Recovery at home

The spirometer.  I take a deep breath, and it tells me
how much air I inspired.  There's some prune juice in the
 background.  Good stuff.

It's been a week and a half since my surgery, and I feel really good.  This recovery is so much better and faster than my previous robotic lap two years ago.  I guess the size of the main incision and how much endo is removed makes a big difference in how you feel afterward.  Two years ago, I had the hit-by-a-bus feeling for almost two weeks after surgery.  This time around, I felt almost normal just four days post-op.  Of course, by "feeling normal" I mean while sitting comfortably in a reclining chair happily medicated on two types of pain meds.  Once I had to get up and walk, it was another story.  ;)  About that time I could start to sleep on my side instead of on my back, so my quality of sleep improved greatly (I don't sleep on my back normally).  The first week I was faithfully using the spirometer they gave me in the hospital to do my breathing exercises to fully inflate my lungs.  I had never used a spirometer before, but my breathing post-surgery has been noticeably better than after my lap in November.  The shoulder pain (referred pain from the gas used during surgery) hasn't been too bad and tends to recur when the previous dose of ibuprofen is wearing off.  Already I can bend forward slightly at the waist, which I didn't expect to happen this soon.  I took my last opioid two days ago and have been managing well with ibuprofen alone.

I am a little nervous for my phone follow-up with Dr. E tomorrow.  She told me that she removed all the endo, but there was more to the story.  I have little black spots all over my abdominal cavity, which she assumed to be carbon deposits.  She said she has never seen something like this before. She could only biopsy them with the robot, so there was no way to know what they were for sure until this surgery.  The path report confirmed they are an inflammatory response which usually happens as a reaction to a foreign body.  Dr. E wrote me a very brief e-mail saying she thought they were a reaction to the vaporization of endo (from the surgery with her two years ago).  I have no idea what this means.  Do I need another surgery?  Do they affect fertility?  I do remember when Dr. E stopped by to check on me the morning after surgery she brought up these carbon deposits.  She said that if they needed to be removed, it would require a lot of work because she'd have to cut off a whole layer of tissue (these carbon deposits are everywhere), and then she'd place Gore-tex (material to help prevent adhesions) that either would be removed in another surgery a week later or would be left there permanently.  I am hoping there will be no more surgery, but lots of little spots of inflammation don't sound too good to me.  We shall see...

Day of surgery

Today has gone really well.  Surgery started at 8:00 a.m.  I was out of surgery after about 3.5 hours.  I remember a little of the communal post-op room, but  there's a hole in my memory until I woke up in a private room around 1:00 p.m.

The post-op nurse gave me some toradol in my IV for pain, which worked so well that I was nearly pain-free.  It is some amazing stuff. :)  I haven't needed any other pain meds.

I've felt so much better than I did after my previous robotic lap.  The anti-nausea patch behind my ear is working quite well.  I was allowed to eat solid foods at 3:00 pm; snacks never tasted so good.  Around 5:00 p.m. I took an escorted walk down the hallway and then spent several hours sitting up in the chair next to my bed.  Two years ago I didn't get out of bed until the following morning and that was only to go to the bathroom.  I'm guessing that part of the difference is that two years ago one of my incisions had to be made larger so fibroid could be removed; that wasn't necessary today.

The catheter was removed at 6:30 p.m.  It hurt and left me with uncomfortable cramps.  However, I am happy to report my bladder has been working quite well, both before and after catheter removal.  (I'm sure you all wanted to know that.) That's a definite improvement from two years ago.

A nutritionist stopped by to help figure out what I could eat for dinner with all my food intolerances.  She was really helpful and ended up going to the grocery store to get a few items just for my dinner.  I was so impressed and grateful.  She even called me from the grocery store to confirm that a couple ingredients would be okay.

My dinner was delicious.  :)  (That's almond milk in the white cup!)

The goal for my discharge is still by lunch tomorrow.

Out of surgery

My surgery is done.  It took about 3.5 hours.  Dr. E spoke with DH and said she was able to remove all the endo.  I'm all tucked in bed and am looking forward to being able to eat solid foods in about an hour (when my diet restrictions are lifted).

Thank you all for your prayers!!

A bit like Mardi Gras

My robotic laparoscopy to remove the endo is Thursday.  Tomorrow I'll be on a clear liquid diet all day plus the ever-popular bowel prep (bottle of magnesium citrate at midday).  I'm hoping the car trip tomorrow night will be...uneventful in the GI department.  :)  That means today is my last day of real food, so I'm enjoying it as much as possible, sort of like celebrating Mardi Gras before fasting on Ash Wednesday.

I received the Anointing of Sick after Mass on Sunday which has kept the anxiety away.  My pastor kindly volunteered to offer Mass on Thursday for me.

I've been taking advantage of my last few days of mobility.  I cleaned the bathtub.  I vacuumed the whole apartment.  Tonight I might clean the inside of the refrigerator.  There's nothing like the prospect of not being able to bend down for weeks to get me motivated to clean.  ;)

The plan is that I will spend Thursday night in the hospital and hopefully will be discharged Friday.

I will be offering the pain of my recovery for all those considering abortion, for those affected by abortion, for Lucky as Sunshine and her husband, and for all of you.

DH or I will post something here on Thursday after surgery is done.  Thank you in advance for your prayers!

Surgery recap and recovery

This is rather long.  Read what interests you, and skip the rest.  I mostly wrote it out as a record for myself.

