Showing posts with label Diagnosis. Show all posts
Showing posts with label Diagnosis. Show all posts

September 14, 2015

CD1

Well, here it is. Cycle day 1. I was starting to get nervous this morning because I hadn't started bleeding, I had zero cramping or bloating, and it was day 14 post ovulation. But Aunt Flow arrived right on time and as I was leaving the Children's Hospital (volunteering, don't worry!) I noticed that it started.

So far it's been a medium-ish flow and it hasn't been as painful as last cycle but there's still quite a bit of cramping going on. But I'm pleased that it's here. I called Dr. T's office immediately and got my sonohystogram set up for next Monday, cd 8. He had one appointment on Monday and I scooped it up since it's my day off. Win!

So now we wait again. I'm so anxious and ready to get going. Poor E has dealt with me talking almost non-stop about "when we get pregnant". Poor guy!

We have a couple of things to look forward to, though, that are completely unrelated to trying to conceive. E has a work trip to Columbus at the end of the month and I decided to join him because two of my best friends from college live there. Woohoo! AND we'll be going to visit his parents in Finland (they're there for about a year for his dad's job) and traveling around a bit.

I'll update next week!

April 21, 2015

We have a date!

I received a call from Ellen (nurse) this morning to answer my questions from yesterday. First and foremost, she said because I'm heterozygous A1298C MTHFR, I don't have to worry about any issues with birth control. So for now, I'm sticking with it and after surgery I'll probably try to avoid it just to be on the safe side.

Ellen also mentioned that Dr. M. wants me to take extra folate (Woohoo! That was one of the questions I forgot to ask!). Unfortunately she didn't have the exact amount, so I'll have to wait for a call back on that.

THEN...the moment I've been waiting for. My MRI results were in! She read me the long version and this is what I got from it: "arcuate uterus" "not a definitive septum" "surgery". Yup, surgery is happening folks. I appreciated the fact that Ellen admitted that she had no idea what an arcuate uterus was and put me on hold for a few minutes to do some quick research. She explained that it's similar to a uterine septum but much smaller. She also mentioned that while they don't see a definitive septum in the images, it's still possible that they'll find one when they go in for surgery. She left me with the expectation of a phone call about next steps sometime tomorrow since Dr. M. wasn't in the office today.

Of course I then visited Dr. Google and found a couple of encouraging tidbits. While it seems rather unclear if an arcuate uterus increases the chance of miscarriage, most research seems to recommend resecting the arcuate uterus if reccurent pregnancy loss has already occured. I also found a number of women who were diagnosed with an arcuate uterus via MRI only to find during surgery that they had in fact had a septum.

SO, I see this as A. a possibility that we will find a septum to fix. B. if there isn't a septum, at least she can resect the arcuate uterus. C. the arcuate uterus could still be our issue if there isn't enough blood/nutrient flow to the area and the babies keep implanting there.

Much to my surprise, I received a call from the doctors office this afternoon to get surgery scheduled. The only downfall is I found out how expensive it's going to be. I assumed it would be around $1200 but man oh man was I WAY, WAY off. I scheduled it anyway and decided that I would talk to E tonight and if I needed to cancel then I would.

E definitely had the same case of sticker shock that I did when I told him how much it was going to cost. After 30 seconds of silent pondering he said, "So we're basically spending x amount on an exploratory surgery?". I certainly didn't think of it that way but, yeah, he's right. His response to my "yes" is one of the reasons that I love him so much. "I don't want you to have to live through another miscarriage. Between the emotional and physical pain, it's not worth it. Even if nothing gets fixed, it will be worth spending the money because at least we tried." He's so selfless. I had to remind him that it's not just me going through the miscarriages but him as well.

So, it's decided.

Pre-op appointment: May 11th (and a little less money in our pocket)
Surgery: May 13th (and a lot less money in our pocket)
Post-op appointment: May 26th (and hopefully a good report)

And I'll leave you with this. Our fourth, and hopefully final, bear came in the mail late last week. Thanks Project B.E.A.R! (Ignore all of the clothing. I have them on a shelf with old clothes so I see them every morning and night)


April 19, 2015

Confusion

I'm officially confused and don't know where to go from here. For real.

