Uncommon Julia

Interestink!! (Highly-Scientific Results and Conclusions from the RE Study)

Here is what I've concluded from our completely random, scientific sampling of women's RE's:

1. My RE is a bitch.

2. My RE is not well-hung, and thus, the stud fee I was charged should be refunded.

3. My assumption that a female RE would be predisposed to greater empathy and understanding is WAY OFF BASE.

4. I should switch to Tessa's RE if mine doesn't straighten up and fly right. Special Note: This is handy, considering we apparently go to the same practice.

And the big lesson:

5. There is not one overriding personality type for REs (though there may be two, bitchy women and attractive, grandfatherly men). My assumption that they all suck is apparently false. Good to know!

The Type-RE Personality

Last week, my therapist and I had an interesting discussion about what kind of a person goes into the field of reproductive endocrinology. We decided it must take a special sort.

My therapist - we'll call her Dr. Luz, so she doesn't have to remain nameless for the duration of this blog - suggested that we enlightened, reproductively-challenged folk put our considerable brain power and experience together to develop a personality profile of the average RE. This way, we as consumers will know when our doc's behavior is just normal, run-of-the-mill quirky and when it strays into the land of sheer incompetence.

I think it's a splendid idea!

I'll start:

My RE is a young-ish woman, who apparently has no children of her own. I deduced this from the lack of personal photos in the office. She may be single, too, I failed to notice the ring finger. She's white, petite, and very neat (neat - anal-retentive; not neat - nifty).

She's a statistician who prides herself on telling it straight and not dancing around the hard truth. She believes in hard science, as opposed to "anecdotal information". And she does not perceive any connection between what she does for a living - creating embryos and hopefully infants - and what her patients do - bring children into this world. Thus, her comment to me about not losing any time before getting back to TTC before I hit the daunting age of twenty-seven. Heaven forbid I take a moment to grieve and heal.

She's got a terse bedside manner and does not give patients the warm-fuzzies. But she does at least pick up the phone to personally deliver bad news. I know for a fact not all docs can bring themselves to do that one.

What's your RE like? Share his/her profile in a comment, and I'll do the oh-so-scientific compilations. The FBI's got nothin' on me!

She's Baaaaaaaack

The Infoholic Witch made a vengeful come-back last night. And this time, she came bearing justifications, spewing them even as she typed the Google key words: "Now you have a diagnosis, you see, so it would make sense to look into the problem and educate yourself..."

And, once again, she succeeded in scaring the pants off me. It turns out that the birth rate for women who've been treated for uterine adhesions can vary significantly - and by significantly, I mean like someone throwing a yo-yo while riding the Tilt-O-Whirl.

She brought me the following from the Center for Reproductive Endocrinology:

"Reproductive outcome appears to correlate with the type and extent of the adhesions. After treatment, patients with moderate adhesions have full-term pregnancy rates of approximately 70 to 80 percent, and menstrual dysfunction is frequently alleviated. Alternatively, patients with severe adhesions or extensive destruction of the endometrial lining may only have full-term pregnancy rates in the 20 to 40 percent range after treatment. Women with extensive damage to the endometrium unresponsive to conventional therapy by hysteroscopy may be offered gestational surrogacy."

and then from another source:

"Such a pregnancy, however, has a greater chance than usual of ending early as a miscarriage or as premature labor. More seriously still, the placenta of the new pregnancy can grow deeply into the wall of the uterus (called 'placenta accreta'), and might not come loose after the fetus or baby has been delivered. The result of this can be bleeding that is sometimes unstoppable short of an urgent hysterectomy."

Imagine my delight!

The Wizard used the term "heavy scarring" to describe what she saw in my HSG. I am absolutely too petrified to call her and find out if that means what it sounds like. I imagine she'll give me the 'ol "I can't say until I get in there" answer anyway.

So, after to succumbing to the Infoholic Witch's evil plans, a new one of my own suddenly popped into my head:

Perhaps, if all goes well and we convert my yucky ute into a cute ute, we could try for hyperovulation. Follow my reasoning, if you can. With hyperovulation the chances are better that A) we'll conceive, B) at least one fetus will be of sound chromosomal make-up, C) at least one fetus will implant successfully, and D) we may only have one shot at me being pregnant at all if my uterine lining is in danger - so multiples might be the only chance to have more than one biological kiddo.

