/s, it was determined that my bum ute is dealing with adenomyosis, endometriosis, and more fibroids.  (God bless America, don't look at the fibroid pics on that link. Gag!)  Dr. Terrific, in his worst accent of course, said, "By God, get that bloody piece of crap out 'a there!"  Geez - crazy dude.


Because of these issues, an endometrial ablation is probably not the best answer for me.  DH and I are talking about the best option for me/us and we'll make a decision soon, even though I think our decision is made.  It's just a timing issue at this point and I'll probably need to look at paying for more effing medical costs again.  (Poor baby might now get new nursery furniture - ha!)

But don't worry my dear followers and loves . . . my barren uterus will be more than barren, but it will continue here to ramble on and on and on.  You know, I'm gonna be a Mommy someday!  Woohoo!

The PLAN

Sidenote: I had to call Dr. G&D's office today about obtaining my records, and (of course) it took a few calls just to execute a simple task. I asked them to send all of my charts to Dr. T's office, so he'll always have them and I can always access them. I honestly don't understand why patients can't get ALL of their chart. It IS my uterus. I should be able to have every single sheet of paper and film in that file. Makes me wonder what's really going on in that file if I can't have it ALL. Anyway . . .

I made it back home today, and I'm so glad. It's nice to be in a doctor's office where people are polite, caring, friendly, and doing their jobs as expected. Of course my blood pressure was high, but we aren't talking about that right now, are we? I'll try to make this brief, as it seems all of my recent posts have been close to the length of War & Peace.

Dr. Terrific and I sat down for my consult. Taking out my notes (dialogue) from the last discussion I had (and will ever have) with Dr. G&D, awesome Dr. T knew I was ready to get down & dirty. Dr. T first mentioned he heard that Dr. G&D has little sense of a personality. I told Dr. T he was wrong - that Dr. G&D has NO personality. He chuckled and said he was just being nice. :) He asked me to catch him up, and boy did I!

A brief analysis of points made by the FORMER RE, and Dr. T's responses. (not quoted, but very very close to his exact words)

Dr G&D, Point 1: No bicornuate uterus
Dr. T: told me he already knew that as he & I discussed last month. He just didn't see it during my lap surgery, which is when it would have been completely evident.

Dr G&D, Point 2: "MTHFR . . . is not associated with an increased in m/c."
Dr. T: Bullshit. We both know that isn't true. Especially for those who have the homozygous mutation. You will be taking Lovenox for your next pregnancy.

Dr G&D, Point 3: (speaking of Lovenox) I don't need to be on Lovenox for future pregnancies.
Dr. T: see response to point 2 (now Dr. T is getting agitated)

Dr G&D, Point 4: I can get pg, and if I make it past 8-10 weeks I might be okay.
Dr. T: I guess that's the fourth thing I completely disagree with now. WTH? (his words) A majority of fibroids cause problems in the middle of the 2nd Tri. Your losses have all been early, thus pointing to something else. I think it's a biochemical issue, which is why we need to do Lovenox.

Dr G&D, Point 5: Injectibles (Follistim) should be used to get pg quickly.
Dr. T: "And that's number 5."

Dr. T has been doing this for 23 years and has delivered over 8000 babies. Yet another reason why I value his opinion and trust him. (I have no proof of that with Dr. G&D.) I asked Dr. Terrific what he recommended. He told me that he couldn't make a choice for me, but he would give me the possibilities.

Possibility 1: Get pregnant (we know I can get pg) and start Lovenox the day I get a bfp. Continue with folic acid and baby aspirin. Close monitoring (including a perinatologist).

Possibility 2: Have a myomectomy which would include an abdominal incision, 1-2 days in the hospital, recovery time, possibility of breaking through the uterus, 5% need for blood transfusion in the OR for blood loss, scar tissue & making the uterine lining worse than it was. Then get pg, start Lovenox, continue folic acid and baby aspirin, close monitoring, etc.

Well, gosh. What do you think, my wonderful readers??? Well, I'm thinking Possibility 1 in case you're wondering. Dr. Terrific thought that would be a good idea, yet he also encouraged me to discuss it with DH. He then "scribed" (uh, scribbled!) our "PLAN" options.

PLAN A: SEX. Foltex. Lovenox.

PLAN B: Myomectomy. SEX. Foltex. Lovenox.

We're going with Plan A. In fact, we set PLAN A into action tonight. :) I'm pretty sure I've already Od according to my temps, but the PLAN is moving forward. It's so nice to have a PLAN. Please pray that this PLAN works to bring us not only a pregnancy, but a healthy pregnancy that ends with me delivering a healthy baby. That is all we want.

Lesson learned - ALWAYS TRUST YOUR GUT. A woman's instinct is one of the strongest natural forces out there. If something doesn't look right, feel right, or sound right, validate your feelings and go with it.

Thank you, Dr. Terrific. I'll be calling about checking my cervix in the garage very, very soon. :)

I need a secretary to take dictation.

I've had it.

Go the bathroom (or insert a catheter), get some popcorn (or a couple of meals), pour a cold drink (or ten), & let's see if I can get this down. I don't even know how to type all this crap out now. I need to get it out so I don't go completely insane and to help me remember when I do go nuts. Plus, I need the reminder in case I ever consider talking Dr. G&D ever, ever, ever again. Before I forget - I called the RE to whom I had been referred by friends and the first available appointment is at the end of February (aka as another cycle gone).

After the first call from Dr. G&D's office, my cell phone rings again. Two more times. While my class is taking a test! (Thank goodness for the vibrate ringer.) Dr. G&D wanted to at least do a phone consult with me. They asked if he could call me at 3:45. Sure. WTH.