First things first. I had my MRI on Friday and it was easy peezy compared to when I had one on my head. The only thing that threw me off was needing to get an IV. I didn't realize Dr. M. wanted a few images with contrast so it was unexpected. Thankfully she only had to poke me once. Unfortunately she had to dig around and I now have an awesome bruise.

The picture was taken Saturday morning but its much darker now. Yikes! But with that being my only battle wound, I really can't complain.

Onto the more interesting news. Dr. M. called this Saturday afternoon (I was shocked, too. Why is she calling on a Saturday?!). She said that all of my blood work was looking good so far. I asked about the Antithrombin III that the nurse told me was slightly elevated. Dr. M said it's nothing to worry about as it's usually an issue if you have decreased numbers. We'll just re-draw in 6 weeks.

She did, however, let me know that I am heterozygous for MTHFR. She quickly went on to let me know that it's nothing to be worried about because traditionally it was thought that both heterozygous and homozygous forms caused losses but now it's more commonly believed that it's only the homozygous mutation that causes losses. She said that I could continue the baby aspirin, but she doesn't believe this to be our problem. She also said that my homocysteine levels were "perfect". *More on this in a minute*

I also let her know that I had my MRI and asked when she expects to receive the images, which she believes should be this week. I asked if she thinks that surgery is still in the near future and she responded with an immediate "Yes". She said that she could feel something while doing the D&C and while the images during the diagnostic hysteroscopy weren't the best (because of all of the blood) she believes that she saw something as well. She, apparently, was ready to do the surgery after the ultrasound but had me do the MRI so that we can try to avoid a laparoscopic procedure. She wants the best view possible so that we will, hopefully, only have to do the hysteroscopy. But it sounds like maybe it will be in the next month or so.

Now, swinging back around to the MTHFR. I was actually the one who suggested that we test for it the day that we found out that nugget's heartbeat had died. I remember Dr. M. saying that MTHFR usually caused second trimester losses, but if it was something that I wanted to check, she was willing to. The reason I wanted to check? Because of my friend, A.

A had 7 losses, all in the first trimester. She finally found out that she had MTHFR and saw a hematologist who said that because she was heterozygous, there was no reason for her to be on a blood thinner. She was grasping at straws and a blood thinner was really her last resort, so her OB prescribed it for her throughout her next pregnancy. She ended up with a little boy who is now 1.

I texted her after speaking with Dr. M. and she thought it was crazy that Dr. M. didn't think this was an issue. We chatted a bit and then she asked if the doctor told me to stop my birth control pill immediately as it's very dangerous with MTHFR. Um, no. Apparently her doctor told her that he will never ever prescribe a birth control pill for her (and her IUD is hormone free) because it can cause even more clotting issues for those with MTHFR. I promised to call and ask Dr. M. about that on Monday.

Right now, I'm not 100% sure which route to follow but here's the thinking that E and I are going to run with (for the moment at least).
  • Call Dr. M. on Monday to ask about birth control and ask if folate supplements are needed.
  • Continue with the surgery route. The way I see it, if she goes in and does surgery and doesn't find anything, she's not going to scrape anything so I won't have any scaring. I would be out a couple hundreds of dollars and know one way or another. If she does find something, it gets fixed.
  • Once surgery is done, I'll discuss with Dr. M. her beliefs on blood thinners, such as lovenox, for someone like me with heterozygous MTHFR. The limited research that I've done has shown mixed views. If I'm unhappy with her answer, I'll get a second opinion from a specialist and go from there. 
Both E and I feel so overwhelmed with all of this. I know there's a very good chance that we may never get a concrete answer, but limbo stinks and this maybe, maybe, maybe pattern that we're stuck in is making it all that much more difficult.

Fingers crossed Dr. M. gets the MRI images early this week and it actually SHOWS something!!

April 8, 2015

Next Step

I spoke with Dr. M yesterday and again today. Here's how the conversations went:

Yesterday
The good news is that E is chromosomally normal! Woohoo! She read the entire disclosure to me which states that this test isn't able to detect certain issues but she said those issues are very rare and he doesn't have any glaring chromosomal issues. I figured as much :)

We still don't have the pathology results. I had the surgery on March 13th, so hopefully we'll have them soon. A month's time is fast approaching!