Now, I know for a fact that I am getting the proverbial cart WAY ahead of the horse. I can't seem to help it. I'm neurotic that way. But this idea just popped into my head as unsolicited as the witch herself, so I thought I'd share.

The funniest part is that this latest brainchild of mine scares the bejeezus out of me.

So now I stand here sans pants and bejeezusless from fright.

Any thoughts?

Feeling Numb (and other oxymorons)

So, I've had a nice weekend to pad the trauma of my recent "yucky-ute" news. A little perspective is always nice. So is tequila with your husbands co-workers... Wha? Who said that? The result has been a nice little vacuum that I really wouldn't mind hanging out in for a while. But I know I'll be kicked out in a little while.

As soon as I ovulate I've got to set up the hysteroscopy. So in about three weeks, I'll go under again. The pain meds after are nice, though. Tequila without the headache.

All evidence to the contrary, I'm really feeling quite free and self-pity-less. I've even sent Patty Potty-Mouth packing for a few days (you remember her - she showed up in my last post). I'm certainly enjoying the liberation that comes with knowing you won't be pregnant for a certain period of time. The choking cloud of question marks that comes with trying to conceive can really be overwhelming. We've actually planned a vacation for this summer - without wondering where I'll be in a pregnancy!

And amazingly enough, I still have clients who are beginning to line up projects for this year - employment, YAY!! After the disappearing acts I had to pull over the last year, it's a damned good thing that people appreciate my work. Perhaps I'll make paychecks a regular feature of 2004. That would be nice.

As you can tell by the category of this post (Random Nada) I really don't have all that much to inform you of today. Perhaps later I will tell you about this weekend's festivities, or rant about asshats who have crossed my path. But for now, I'm going to ride out this numbness. It's quite lovely.

Choc Full 'O Adhesions

"Her womb was a rocky place where my seed could find no purchase." ~ Raising Arizona
(Sorry Suzanne, this quote was just too appropriate. I had to steal it.)

So, after playing a rather lovely, par-for-the-course round of phone-tag with my RE's nurse, I finally got the news. You know it's bad when the Wizard herself tracks you down on your cell phone after trying both your home and work numbers.

Fuck. (Sorry gals, but some situations just call for that word, and this qualifies.)

Fuck, fuck, fuck.

I'm apparently sporting a lovely array of scar tissue at the top of my uterus. For some reason I think I already knew this. The Infoholic Witch clued me in with a bit about lighter-than-usual periods during my frantic Google binge yesterday. I've been having odd cramping at weird times during my cycles, too, which could be symptomatic.

So this afternoon I get to call Wendy, the surgery-scheduling nurse, and set up an appointment to have another invasive pelvic surgery.

WHEEEEEEE!!!

It's going to be a hysteroscopy, and then "we'll see," depending on what the Wizard finds. She says we're going to discuss things in greater depth at my pre-op appointment. I have to admit, as stoic as I've been about all the surgeries and medical conditions that life's doled out to me like so much 20-year-old candy out of grandma's candy dish, I'm really beginning to fear surgery. Call me crazy (hey, I likely am), but there's only so many consent forms you can sign warning of uterine impalement, hysterectomy, and oh yeah - death - before your teeth begin to chatter out Morse code for "Stop it, for the love of God!"

The Wizard says the adhesions could likely be the cause of my last son, Todd's demise. This little piece of knowledge sucks royally. Knowing the statistics (thanks again to the Infoholic Witch) on the probability of forming adhesions after a D&C procedure, I frankly stumped as to why my OB never suggested an HSG prior to giving me the go-ahead to conceive the third time. I think two D&Cs might have given her cause for concern.

Beyond that, it sucks that I now know my own body might have fallen down on the job and basically starved him to death. Who needs that chunk of wisdom mucking things up upstairs?

