It all started with infertility
I’ve lived most of my womanhood with the diagnosis of
Polycystic Ovarian Syndrome (PCOS) piggybacking on episodes of abdominal or
pelvic pain, a cyst rupture making me feel like I was near death, and abnormal
cycles. This can be a confusing diagnosis which left most of my doctors,
especially endocrinologists, puzzled, questioning whether or not I really have
PCOS or multiple cysts planted on my ovaries. This is something they usually
determine through bloodwork which mine have shown slightly abnormal hormone
levels, but all my ultrasounds have consistently shown its present. My
self-treatment regimen typically involves Ibuprofen and a heating pad. Pain
that I’ve adapted to and pushed through thinking this was all just part of
being a female. Surgery 2 was set and scheduled 1.5 weeks after my breast
surgery (as mentioned in previous post) and all started with the topic of
infertility.
Disclaimer or fair warning: This
a sensitive topic for some; however, this LENGTHY series of personal posts
includes information I have decided to share for readers and/or their loved
ones who may be at the start of discussion wondering where to begin. In
addition, this isn’t just for those facing infertility, several issues unfolded
as we gradually entered this topic. This
message is written with hopes of helping others facing any unknown or
questionable issues that are hard to define or diagnose. Please do not use this
information to self-diagnose or make any presumptions. Links are provided for
additional information and always talk to your doctor about any medical
questions.
Things I didn’t know…
Women are infertile for most of their monthly cycles.
Infertility is defined as the inability to achieve pregnancy or conceive for at
least one year. According to the CDC,
6% of married women from the ages of 15-44 (didn’t know teenagers were getting
married!) are unable to conceive after 1 year of unprotected sex. My new
fertility/ob/gyn doctor mentioned to me that if pregnancy or conception isn’t
achieved in 2 years, the chances of never achieving pregnancy rises. While some
couples may have unexplained answers to infertility, there are a number of
factors that could affect fertility. This is where our story unfolds.
My husband and I didn’t know where to start when talking
about infertility early 2016 after a few rounds of “trying” with medications in
2015. Every couple responds differently to this topic. For us, this has been a
prayerful journey. We didn’t want to force things to happen nor did we want to
rush into the fertility clinic. Therefore, we have purposely avoided getting
too emotionally involved to the point of desperation. We are rather seeking
God’s Will and plans for our lives and therefore, willing to “try” with minimal
fertility treatments as possible.
Our decision to move forward with a specialist began in
April. This involved a consult, extensive check-ups, and small procedures (one
sending me to the ER due to my heart rate and blood pressure plummeting to the
30s!). While lying in Trendelenburg position on the table recovering from a
vasovagal response during what I thought was supposed to be a simple procedure,
a hysterosalpingogram (HSG), an x-ray procedure to check the patency of my
tubes, I said, “I may need to rethink about having kids.” The doctors giggled
while I was trying to have some sense of humor to lighten the pain. I had a
vasovagal response that plummeted my heart rate and blood pressure requiring IV
fluids to bring everything back to my normal. I was emotional when they told me
I needed to be evaluated in the ER, questioning this fertility route feeling
somewhat guilty as if I was “forcing” things to happen. With spiritual guidance
from family and friends, I was reminded that God is the author of all human
talent gifting each of us with special skills such as medicine to take care of special
cases.
After a couple months of testing, everything was normal and we
were cleared to start our first treatment. It was too soon and we were still
uneasy about it all. Therefore, we decided to move forward with our first IUI (intrauterine
insemination) treatment later in the summer.
The last-minute switch: New doctor new discovery
Days before we were about to start IUI, I heard about a more
natural approach to fertility through the science of NaproTechnology using the Creighton Model (CM).
In fact, this method can also be used to avoid pregnancy (even during
breastfeeding) which is nearly 99% effective (click to view effectiveness of CM).
So far, we are very pleased with our new doctor and the bi-weekly follow ups
with the nurse using the CM. Regardless of the outcomes, this new journey alone
has been very informative for the both of us and intriguing! There is a lot of
evidence based research behind it all. For starters, chances of getting
pregnant with CM is significantly higher than IUI alone. And, the likelihood of
success with using CM and a doctor is about 83%. During my consult with
our new fertility/ob/gyn doctor, he suspected endometriosis given my medical
history and having polycystic ovaries or PCOS. A very high percentage of women
with PCOS also have endometriosis. These are all facts my previous fertility or
ob/gyn doctors did not mention.
The cause of endometriosis, PCOS, and sometimes infertility
are all unknown leaving doctors and women with many questions. However, studies
do show somewhat consistent percentages of women who have PCOS and/or
endometriosis also face infertility. When endometriosis is removed inside the
uterus, the percentage of achieving pregnancy goes up but it’s not guaranteed.
In addition, endometriosis is typically unraveled when infertility comes into
play. Here is a website by Mayo Clinic that is easy to read and understand about
endometriosis. Please note, all
symptoms, treatments, etc. vary from person to person (click here for Mayo Clinic definition).
The result of this new visit left me with 2 options: 1) treat
more conservative with another 6 months of trying a different form of medication
to help with ovulation or 2) proceed with surgery (the only way to diagnose and
excise endometriosis is via laparoscopic surgery). Again, I looked to my
husband and questioned the fertility route. I wondered what goes through the
minds of women in this situation. Do women actually choose to endure all this
just for a small dose of a chance? My husband has been so supportive through
all of this and provided me great words of wisdom. Yes, it’s hard for a guy to
understand but he has been my voice of reasoning. He was right, this is my
health and regardless of the outcomes, at least I’ll feel better.
