Monday, October 30, 2006

IUI #1 Completed

Last news I got was that we had to move in December, so we only have two more cycles at WHMC! When I went in for my CD12 monitoring, I (fortunately) got Dr. J (the bestest, most understanding and accomodating), and he agreed my next two cycles can be IUI's! Hooray! The morning monitoring was interesting to say the least. I got #1 for Ultrasounds, but the residents had screwed me up by telling me last week NOT to get my blood drawn. Come to find out, I had to get it done. By the time I found that out, about 10 people already had lab #'s. So I waited a while, I think I was the last ultrasound of the morning monitorings, but I was out by 8ish, so no big deal. I'll know better, my instinct told me to just get a blood lab #.

Here were my CD12 numbers's:
E2: 1011
FSH: 3.4
LH: 12
Left Ovary: 14.5, 17.9, 16.4, few less than 10
Right Ovary: 14, few less than 10
Lining: 8.4

As this was Thursday, the doctor said he'd either want a Saturday (CD14) or Sunday (CD15) IUI. He told me to come in tomorrow to see if my LH was surging yet, and if it wasn't we'd do Sunday. I came in Friday (CD13) and got:
E2: 1447
FSH: 2.8
LH: 12

I picked up my HCG shot (Novarel) and was given instructions on using it. WH is doing studies on pregnancy with 12hr or 36 hr post-trigger IUI's. I'm in the 12-hr group, so J gave it to me intramuscularly on Saturday night. I was anxious leading up to it, but the dr called that night to make sure I felt ok (see why I love him?). J did so well (precious husband) that I didn't even feel it, though I did ice the area for 10 minutes beforehand and sang loudly as he injected it. Still, months ago when I mentioned the future possibility of needing him to give me shots, he insisted he'd never do that. When it came down to it, he agreed. Much better than giving it to myself (the doctor wasn't in favor of it for this shot my first time)

Sunday morning was the Big Day: my IUI. Everything went perfectly, and it was only slightly painful cramping for an hour or so. A resident dr and my fav dr did the procedure. Later, when all the follicles were releasing their eggs, my left ovary hurt immensely for the rest of the evening. It was the one that had 3 follicles. I was so very glad to know what was going on and that everything was timed so perfectly. Although - for what it's worth, I chart religiously and my temp shot up that morning. I imagine I already ovulated at least the biggest egg. I asked the doctor about it but he said it should be ok. I'm a little upset they don't do ultrasounds or blood draws on the IUI day, but I guess their philosophy is, we're going to do it anyway, why waste the resources? Sperm count post-wash: 95 million, 55% motile.

I also want to mention, I know I've expressed frustration with the military infertility clinic here. Well, 3 visits ago, for my hysteroscopy and baseline ultrasound, I got another of the 4 staff doctors, but one I hadn't met. I have finally learned who the staff doctors are, and who the residents are, and that the only people with authority and real knowledge are the staff doctors! Anyway, I got Dr. J and he was completely different than the others. Very willing to work with us, initiated asking me how long we'd be in San Antonio, and offered to put us on a faster track since we wouldn't be here long. He's not all caught up in the schedule of how things should go, he calls me personally to verify or inform me of things, and he is sincerely kind and personal. Plus he's good. He answers every question I can think of. So I'm thrilled. From now on, I'm going to try to get appointments with him. So here's hoping for some good news in 2 weeks. But if not, we shall try, try again.

Thursday, October 19, 2006

Hysteroscopy Update

Good news! The hysteroscopy went wonderfully! They did not find anything unusual or bad in my uterus, they said it looked great. (So the Reproductive Endocrinologists were right, the Radiologist was wrong.) I was able to watch it all and it was quite interesting; I'm thrilled to know what the inside of my uterus actually looks like. I was given a Valium took take an hour beforehand, and although I didn't feel it doing anything, the firend driving me told me I wasn't giving appropriate answers at times (too slow)! When the doctor initially came in to introduce himself to me, he told me I wasn't acting like someone on drugs. :)