Day of Surgery

hospital socks

Friday morning (Nov. 21) I was supposed to be at the hospital at 5:30 a.m.  I showered with a special soap that morning (and the night before).  After we filled in the paperwork at check-in, I headed over to the chapel to spend a few minutes with Jesus in the tabernacle.  I love Catholic hospitals.  :)

When the nurse took me back, before putting on the hospital gown, I had to use large wipes on my entire body.  The wipes were supposed to leave a film on my skin that would help prevent infection during and after surgery.  I think she said it was protective up to 24 hours after surgery?  It was new since my previous surgery at this same hospital.  I also put on the fashionable hospital socks that have no heel and are the same on both sides so you can't put them on upside down.

In the past, my biggest worry the morning of surgery was the IV, but this time I didn't even blink when the nurse inserted it.  I guess years of blood draws and some awesome prayer warriors can help a girl get over her fear of IVs (and needles in general).

my view in bed all prepped for surgery

This time they put what I call "water wings" on my calves while I was still conscious. They're supposed to help prevent blood clots by sporadically inflating to squeeze my legs.  After I was all tucked in bed, the nurse turned on the warm air to inflate my gown and keep me comfortable (and to keep my body temperature up which improves recovery after surgery).

When the anesthesiologist came in, I mentioned that I had nausea and vomiting after both previous surgeries.  He said he read that in my file and would be giving me a patch to prevent that.  I was definitely looking forward to no vomiting.  :)  Later the nurse anesthetist came to give me the patch. She stuck it behind my ear and said I could keep it on for up to three days.  She warned me not to touch it, but if I did, I would have to immediately wash my hands.  I guess if you touch it and then rub your eyes, it will dilate your eyes and give you a headache.  She gave me a rubber glove to use to remove it at home.

Around 7:20 a.m. Dr. E arrived with a third year med student who was accompanying her for the day. It was the student's first day on her ob/gyn rotation, so she was just going to be observing, not assisting.  I gathered that Dr. E hadn't had a chance to explain much about her training or NaPro, so I decided to fill the med student in a bit.  Just a bit.  :)  I told her that many of Dr. E's patients travel long distances because she has done a special fellowship in surgical techniques for endo and that she's 1 of only 14 in the country (not including Dr. Hilgers himself) to have that kind of training.  I think I might have slightly embarrassed Dr. E, but I wanted the med student to know ahead of time that she was going to be observing a highly-trained surgeon.  The med student seemed intrigued.

Dr. E then prayed over me which I loved.  I noticed at the end of the prayer the med student made the sign of the cross when Dr. E did, so maybe she'll be even more interested in NaPro because she's Catholic...  Hopefully Dr. E was able to plant more seeds as she spent time with her...  :)

Dr. E promised to tape a rosary to my hand before surgery started.  She said she had a bunch that were blessed by Pope Francis.  My last surgery I had one that was blessed by Pope Benedict.

rosary blessed by Pope Francis

Just after 7:30 a.m. the nurses came back to wheel my bed to the OR.  I was awake long enough to see the inside of the OR briefly before the anesthesia kicked in.

My surgery lasted about an hour.  I don't know what time I woke up from anesthesia, but when I did I was in a large room with curtains around each bed and a rosary wrapped around my hand.  I wasn't nauseous at all.  :)  I asked the nurse standing next to my bed for water, but she said that would make me nauseous so she brought me apple juice instead in a cup with a straw.

Dr. E stopped by to explain what she found during surgery.  I tried really hard to concentrate on what she was saying because it was unlikely I would remember anything based on previous post-surgery talks with the surgeon.  I remember her saying that I had stage I (nearly stage II) endo and that perhaps Dr. K (at PPVI) would want to do the next surgery.  Somehow I was coherent enough to reply that my insurance didn't cover the hospital in Omaha.  She said she would at least consult Dr. K before doing my next surgery.  What is not clear in my memory is if she said it would be robotic "with the possibility of opening you up." (meaning a full laparotomy)  I really hope I am remembering that part completely wrong.  A laparotomy would be a six-week recovery versus the robotic laparoscopy's two-week recovery.  She also said that she could tell I had ovulated prior to surgery by looking at my ovary.  Surgery was on P+1.  She did cultures of my endometrium and cervix, but I won't have those results for a while.

Dr. E spoke with DH separately and gave him pictures of my insides.  As she explained them to him, she labeled some of them.  I had endo near where my rectum meets the colon, and that would be the tricky spot to remove.  I had another spot of endo near my cervix.  There is some scarring on one ovary, but I don't know if that's endo.  There was another questionable spot that might be endo or could be something else.  All of the endo is in new spots.  Why, oh why does my body regrow new endo so easily?  :(  It's been 21 months since my last surgery.

The nurse anesthetist stopped by briefly to ask if I was nauseous.  I said no.  She smiled and said she has a 100% nausea-free streak with the patch on her patients.  I'm glad to have kept her streak alive.  I ended up keeping the anti-nausea patch on for a day and a half.  I'm definitely asking for it next time.  :)

So there I am lying in bed sipping my apple juice and feeling pretty good.  The next thing I know the nurse says it's time to get me dressed.  I was really surprised (since I hadn't urinated yet...that was the ticket out of there in my first surgery) but I didn't mind.  I got some granny-style hospital underwear (so comfortable!) and two large pads.  Why two?  I don't know.  I didn't discover the second one until later in the day when it fell out in a rest stop restroom...  At that point I was thankful the first one was still in place.  :)

Shortly after getting dressed, the nurse moved me to a chair next to the bed.  DH came into my curtained room and got some last minute directions from the nurse.  Another nurse brought a wheelchair and wheeled me to the hospital entrance.  It was about 10:30 a.m.