I slowly accepted the idea of laparoscopic surgery and removing
possible endometriosis and set a surgery date. I’ve heard of this term but
never really explored the diagnosis or symptoms or even questioned any doctor
about this issue. After an ultrasound of the pelvic, I received a phone call to
add another step in the surgical procedure. Due to the size of my ovaries and
number of follicles on them, he would like to perform a wedge resection
(removing a pie shape) of each ovary. Well, good grief…I was just accepting the
idea of excising possible endometriosis and now, this sounds a bit much! I’ve
had PCOS for as long as I can remember, so I suppose this was another
confirmation to move forward. Evidently, it’s a pretty clear picture that I DO
have PCOS and now should remove parts of it to make my ovaries more normal (too
many follicles and large ovaries can interfere with fertility). Wedge
resections have been done for many years but recent studies have shown an
increase of pregnancy rates because of the procedure. This isn’t life
threatening, but goodness, it’s a lot to absorb.
After an easy breast surgery, I wasn’t sure what to expect
before, during, and after this surgery. I was scared about a number of things
and one being, not waking up due to my sensitive, vasovagal response. Secondly,
I thought I could go back to work on Monday after surgery on a Friday. Two
weeks prior, I found out, the doctor ordered 2 weeks off work! Wow, this must
be a BIG deal!
They set up this type of surgery hoping to perform it days after
a woman’s menstrual cycle starts. Needless to say, I had forgotten about the
possibility of starting that week with the pre-op instructions reminding me to
avoid Ibuprofen 1 week prior to surgery. Oh why did I forget to prepare?! Three
days before surgery, I started cramping in the morning and because I’m so used
to popping Ibuprofen I couldn’t prepare well for what was to come.
Another confirmation
On my way to a meeting for one of my jobs, I stopped by
Walgreens to find extra strength Tylenol and a heating pack for my belly. The
pain was bad but tolerable. Minutes after my stop while driving, I felt trouble
coming on. The pain was worsening and the onset symptoms of fainting were
creeping in. It was rush hour traffic so finding a place to pull over was quite
challenging. I finally swerved into an empty lot, jumped out of my car to crawl
into the back seat to get my legs elevated. The pain was so unbearable the
thought of calling or texting someone or even waiting wasn’t an option and I
simply wanted to be alone. After 15-20 minutes, I decided to attempt to turn
around and get back home. That wasn’t such a good idea. Traffic was notorious
and the short few miles back it took close to an hour! I had to pull into a
side street to park and climb into the back seat, again. This time to curl in a
ball and pray. I begged God to give me the strength to get home safely. After
15 minutes, I was alert enough to sit in a little bit more traffic and barely
made it through the door of our condo before I got sick. Ironically, I had a
pre-op appointment a couple hours later and curled up with my heating pad until
then.
PRE-OP
For a girl who was nervous about general anesthesia and
having surgery, this painful episode switched my emotions to being more excited
to have this surgery! All this time I thought my pain was related to PCOS, but
during my pre-op appointment, my doctor said he would be shocked if he didn’t
find endometriosis. At that point, I was hoping and praying he would find it,
otherwise, he’d have to problem solve where the pain is coming from. I asked if
this was related to PCOS and he said no, but no matter the stage of
endometriosis, there can be significant pain whether stage 1 or 4. In fact,
some women never know they have endometriosis.
Two days before surgery, my husband fell ill with a virus
sending me to sleep on the couch and sanitizing the condo! Neither of us wanted
to delay this surgery. The day before surgery was a busy day filled with pre-op
blood work, post-op appointment from breast surgery, and last minute work
projects. Thankfully, one of my mother-in-laws who is also a nurse flew in that
evening. Laparoscopic surgery requires bowel prep, too (YIKES). What I didn’t
realize is that CO2 is pumped into the abdomen to expand and make room for the
surgeons to see and navigate. In addition, going under general anesthesia meant
being intubated and drawing blood in case of need for blood transfusion. My
head was spinning.
Surgery morning, I said a prayer. Then my mother-n-law said
a prayer before we left (almost the exact words I used in my prayer!). Another
one of my gracious friends who lived close by, dropped my mother-n-law and I
off at the surgery center. As we entered the whirlwind, busy, factory-like
atmosphere, my body, soul, and mind went numb. I suppose I was ready to tackle
this. Shortly after check-in, they handed my mother-n-law a pager, a card with
my ID to track my progress on the screen and I crawled into the hospital bed
with a paper gown. Traffic of nurses were coming in and out of the room with
everyone asking me the same questions: what are you having done? What is your
name? What is your birthdate? Are you going home? etc. Finally, when the anesthesiologist
entered and asked me “are you going home today or staying overnight?” I
responded, “well now I don’t know, I’m supposed to go home but am I?” He
laughed and said it was protocol to ask questions several times. My doctor came
into the room to review the multiple parts of the procedure again and begging
me to take it easy after surgery and no working out. He also said a prayer with
us which gave me quite some comfort. My husband arrived shortly before I was
wheeled off. I remember seeing him at my right side, and he warned me the drug
is going to make me feel funny. I said, “oooh, I feel so tipsy.” I was so happy
he got there in time…his face and contagious laugh was the last thing I
remember as I dozed off into a deep sleep.
Stay tuned for the continuation of this series…
Quote of the day:
You gain strength, courage, and confidence by every experience in which you
really stop to look fear in the face. ~ Eleanor Roosevelt
Bible verse of the
day: Do not be anxious about anything, but in everything, by prayer and
petition, with thanksgiving, present your requests to God. And the peace of
God, which transcends all understanding, will guard your hearts and your minds
in Christ Jesus.
~ Philippians 4:6-7
(a special and perfect verse sent to me by my mother the
morning of surgery)
*A special thank you to my mother who also works 2+ jobs and squeezed in time to edit my post.
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