Blissfully Ignorant

We won't get another call about our embabies until tomorrow morning. I have no idea what's happening or how they're doing. I think that's kind of a good thing though. As far as I know, we still have 9 little embryos. For today, I can pretend that they're all dividing beautifully and growing strong. I know that that's probably not true, but acknowledging or dwelling on that truth isn't going to make it any more or less likely to happen. I am worried about them, but I'm not feeling crazy with anxiety. When I think about them, I just say a quick prayer and go about my business.

Tomorrow, the panic will set it. Luckily my first class isn't until late morning so whether I'm going in for a Day 3 transfer or not, I don't need to be up until 7 AM. I'm going to try to sleep as late as possible to minimize the amount of time I have to sit starting at the phone.

Hopefully, this is what our embryos are doing right now:

On Day 3, they like to see embryos with 6 to 10 cells. If we have a good number of "superior quality" embryos, they will push us back to a Day 5 transfer. If things aren't going so well, we'll go in tomorrow to hopefully transfer our strongest little embryo. Best not to think about the other possibilities for now.

Official Post-lap Report

Today I was supposed to see Dr. M to check on my surgical site infection, but when I got there Justine said that he was going to do my full post-op appointment so that I didn't have to make two trips. I was nervous at first because Seth wasn't with me today, but I figured we had plenty of time to make decisions after I relayed the report to Seth.

First, Dr. M checked out my wound. He said it looks like it's healing fine which is great news. However, he still wants me to see an infectious disease specialist. He said that he doesn't have a lot of experience with MRSA and wants to make sure that I'm treated correctly. I'm glad that he was honest about it but I'm bummed that it's not over yet. My new insurance is a giant pain in the ass so I have to go see a PCP, get a referral from them, and then make an appointment with the specialist. Fun.

Next, we went to his office and Dr. M went over all of the results of my surgery. It was pretty much exactly what he and Seth discussed on the day of my surgery, with just a little more/different information.

1. I had Stage 2 endometriosis (very abundant, widespread, blah blah). Dr. M said that there wasn't enough to call it Stage 3 (no adhesions or scar tissue!) but there was absolutely enough to cause fertility problems. Almost all the endometriosis was removed.
2. A "strip of endometrium" (piece of tissue) and a small polyp were removed from my uterus. They were both benign. The "strip of endometrium" was pretty big, so now that it's been removed my uterus is nice and clear (thanks for the reminder). There were no other issues with my uterus.
3. The cysts were not on my ovaries like I initially thought but on both of my tubes instead. A large paratubal cyst was "obliterating the span of the fimbria" on my left side. A smaller paratubal cyst was also interfering with the fimbria on my right side. They "were both removed hopefully to improve ovum pickup". The cysts were also benign - everything was just endometrial tissue.

Dr. M said that the surgery went really well. He said he found exactly what he wanted to find. I'd have liked to have not found endometriosis at all, but I know what he means. At least we know what the problem is. Then he said something that I didn't expect. He says that he recommends that we do nothing for now. No treatment. Just try on our own for 3 to 6 months or however long we feel like it. He doesn't think clomid is a good fit for me and since we don't have an MFI issues, IUI wouldn't really be worth the extra money. Dr. M also said that he felt like I had a 50% chance of getting pregnant in the next six months.

I felt really, really disappointed. I cried. I cried in the office and I cried on the way home. Shouldn't I be happy that he doesn't think I need any additional treatment? I know that surgery is a form or treatment, but everything I've read seems to indicate that it may not really improve fertility rates. One study showed that the natural conception rate for women with Stage 2 endometriosis was only 44% for the first year after laparoscopic surgery. Two other studies reported that, even with superovulation, conception rates were only 2-15% per cycle for women with surgically treated Stage 1 or 2 endometriosis. Even Dr. M's "50% chance" just sounds like he's covering his ass. Really? You're 100% sure that I'll either get pregnant or I won't? Good to know.

Maybe I'm depressed or maybe this is the "IF brain" that I keep hearing about, but I'm having a really hard time feeling happy. I know that the surgery was important and helpful, I'm just having a really hard time believing that I'll be one of the lucky ones.