We drove to a pharmacy near the hospital to pick up my two prescriptions for pain meds.  I learned that Dr. E doesn't call in pain meds, so we had to walk in with the prescription in hand (well, DH walked in) and wait until it was filled.  Thankfully it only took about 10 minutes, unlike my previous two post-surgery experiences where it took an hour or more.

I had a small pillow in the car to put between me and the seat belt to cushion bumps in the road.  I reclined the seat a bit because that was more comfortable than sitting straight up.  I ate a few snacks, which tasted so good after the previous day's clear liquid diet of chicken broth and apple juice.  :)

At home, DH made me chicken noodle soup, my comfort food of choice.  I set alarms in my phone to take the pain pills on a schedule (hydrocodone/acetaminophen aka "the good stuff" and ibuprofen) and then napped until dinner.

Day after surgery

Early the next morning, I awoke after a poor night of sleep thinking I'd spend the day watching movies and napping.  As DH was helping me out of bed, he stopped and sat on the side of the bed.  He was having terrible abdominal pain on his right side.  He never has pain like that.  After a few minutes it subsided.  He took a quick shower in case in came back, and it did.  I was worried about appendicitis.  He normally avoids going to the doctor, but he said he needed to go to the ER. I knew that meant it was bad.  If he didn't volunteer to go, I would have forced him in my I-can't-get-out-of-bed-by-myself state.  Don't mess with a girl who just had surgery.  ;)

I did spend my day watching movies and napping at home as I had expected...but also e-mailing back and forth with DH who was lying in a bed in the ER.  It turned out to be a kidney stone. Thank God it wasn't more serious.  He came home in very little pain.  He had no pain when he passed the stone.  A little tiny thing sure caused a big problem...

Rest of recovery

The next morning I felt decent enough to make a public appearance, so I went to Sunday Mass with DH.  I took both pain meds beforehand so I was happily drugged up.  I couldn't genuflect, but everything else was fine.  Afterward I was exhausted.  You don't realize how much up and down there is (sit, stand, sit, stand, etc.) until it's hard to stand up on your own.  Mass on Thanksgiving was better (no pain meds), but I still felt like I had competed in the Olympics afterward (i.e., was wiped out).

I took my pain meds on the prescribed schedule for the first four days, and then I started to wait and see how I was feeling before taking something.  On Wednesday, I only took one pain pill.  I took my last one on Friday, a week after surgery.  Since then, I have been using the heating pad for random pain flares, and it works well.

I learned a new post-surgery trick the hard way.  After surgery, I had no other choice than to sleep on my back.  I normally sleep on my stomach or my side.  By the third night after surgery, I could lie on my side a little.  One night while sleeping I rolled onto my stomach and woke up in the morning in a lot of pain.  Not fun.  To prevent it from happening the following night, I slept on my side and hugged a large pillow.  It kept me from rolling onto my stomach.  I still sleep with the extra pillow because I don't think I'm ready to sleep on my stomach.

Something else new I realized this time around is that a straw is a really useful thing to have, especially during the part of recovery where it's difficult to sit up when you're lying down.  If you have a bendy straw in your cup or water bottle, you don't have to sit up to drink.  It will come in handy more when I have my next surgery.

I experienced a new and unpleasant symptom during this recovery that I didn't have after my previous surgeries.  Involuntary, quick deep breaths started about four days after my lap.  At that point, taking a deep breath was not really enjoyable because it increased the pressure on my incisions, but it was possible if I did it slowly.  I know most breathing is involuntary, but this was strange because they were little gasps for air when I thought I was breathing just fine.  They would happen quickly like hiccups and last a second or less, but they didn't happen as often as hiccups. Oh, did they hurt.  :(  Dr. Google told me it was common after abdominal surgeries.  They lasted 4 or 5 days, but became gradually less painful because my abdomen could tolerate the pressure better.

About the same time the weird hiccup breaths began, I started sneezing quite a bit, which hurt more than a deep breath.  I should have read the discharge directions that said I should hug a pillow tightly against my stomach whenever I had to cough or sneeze to minimize the pain.  Next time I'll have a pillow ready.  :)

Even though I had been told you can expect to go back to work within a few days of a lap, I was happy that I took the week off through Thanksgiving.  Being able to nap whenever I wanted was really nice.

I ended up spotting for eight days after surgery.  My urge to urinate disappeared for two or three days after surgery, so I had to remember to go to the bathroom those days.  I was very happy when it returned.  I guess you don't appreciate things so much until they're gone.  ;)

My incisions still ache a bit on and off.  Sneezing is still a bit painful.  I can bend forward most of the way without pain and pick up things from the floor.  I probably could drive (the prospect of slamming on the brake doesn't scare me like it did last week), but I've preferred not to drive since DH can.  I've been really grateful that this surgery's recovery is so much easier and quicker than the robotic lap.

I haven't heard back from Dr. E yet about scheduling my next surgery.  I assume she's going to consult with Dr. K first to better plan the surgery.  It will be January at the earliest.  I have a post-op appointment in two weeks.  I don't know if it will be in person or virtual (phone or Skype).

Here's a little summary of what I've learned:

What to bring to the hospital when you have surgery

• yoga pants or any clothing that isn't snug at the waist
• underwear that sits either really high (granny-style) or really low
• pads
• all prescription medications in their original containers
• small pillow to put between you and the seatbelt
• large pillow to make napping in the car more comfortable
• plastic bags or bucket for car in case of vomiting (if you don't get the anti-nausea meds)
• food for the ride home

Nice things to have at home during recovery

• straw for drinking when lying down
• large pillow to hug during sneezing/coughing and sleeping (to prevent rolling onto stomach)
• heating pad

Surgery's done

Dr. E found stage I endo in a few spots, and at least one of them is in a tricky place to reach, so I'll need another bigger surgery with the robot to remove it.  There were no new fibroids.  She also did endometrial cultures.  We're heading home shortly, and I'm looking forward to a nice long nap.  I'm offering up the pain for all of you.

