Good News All Around!

I'm so glad that I trusted Dr. M. As we got closer to surgery date I was secretly starting to have some doubts if the surgery was worth the money. After meeting with her on Monday I was seriously starting to doubt if we should go through with it. The images should have shown something, right? Thankfully I stuck with it!

I had a 3cm septum that was successfully (we believe, at least!) resected yesterday. I don't remember much of what Dr. M told me so this is all based on what E remembers. Let's hope he's right ;)

From my understanding, the surgery was on the longer end but they got great pictures (E was sure to let me know that he got to see the inside of my uterus...strange indeed!), they had to do the laparoscopy and they did resect the septum. E tried to explain what he saw in the pictures and it sounds like my uterus was a pinkish color (it looked like "meat" apparently...gross) whereas the septum was white in color which indicated that it wasn't getting blood or nutrient flow. He said that the after pictures showed the white gone and only a healthy looking uterus. Let's hope this did it for us!

I was in recovery for a while because I was in quite a bit of pain and was really nauseous. The recovery nurse was wonderful and I wish I remembered her name because I would love to send her a thank you card! Dr. M. came to speak with me and all I got out of that conversation was that there was a septum and they fixed it. The rest of the time the nurse had to deal with me crying and saying "I'm so thankful" over and over. She was a saint.

We got home around 4/4:30, I believe, and my sister stopped by quickly to drop off some flowers and a gift from her, my parents, and grandma. My nephew picked out the card and it is certainly a two-year old card. So cute!

Then I was pretty much off in la la land the rest of the night and slept. I woke up around 2am and was in and out until 5:30 when I woke E up. He got me a small breakfast and I took some more pain meds. Then it was back to sleep!

I'm actually feeling pretty well now. I'm trying to walk around a bit to hopefully keep the gas pains to a minimum and I haven't taken any pain medication since this morning. The most uncomfortable and awkward part is the catheter. It's not a traditional urine catheter, of course, so its strange to use the restroom. It just doesn't feel right. I feel bad because E has, once again, gotten quite an education with this surgery. He's such a good guy and I'm incredibly lucky to have him!

Right now, all of this uncomfortableness from the catheter and the slight pain is totally worth it and I truly am thankful. While it's going to be a while before we can start trying to conceive again, I'm glad that we're finally moving forward and may have finally found a solution.

The Start of a New Chapter?

Today's the day and I'm scared.

I met with Dr. M. on Monday and she solidified the idea in my head that this is an exploratory surgery. She still thinks there will be something to resect/fix, but she can't say that with certainty until she gets in there. So that means one of two things will happen:

1. If it ends up being just an arcuate uterus, there is nothing they can really do. In that case they'll take a ton of pictures and send me off to a Reproductive Endocrinologist armed with all of my pictures, blood work, chromosome analyses, etc.
2. If it's a septum, they'll resect it and insert a balloon catheter. The catheter would be in for 5-6 days and it would be taken out in office. I would also take estrogen for a month followed by 10 days of progesterone which would bring on a bleed. We would then need to wait 3 cycles to ensure the lining builds up enough before trying to conceive again.

I slept horribly last night and had some really, really screwed up dreams. Then this morning I had a minor cry when I was telling E how nervous and scared I am that they won't be able to do anything. It feels (and sounds) so wrong, but I've been praying that there is a septum in there and they'll be able to fix it. I just want there to be an identifiable problem and a solution, which takes place today. That's not too much to ask for, right?!

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)

Slowly moving forward

Well, I got my MRI scheduled. I think I answered about 30 questions while scheduling the appointment about my medical history. The scheduler mentioned that they needed pre-authorization from my insurance company and my doctor's office hadn't taken care of that. She scheduled me (tentatively) anyway for this Friday at 3:45.

I called the doctor's office on Thursday and asked them to take care of that and finally heard back today. It's a go! Woohoo!

So now I get to wait some more.

In other news, I'm doing well with getting healthier. I started on March 30th but later that week I got a really bad cold. I ended up skipping my workouts for four days (I didn't think mixing working out with the inability to breath would be a good idea) and ate like crap. BUT I weighed myself and I'm still down 4.6 pounds since March 30th. Two weeks? Not terrible! I can't really see a difference when I look at myself, but I certainly feel better. It's really helping to keep me going.

