Surgery details

A novel by polkadot

Here is all you ever wanted to know and more about my surgery experience.  You might want to get comfortable because this is long.  :)  I didn't sleep much the night before surgery.  We set multiple alarms to ensure that we woke up on time (in the middle of the night).  I totally expected to be a nervous wreck and possibly even nauseous...but amazingly I felt pretty calm when I woke up.  Praise God.  DH and I arrived at the hospital at 6:00 a.m.  They took me back to a room so I could change into a gown, non-slip socks, and a lovely pink surgical cap.  The nursing assistant covered me with a thick sheet (nice and warm!) and hooked me up to a machine that took my vitals.  I still wasn't feeling too nervous at that point, and my blood pressure proved it—it was under 115!  Seeing that actually calmed me down more.  The nurse was even impressed.  I take no credit of course for that.  It was all grace.  :)  When she starting setting up to insert the IV,  I warned her that my previous experience with an IV resulted in me fainting.  Maybe she was going to do it anyway, but she gave me an injection of lidocaine to numb up the area first.  Unfortunately, the lidocaine didn't quite go in the right place, so I could feel the IV going in.  She felt really bad and apologized several times, but it turned out fine.  Honestly, the IV was my biggest worry so I was relieved when it was over.  :)

I had a stream of visitors after that—anesthesiologist, nurse anesthetist, other staff members, and finally Dr. C.  I was asked several times to confirm my identity and to list the procedures I was going to have done.  At one point, there was a person on either side of my small bed reading my medical file (which was on my lap) aloud to each other so they were both sure the plan was correct.  :)  Since I "passed" their paperwork inspection, they gave me a blue surgical cap to wear.  Then DH came in for a little while. I'm sure I was quite a sight to behold with all of the cords and things attached to me.  ;)

I remember being rolled into the OR and was surprised that there were so many people in the room...definitely more than you see on tv shows.  hahaha  I didn't really get a chance to look around much before I went to sleep—it happened very quickly.  When I woke up, I was in a small room with the lights dimmed.  DH appeared shortly after that.  I was comfortable and warm and not in pain, but I don't remember much else.  I begged DH for details from his conversation with Dr. C (which happened while I was still sleeping).  He wanted me to relax and not think about the results.  This made me worry that there was bad news...so I was able to pry some info out of him—some endometriosis, open tubes, no polyp.  He started to tell me that the resident was afraid during the surgery so I made him stop talking.  Those details could wait.  ;)

DH helped me get dressed.  Ladies, let me tell you—lounging pants with a flat panel around the waist instead of a drawstring or elastic band are the best!!  At some point the pain set in.  The nurse gave me a pill orally which helped for a while but made me nauseous.  Then a second type of pain started—it felt like really bad menstrual cramps, so she gave me something in my IV.  DH sat on the side of my bed and held my hand for a long time until the pain subsided.  Then the nurse started asking if I had to urinate.  (DH shared with me later that he thought it was a silly question...the nurse had told DH earlier that they had emptied my bladder during surgery with the catheter, and since I hadn't had anything to drink since midnight, DH knew there was no way I would be able to urinate when she asked...)  She gave me a large cup of water to drink.  It's hard to drink let alone chug water when you're slightly nauseous.  Once I finished the cup, she took me to the bathroom down the hall in a wheelchair.  I don't know if she was expecting my kidneys to work instantaneously, but it did seem a little premature to be heading to the bathroom...  ;)  I tried but it didn't work.  So she took me back to the room and did an ultrasound to measure how much was in my bladder. 100 cc is not enough, so she gave me more water to drink and fluids in my IV.  DH amused himself by announcing how much fluid I had received at various intervals.  Trip #2 to the bathroom was unsuccessful.  The nurse seemed to be getting impatient.  If I could have willed myself to go, I would have!  I knew that we could go home as soon as this was accomplished.  Ultrasound #2 showed 200 cc, which was still not enough.  The nurse went on her lunch break so a different nurse took over.  Nurse #2 was less impatient.  Trip #3 was still unsuccessful but only because I could not make my muscles work—I could tell that there was enough urine available but nothing happened.  Doing Kegels didn't help either.  It was a bit scary actually—I thought maybe a nerve or something had been damaged during surgery.  The only specific detail DH had told me about his conversation with Dr. C was that there was "endo on my ureter," and the resident was too scared to remove it because of its location, but Dr. C removed it anyway.  This was going through my mind the whole time...  The nurse suggested that I try walking around, so DH escorted me up and down the hallway.  DH actually offered me his arm and said, "Would you take a turn about the room with me?"  (a reference to Pride and Prejudice, which made me smile)  :)  Finally on trip #4, about four hours from the time I started drinking water, I had success.  It wasn't much as I really couldn't make my muscles work well but it was enough to let us go home.  (It took about a day for those muscles to go back to normal...I wish I had been told that ahead of time...)  I was so relieved.  So was the nurse.