Surgery tomorrow

My laparoscopy to (hopefully) remove endo is first thing tomorrow morning.  We have to be at the hospital bright and early at 5:30 a.m.  I'm thankful that I'm not feeling nervous yet.  I received the Anointing of the Sick last weekend at the retreat, so I'm sure that has been helping me stay calm.

Somehow I lucked out and don't have to do a bowel prep today.  (I'm glad you can only throw virtual tomatoes at me right now...)  I'm offering up my day today on a clear liquid diet for all of you.  :)

DH will post an update here tomorrow when I'm out of surgery.

Nearly normal

It's been four weeks since surgery.  I'm feeling good.  I'd say I'm 95% back to normal.  I can't bend forward all the way to touch my toes but I can pick something up off the ground if I lower myself to a squat first.  It's nice not to have to use my feet to pick up things I drop.  I do recommend practicing that with your feet; it's a good skill to have.  :)  I never realized how often I drop things, especially socks, until it became a challenge to get my hand to the floor.  Cell phones are a bit tricky to pick up with feet, but manageable.  Pill bottles and water bottles are a lost cause.

I haven't taken any pain medicine since last Friday.  Yay!  My "big" scar does still ache on and off, but it's not too bad.  It protests quite a bit when I try to lie flat on my stomach but I can get by without doing that for now and just sleep on my side.

I am happy to report that my toenails are now a lovely shade of bright pink.  I thought that for my surgery two years ago I remember them saying that I couldn't have any nail polish on, so I went into this surgery with naked toenails even though I didn't see that in my instructions.  Painted toenails make me happy even if no one else sees them (and even if I'm wearing socks all day), so mine are pretty much always red or pink.  For the first two and a half weeks after surgery there was no way I could reach my toes, so it's sort of a recovery milestone that I can do that again.  :)

I'm somewhat disappointed that my first period after surgery was almost as painful as it was just before surgery.  It wasn't bad enough to require ibuprofen, but after almost three weeks of prescription-strength ibuprofen I preferred to tough it out rather than subject my stomach to more abuse.  I'm hoping the pain was at least a little related to being post-surgery and that next cycle will be better.

Surgeon follow up

I had a phone appointment with Dr. E today. Normally it's an in-person visit but since I'm a long-distance patient, she wasn't going to make me drive all that way. I did have to e-mail her pictures of my five incisions so she could see how they're healing.

She reviewed the surgery results with me. She said the lactobacillus found on culture was likely a contaminant from the vagina, so my aerobic bacteria culture was essentially negative. The Gram positive rods on the anaerobic culture were not a contaminant and will have to be treated. She said drugs of choice would be Flagyl or Clindamycin. DH and I have been on Flagyl before, and it didn't help my TEBB. It was the IV Clindamycin that eliminated my TEBB for one cycle last summer, but Dr. E pointed out that DH wasn't treated which probably explains the return of TEBB. I'm not sure that I want to do another IV for ten days, and DH definitely doesn't want to do it. I wonder if Dr. K would consider giving us oral Clindamycin, knowing that she doesn't normally prescribe it due to risk of C. difficile infection (very bad infection).

So the plan is to wait one more full cycle before TTC again so I can heal. We'll see what Dr. K's recommendations are in my next cycle review.

In other news, I took my last opioid yesterday, and I will resume the naltrexone tonight. DH is excited.

More recovery and culture results

The doctor wasn't kidding when she said it would be a two-week recovery. I am trying to keep that in mind. It's tough though because I have periods where I feel back to normal and then when the pain returns or I can't move a certain way or I still have to walk really slowly I'm surprised by it (when I shouldn't be surprised...because it hasn't been two weeks yet). I guess they are good reminders to continue to take it easy. :)

Little improvements toward normal make me happy. I am able to put on socks (creatively) without pain and without bending forward. My urge to urinate finally returned yesterday, 11 days after surgery. There was much rejoicing. I don't remember other people talking about that post-surgery so I thought I'd mention it. It feels very strange to lose that function and have to remember every few hours to go to the bathroom.

I am still taking prescription strength ibuprofen on a schedule, although I've stopped setting an alarm to take the middle-of-the-night dose. I take the opioid as needed--especially for when I go out in public. I went out to run errands with DH on Saturday, and it was so nice to have a change of scenery, although by the end I was ready to use one of those motorized scooters. :) I went to Mass on Sunday and was able to sit, stand, and kneel along with everyone else, although more slowly. I couldn't genuflect though. The priest who gave me the Anointing of the Sick asked me how I was doing after Mass; it was nice that he remembered. It was my first Mass since surgery. I was able to watch Mass online while I was not feeling so great, including Pope Benedict's last public Mass on Ash Wednesday. It was bittersweet. I'm going to miss him. :(

DH is doing a great job taking care of me. Acting as a nurse does not come naturally to him, so I am really thankful for all he has done. He has told me multiple times that if it were him having surgery, he would just want to be left alone as much as possible, so I know this is requiring a lot of extra patience from him. He does like to feel helpful though so I think he was a little disappointed when I no longer needed him when getting out of bed or up from the reclining chair. ;)

The bad part about recovery now is that I am post-peak and PMSing. (Apparently major surgery isn't enough stress for my body to have a double peak or even a delay...) When you're taking opioids, you can't take naltrexone because they cancel each other out. The surgeon asked me to discontinue the naltrexone a week before surgery to make sure the anesthesia worked properly, so I've been off of it for almost three weeks. I am currently alternating between extreme crabbiness and crying. I can take HCG tonight so that should help some, whenever it kicks in.