I told her what the ultrasound tech and radiologist assistant had to say about my ultrasound. She didn't have the results yet but said that she was pretty confident that something is there. She mentioned that she could feel something during the D&C and saw what she thought was a septum during the diagnostic hysterocopy. I asked if what she saw could've been a "heart shaped" uterus and she said it was possible and was hoping that the images would give her a better idea.

She then shared a story of someone close to her who had had fertility issues. It really is amazing how personable she is and how wonderful she's been throughout this entire process. I'm so thankful!

Today
She received my ultrasound report and unfortunately, they came back as normal and she didn't get a good view. Now, I'll have to go for a MRI. Sigh. I heard from her office manager and was told that the radiologist should call within 24-48 hours. I figure if I don't hear back by tomorrow afternoon, I'll probably call. Clearly I'm good at waiting nowadays!

At this point I'm praying that I can get in for a MRI within the next week and a half, TOPS. This is torture!

April 6, 2015

On the verge of waving the white flag

Today was a big day!

I started out by going for my big blood draw for the ten million tests at 8am. Angel came back to get me around 8:10 and said that she had to get some extra vials from upstairs but didn't want me to sit in the waiting room wondering where she was. So instead I got to wait in the draw room. When she returned she mentioned that there was a test for which she had never drawn and she needed to find out what she needed so it would be a couple more minutes.

I think we finally got started around 8:35 and I was seriously scared by the amount of vials I saw. 26 vials and 20 minutes later, I was merrily on my way and surprisingly not feeling queasy at all. Woohoo!

Before I went back, Ellen came out to let me know that they had spoken with the pathology lab and they do in fact have the baby. YES! They told her that it typically takes 3-4 weeks to get the results so we should get them fairly soon I would think.

I killed some time by going to my favorite store, Target, and walked out spending only $10. Could this day get any better?!

My ultrasound appointments were at 10:30 and I was supposed to drink 16 ounces of water 30 minutes before the renal exam. I decided to drink it around 9:50 and arrived at the office at 10:00. I filled out my paperwork and was amazed to be called back immediately.

The ultrasound tech was really nice and explained exactly what would happen.
  1. The renal ultrasound would be first.
  2. She would perform a transvaginal ultrasound.
  3. The radiologist assistant would come in and they would do the hysterosonogram together. She explained the procedure and said that it would be mildly uncomfortable but I shouldn't experience too much pain. They would insert a speculum, insert the catheter into the cervix, insert the transvaginal wand, and finally, slowly insert the saline (wow, sorry for all of the inserts).
Of course the renal exam was super easy and I got to empty my bladder right away. I'm a pro at transvaginal ultrasounds nowadays so it was extremely quick. And then she had me empty my bladder again. Clearly I didn't drink the water early enough because they got me in so early (I was done with the transvaginal ultrasound by 10:27).

The hysterosonogram was NOT fun. I have some choice words for whoever came up with that idea because, wow. I like to think that I have a fairly high pain threshold, especially since I've experienced 3 natural miscarriages, one at 9 weeks. But holy cramps! They were intense and sharp and it killed every time they inserted the saline.

At the end they were very excited to let me know that they didn't see a septum. Wait, WHAT? Immediately the tears came a flowing. They were both very sweet and tried to reassure me that I could still have a septum, but maybe they weren't able to see it from that perspective and maybe a HSG would show it better. I tried to hold it together but it was tough and I don't think they're used to comforting someone because they don't have an issue. The tech also mentioned that the left side of my uterus didn't really fill, so maybe there's an issue on that side.

I walked out of the office feeling so defeated and on the verge of waving my tiny white flag. I really, really thought this was our issue and that by the end of April, it would be gone. Now, I know this doesn't 100% mean that I don't have a septum and we're back to square one, but come on! Can't anything be simple?

Dr. M should have the results in 48-72 hours so I'm hopeful that I'll hear back from her by Friday with the next steps. A big part of me hopes that because she saw the septum during the diagnostic hysteroscopy (I've learned so many big and intimidating words in the past year, by the way) maybe that will overrule this ultrasound and we'll still continue on with surgery soon. But the logical side of me knows that's not very realistic and we'll probably have to do some more tests first. Sigh.

One of these days we will get a definitive answer!