Pre-operation consult

Today's appointment went fairly well! Dr. M is very competent and after speaking with him and his very nice assistant (the same one who I had difficulty getting a hold of to make this appointment - yes I forgave her) I decided to make the switch. Dr. M will now by my primary OB-GYN. The assistant told me that my previous doctor, Dr. B, is getting close to retirement and doesn't appear to be as eager to perform new techniques and surgeries. She's apparently "comfortable" where she is, and that's the reason why I was getting referred out. The assistant told me that Dr.M "loves" doing "laps" which I think is short for laparascopic exams (where they take a microscope and look around in your belly --- but i'm not getting one of these). Anyways, she made it sound like Dr. M is the slightly younger (no gray hairs yet) eager doctor while Dr. B is the older (lotsa gray, infact mostly gray), closer to retirement doctor. That's what I see from my point of view as well.

Dr. M told me all about the surgery I am getting - it's called a hysteroscopic myomectomy (the same kinda surgery I've been reading about and assuming I'm going to get). In fact there are links to watch the actual surgery on youtube. Craziness!!! (here it is for all you interested viewers http://www.youtube.com/watch?v=LOJRTTgLFqk)

Anyways, he explained the surgical procedure and its risks. He was very reassuring in the risks (even stating that these have never happened to him -- and knocking on wood that they continue to NOT happen). He said there is a chance of uterine preferation (in otherwords, they poke a whole in your uterine wall) and a chance of fluid overload. They use fluid to inflate the uterus to navigate better, and sometimes, very rarely, the fluid gets absorbed into your lungs. To avoid this they monitor the amount of fluid they put into my uterus and automatically stop when they hit a liter. He continuously said that for my type of fibroid - a submucosal - and its size -- he continues to say it's very small - he doesn't anticipate any complications. I've also been reading that this type of surgery is the least invasive. He also stated that this type of surgery is fairly common and routine (indicating, I think, that he's done the surgery a number of times). So, I guess in the scheme of things, of all the types of fibroids to have, this one is the best one to have. I pray that I dont have any more after this.

We also discussed how I'm still spotting now and feeling some slight pressure in the ute area. He stated that this is all from the darn fibroid. He was a little interested to learn that I still had daily spotting from the fibroid since my period.

I also asked him about the fact that my cycle seems to still be out of whack, and he said that it's common after a miscarriage for your cycle to take months to get back to normal. He did not believe that the fibroid was contributing to the unusual cycle. He also stated that since I do not appear to have any problems getting pregnant (Thank you Lord) that he is not very concerned about cycle lengths. He said in my case, we want to focus on getting the uterine cavity back to its original (normal) shape, and focus on my ability to carry a child to term. (I'm all with you there doc.)

I asked about the possibility of the fibroid growing back, and he wasn't too concerned. He said it could grow back, so we want to recheck for it in a year or two, but since I'm planning to get pregnant next year, he said we wont need to check right away.

I also asked about scarring from the D&C or from this surgery. He said that when he did the HSG he didn't see any scarring (and that one can normally tell from an HSG if there is scarring). He also stated that if he sees any scarring when doing the surgery, he'll "clean it up." Thanks doc!

As for recovery, he said I'll experience some cramping after the surgery, but it should be ok in a day or 2. He also stated that I should be able to resume normal activities within a day or 2, including workouts. He said I should resume activites based on how I feel. Of course, I'll have to stay on "pelvic rest" for two weeks. I then will see him for my post-operation consult on January 5.

And the most important thing: I can resume TTC in 2 months - he said by February!!! He wanted to be sure we gave my uterus a chance to heal. Soooooo here's to a happy, and re-productive February! Hooray!!

I ovulated yesterday.

I think I ovulated yesterday. I'm still doing the "old school" method of figuring out my O date --- just plain old temping, charting and observing my CM and CP. I'm too cheap to buy OPKs. In fact, I only finally gave in to getting the "VIP" FF membership yesterday. Previously, I was just using the free membership, but finally decided to suck it up and get the paid one. I figure, I might as well, since I wont be getting PG anytime soon. I can at least have the most advanced technology available through FF to track my cycles while I bide my time until I TTC. I want to be spot-on about my O dates when I finally get the A-OK to TTC. Yesterday, I read that the recommended wait time to TTC after a hysteroscopic resection (the type of surgery I'm getting) is 4-6 months! GOOD LORD! But I digress...back to me thinking I O'd yesterday.

So I think I had EWCM yesterday, but who knows......It's difficult to observe my CM when I'M STILL BLEEDING! Yup, I am still spotting and it's been 23 days since the first day of my period. According to Dr. M, this is all because of my fibroid, and my googlination research confirms that fibroids cause excessive bleeding during, between and/or after a period. I also think I O'd because my temperature increased and was higher than the last 6 previous temperatures, and yesterday's temperature appeared to be a dip in temps. Something I also learned should happen to indicate O occurred. Based on my previous cycles, I regularly O'd around CD 21, 22 or 23....so chances are I O'd yesterday. Too bad I'm not TTC, or I would be in my 2ww and anxiously counting the days until I could test. My LP has previously been 12 days, so I should see AF on Wednesday, 12/17/08. Not sure how my fibroid surgery on 12/11 is going to affect that though.

Anyways, it's Friday. Thank God! The weekend is here! My dad is flying in to visit with me on Monday. I'm excited to spend some time with him. That should keep me busy for a few days until my surgery. T-minus 6 days until I say bye bye fibroid! I pray that the surgery goes smoothly and the fibroid is completely taken out.