The surgeon sent me a big packet of papers (everything that she faxed to Dr. K at PPVI) with most of my surgery results, including op report, pathology report, and all culture results to date. Very interesting reading. :) The fungus results won't be finalized for a month, unless they are positive, which means they would be ready sooner. They let it sit for a month before declaring that there is no fungus.

The part I was excited about was the bacterial culture results. They were positive! It's not normally something to be excited about but it's something to try to treat that might be a factor in our IF. (I'd rather know what's wrong and have the doctor try to fix it than have everything come out normal and have no where to start with treatment ideas...not that my preferences have any weight or influence of course.) ;) Anyway, I had lactobacillus and multiple Gram positive rods (specific anaerobic bacteria were not listed). I wonder how many antibiotics it's going to take to wipe out these bugs. Given how many antibiotics I've been on in the past few years, I might have some pretty tough (resistant) bacteria living in my uterus. Bacteria, your days are numbered!! :)

Surgery results and recovery

My surgery was scheduled for noon on Friday, and I was supposed to arrive at ten.  I woke up with only enough time to shower and get ready so I wouldn't have extra time to be nervous or hungry.  When we got to the hospital I made a short visit to the chapel, which had a tabernacle.  A little time with Jesus was just what I needed.  I love Catholic hospitals.  :)  Shortly after checking in, a nurse took me back to the pre-op room.  DH was asked to stay in the waiting area.  They gave him a pager so they could notify him when I was ready.  I changed into a pretty lavender gown and some fashionable hospital booties.  The nurse made sure I was comfortable on the bed and covered my legs with a heavy blanket to keep me warm.  Then she connected a hose to my gown and turned on a machine.  My gown had a lining which could be filled with hot air.

This is not me. I was not quite that smiley. That is the same gown as I had. The inflated
gown added 100 or so pounds to my profile so that part of the picture is accurate.

The nurse explained that if a patient is warm, it improves circulation and helps with healing.  I had a hand-held control to adjust if I wanted to sweat like I was in a sauna or just be pleasantly toasty.

The nurse started an IV and asked me a bunch of questions about my medical history and medications.  She said Dr. E wins the award for longest surgery consent form because of all the procedures (and possible procedures) she planned to do.  After she finished, Dr. E stopped by to see if I had any last minute questions.  She prayed over me while holding my hand, and the nurse held my other hand.  I was so touched by this that I cried a few silent tears. Then Dr. E taped a plastic rosary to my hand that had been blessed by Pope Benedict XVI.

She told me she had already prayed a rosary for me and that she was hoping to stop in the chapel for a few minutes before surgery.  I may or may not have cried a few more tears...I was in a very emotional state.  Plus, it's not every day that your doctor tells you she's praying for you.  :)

After Dr. E left, the nurse brought DH back to the room.  A few other people streamed in to ask me the same questions over and over again (do you have any metal in your body, did you eat anything this morning, why are you here, etc.).

The anesthesiologist's visit was interesting.  He started off asking similar questions to everyone else and then started to go through my medication list.  He got to naltrexone and made a funny look.  He asked why I was on it (knowing it's usually used for alcohol or drug addiction).  I said it's for PMS and that it works great.  He raised his eyebrows and said he'd never heard of it being used that way before, which is how every non-NaPro doctor I've ever met has reacted.  I waited for him to move on to the next medication but he paused and then proceeded to ask me what my PMS symptoms were, what the naltrexone changed about them, and what dose I started at.  I joked that he should be asking DH, who was sitting next to me.  DH said I was a different person while on it.  The doctor apologized for getting side-tracked but said he was personally interested in the details...for his wife, who apparently has bad PMS.  I told him to talk to Dr. E about getting naltrexone for his wife.  I think he's going to!  He seemed pretty excited about it.

Then he got serious again and said that I need a second IV in my other arm.  I'm not a big IV fan, and I was happy not to have passed out during the first one.  The nurse hadn't done the second one because she thought it could be done in the OR during surgery if and when Dr. E decided to switch from regular laparoscopy to robotic.  (It would only be needed if she did robotic surgery.)  The anesthesiologist wanted it done beforehand just in case.  And I was hoping to avoid another needle...  Either they forgot this plan or changed their minds because I didn't get the second IV while I was awake.  They gave me something in my IV to "take the edge off" and started to wheel my bed to the OR.  We turned a corner in the hallway and that's all I remember until I woke up after surgery.  For my surgery two years ago I remember being awake in the OR for a few minutes while they prepped me.

After surgery when I woke up all I wanted was ice.  My mouth was really dry.  I also asked for something in case I threw up.  My stomach was feeling okay, but I remembered my prior reaction to anesthesia wearing off and wanted to be on the safe side.  They gave me two bags, and I set them next to me on the bed.  I dozed off and woke up in a private room.  DH was sitting next to me.  He gave me a constant supply of ice chips and made sure the washcloth on my forehead stayed cold.  (I was burning up and in pain so a cold washcloth was helpful.)  He was a very good nurse.  :)

It was kind of obvious to me by now that I had had the robotic surgery and was looking at a two-week recovery.  I asked DH about my surgery.  He said it had taken five and a half hours.  That is a long surgery!  I wondered what Dr. E had to do while she was in there because my laparoscopy two years ago took under two hours, and the surgeon did most of the same procedures that Dr. E was going to do.  DH gave me a few details of what Dr. E found but he couldn't remember much, and he didn't record the conversation with Dr. E on his cell phone like was originally planned.  I would have to wait for the details...

