Thursday, December 29, 2011

What "They" Don't Tell You About Laparoscopy

1. It will hurt... for a week or two... not a little hurt, I'm tough and I'd call it a significant pain.
2. The pain will be worse around your belly button (primary incision).
3. There will likely be some bruising.
4. You will be bloated... a lot... for a few days from the gas.
5. You will be constipated, pain meds will make this worse. (They might tell you this one.)
6. Don't even try to wear jeans or button pants for at least a week (remember the belly button pain?).
7. Sitting fully upright will hurt because your belly squishes (even if you don't have extra there).
8. You will have bleeding. Not "spotting"... this was likely worse in my situation due to over dilation of my cervix as part of the repair.
9. You will feel "stinging" pain in the areas that scar tissue/implants are removed as the areas heal... (at least I did... but my bladder was involved.)
10. You will probably be glad you opted for the procedure even if everything came back "normal". Call it peace of mind.

I'm exactly one week post op today. Yes, I still have pain... mostly it's incision pain, mostly around the belly button. Even though I stopped taking pain meds on day 3, I'm still battling the constipation issues. I still can't wear jeans... I tried, the buttons made a big bruise under my belly button (and hurt REALLY badly). The bloat is mostly gone now... my belly has returned to it's normal jiggly size instead of inflated balloon size. :-) I can button those jeans... it just hurts to wear them (bending, sitting, etc... yuck!).

I had significant scar tissue and adhesions on my bladder, uterus, and bowel holding the three organs together. Because of this, I have had pretty significant bladder pain for YEARS. It was one of those things I thought I had to live with... the urologist and gynecologist never found any reason as to WHY... I frequently thought I had bladder infections when I did not. I am THRILLED for them to be gone and praying that the scarring does not return!!! My bladder is already feeling better... although not completely healed. I've had some stinging pain in the same areas I used to have the tugging pain... so I know that is the areas healing from removal of scar tissue. Already by bladder is happier... It doesn't hurt when distended and released... I don't have difficulty draining my bladder or retained urine. This has me doing the happy dance.

I also feel good knowing that the rest of my insides are looking good... no endo... no damage... no blockages. And that my cervix is returned to a properly functioning body part (although I don't know yet if CM will return). I've had bleeding/spotting every day so it's hard to tell what is cervical CM and what is uterine fluids, etc...

And... I ovulated on CD16 despite having the surgery. This is a good thing... I know the likelihood of conceiving this cycle is slim, but I'm glad that my body is still responding appropriately.

In other news... my PMS symptoms are worse this time than the last two cycles. I'm only 3 dpo, so I don't know yet if they will reach my previous normal... BUT my breasts are very sore... the last two cycles, I've had almost no breast tenderness (and great progesterone levels at 7dpo) and my emotional status has been more stable, not being pregnant was relatively easy for me to deal with. So... I'm wondering if that was due to acupuncture or medicated cycles (controlled ovulation)... I've not had acupuncture in two weeks because of holiday vacations and obviously, this wasn't a medicated cycle since I was having surgery... I wish I was having acupuncture still so that I could determine which was the cause. My next session will be on Jan. 4th.

In my mind... worse PMS symptoms without controlled ovulation mean that I still am having hormonal/ovulatory dysfunction... which I really want to correct so that in the future, even when I'm not actively trying to conceive, I can avoid hormones. NFP is really important to me... but when you are in dire straights physically and emotionally for two weeks every month it takes a toll on your marriage, parenting, and life in general! I'm praying that with continued acupuncture, dietary changes, and supplements... I will be able to get the PMS symptoms down to a manageable level (as they have been the last two cycles!).

Thursday, December 22, 2011

Post Laparoscopy

I went in this morning for the laparoscopy and cervical dilation. It went well. The good news is that I don't have endometriosis. Dr. A found severe adhesions/scar tissue holding my uterus and bladder together. He was able to remove all of it, so hopefully the bladder pain I've dealt with for years will go away now!