I slept in the car for about an hour.  Then we stopped at a Walm.art along the way to fill my prescriptions.  I thought it would be good for me to be up and walking around, so I went in with DH.  I was doing well for about 15 minutes, but perhaps it was too much activity too soon because I started getting nauseous.  Luckily I made it to the restroom in time.  It would have been rather embarrassing if I hadn't made it.  Afterward I felt much better but retreated to the car to take it easy.

We made it home around dinnertime.  All I could manage to eat was applesauce.  I had been instructed to take the prescription ibuprofen on a schedule for the first 24 hours whether I was in pain or not.  I was surprised that they also gave me oxyco.done...I thought my pre-op instructions said I should just take over the counter ibuprofen as needed.  However, I was very thankful to have it.  I learned quickly that the ibuprofen only relieved the uterus cramping, and that the oxy.codone only relieved the more generalized abdominal pain.  I was able to sleep for a few hours at a time between doses.  I also learned that if I had extra abdominal pain between doses, it meant I had to go to the bathroom.  (I had absolutely no other indication that I needed to urinate—no urgency, nothing.  In fact, I still don't.)

The next morning DH had to go to work, so he set up everything I needed near the bed.  I planned to spend most of the day in bed because the oxy.codone makes me dizzy and nauseous if I walk around much, and I was still pretty exhausted after two nights of little sleep.  Plus getting up from the bed by myself was still difficult and painful.  When both pain medicines kicked in, I was able to take a nap.  When I was awake, the heating pad helped a lot.  DH called during the day to check on me.  By the time he came home, I was feeling so much better.  My appetite was back finally, and I wasn't needing the oxy.codone as much.  I tried to walk (hobble) around as much as I could.

Then after much anticipation, it was time to listen to Dr. C's post-op report that DH had recorded.  Dr. C printed out pictures from the surgery and explained them all.  He didn't mention what stage the endometriosis was, but he found it in 5 spots: above the uterus, near one uterosacral ligament, under an ovary, right over the bowel, and near a ureter.  He was confident that he found and completely excised (cut out, not lasered) all of the endo, even the two spots that the resident was too scared to touch (bowel and ureter).  I appreciate that Dr. C was somewhat fearless in removing the endo.  :)  He said he did check the integrity of the bowel after removing the endo, and it was fine.  He found a small fibroid sticking off of the top of the uterus, but he didn't think it would affect fertility because of its location and small size, so he left it alone.  My tubes were completely open, and the fimbriae looked healthy.  He explained how he leveled off most of septum so it wasn't obstructing the uterus so much; the after picture looked really nice compared to the before picture  The whole surgery was done in under 2 hours.  He said we'll talk about the next steps at my post-op appointment in three weeks.  In the meantime, I am taking Premarin (estrogen) for three weeks (to build up the lining so it doesn't stick together where the septum was removed) followed by Provera (progesterone) for 10 days (to stabilize the lining).  How Dr. C described it:  If the lining of the uterus is like a lawn, estrogen is the fertilizer, and progesterone is the lawn mower.  When I stop the Provera, I'll have a withdrawal bleed and then go back to normal cycles.  I also have a stent (balloon) in my uterus holding it open to prevent adhesions.  It can be removed after three days (by DH or me).  The cord is like a large, plastic tampon string, and I am looking forward to life without it.  :)

I am remembering you all in prayer and offering up my pain for you.  I am trying to be patient during recovery, but it is hard, and I admit I have cried a couple times.  DH has been so supportive and an amazing caregiver, and he has been helping me try to stay positive.  Thank you again for all of your prayers.  They mean so much to me.  :)

Surgery is done!