So, let's review our tally here:
One son, died at six months gestation due to medically necessary termination from arthrogryposis.
Second son, died in a first trimester missed miscarriage, most likely from some chromosomal abnormality, or the ever-famous "bad luck".
Third son, died at 11 weeks gestation in a missed miscarriage, perhaps from poor blood supply caused by adhesions caused by the second loss; or perhaps from low progesterone levels.

Well, no one can say I don't turn over every stone in my search for new and interesting ways to lose children. Perhaps some of my bitterness will wear off in the coming days. That would be good.

In the meantime, me and my tore-up womb had a bottle of wine with our name on it.

Fuck.

Nervous as a Cat's Tail in a Room Full of Rocking Chairs

Yep. That's me.

I had my HSG performed on Monday, and today is Thursday. I should get the results today. So far, no call, and I waited long enough that the office is closed for lunch at the moment. I won't pretend I'm strong enough to hold out much longer. I'll be calling around 1:30 to see if they have any news.

In the meantime, I've given into the divisive little monster that lives inside of me whispering, "Hey, why don't you do a search on Google, or WebMD, just to see what the worst case scenario is... you know, to be prepared."

Prepared, my ass. Petrified would be the correct term.

We'll refer to this monster as the Infoholic Witch. She pops up quite frequently in my life. Though, I must admit, I make it easy for her. A chick like me with a medical resume as long as your arm is an ideal habitat for the Infoholic Witch. She loves terms like "rare disorder", "Minocycline-Induced Lupus", "statistical improbability", and "unexplained, sudden-onset hypertension". I am a veritable feeding-ground of worry and ripe soil for any manner of clinical disorder.

But the most attractive aspect of this habitat for the Infoholic Witch is my passing acquaintance with biology, genetics, and science in general. My father was a biologist, and I planned on following that line until I woke up my sophomore year in college and realized that English was much better suited to both me and my GPA. I grew up receiving the real answer to such questions as, "Why is the grass green?" or "Why do magnets stick?" None of that "'Cause God made it that way" stuff for this young girl.

As a consequence, I have an uncanny ability to understand and reiterate other people’s scientific knowledge. Just enough to delve into the underbelly of it all without a tour guide. The result is pathetic. It usually involves self-induced panics and gloss-eyed stupors as my hand scrawls down note after note about certain clinical terms and hair-brained theories on how certain conditions may be linked.

I must be a doctor's nightmare. But the Infoholic Witch, she's in heaven.

So after giving into her this morning, my Google search produced a lovely array of titles full of lovely words: Hysterectomy; Infertility; Lesions; Dissection; and yes, Hysterectomy a few gagillion more times - just to drive the point home.

Did I mention Hysterectomy?

So, I've fed the Infoholic Witch a turkey sandwich for lunch in hopes that that will stave her off until I make the phone call. I know it's not nearly as satisfying a meal as paranoia with a side of hysteria, but I pray it will do.

Irony (or leastwise, something horrifically close to it)

So, Julia, how'd you spend your afternoon?

Well, inquiring mind, I spent it sorting through a file aptly labeled "Hospital Bills - Angel #3". You see, there's this special, sick, grimacing sort of hell that miscarrying women have to go through whereby they sort out bill after bill, deftly matching them to benefit explanation sheets, and organizing them according to such lovely descriptions as "Incomplete/Missed Abortion" and the likes.

"Let's see... was that D&C number three or four? Hmm... let me find the dates, that'll help. Oh, look! There are the multiple fees for the six different IVs I had to have in one fun-filled day! Misty water-colored memories... "

So, once the bills were matched to the explanations (which really don't qualify as such), and the checks were written, I decided it was only fitting to use the last of my Christmas stamps to send the 'fing things out. What's more fitting than sticking a glowing picture of a saintly mother and cherubic newborn on the bills that say, "Thank you so much for removing the product of conception from my unfit loins."?

Lovely.

"I like big butts and I cannot lie."

And yes, I'm a fan of old-school, ghetto rap.

All that aside though, this last year has taken a real toll on the 'ol bod. So my husband and I have decided to tighten up and batten down. Keeping this in mind, I was fascinated by some tips given by some "expert" (he must have some qualifications, though I know not what they are) on Good Morning America. He swore that if you do these things, and nothing more, you'll lose weight.