So that's that. We're just going to continue trying on our for who knows how long. I hate to end on a post on negative note though, so I'm going to try to focus on the positive.

The positive OPK I got today. YAY for a "normal" post-surgery cycle! The little smiley face is very comforting.

ETA: To be clear, I will be THRILLED if we don't need any other treatments. Obviously, that's what we always hoped would happen - to just get pregnant on our own. I'm just having trouble believing that it will happen that way and I'm afraid of giving the endo a chance to grow back. I'm just terrified of getting my hopes up too high.

FML

So today sucked.

I usually don't like to use the phrase "fuck my life" seriously because I have so much to be thankful for but today my life can go fuck itself.

Things started to head downhill this morning. For some reason, I started to worry about that blood work I had done last week. I logged into my insurance site and sure enough it said that the claim was "under review". Then I realized that there was a good chance that the testing would be considered infertility testing and I have zero infertility coverage. The charge for the test is a over $1000 dollars. I'm in big trouble if it's not covered. It was actually coded as "infectious disease testing" so maybe it will be covered, but I'm not counting on it.

I called Seth crying because I felt so bad. With the surgery and now possibly this, I've cost us so much money this month alone. I know this stuff isn't my fault, but I can't help feeling really guilty about it all. Of course, Seth doesn't want me to worry about it and I certainly wouldn't be blaming him if the situation was reversed, but I'm always really hard on myself.

Then, after lunch, I had a message from Dr. M's nurse Justine telling me to call her immediately. We all know that's never a good sign. I called her right away and she told me that the results from the culture of my incision infection showed that it was/is a MRSA infection. I think I said "Jesus Christ" or something equally inappropriate and Justine replied, "Right - so I guess I don't need to tell you that this is serious". She told me that they would to give me a new antibiotic immediately and that I needed to come in and see an "infectious disease" specialist. Really? I needed to hear that phrase twice today?

I started crying on the phone and I couldn't stop. Sure, I've heard horror stories about MRSA infections so I am worried about that aspect but honestly all I could think about was how expensive this could get. My new insurance doesn't start until September 1st, so right now I just have a crappy short-term plan. This feels like a nightmare. I mean, thank God, I found the temporary plan. It's not that awesome, but it's better than nothing. Justine was able to find a pharmacy that doesn't charge for the antibiotics so that's nice. Hopefully this won't require too many appointments or treatments.

Of course, the other thing I worried about was whether or not this would impact my "fertility". A MRSA infection near my reproductive organs scares the shit out of me. Even if it's not serious, we'll probably be benched again this month. I was so happy and hopeful. I should have known better.

I'm feeling okay now. I calmed down after Seth got home and I talked to my friends who know more about this than me. Tomorrow, someone will call and let me know when the doctor can see me. I just have to try not to think about anything for now. It is what it is and I'll have to figure out a way to deal with it.

Off the Bench!

Cycle day ONE bitches!!! 

This is the first time I've been happy to get my period in a long time and I'm going to fucking celebrate it. Today was CD25 before it turned into CD1 which is perfectly "normal" for me. Thank you, body. You may have endometriosis and you many not be able to get pregnant, but thank you for being so dependable. I am so grateful that surgery didn't fuck up my cycle. I mean, I guess there's still time for that but let's just enjoy the moment.

I am so pumped to be off the bench. I feel like this is the first time since we started TTC that we may actually have a chance. We have a meeting with Dr. M two weeks from today. At that point, I should just be starting the TWW. We'll be able to come up with a plan for next cycle so even if things don't work out for us this month, I feel like there is hope for us. After 13 months and 15 cycles of nothing, we're finally taking steps in the right direction.

Bonus: I'm feeling pretty good, all things considered. I have heard that the first post-surgery period can be absolute hell and that it can take a few months to notice an improvement in your pre-surgery symptoms, but right now my cramps are non-existent to mild. Let's see how long that holds up.

Keeping Busy

I've noticed that I haven't really been leaving the house very often. It started because I was working from home most of the summer, but then I stopped going out with people on the weekends. I noticed I was mostly avoiding people other than Seth as much as possible. Hanging out at home in my PJs is fine every once in a while, but I'm afraid it was getting towards the unhealthy side of the spectrum. We decided that we need to make more of an effort to get me out of the house.