Well, ladies, I survived.  :)  Thanks for all your prayers!  I appreciated them so much.  I'll write a more detailed account this week, but here's a short summary for those of you dying to know how it went.  I know there has got to be at least one person out there who is as curious about another IF blogger's surgery results as I am...  ;)  Ironically I'm not as impatient with knowing my own results as you will learn shortly.

Dr. C found and removed some endometriosis.  I don't know what stage it was, but there wasn't much.  My tubes were open.  I don't think there was a polyp.  My uterine septum is history.  That is about all I know of the results.  Dr. C spoke with DH before I woke up from anesthesia and recorded the conversation on my cell phone so I can listen to it tomorrow.  Today I just needed to (try to) relax and recover.  My pain is pretty well-controlled by more than one medication.  DH doing a fabulous job taking care of me.  More details to come tomorrow after I am more rested.  :)

Anointing of the Sick

I have wondered for a while if infertility is an acceptable reason to receive the sacrament of Anointing of the Sick.  Somehow it happened that every time the thought crossed my mind, I was nowhere near a computer to look it up.  I knew the sacrament was for the seriously ill, but how serious did the illness have to be?  I have known people to receive the sacrament before having surgery.  DH suggested that we just go to our priest for the answer.  So we did.  After Mass on Sunday, we were sort of able to pull Fr. aside amidst the line of exiting parishioners greeting him on their way out.  I said I was wondering about the Anointing of the Sick.  Fr. looked all worried and asked if I was the one to be (possibly) anointed.  When I nodded, he asked why I was going into the hospital.  (I had not said I was going into the hospital...that was his assumption.)  I said I was having surgery for infertility.  That was all he needed to hear, and he said, "Let's do it right now."  Before I could answer he was halfway to the ushers' room so he could wash his hands.  By the time we reached him, he already had the holy oil.  (He wasn't wasting any time!)  He led us to the back of church.  DH stood next to me as Fr. started to pray over me.  He placed his hands on my head, was silent for a few moments, then continued to pray out loud.  By that point I couldn't hold back the tears anymore--it was so moving.  Then he anointed my forehead and hands.  I felt the most incredible peaceful feeling come over me.  Afterward Fr. promised to pray for us and to ask for the intercession of St. Paul of the Cross, who was known during his lifetime to be a powerful intercessor for couples who could not have children.  (I did not know that.)  Fr. said women would travel long distances to ask him for prayers for this very reason. 

Since the Anointing, I have been feeling a lot less anxiety about the surgery itself.  :)  I can't believe it's less than a week away!

I had my pre-op appointment last week.  Aside from waiting 1.33 hours to be seen, it was uneventful.  A doctor I had never met before reviewed the consent form with me and answered my questions.  I asked if they found too much endo, would they turn the surgery into a laparotomy (bigger incision, much looonger recovery time) to clean out all the endo (no).  I learned that they are doing something called chromotubation instead of the HSG.  The concept is the same—squirt liquid in the uterus and see if it spills out the tubes—but instead of viewing the results on a screen like they do with the HSG, they watch live during surgery.  She said if no liquid spills out, it's not a conclusive test, so then I might still need an actual HSG.  Let's hope that is not the case... 

Then a nursing assistant gave me the instructions on how to prepare for surgery.  No bowel prep.  Nice.  :)  I just have to wash with antibacterial soap the night before and morning of the surgery and not eat or drink anything after midnight.  The not eating part won't be a problem, especially if the surgery is in the morning, but the not drinking part will be harder.  My water bottle and I are attached at the hip.  ;)  Given the long drive to the hospital, I told DH he has to hide my water bottle so I don't accidentally drink some.  There's a big note at the bottom of my surgery prep sheet that says your surgery will be canceled if you break this rule. 

After receiving my pre-op instructions, they sent me to the lab for bloodwork.  I had to laugh...one of the tests ordered was the HCG/pregnancy test.  I should have e-mailed my doctor ahead of time to cancel that, although I suppose it might be a routine test for all patients.  With the timing of this past cycle, we decided to avoid pregnancy (and we ended up not using any days pre-peak), so any conception would have been of the immaculate variety.  ;)  This was my first ever pregnancy test of ANY kind...and it was during a cycle when it was impossible that we conceived.  And as it turned out, they e-mailed me the results on Valentine's Day.  Good thing I already knew what the results would be...  ;)

Can you put infertility on your resume?