DH left around 10:00 p.m. to go back to the hotel, so I decided to watch tv to distract me from the pain.  Besides having a bunch of tubes coming out of my arms and a catheter you-know-where, I had large cuffs around my calves that inflated every 45 seconds. (I timed it...what else did I have to do while lying there?)  ;)  At one point a nurse came in to take my vitals, including blood pressure.  She put the cuff on my arm, and I couldn't figure out why she didn't just use the cuffs on my legs...until it dawned on my that I didn't have blood pressure cuffs on my legs.  (My mental capacity was not 100% as you can tell.)  I asked what the cuffs on my legs were.  She said they help prevent blood clots.

This is not me.  These leg cuffs inflated every 45 seconds
all night long.  It was a long night.

The nurse came in every once in a while to ask my pain level or give me my usual medications.  I had brought my T3 in a pill box and not in the original bottle from the pharmacy so there was no way to verify what it was.  This was a problem.  The nurse said she would have to call the pharmacy to confirm that it was T3 before she could give it to me.  I knew Kubat's was closed for the day, but she still called.  She ended up giving it to me anyway.  I think she had spoken to Dr. E about it and maybe got permission from her.

Eventually I fell asleep but never stayed asleep for very long, probably not more than an hour at a time.  Sometimes the pain woke me up, but I could press a magic button and a nurse would appear with a pain pill for me to take.  A nurse or nursing assistant came in periodically to take vitals or do other things that required me to be awake.  One came to draw blood.  I don't remember why she needed blood but it was around 2:00 a.m.  In my exhausted state I asked her why she couldn't use one of my IVs to draw the blood.  (One IV was my pain medication lifeline, but the other was not in use.)  She said the IV would clog up if she did that, so she had to poke her own hole.  At 6:00 a.m. a nurse came to remove my catheter.  I couldn't feel it while it was in, which was nice.  (I was not looking forward to having a catheter in at all.)  When she was putting gloves on, I realized that if she removed it, I would have to get up to go to the bathroom.  That prospect scared me, and I wished I could just keep the catheter for a while longer.  I had not been up out of the bed at all since surgery.  The removal part was over quickly.  The nurse said I needed to go to the bathroom in the next six hours.  When I did get up to go a few hours later, they gave me a pair of hospital underwear which I thought was quite comfortable.  (My own was in my overnight bag on the chair a mere six feet away, but the nurse didn't want to go through my stuff to get it, and I was in no shape to do it either.)  She asked if I had slippers--which I did, in my off-limits bag--so she went to the other side of the room to get me hospital sock slippers.  It ended up being a good thing that I used hospital-provided slippers...I may have had to throw them out if they had been my slippers because they can't go in the washer...

DH arrived after I was all settled back in bed and had eaten some breakfast, my first food in over 24 hours.  Dr. E came later to check on my progress and to tell me what happened with the surgery.  She found endo, which she estimated to be stage II, in three different locations (one location had multiple spots of endo).  She said she was not surprised at all that I had painful periods given the endo she found.  She thought that they were all new locations, not recurrences from two years ago, but she said she'd have to check my files to be sure.  One of the locations was on one of my ureters, and apparently it was very tedious and tricky to remove.  I did have endo on a ureter two years ago which the resident assisting my surgeon was afraid to touch (but the surgeon removed it anyway).  Maybe endo on ureters is always tricky?  She said she looked extra closely at both my ovaries but could not find any endo.  (My ultrasounds from last year showed a shadow on my left ovary that could have been endo.)  She knew about one fibroid ahead of time that was sticking off of the top of my uterus, but she found two new fibroids.  One of the new fibroids had adhesions around it, so she removed all of that, along with the endo.  She had to make one incision larger in order to remove one fibroid, so she said I'll be extra sore there.  She also found adhesions near my large intestine (not far from the appendix) but she had no explanation for why they were there.  She didn't think they were from my first surgery because of the out-of-way location, and she also didn't think they were from a missed case of appendicitis.  She didn't remove those adhesions because she didn't think they'd affect fertility where they were.

She did a selective hysterosalpingogram (SHSG) and said the pressure in both my tubes was normal and that they were completely open.

She did a hysteroscopy to look around inside my uterus and found endometrial stippling (little white dots) and micropolyps--otherwise known as endometritis.  She took biopsies and cultures of the cervix and endometrium but we won't know the culture results for a month.  (It takes that long to see if the bugs grow or not.)  She is pretty sure infection is the cause of the endometritis, but the question remains if we'll be able to identify the bug, even with the cultures.  Honestly I am hoping that something with the cultures comes back positive, otherwise we may go back to blindly picking an antibiotic.  We've never tried Biaxin, which Dr. E was surprised to learn, so that would be a logical place to start.

Since I passed all the requirements (walked, urinated, passed gas, etc.), Dr. E said I could go home right away.  I was happy to leave the hospital but I did enjoy having IV pain meds controlling most of the pain.  She sent me home with a prescription for an opioid and ibuprofen and said to take both on a schedule at first to stay ahead of the pain.  She also didn't want me sitting in the car for more than two hours at a time, so we'd have to stop for a short walk on the way home.

The car ride home wasn't bad (aside from the fact that I felt awful and wanted to be in bed).  I had a small pillow between me and the seat belt to cushion any bumps along the road.  We stopped at a pharmacy along the way to pick up my prescriptions and ended up having to wait over an hour for them.  I slept most of the time.