Friday was a really nice day, so we went to the beach. We are so lucky to live so close to such a beautiful beach and I really need to take advantage of that more often. In the evening, we took the dogs to a nearby state park. It's nice and shady and when you're in the park you don't feel like you're in a small city/huge tourist town. Binky and Bear go wild at the chance to sniff new things. Plus, they love riding in the car to get to the park.

On Saturday, we took the water taxi downtown to have lunch. The water taxi is awesome (especially when you find a 50% coupon like I did). It takes you up and down the intracoastal canal and stops along the beach and downtown area. You're allowed to bring drinks on the boat, so we filled our little cooler bag with a few beers and enjoyed the afternoon on the water.

It DOES feel good to get out of the house. It keeps me from thinking too much and feeling like time is dragging by. I'm already planning for next weekend. We're either going to go to an MLB game or try a new bar that I read about yesterday - it serves all craft beers and has dozens on tap! My father-in-law and his girlfriend fly in on Sunday and they'll be here for two weeks, so I should have plenty of things to do to distract me for a little while!

BTW, update on my incision: It is infected. Justine, the nurse, was able to see me this morning and as soon as she took the Steri-Strip off we could see that it didn't look right. She called the doctor in and he took a culture and prescribed an ass load of antibiotics. Hopefully they do the trick! It's a good thing I went in because today is the last day of my good insurance. Starting tomorrow I have a temporary COBRA plan and I'd be paying out my ass for the culture. I also managed to sneak in some blood work today - they're checking my Anti-Mullerian Hormone (AMH) which might shed some light on my ovarian reserve.

Shit.

I think one of my incisions is infected. Both of them started hurting a few days ago - just extra sensitive if I accidentally touched them. I figured this was normal healing pain or maybe I wasn't be as careful since I'm not feeling any abdominal soreness anymore. The left side started hurting even more so I checked it out more closely today and it definitely looks different than the right side. It almost looks like I pulled the stitches apart a little bit and the wound was too open. Probably when I was high and running around freaking out about Bear and Binky. Fuck. Of course it's Sunday, so there's no one in the office. I guess I have to call first thing in the morning and hopefully I'll be able to at least see a nurse.

The after-care "Surgical Site Infections" sheet can go fuck itself, by the way. It says that most infections can be treated with antibiotics but some will require another surgery in order to be treated. I don't need to hear about that possibility, just surprise me with that info later please.

Fingers crossed that it's not infected or can be easily treated.

Finally, some answers!

Well, after going through the laparoscopy and hysteroscopy on Thursday morning, I'm finally feeling a little bit better. My pups are feeling better as well - they never got sick after leaving the vet so I think it's safe to say that they're going to be fine.

So. About the surgery.

Surgery day and Recovery - I arrived at the hospital around 6:30 AM and they took me straight back to the prep room. I changed into a surprisingly comfortable gown and they put me under a nice little heated blanket. The nurses asked me a bunch of questions and then they hooked me up to an IV. Seth and my parents were allowed to come back to sit with me while I waited. For two hours.

Finally, Dr. M came back, explained exactly what was going to happen, and then it was time to move to the operating room. The nurse gave me some meds through the IV to help me relax. They wheeled me into the operating room, I read a sign that said "Biohazard", and the next thing I remember is waking up in the recovery room. I never even saw the anesthesiologist. So that was nice.

The nurses gave me some medicine for the pain and nausea before I left the hospital (around 1:00 PM), but the nausea was pretty unpleasant for the first few hours. I ended up getting sick on the way home, but luckily I had my supply of saltines and ginger ale. That was really helpful until I was able to take some Zofran when I got home. The nurse also gave me a cold cloth to hold on my face and that also helped me feel better.