I'm staying on top of the pain... taking one percocet 5/325 every four hours for now. I don't like taking pain meds so this is a challenge for me. Dr. A informed me that I can take up to 4 pills every 4-6 hours and I can piggy back with ibuprofen if I need to. DD and I have had several laughs the last couple of days about Dr. A being a "pill pusher". I think it's that as an RE involved with IVF and all kinds of painful fertility treatments, he knows that we need pain relief. Some doctors (especially males) have a tendency to undermine the amount of pain... "you'll have a little discomfort". Dr. Awesome is not one of those guys.

I know every woman is different, but I thought that posting a summary of what I'm feeling/experiencing here may help someone else prepare for their procedures.

I checked in at the ASC (ambulatory surgery center) at 8:00. I changed into a weird looking disposbale gown that was made out of what felt like flannel paper, it was thick and soft and actually wrapped around the back to tie on the side for coverage. Once I was seated in a nice recliner, a hose was hooked up to my gown and it blew warm air into it. AWESOME. If you have to be there, the air gowns are a definite bonus. I've had surgery before but this is the first time I got warm air. :-) The IV took two attempts... bummer. But I'm used to that. My veins don't cooperate and I get more nervous because I know they don't cooperate so all in all it's a challenge for the nurses. Luckily, the second one worked, I'm not sure I could have held out for a third!

Dr. Awesome was running a few minutes late... he is a very busy man. He walked in at 9:08 which isn't bad at all. Chatted with me for a few minutes, signed the papers, listened to my heart and lungs... and said "see ya in the O.R. in a few minutes" as he jovially walked out the door.

I was able to walk into the O.R. which is great... it gives a little sense of control in a situation we really have no control over. I've been wheeled in on a gurney and allowed to walk in a couple times and I definitely prefer walking myself in. That's actually on my list of questions for the hospital once we are well pregnant and ready for a tour. I'll be a scheduled cesarean because of my L&D history. I want to walk into the O.R. ... I know that seems like a small, inconsequential thing but it really helps me cope.

Once in the O.R., I manipulated my I.V. line (we had to place on the right arm which isn't the best for the O.R.) and climbed onto the surgical table. The Dr.'s joked about how I could have done a triple dismount there. We started chatting about cheerleading and my almost 7 year old daughter's innate abilities. The anesthesiologist says "I'm giving you some medicine now to relax you". I can feel it in my body, makes me feel a little strange. We keep chatting about cheerleading and that's the last thing I remember. I don't even recall the part where he says "you'll be going to sleep now" or whatever it is they tell you as they put you under. Definitely no counting backward for me. I was out.

When I woke up in recovery, I couldn't open my eyes... it was like dreaming. I remembered conversations and thought I responded (or was I hearing people and only responding in my head?). Once I was able to open my eyes, I was able to have conversations better and woke up pretty quickly after that. Once my eyes were open and I could see the nurses, I asked if my husband was coming back in. One of them said something about him doing grading out there and she'd go check. It was nice to have him back in with me. Plus I knew he was really stressing about me having surgery so he needed to be back in with me... to see I was okay.

I had taken some gluten free crackers in with me to eat afterward, since I knew they would want me to keep some food down and saltines were out for me. When I was waking up, I did have pain in my abdomen... at first it was a deep pain, then as the nurse gave me meds in my IV it changed to just a superficial pain at the entry sites, she gave me more IV meds. Then I ate my crackers and she gave me an oral percocet because I didn't want an IM shot (ouch).

My throat hurt (and still does 12 hours later) from the breathing tube. My husband spoon fed me ice chips which helped a lot. Then I had sips of water with the crackers. Once I was awake and medicated, they had me moving out of there pretty quickly. I was up and dressed and discharged. I was allowed to walk outside to the car with the nurse holding my arm, another nice treat since wheelchairs make you feel like an invalid.

I do have quite a bit of bleeding. Dr. A said it would be more than from a laparoscopy because of the cervical dilation. I would call it medium flow vs. the normal spotting from manipulation of the uterus during the lap.