Recovery has been going pretty well.  Since being home my appetite is close to normal.  The first day or two DH brought me my meals in bed, but now I can sit at the kitchen table.  I can usually get out of bed without assistance but DH stands there to make sure I don't fall (and it's less painful when he helps).  I can walk but I move very slowly.  My sleep quality at night is improving--either because I'm in less pain or because I'm getting used to sleeping on my back--so I'm not napping as much as the first couple days home.  The pain is not usually too bad except when it's between doses, so I have alerts on my phone going off to remind me which pain pill to take.  My incisions are starting to itch like crazy.  I had to cough yesterday, and I thought I was going to split open because of the pressure it put on my incisions.  Not fun.  I don't plan to cough anymore if I can help it...or hiccup, sneeze, or laugh.  I told DH he's not allowed to say anything funny for two weeks.  He made me laugh once which really hurt, so said he'd try really hard to say only boring things.  I have periods of time where I feel almost normal...and then I get up off my reclining chair to walk around, and the pain returns.  So as long as I don't move I'm fine.  ;)  Okay, that's not always true--I do have pain while sitting also...like now.  :(  Lots to offer up for Jellybelly.

Brief surgery results

Dear readers,
This is polkadot's DH with an update from today's surgery. The surgeon had to use robotics in order to remove patches of endometriosis, adhesions, fibroids and polyps. She is spending the night in the hospital and will be on her way home tomorrow. Prayers for a speedy recovery are welcome!
DH

Getting ready for surgery

My surgery is this afternoon.  I don't feel too nervous, which is a blessing.  The thing that is making me a bit nervous is the fact that I won't know until I wake up what kind of surgery was done and how long my recovery will be (few days vs. 2 weeks).  I was really starting to get anxious about everything on Saturday.  Then on Sunday I received the Anointing of the Sick and all the anxiety melted away (and stayed away since then!).  My parish priest was really concerned that I was asking for the sacrament (I don't think it's too often that he administers it to a younger person).  He said some really kind and comforting things to me and assured us of his prayers.

Getting ready for surgery has been similar to last time--don't eat anything the day of, don't use deodorant, etc.  This time I had to shower with a special antiseptic soap.  Last time it was a water-only shower (no soap at all).  It's interesting to see the differences between hospitals.  The bowel prep wasn't too bad.  I just had to drink a bottle of magnesium citrate.  It takes like Smarties (the candy) dissolved in water.

I'll update when I am feeling up to it.  :)  Please pray that everything goes well.

Everything since Christmas

1. Before I start with my updates, I'd like to say thank you so much to all of you who prayed for those of us still waiting during Advent as part of the spiritual bouquet. (Yes, that was a month ago.) It's so easy to feel forgotten by those who have moved on into the world of motherhood and whose IF blogs have become mommy blogs. Your prayers and sacrifices were so touching and very much appreciated.

2. After some tough few weeks of Advent, I ended up having a fairly joyful Christmas (as much as possible anyway, considering the circumstances). It was nice to spend time with my grandma. She made way too much food as usual and wouldn't accept anyone's help as usual. :) None of the relatives asked us about having kids, which was nice. I wonder if they think we're not going to have kids given that we've been married for so long. One of my cousins got married last summer, and I admit I was quite relieved (maybe too relieved) to see his wife with an alcoholic drink in her hand. Family gatherings are usually my "IF safe space"--there are no babies and no pregnant women. The only children are school-aged, and my only married cousin announced they were "done" as soon as she was pregnant with their second child, who is now six years old.

3. New Year's Eve was not an IF safe space. We went to a party with friends. There were babies being passed around and multiple pregnant ladies. I had a pleasant (to the outside observer) conversation with a very visibly pregnant friend about maternity dresses and how well they fit. I felt so fake asking questions and pretending to be interested so she'd never know it was killing me inside. I really just wanted to run to the bathroom and cry. Oh, I forgot to mention AF arrived 10 minutes before we left for the party. I was in an unhappy mood (to put it mildly) most of the night, especially since I had gotten my hopes up more than usual because my post-peak phase was a day and a half longer than normal. So I was mad at myself for hoping and mad at AF for appearing when she did. Thankfully DH understood when I wanted to leave five minutes after midnight.

4. A curious thing happened on my chart this cycle, and I'm wondering what might have caused it. I had significantly less TEBB. Usually when I have it, it's present all day long and in large amounts (ewwww), but this cycle it was just a little bit once or twice each day and much lighter in color. Technically I only had two days of TEBB this cycle, compared to seven days last cycle. I did have two other days mid-cycle with a single occurrence of brown, but they were not directly after AF.

There were several things different that may have caused this change. I spent the last two weeks of the previous cycle visiting family for Christmas and New Year's, in a different part of the country from where we live. I think I ate more healthy foods while traveling--and more food in general--but I also completely overdosed on sugar. "Overdosed" is not an exaggeration. My family made multiple batches of cookies and other addictive tasty desserts just for me (with all my diet restrictions). There was a container labeled "polkadot's treats" (actually two containers) and a separate one with "treats for everyone else." I had not yet gone sugar free as Dr. K recommended--I was planning to do so after all the New Year's festivities. In my attempt to offset all the sugar, I took a probiotic twice a day without fail. (Normally at home I'm lucky if I remember to take a probiotic at all because I keep it in the fridge, so it's not in my pill box.) The probiotic is my best guess at what would have deceased my TEBB. I really haven't been diligent about taking it regularly since I had the IV antibiotics last summer when my TEBB disappeared for one cycle.