After the drugs from the hospital wore off, the pain in my abdomen was pretty intense. Not the worst ever, but bad. Vicodin sucks. I think I'm immune to it. It really didn't do much for the pain so I couldn't get comfortable enough to sleep. I was hoping it would at least make me tired so that I would pass out, but no luck. I didn't sleep at all on Thursday and I only slept for a few hours off an on Thursday night. That really sucked. On Friday, I was able to take some Tylenol 3 instead and even though that's not as strong as Vicodin, it worked much better for me. I was able to get some rest and slept pretty well last night.

Now, the pain in my abdomen isn't unbearable. I have one spot on my left side that hurts a lot, but otherwise it feels like I just did a really intense ab workout. I think I'll probably be feeling back to normal in a few days.

The bloating and constipation are unreal. Colace did absolutely nothing. My friends who have been through this before recommended I try a laxative, but it's still not working. It sucks.

Initial Diagnosis/Results - While I was in recovery, Dr. M went out to talk to Seth (and my parents). This is what he found during the surgery:

• The endometriosis was "extensive and widespread". It was everywhere - covering my ovaries and bladder and also all over my bowl, rectum, and abdominal walls. He was able to remove most of it, but it's too risky to get all of it from the bowel and rectum so that had to stay. Dr. M said he would classify it as Stage II endo rather than Stage III because he didn't find any scar tissue so that's good news.

• There were a few "insignificant" polyps in my uterus. Those were removed and they'll be sent out to be tested, but chances are good that they're nothing to worry about.

• Several cysts were removed from my ovaries (maybe just the left one, I'm not sure). The cysts were partially blocking my left tube. When they were removed, the little fingers on the tube were able to open up completely. The cysts were not endometriomas. For some reason, Dr. M thinks that they have been there since I was born. I have no idea why he thinks that or why they didn't show up on any of the ultrasounds, but I guess we'll find that out later.

Overall, I'm feeling pretty positive. I am 100% sure that surgery was the right choice for me/us so that feels good. I'm also relieved to know that I'm not crazy and that I wasn't imagining the pain. While it absolutely sucks that I have endo, I am grateful that it is only stage II and that most of it was removed. Now we know why my left tube looked funny on the HSG. It's great to know that the tube isn't obstructed anymore. It's nice to know what was causing the pain on my left side and hopefully now that the cyst is gone, that will go away.

Obviously, our plan is still to try to get pregnant as soon as possible. We want to make the most of this time after surgery when we know that the amount of endo present is minimal. My follow-up appointment isn't until September 6th, so we won't be starting treatment during my next cycle (#16). After that, I think we'll be moving to medicated TI or IUI. For now, I'm just going to try to stay positive. I know that surgery isn't a magical fix for infertility, but it was definitely a necessary step for me and I'm so glad that it's over!

Prayers for my Pups

When we left for the hospital this morning at 5:45 AM, I just grabbed my wallet and left my bag on the dining room table. When we got home, my bag and all of it's contents were on the living room floor. I freaked out because I had two (almost empty) packs of gum and I know that there's an ingredient in sugar-free gum that is toxic to dogs.

Awesome just what I needed. I may have gone a little nuts, but I couldn't help it. I was already feeling sick and anxious and I just completely panicked. We can blame the drugs, but I would have been just as worried any other day. I felt super guilty since it was my bag and I should know better.

First Seth tried to get them to vomit. Binky did and we could see that he ate the gum, but Bear was being stubborn. So we called the vet and they said to bring them in immediately. Thank God that my parents are here. Seth and my dad took the dogs to the vet and my mom stayed home with me.

The vet got Bear to vomit and it didn't look like he ate anything. However, he got really sick so the vet gave him so fluids through an IV. She wasn't worried about Binky since is seemed like he got rid of the gum. We just need to keep an eye on them for the next 24 hours. If they act weird or get sick tomorrow, we have to take them in right away. I feel a little bit better now. We found out that they had only been left alone at 1:00 o'clock and we were home by 1:30, so Binky didn't really have time to digest anything. If you can spare some prayers or good thoughts for them, I'd appreciate it very much.

My poor little babies. This picture isn't from today, but this
is what they look like after getting sick this afternoon.

As for me, I'm okay. The surgery went really well. I was sick earlier and I'm feeling a lot of pain right now. I haven't been able to sleep at all since I woke up at the hospital, but hopefully I will get some rest tonight. I do/did have endo, so I'm really glad that I decided to do this. I'll give a full update tomorrow after I calm down and get out of my drug haze.