I pee'd blue for a good part of the day today. This was from the blue dye Dr. flushed through my tubes to make sure they were clear. Mixed with the blood, I had purple toilet water. This was kind of entertaining.

I've been able to eat normally. I've gotten up and walked quite a bit. I've done a little too much but it's really hard for me to be still, especially when there is a household to run. I'll try to rest a lot tomorrow because then Christmas and it's busyness will be upon us.

I'm bloated... a lot. My belly is hard. I know this is from the combination of fluid left in to keep my organs floating (which helps prevent new scar tissue from forming) and leftovers of the gas that was placed in my belly to inflate it for better viewing. I've had some minor referred pain in my shoulder also from the remainder of gas... nothing serious.

My incisions are still covered with band aids, but the belly button incision has done some bleeding, it is also the more painful incision. Dr. A only had to make two incisions since I wasn't an endometriosis mess like we feared. Even the band of my yoga pants is tight and uncomfortable on my abdomen.

Dr. A gave DD pictures of my insides before and after... I'm kind of a medical geek, so I like that. Some people are all "gross" and don't want to see it, but I love it. I also have pictures of my placentas and of my cut open belly during my cesarean.

And I think that's it... obviously, I'm coherent enough 12 hours post procedure to write. I was nervous (mostly about general anesthesia)... it's a relief to be done and have answers.

Monday, December 19, 2011

Surgery on the Horizon

My "procedures" are on Thursday... today is Monday. Three mornings from now, I will wake up... unable to feed my hungry body. I'll be nauseated from low blood sugar... and likely, dieing of thirst. Isn't that how it always goes when you can't have even a sip of water?

The surgery center called today to "pre-register" me for my "procedures". This consisted of a young woman telling me everything I'd already received in the packet. I guess they figure that by speaking with the patient they are assured I'll show up?

Since I'm gluten free, I'll be sure to pack a safe snack for after surgery... since they always want you to eat before letting you go home. I can't eat crackers or I'll be one sorry chicken. Tonight, I also purchased two more pair of yoga style pants (which I needed anyway) because my belly probably won't feel like wearing jeans for a week or so after (wondering how I'll manage two church services over the Holiday).

What are they going to do to me EXACTLY?

Well... I'm having a laparoscopic removal of endometriosis. This means, Dr. A will make 1-4 tiny (5mm ish) incisions in my abdomen. Through these incisions, he will insert a camera and other necessary tools. They will blow my belly up with gas to enlarge the cavity and allow better viewing pleasure. With any luck, Dr. A will locate every last bit of the nasty endo and adhesions and eradicate them (including the pesky things on my bladder causing me so much distress). Dr. A will also go in and fully dilate my cervix (think giving birth dilate). This will break up the scar tissue that is has sealed over the entrance to my womb (and thus far kept the swimmers out effectively). My big questions for my pre-op on Wednesday are--- conjugated estrogen cream on the cervix following surgery to help prevent formation of new scar tissue (I skipped this vital step the first time my cervix was punched open after my cautery)... AND will we be taking a look inside my uterus as well via hysteroscope to make sure my lining is a-okay (previous surgery may have burned out too much lining).

In all likelihood, I'll be MIA for the next couple weeks with surgery and Christmas upon us... (Not to mention all the littles are out of school).

Am I nervous about surgery? No... I'm actually looking forward to it. Why? Because it is my prayer that this procedure will allow us to conceive a baby or two. Without it, my chances are looking slim (unless we magically come up with 15k for IVF).

So, I'm relaxing... breathing deep since I don't have to be concerned with timing and POAS and watching CM... and waiting, worrying, hoping... I get a cycle off, to just relax. That's a good thing since my acupuncturist is on vacation for two weeks. :-)

Merry Christmas... I'll check back in after the New Year!

Tuesday, December 13, 2011

While We Wait

Since baby making is on hold for the next two months, I've decided to jump back on my clean eating bandwagon and shed a few (or 30 pounds). The last time I stuck to clean eating, I lost 40 pounds in just over 3 months... A year later the weight started creeping back on because I wasn't eating clean anymore, going out for dinner too often, and enjoying a few too many mocha's.