Got a call from my doc

Yesterday, Dr. M called. Unfortunately, I still do NOT have a surgery appt. date, but at least he called me. He said that his assistant will be calling me soon to set up the surgery appt. date as well as the pre-surgery appt. date with him. He also told me that the surgery will be similar to a D&C except that I'll experience more cramping afterward and I should expect to feel a little out of it for the rest of the day after the surgery. He also confirmed that my constant spotting going on now 10 days after my period is the result of the fibroid. Thank God I'm getting it removed now. Whew. He also said that generally the OR rooms are booked 2 weeks in advance, so if that darn assistant calls me this week, I can hope to have a surgery appt. date the week of Dec. 8. Last, but not least, I asked if Dr. M could be my primary doctor. He said sure, he wants to be sure that I'm happy with my treatment. I explained that while I'm happy with Dr. B's treatment, since I have a more complicated case, I'll need to see a doctor who is able to perform the procedures I need. It's clear that he's a doctor that can, (duh, since she referred me to him).

In other brief news, I'll be traveling to a neighbor island via a ferry for the holidays to spend time with my family. DH and I leave tomorrow and we're excited. We're taking our doggie with us too. This is a big deal, b/c our doggie hasn't traveled with us since he was just a few months old. Everytime DH and I travel, we miss our doggie and worry about him. Now we do not have to worry about him anymore. This little doggie is such a spoiled doggie. I cannot wait till we have children upon whom we can lavish our love.

Thank you all for trying to vote for my blog on Ronda's Rants. I think voting ends today, so if you haven't done so, please go vote for me. (See my last blog for more details).

Anti-climactic appointment

Today's appointment was anti-climactic and almost a waste of my time to say the least. Dr. B basically reenforced everything I already knew from my own research and was told by Dr. M (the doctor who did the HSG and diagnosed the fibroid). She agrees with Dr. M, I should not get PG until I have the fibroid removed. She also stated that generally it's an out patient procedure that lasts 1 day and that I will be instructed to be on "pelvic rest" (nothing in the vagi. for 2 weeks) and will need to come back for a follow up appt. after the surgery to make sure I'm ok. She also stated that they would not like for me to get PG for at least 1 to 2 cycles AFTER the surgery.

So at this point, I'm like, let's get this surgery started --- today even! Unfortunately, Dr. B does not do this type of surgery (or anything at all it appears -- she's referred me out for the D&C, the HSG, and now the hysteroscopy resection - do we see a pattern here?). She provided me with a couple of names of whom to refer me to, and Dr. M was on the list. Since he is the doctor who diagnosed me and did the HSG, (and the doctor on the top 50 best doctors list in our town), I elected to go to him. However, the way Kaiser works, I have to see him again for a consult/physical exam before we can even do the surgery. And he was not in the office today, and will not be in the office for the rest of the week, so I couldn't even set up an appointment for the consult/physical exam or surgery!!! GRRRRRRR!!!! Apparently, when he returns, his assistant will contact me to set these up. I did try to see if I could have the consult done over the phone, because heck, what else is there for him to do? He's already diagnosed me and seen all of my inner parts once (twice if you count the time he saw me when I first miscarried and went in for an emergency exam...but I dont know if he remembers)....Dr. B said this is a possibility but will have to check with Dr. M.

So as of today - I have no date for the surgery. I do know that at the very least I'll probably be not TTC for at least another 3 months.. =( So my hope of having a x-mas BFP is shot. =( I do know that the next time I see Dr. M, I'm going to ask to have him be my primary OB, b/c I'm over this whole running around in circles routine Dr. B has me going on. I initially chose Dr. B back when I was an innocent naieve, and thought all of my inner parts worked ok, b/c she had great bedside manners, but apparently, that's all she has. I need a doctor with substance, who will not refer me out...I cannot keep seeing doctor after doctor with weeks inbetween silly appts. It's such a waste of time and money. grrrrrrrr!!!!!!!

But lets end this post with good news, good news is.....well it's sort of good news...we all hope its the cause of my MCs and once the fibroid is removed, it will be smooth sailing pregnancies from here on out........right????? I pray that this is all worth it.

Pre-appt. Anxiety

I go to my doctor's today to discuss the fibroid situation. I'm nervous, I'm anxious, I'm excited. I want to start TTC and want to have a plan in place for that journey. Part of me hopes that she'll say, oh, it's nothing, you can start TTC today if you want...but a huge part of me knows that she wont and doesn't want her to. The other doc who found the fibroid (the one who got nominated as one of the top 50 doctors in this town) said he thinks this is the cause of my prior MCs...I cannot take that statement lightly. Plus from my own research, it looks like removing the fibroid is pretty simple. So, why not have it removed, and ensure that my next PG has that much more chance at success? I'd hate to have to go through ANOTHER loss.

I'm nervous, nervous, nervous --- 2:15pm cannot seem to get here fast enought.

More on fibroids and pregnancy

So, work is slow and I'm doing my google research.

I've found lots of information regarding fibroids and pregnancy. I have a 2cm submucosal fibroid - the kind that bulges into my uterine cavity. The general consensus from my research is that I'll have to have this fibroid removed via hysteroscopy myomectomy before getting PG again. But the awesome news is this appears to be a procedure that is simple ("Hysteroscopic myomectomy is a technique that can be performed only if fibroids are within or bulging into the uterine cavity (submucosal). This procedure is performed as outpatient surgery without any incisions and virtually no postoperative discomfort.") and my chances of a healthy pregnancy will increase by 70%! I'm feeling hopeful. I hope Dr. B has the same good news as my research has uncovered.

If you're interested in learning more - check out this very informative site.

http://www.fibroidsecondopinion.com/pregnancy.htm