1. Drink water. (Yeah, we all know this one, but doing it can be a real chore.)

2. Eat breakfast every day, and preferably, something with calcium. (We also know this one, but the numbers and statistics he threw out were enough to make me eat a bowl of cereal this morning.)

3. Three apples a day keeps the doctor away. (Apparently, eating one apple - no matter the variety - before each meal does the trick. They're mostly water anyway, and they're filling enough that you don't cram your face... or that's the plan anyway.)

4. No caffeine. (ZZzzzzzz.... wha?! who? I'm sorry, I must have nodded off.)

5. 2-3 hours of exercise per week. (Now, when I heard that one, it sounded wonderfully do-able. But I think it's important to note that I did not exercise yesterday, nor this morning, nor do I find it likely that I'll do so tonight.)

And then, on another mindless morning show...

6. Have sex! As much as you can, however you can. It's apparently good for all sorts of reasons. It's sometimes aerobic, generates all sorts of magic chemicals in the brain and bloodstream, and let's face it - if you're too tired from screwin' all day, when are you going to have time to eat?!!

Three guesses for which of the aforementioned steps I'll be following....

Upon Waking This Morning...

... I thought to myself, "Today seems like the perfect day to have a relative stranger introduce an inflatable balloon into my hoo-ha. And while she's there, I'll ask her to inject some dye, too."

And so I did.

Thus spaketh the Wizard.

Here's what I learned:

1. Ouch.

2. A 2:00 "appointment" is really more of a "suggestion".

3. Some technicians can actually be nice, though they are obviously the minority.

4. My tubes are open. [Yeah!! We were already pretty sure of that, but I'll take what I can get! Insert cheer here.]

5. Ouch.

We await the rest of the results in a few days.

Tick-Tock Tick-Tock

Let me begin this by stating that I am twenty-six years old. Let me repeat that: I am twenty-six. I have believed, for quite some time now, that this is an ideal age to conceive and give birth. And I've found no small amount of comfort in the fact that my husband and I [knocking on wood] have conceived with relative ease for each of my three pregnancies. Dr. Wizard confirmed this notion during our consultation on Friday.

"I know that after the experiences you've been through, you need a break psychologically," she says while clicking her pen. I nod furiously, "owning" my feelings about being in way over my head in the grief department. My therapist's words echoing in my head "your mantra for the week should be 'slow down'."

"But," (we knew there was a "but" coming, didn't we?!) "the best thing you have going for you right now is your age. Your youth is a huge benefit for you. And I wouldn't want you to run into further difficulties, only to find yourself frustrated that you let six months go by without doing anything."

Now, correct me if my math is fuzzy, because I would never claim to be a mathematician, but in six months time, I will just be turning twenty-seven. Let me repeat that: I will be twenty-seven. Has the magic maternal line in the sand just been moved up?! Will something change between now and this summer that will make me old enough to be concerned about the six useless months that have just slipped through my fingers like so much wonderfully virile, sperm-laden semen?!

The trauma caused to my psyche over the past year is cause for more than a brief pause, in my weighty opinion. And I am only just now, after not even two months since my last loss, begun to feel the itch of the scabs over my latest emotional wounds. Is Dr. Wizard now suggesting that we make haste and rip the band-aids off? Shall we jump back in those freezing waters without waiting for our lifeboat to re-inflate?

I don't get it. This is the first time I've ever had a doctor encourage me to get up off my ass and get back to gettin. Hurry, dammit, time it is a tickin! [as she taps the face of her wristwatch]

Our original plan was to wait until this summer at the earliest to try and conceive. Now we're back in the familiar land-of-the-shrugging-shoulders [you take a right before reaching Oz just off the yellow brick road to get there].

Grrr.

So, my question is: If this is what Dr. Wizard tells her twenty-six-year-old patients, what, pray-tell, does she say to my many friends whose "maternal age" is cause for "concern"?!!!

Somebody hurry up and fill her crack pipe back up to the top before she comes down off that lovely high!