Wednesday is, for a lack of a better term, a special day. April 15th marks the one year anniversary of our first loss. I can't believe it's already been a year and here we are with three more failed pregnancies and dwindling hope.

But I really am trying to stay positive! Hopefully this MRI will show what we need and we can move forward.

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!

No news is NOT always good news.

Today was the day! I FINALLY had my post-D&C appointment and I was really looking forward to it. I was seriously giddy all morning.

I called E right after the appointment and summed up the appointment really well. "In true Crystal fashion, nothing can happen easily."

Here are the highlights:

•  Dr. M is concerned because we don't have the pathology results from the baby. She was honest and said that we should've had them by now, she's put multiple calls into the lab and she still hasn't heard back. She's concerned that the lab may have lost the baby and no testing was done. Fingers crossed that isn't the case!
• She mentioned that if we do get the results, she believes they will show that the baby was chromosomally normal. This is where we transitioned to the septum. She said the septum was rather large (I think she said something to the extent of it taking up about 3/4 of the "endometrial area" or something). She believes that this pregnancy didn't survive because there wasn't enough room for the sac and baby to grow. She thinks it literally ran out of room.
• She's decided to do a hysterosonogram/saline infusion sonogram instead of the MRI. I was really excited when she told me the reason she decided on this. She said it typically takes 2-3 weeks for someone to get in for the MRI but the hysterosonogram could be done today! WOOHOO! Yes, please! 
• She's going to get started on the surgery side of things (insurance, booking, etc.) in the meantime. The surgery will be performed by her and the senior doctor of the practice will be doing the ultrasound during the surgery. She's also booking me for a laparoscopic surgery just in case the ultrasound doesn't show everything well enough.
• After the surgery, we'll have to wait 2-3 cycles before trying again.
• She put me on birth control pills after the D&C so she said to continue them but to not take the placebo pills, just continue on with another pack. The purpose is to allow us to do the surgery right when we want. Apparently it's best to do the surgery soon after the start of a new cycle, so when we have the surgery scheduled, we can manipulate my period to allow for the best timing.
• She believes the septum is the issue and didn't think the additional blood tests were necessary. I asked if we could still do them because I want to cover all of our bases and she agreed.

So after my appointment, I got the write up for the hysterosonogram (and a renal ultrasound...apparently uterine issues can sometimes signal kidney issues so she just wants to check things out), got blood drawn for HCG and my chromosome analysis and was on my merry way to the radiologist office.

Here's that saga:

• I went over, showed the receptionist my paperwork and asked if I could get in today because I was willing to wait (Dr. M has sent dozens of patients over and they were able to get in the same day). The receptionist informed me that they do the renal ultrasound there but not the other.
• I went back to Dr. M who tried calling over but she was put on hold for 10 minutes. So, she wrote "saline infusion ultrasound" on the paper and sent me over again. She said if she still insisted, we would find a different place because she wouldn't want them doing it.
• I returned to the radiologist and was told the same. Sigh. She told me I would have to go to office A for the hysterosonogram and office B for the renal ultrasound. Awesome.
• So I found my car and called the central scheduling office. That poor woman. She was probably so happy when she hung up with me.
• I told her the tests that I needed and also said I understood that I would need to go to two different places and that was fine. She put me on hold and then returned to the line after 5 or so minutes. She was happy to inform me that there was one office that had a tech who did renal ultrasounds and another who did the hysterosonogram and that they were in the office at the same time a few times a week. Perfect!
• She said the best time to do the saline ultrasound was between CD 7-11 so I would have to call back on CD 1 to get it scheduled. Uh oh. I explained my predicament (Dr. M wants me to continue with the BC pill and no placebos until surgery time). I ensured her that there was no chance of me being pregnant and that I would have my HCG results tomorrow. She seemed unsure but booked me anyway for next Monday. I gave her the date of my D&C and she said she would push the information onto the ultrasound tech. If the ultrasound tech is concerned or won't do the ultrasound then, I'll have to stop the birth control and call back on CD 1. AHHHH!

Like I said, nothing can happen easily. Best case scenario? I'll have the ultrasound next Monday, Dr. M will have the results within 3 days, and I'll have surgery during the month of April. Then we'd wait 2-3 cycles and as Dr. M said, hopefully we'll be in the second trimester at the end of 2015.

Keep your fingers and toes crossed that the best case scenario is what becomes reality!!