Preparing for the Laparoscopy

Less than two days until my surgery. I'm really nervous. Mostly about the anesthesia. This will be my first time going under the full anesthesia with the breathing tube and that freaks me out. I'm feeling okay about the actual surgery though. I feel really comfortable with my doctor and I'm looking forward to getting this over with and finding out what's going on. If there even is anything.

Since we scheduled the surgery, I've been doing a ton research to figure out what the recovery will be like and what I can do to make that easier. Luckily (for me, not them) I have two friends that have had laparoscopies to remove endometriosis in the past so they were able to give me a bunch of tips as well. I figured it would be a good idea to make a list of what I have and, after surgery, what was actually helpful in case I ever need to do this again or in case anyone reading this needs to go through surgery as well. So here is my           Pre-Laparoscopy Checklist:

1. Loose clothing - Doctor will make three incisions in my lower abdomen and I'll also be puffed up with CO2, so it's a good idea to wear loose clothing to the hospital. I bought a cotton t-shirt and a pair of PJ-ish sweatpants that are a few sizes too big. Seth was surprised that I "needed" a new surgery outfit. Duh.
2. Prescriptions - Picked up all of my prescriptions a few days ago so I don't need to worry about it on the day of the surgery. They, and all of my other OTC supplies, are in a box next to my bed.
3. Heating pad/hot water bottle - I've heard that one of the most painful things about the recovery is when the CO2 moves around and gets trapped around your shoulders/collarbone. A heating pad should help the gas get re-absorbed more quickly and ease the pain. I have a really awesome memory foam heating pad. It was a birthday gift from Seth. He also gave me a TempurPedic pillow and a bottle of vitamins that year. I believe I was turning 65 25.
4. Over-the-counter supplies - Your throat may be sore from the breathing tube, so I picked up my favorite throat lozenges. Gas-X can help with the extra gas and bloating. I've also seen Colace (stool softener) recommended many times. I forget why - either the pain killers or the anesthesia can mess with your digestive system and since your abdomen is already in pain you don't want to get...blocked up. I also grabbed some baby wipes and tissues. Just because I felt like I might want them.
5. Mild foods - The anesthesia and pain killers can make you feel sick, so it's a good idea to have some bland foods handy. My friends recommended saltines, graham crackers, ginger ale, and mashed potatoes. I also picked up some gatorade to help with the bloating.
6. Movies/books/activities - My friends told me that they weren't in too much pain for long, but they felt a general crappiness for a few days after the surgery and spent a lot of time in bed or on the couch. I picked up a few books from the library and I have my yarn and crochet needles to keep me occupied.
7. Clean sheets - Tomorrow, day before surgery, I'm going to wash my blankets and put fresh sheets on the bed. I hate when sheets feel "old" and if I'm going to be spending a few days in bed I want everything to be nice and clean.
8. Pillow and plastic bag - Apparently it is a good idea to bring a pillow with you so that you can hold it over your belly during the car ride. I think I'll ask my dad to drive. Seth's a wild driver - too many years driving in Guatemala City. The plastic bag will serve as a barf bag. Yay.
9. Baby gate - This one makes me really sad, but I think it's necessary. We're going to put up one of the gates in my bedroom doorway so Binky and Bear can't get in. I know they'll want to jump in bed and snuggle with me, but it's probably not a good idea. They think they're lap dogs, which I love, but I might not want 50 lbs resting on my stomach for a few days.

They hate being separated from us. They also haven't figured out that they could easily
A) jump over the gate or B) bust right through it.

I think those are the highlights. We'll see what is actually helpful (the new surgery day outfit is going to be key, I know it).

This morning, I went to the hospital so they could collect some blood. I'm scheduled for 5:30 AM on Thursday, but they'll call me tomorrow afternoon to confirm that. My parents are arriving tomorrow morning and I can't wait for them to be here. Having them here will make the day go by quickly. Before I know it, it will be Thursday afternoon and all of this surgery bullshit will be over. I can't wait for that!