I know that weight isn't contributing to my infertility issues as my ovulation pattern has been more regular than ever AND I conceived three children previously with my body at the same weight... this is the place my body likes to be even though I don't like it here.

For the first two weeks (when I know there is ZERO chance of conception)... I am taking Alli as well as recording 100% of food (calories and fat). I'm eating clean... I'm eating every 2-3 hours... I'm drinking lots and lots of water. I'm food obsessed but it's only day 2... it will get easier. Today I took in 1681 calories & 58 grams of healthy fats. I know many people think of a weight loss diet as having a much lower calorie intake, but I tell you this... I would not survive. I've discovered the metabolism miracle of eating clean, frequent, and in the right combination actually allows me to consume more calories than I would on the Standard American Diet.

I'm not sure that I've mentioned... I'm Celiac but 100% gluten free... not sure if that is at all related to the infertility...

Here's what I ate today:
7am- 2 eggs (free range) scrambled, 1/2 cup GF oats, 1 tsp coconut palm sugar, 1 Tbs. cream
8:30am- Coffee w/ 4 Tbs creamer 140 calories/6 grams fat (and not clean, this is going soon)
10:30am- yogurt 190 calories/2 grams fat (better if homemade)
1PM 1 cup brown rice w/ 1 small zucchini & 1/2 cup mushrooms (saute), 1 oz grated cheddar cheese, Celtic sea salt & pepper. 376 calories/ 11.5 grams fat
3:15PM 1/2 Lg. banana w/ 1 Tbs chunky peanut butter 175 calories/8 grams fat
6:00 PM GF spaghetti w/ ground turkey, big organic salad, 1 Tbs Ranch 460 cals/17 grams fat.

I'm drinking lots of water and taking one Alli with each of the three meals.

Maybe the weight loss focus will help redirect my baby crazy brain... :-)

Sunday, December 11, 2011

Cycle 2- FAIL

Today officially marks the end to cycle 2... AF showed up.

I knew we were out of this cycle two days ago when my BBT dropped almost a full degree. I was surprised AF didn't show yesterday but what I've noticed with medicated cycles is that my progesterone is good (19.6 cycle 1, 23.4 cycle 2)... while I don't know what my progesterone was on non-medicated cycles, I'm assuming that my slightly longer LP is due to the progesterone taking a bit longer to get out of my system since it's a nice, high value at 7dpo.

My progesterone draw on CD22, confirmed my ovulation for CD15 (day of u/s scan) and we didn't IUI until CD16 because scan on CD15 showed one big follicle at 26mm and the LH surge showed on my OPK later that morning... we were assuming O was going to be the NEXT day. However, I woke up on CD16 to an elevated BBT indicating O had occurred already and our IUI wasn't scheduled until 10:30AM.

We went ahead with the IUI... I was praying that the combination of my cervix still being slightly open (IUI cath could PAINFULLY pass through without breaking scar tissue this time) and BD on CD13 PM, combined with IUI on CD16 that we still had a chance...

Amazingly, I've been much calmer this cycle (even calmer than the last cycle). A combination of acupuncture, a plan, and expecting it to NOT work... ? I didn't even really cry this time, although I had a few moments of self pity.

My surgery is scheduled for Dec. 22. Dr. A will go in an remove all the endometriosis implants (including any on my bladder and bowel), flush my tubes to make sure they are clear (and remove blockages if possible), and fully dilate my cervix to break up all the scar tissue keeping it closed.

I'm a bit apprehensive about surgery... but at the same time, I'm looking forward to it. Prayerfully, we will get an all clear afterward and be able to conceive (naturally, even?) OR we will at least have a name as to what is wrong with me. I'm pretty confident that if Dr. A comes back with a poor prognosis, we won't be able to even consider IVF (due to finances among other concerns)... so at that point, I will have to close the book on pregnancy and start exploring foster/adoption (which is likely in our future whether we conceive or not).