It did take about 20 minutes (as they switched cameras once) and was a bit painful (very manageable and only real hard for a few minutes). Nothing like the HSG. I have never felt so well taken care of at the clinic there. For my other appointments I've felt rather like one face in a million, and as if they were always rushed/busy (or sent me resident doctors who didn't really know much). This time, Dr. J (a head dr) came in early and talked to me (never had him before). He had the kindest bed-side manner I've ever seen in a dr - even let me squeeze his hand during a painful part! They had 2 resident dr's doing the procedure, they were nice and pretty gentle. Then Dr. M (another head dr) came in later to watch during the hysteroscopy also. So I felt like I was really being looked after. Then they did the ultrasound and one cyst was gone, one was down to 1.5 cm from 4 cm (the corpus luteal cysts from too much clomid, 100 mg). So all was good. I will go in next Thursday for my next ultrasound.

Even though I would have liked them to have actually found polyps or something easy to fix (how I hate being unexplained!), I'm still glad of it. They also learned that we have to leave San Antonio for Georgia in January, so they'll do IUI next month if this one doesn't work. They undertand there's a little more priority for us, so I'm thrilled. I'd rather conceive naturally, but while we're here, I want to give it our best shot possible.

Tuesday, October 17, 2006

Upcoming Hysteroscopy

Well, yes, another cycle without a pregnancy, but God has had lots of things scheduled for these upcoming weeks, so I'm encouraged. I think I've taken this "failure" better than any other (except maybe the 1st couple of months, before I realized how long this would take). I really only dealt with some tears and hurts for a few minutes, and J held me and kissed me and comforted me, and then it was over. Really a blessing. I give God the credit for that.

So, Thursday I go in for a hysteroscopy. (This is where they take a camera into the uterus so they can see exactly what's in there.) The doctors re-reviewed my HSG and determined that they aren't necessarily changing their first analysis, but they are recommending a hysteroscopy so they can actually see what the "abnormal filling" is. They said that if it were polyps, they would not allow a fertilized egg to implant!!! I'm really hoping that's been our problem all along, and that they can do an in-office precedure and remove them (rather than an anasthesia & later appt). Anyway, that's also the day of my baseline blood work and ultrasound. They will check on the growth of my follicles, and my endometrial lining, and then tell me when next to come in.

From then on, I'll be checked fairly regularly like this, and when the follicles are considered mature enough, I will either get or administer to myself a shot of HCG, to induce my body to ovulate. This is just a part of how they do monitored cycles. I do not need it, but it's procedure. That's fine with me. My body has always ovulated nicely, and for the last cycle my 7 DPO progesterone level was a 98!!! That's a great number! They only look for a 10 or 15 on a medicated cycle (the higher the number, the stronger the ovulation). Anyway....

Tuesday, October 10, 2006

ER Visit!

I So know I'm not the only one on on an unmonitored Clomid cycle, but I have been warned it isn't safe. I have asked to be monitored this 2nd cycle, but the doctors refused. Now I'm mad.

First off, let me say that on Friday J and his 2 brothers left for a wild boar hunt. They were out where there is no cell service, and the little cabin only runs on a generator (no toilet, even), so no phone whatsoever. His 15 year old sister C was staying with me and we'd planned a fun few days. The boys weren't to return until Sunday evening.

I went to bed Friday night with strong lower abdominal pains. Felt like gas. I slept and awoke at 2:45 in severe pain. I went to the kitchen for a Gas-X and my vision got black for 5 seconds. I held the counter. Then I reached up for the medicine.... The next thing I know I'm lying on the kitchen floor, staring at the ceiling, not knowing how I got there or how long I was passed out. I headed back to my room and again, thinking "I've got to lay down", and I wake up to find myself on the closet floor, stairing up, wondering how and why I was there (again, I'd passed out).

I didn't know why I was passing out. I went to tell C what was up. I called a hospital who told me they couldn't give medical advice. They gave me a nurses line to call. The nurse said it was serious and I should come in, but not drive myself. C can't drive a stick, and all I had at that point was one. I didn't want to call any friends at 3 am, and they all live at least 15 minutes away. So I called the ambulance. I have no idea whether TriCare covers that, I tried to look it up, and it looked like they might. I was relaly hoping J wouldn't get upset at me for calling an ambulance!