Sometimes I feel like trying to find the cause of our infertility amounts to a part-time job...without a paycheck, of course.  ;)  I wonder if it could be used as an example during a job interview, say, as the answer to the question, "Describe your organizational skills."  I remember being asked that question during my last job interview...  You would think that the tasks we do routinely—calling the pharmacy to refill prescriptions, picking up prescriptions or arranging their shipment so they arrive in time for the appropriate cycle day, finding a lab who will work with us, coordinating with the doctor's office to have the latest order faxed to that lab, scheduling appointments and lab draws around my work schedule, calling the insurance company to confirm coverage, staying on top of medical bills—should count for something, right?  You could imagine what a description for a resume might look like...coordinated logistics, managed inventory, liaised with health care professionals... Maybe someone who's more creative than me could write up a pretend resume entry.  ;)

This week my assignment was to prepare for a SFA.  This will be our first one.  I knew it would have to be done at some point, but I'm still not really looking forward to it.  I am a bit surprised it wasn't suggested sooner; however, my chart had definite issues that would have been addressed regardless.  Technically, my non-NaPro ob/gyn did mention SFA back when we had only been TTC for 8 months or so (but it was too soon to order it at that point, in his opinion).  He knew we were Catholic, so we had this little discussion about our theoretical infertility testing:

Doc: One of the first things I would want to do is get a SFA.  Would that be a problem?
Me:  No, of course not.  I'll just order a kit.  [to collect SF in a licit manner]
Doc:  Hmmm.  I thought you'd say that.  The lab here really doesn't like it when samples are obtained that way.  *sigh*  But it's going to have to do.  Okay, that's what we'll do.

Anyway...so this week I called the PPVI Institute to order the SF collection kit.  (Side note:  Anyone can order one from the Institute; you don't have to be a patient of theirs, and you don't need your doctor to send them anything.)  Next I had to find a local lab that would do the analysis.  I figured it would be easy, right?  I just needed to confirm the location of where to drop off the sample and when they open in the morning, and we'd be all set.  Well, not exactly.  I started by calling the hospital lab number.  The woman was nice and said they don't handle SFA there, but she would transfer me to woman #2 in the hospital who could help me.  Here's the conversation with woman #2:

Me:  Hi, my husband needs to have a se.minal fluid analysis done.  Are you the person to speak with about that?
Her:  You need an analysis...of what?
Me:  sem..in..al flu..id (spoken slowly and enunciated as clearly as I could)
Her:  Ummm.  I'm sorry.  I don't know what that is.
(*short pause*)
I was about ready to say, "Well, it's the fluid produced when..."
Her:  Just one moment, please.

She put me on hold and returned about a minute later.  Thank goodness someone in her office knew what SF was so I didn't have to explain it.  :)

Her:  You're going to have to call clinic XYZ about that.  We don't handle it here at the hospital.
Me:  Do you have that clinic's number?
Her:  No, sorry.

I pulled out the phone book and called clinic XYZ.  I explained that we would be bringing the sample into the clinic, which the receptionist seemed to understand.  She said it had to arrive within 30-45 minutes.  (I had heard less time than that so we'll try to err on the shorter end of that range.)  Okay, no problem, I thought—just tell me where to drop it off and your hours...  Not so fast.  She said DH needs an appointment with the nurse who will talk to him and then send the sample to the lab.  Those appointments are only available two days a week.  So now instead of just hurrying to get the sample to the clinic within about 30 minutes of its collection, we will have to time things (aka "sample collection") more precisely so we arrive at the clinic at an appointed time, which also happens to be within the appropriate window of time so the sample is still usable.  Do you see the (small?) dilemma here?  This seems like a lot of pressure on DH.  He handled the news about these new logistics remarkably well, given the extra constraints.  I didn't make the appointment yet.  I think it will probably be after my surgery so we can do it post-peak, which is my preference.

Speaking of my surgery...I didn't know what needs to be done ahead of time in terms of informing my insurance company about it, so I called the hospital where the surgery will take place.  They said my doctor's office should have already sent the surgery info to my insurance company, but I should call them to confirm that.  So I did.  They had no knowledge of the upcoming surgery but they said because it's an outpatient procedure, a pre-authorization isn't required.  To any of you who have had a laparoscopy before, does this sound right?  My pre-op appointment is next week, so I'll ask again then.