So, the office calls AGAIN --- remember, they are efficient --- and when I call back, Dr. G&D is there to talk with me. I think he had enough sense to know that I am pissed at him and he is not my friend anymore. (I've been on the playground with the kids too much lately.) I was VERY short in my responses and my monotone voice showed my curtness, not courtesy.

Bottom line: I do not have a bicornuate uterus. I repeat, I do not have a bicornuate uterus. I do not have a septate uterus. I repeat, I do not have a septate uterus. WTF????? I'll be using a lot of quotation marks from here as I quote exactly what I wrote down while talking to Dr. G&D.

The HSG report showed "bicornuate uterus suspected." The MRI results "were not consistent with a bicornuate uterus or a septate uterus." He said on more than one occasion that my "uterine cavity is not normal." In looking at the HSG and MRI, Dr. G&D said that it appears there is a :uterine fibroid in the fundus (top) of the uterus." Another fibroid? And why is that damn thing STILL THERE? Didn't I just have surgery just 60 days ago to get all that crap out of my bum ute? I digress . . .

Dr. G&D also says that this is probably the only reason I'm having difficulty; that basically nothing else points to my losses. (I think he's more concerned than I am about WHY I've lost three babies. I've had to write off getting those answers to prevent me being taken away by the nice men with a three-armed white jacket.) I digress again . . . I responded, "Well, that and the MTHFR." He then states that "MTHFR by itself is not associated with an increase in miscarriage." Oh really, Sherlock? That's not what the research I've read offers. Through my research and talking with other women who have the MTHFR mutation, I beg to differ. Actually, I won't beg. I know that can't be true. There's just no effing way.

Then comes the suggestion that "we need to address the fibroid." As in send it a postcard? As in I need to send invitations to everyone for another hooha party? Dr. G&D vacillates between the facts that (1) I'm running out of time, (2) the fibroid needs to be "addressed", and (3) I need to get pregnant. I try multiple times to figure out what exactly he's talking about, and I begin to wonder if he even knows. (Funny that I would question that - AGAIN.) When I asked him what options he means, he says that it needs to be "addressed either abdominally or hysteroscopically." I think he's talking surgery. Again. The fourth in less than two years. Me = not happy. Still.

He continued to vacillate more than a cheap, old, metal fan with rust on it at your Meemaw's 100 year old house. He said that I could get pg, and if I "made it past 8 to 10 weeks" then things would probably be okay. How reassuring! I always spot in the sixth week of pregnancy (6w3d to be specific) and have miscarriages in the eighth week, so gosh, let's try the pg crapshoot again. I finally tell him that "I am getting mixed messages here. Are you saying that I need to get pg or have surgery?" I need one or the other. He finally says it - "Surgery."

Then I'm getting even more angry. I told him (while choking back tears because I cry when I don't scream) that "I wish I would've known this before the end of last year. I spent close to 1/10 of my annual salary last year, and this is STILL NOT FIXED." His heartfelt response? "I'm sorry." Asshole. That's just not enough. I then told him I needed to speak with my husband and ended the phone conversation.

Crying, I leave everything behind at school (and you have no idea HOW BEHIND I am right now) & trying not to completely lose my shit. For the bajillionth time in the past 22ish months, I have my personal cryfest in the car. I curse at people, I cry, and then the phone rings. It's DH. He knows I'm upset, so I tell him I talked to Dr. G&D and I'm not happy. We can talk when I get home.

Continuing on my quest, I call Dr. Terrific's office & leave a message with "Nurse Excellent" (Dr. T's wonderful, excellent, empathetic nurse) that I need to speak with Dr. T. She calls me back within twenty minutes and is not happy to hear what Dr. G&D said. When I mentioned surgery, Nurse E said, "Why don't you let Dr. T do it if it has to be done?" I hadn't thought of that. I told Nurse E that I will be contacting Dr. G&D's office on Monday to get all of my files together. "I want all reports, charts, films, and (party) pics. It's my uterus, and it will become a part of my uterine briefcase now." She wholeheartedly agreed. I'm going to become Rain Man after all by keeping my "red, severe injury book".

So . . . the next part of this screwed up story is a consult with Dr. T on Wednesday. If he can get me through this, get us pregnant, keep us pregnant, deliver us a precious little baby, and up my Prozac dosage in the meantime, then we might have a plan. He's my main man anyway.

Aannnnddd - SCENE.

As My Uterus Turns

After calling Dr. G&D's office multiple times in two days, I called him on his personal cell phone last night. He was going to be on my time for a change. I figured if i couldn't get an answer in a timely manner, that I would hunt it down (i.e., hunt him down). Thanks to my RE-chasing, the verdict from my HSG, MRI (and other hooha related fun) is in.

The HSG and MRI showed no septum, but it did show that I am sporting a bicornuate uterus.

The good news? No surgery needed. YEA! I'll get to enjoy the final days of 2008 without any more hooha parties!

The not so good news? A bicornuate uterus increases the chance of miscarriage (uh, ya think?) and early delivery/PTL due to a shortened cervical length.

Where do we go from here? Dr. G&D wants DH to go in for an SA since he hasn't had one before. (Might as well let DH see just a tiny glimpse of what I've been through the past 21 months.) Then we'll go in together, review the results, make a plan which will include injectibles (pray for donated meds), and go for it.

DH and I are both on Christmas vacation through the 5th, so we hope to spend this time relaxing, enjoying, and just hanging out. I hope all of you can find some time do the same as well!