I was taken to a hospital and the inital thought by the doctor was that my ovaries had ruptured cysts on them. The dr was angry I was on unmonitored clomid (100 mg, which I think you should start out on 50mg) and said it was irresponsible. I have to agree, even though I know it's cheaper to not monitor people & I'd already done one cycle just fine with it. The hospital gave me an IV with Demerol and fluids and something else. The Demerol made me see two of everything and loopy. C read to me and I kept thinking I was saying gibberish. She says I said nothing but moaned.

I had to have a CAT scan to ensure my appendix was ok. It was, but they said I had a lot of fluid and a little blood in my abdomen. That was the cause of the pain/swelling, and I passed out from pain, they said. They sent me home after 9 hours, but told me to follow up with an OB-GYN on Monday (they're all off, so I'll go Tuesday). They said it could have been a ruptured ovarian cyst, and unrelated to the clomid, we're not sure. It seems highly unlikely that I as a healthy female who's never had any pain or trouble with my uterus/ovaries/etc would all of a sudden have a cyst burst.

Right now I'm mad at the dr's at WH for their irresponsibility in this. I'm mad I went through this (almost) all alone. I'm upset J wasn't there for all my pain.

***UPDATE: So I finally broke the news to J as they drove away from the ranch. He took it TOO WELL! He was so calm, I got so upset that he just didn't care! However, he was inwardly upset but just didn't know how to react, he told me. Monday we took the siblings to the RiverWalk and had a grand time. I was in mild pain, and did end up getting a 102 fever that evening/night.

The dr's appointment on Tuesday was a joke, at first. For some reason the files didn't show why I came in - they thought I was just coming in to bug them about the HSG results! All I got this time was a resident dr and they have no authority at WH! She kept trying to tell me that the clomid could in no way cause my ER visit and blah blah. I started crying and basically told her I couldn't stand for this to happen again and I needed answers. J says she looked out of her league & she went off to get one of the staff dr's. He immediately said "Let's do an ultrasound." And he found a "hemmoragic corpus luteal" cyst on each ovary about 2cm in size, and blood/fluid in my abdomen. He said I'd released eggs from both ovaries, and I don't know why they were hommoragic. I had to press for options to keep this from happening agian. He said I could now go on 50mg Clomid, rather than 100, and be monitored! Yes! They didn't have the HSG results back.

Wednesday, October 4, 2006

HSG Confusion - WHAT???

I had my HSG on 8/23 and the doctors told me it was ok. There was a "whitish area" (the places the dye went was black) on the xray that the tech said looked like "air bubbles." She told me she'd inject more dye, and if it was air it would move. It didn't. She said she'd still call it a normal HSG. When we went in to get ALL results from the doctors (blood, SA, and HSG), they said Everything was normal for both of us. I specifically asked the drs about the white area, they said, "We personally didn't look at your xray, another doctor did, but I'll check it out and let you know." They never did, so I assumed it was good.

Today I went in to a different doctor about a rash (totally unrelated to IF) (a flight surgeon for you military people with 20 yrs as an ob-gyn) and we started talking about my tests and infertility (because I'd seen him for the referral to the IF center). He took a look at my tests and he opened the file on my HSG.... It clearly said there Diganosis: Abnormal! It kept talking about the mass and said possibilities were endometriosis, uterine polyps, sinichea, and versus submucoal fibroids. WHAT?!?!?!? I called the IF line (you can't ever talk to a real person, just leave a message) and left a message asking for an explaination!!!

I got a call back from a resident doctor over at WH. At first she excused it and told me "The doctors here said it looks good, and I can tell you there are 2 doctor's signatures on the file and they're all excellent doctors." I really had to push and tell her I SAW with my own eyes where it said it was an ABNORMAL HSG and that I had a mass in my uterus. Finally, she said she'd check the radiology report. She got silent and said..... "Maybe we need to take a closer look at your file." Sure enough, that was where the discrepancy was. She said the RE and the Radiologist disagree with the interpretation of the HSG. So she said they'd review it on Thursday and she'd call me back on Friday.
I was rather infuriated.... She tried to write me off so many times ("You're on clomid and we can't do anything for you for a long time anyway, why not just wait for your follow-up appointment in November to hear about this?").

However, I am maintaining trust in everything God's taking us through. More later.