Ahhhh. That's so much better.
I'm pleased to announce that I'm tickled pink with my new RE. We had a great consultation/pre-op appointment this morning. I think I'm going to call him Dr. Smooth from now on - because that's what he is. Calm and smooth. None of the alarmist tendencies of my previous doctor.
I had to go sans husband because he had a business trip that couldn't be detoured. So I took my long lists of questions and a tape recorder and asked away. He answered every one of them without making me feel rushed, judged, or silly and his answers were measured and right on target. He even attempted to communicate via drawings! (see pic) He's no arteest, but I appreciate the effort!
So, here's the low-down:
My Ute:
I have moderate to severe adhesions, but he says that diagnosis leans more toward moderate than severe. The concerning factor is the locations of the adhesions, less than their degree. They're at the top of my uterus, which is where pregnancies tend to implant. They take up about 50 percent of my uterus, but it is the important half. He can't tell much else about the quality of the adhesions (dense, thin, calcified, etc.) until he's in there looking around.
My Surgery:
Because of the location of the adhesions, Dr. Smooth is going to perform a hysteroscopy AND a laproscopy all at once. Because the hysteroscopy gives him a view from the cervix in, my adhesions will essentially be extending out toward him. The laproscopy (incision through the bellybutton) gives him a view from the other side simultaneously so he won't be nearly as likely to puncture the uterus and has a better feel overall for what he's doing.
This means full-on general anesthesia for me, and a bit longer recovery, but I'm fine with that because it logically seems like the best route. I'm all for an un-punctured ute.
Balloons, anyone?
In order to prevent this lovely scar tissue from re-forming, he'll be using a balloon catheter to separate the walls of my uterus post operatively. There are two different kinds, based on the severity of the surgery, so I won't know what kind he's used until after. Recovery is basically the same, though. The balloon end is inserted through the cervix, inflated, and left in for two weeks.
I'll be on antibiotics that whole time to prevent infection from my new foreign-bodied friend. They'll give me estrogen therapy for that whole time to encourage my lining to grow back over the areas where the scar tissue was. After, I'll have the balloon removed in his office, and I'll go on progesterone to bring on a period. After the first cycle clears out, I'll go back for another HSG to make sure all is clear.
Magic Eight Ball:
Dr. Smooth thinks my odds of a successful pregnancy post-operatively are good. As long as we don't turn up any other problems, he says I should fall on the higher end of the success rate chart. (And yes, I really did just knock on wood while saying that "if".) He also believes that he'll be able to turn my yucky ute into a cute ute in just one surgery. I was thrilled to hear that!
As far as the likelihood of placenta acreta (where the placenta implants too deeply, causing massive bleeding problems at delivery), he said it was difficult to say because doctors don't have a firm grasp on what mechanisms cause that in the first place.
Miscellany:
As opposed to making me feel like a ninny for even considering the possibility, Dr. Smooth wants me to make an appointment with my old Rheumatologist (did I even mention my weird disease called Minocycline-Induced Lupus?) to have me tested for "every antibody he can think of". If you'll recall, my old RE simply said I could just take baby aspirin and be done with it, rather than do the testing.
He also wants me to get my GP to coordinate my high blood pressure information from my old Nephrologist (kidney doc) to advise him about how much estrogen therapy to proceed with. My old RE simply said there wouldn't be any conflict.
In Summary:
I haven't left a doctor's office smiling in quite some time... it's a lovely feeling! And man, I am SO glad to be done with Dr. Meanie.
I'll try and post more fun and/or witty entries in the next few days, so I don't bore you gals with the tedium of my girl parts.
Oh, and Tessa - I think I may have confused things further... are you with Dr. V or Dr. S?