5. Another thing different about last cycle was that it was the first cycle at a slightly increased dose of Clomid (went from 25mg to 50mg on CD3-5). I had the best mucus I've ever seen. (My mucus cycle score, a way to rate the mucus quality, was the highest it's ever been. I looked through all my old charts to confirm this.) I took very little Mucinex or B6 that cycle...so much for Clomid drying up mucus! I also had breast tenderness from P+2 on which was quite a bit more painful than usual. I guessed that my body was responding well to the higher Clomid dose. My P+7 blood draw was not shipped to PPVI like normal because I was traveling, so it can't truly be compared to the PPVI values from previous cycles...however my progesterone was 43 and my estrogen was 32. Both were twice as high as the previous cycle. My body likes more Clomid. :) This cycle the breast tenderness is really mild, so I think I might be back to my "normal" hormone levels.

6. Back in December I had received an e-mail from the surgery scheduler at PPVI saying that she would be contacting me in January about picking a date for my laparoscopy with Dr. K. When I received a phone call to schedule my surgery, I was quite surprised that it was from Dr. E's office, the NaPro surgeon who is a few hours from here. It turns out that she had openings in her schedule much sooner than originally expected. When I had my appointment with her in November, she had estimated February or March, but when I later spoke with the scheduler, it was going to be a longer wait. Upon learning that, Dr. K at PPVI offered to do the surgery, so DH and I agreed because we didn't want to wait. But now since Dr. E had openings in February, we're going with her. Interestingly, Dr. K's scheduler called the day after Dr. E's scheduler called. Dr. K's scheduler was aware of the situation and was very happy to hear that Dr. E could do the surgery because she knew we much preferred to have it done closer to home.

So my surgery is Friday, February 8th with Dr. E. That's next week!!! I am excited that is it so soon and that we can drive there. I have a pre-op appointment and blood work the day before, so we'll stay overnight that night. My surgery is at noon. Dr. E will start with a regular laparoscopy, and if there's endo in hard-to-reach places or a lot of it, she'll switch to a robotic laparoscopy. If she switches to robotic, I'll spend that night in the hospital and have a two week recovery. If she stays with the regular laparoscopy, I'll spend that night in the hotel with DH and have only a few days of recovery. After my surgery two years ago it took a full week to get back to feeling close to normal, but Dr. E thinks a lot of that had to do with my uterine septum reduction. (I am very curious to learn how things look inside my uterus now...) She said a weekend would probably be enough recovery time for a typical laparoscopy. Without going into details of why I was having surgery, I explained the situation to my boss that I might be out for up to two weeks or it could be less. (I didn't say that I might be back the Monday after surgery though...) He was really understanding and said to take whatever time off I need.

7. Besides the laparoscopy, Dr. E is going to do the following: biopsies and cultures of the endometrium and cervix, selective hysterosalpingogram (she'll also clean out the fallopian tubes if they're blocked), and hysteroscopy.

8. I've started making a list of things to take along on the trip for after the surgery since we won't be home until the following day. Normally I'd be packing a lot of food for an overnight road trip, but if it's anything like last surgery, I was too nauseous to eat much for about a day. And I'm on a liquid-only diet the day before surgery, so that limits my options. I'm trying to remember what I used last time or had just in case...so far I have a pillow for the car, heating pad, sweat pants, etc. If I would be spending the night in the hospital, any advice for what I might want to have with me?

9. I'm glad I wasn't given that much advance notice of my surgery date because it's less time to be worried about what the surgeon might possibly find. I have this fear in the back of my head that the inside of my uterus is all scarred up from the septum removal, and Dr. E will say our TTC days are over. Irrational, yes, but isn't most fear like that? ;) I'm also a bit scared that she'll find absolutely nothing wrong--no endo, etc. That I think is less likely because my ultrasound series from last year showed a shadowy area on my left ovary suspicious for endo. I guess I want to know whatever it looks like inside. Any info will be helpful going forward.

New TTC timeline

I had my post-op appointment with Dr. C last week.  He went over the pathology report from surgery and told me that he had found stage II endometriosis.  Now I'm totally endo free.  :)

I learned that I misunderstood one of the discharge instructions...  When Dr. C went to look at my incisions, he was surprised to see all three of them covered with gauze and clear tape—just like he had left them on the day of surgery.  He asked if I had recovered them since then.  Umm, no...the nurse told us (so I thought) that I was not to touch the bandages; they would fall off over time.  I wasn't in any rush to see my new scars, so I obeyed.  Apparently, I was supposed to take the bandages off the day after surgery.  Oops.  Dr. C laughed a little and then proceeded to peel off the tape.  Ouch.  It would have been better if I had done that at home...  Everything is healing nicely though.  Instead of a visible scar for the middle incision, I pretty much have a new belly button.  It's sort of funny looking, in my opinion, because I was used to my old one, but I guess it will have to do.  ;)

Now I am to expect a withdrawal bleed (quasi period) after finishing the Provera.  I think my body started the withdrawal bleed early, but that's another story.  After my first normal cycle, which is projected to end about a month after the withdrawal bleed, we can TTC again.  That is assuming, of course, that my body goes back to normal cycles right away.  If we're not pregnant after six cycles, we'll recheck my hormone levels and go from there.  Sounds like a plan.  I like to have a plan.

I asked Dr. C if we could check my vitamin D and thyroid levels while we're waiting.  I've never had my vitamin D checked, and it's been over three years since my last thyroid level.  He agreed, but he wants it to be done when I'm back to normal cycles.  Fair enough.  I had been curious about my vitamin D since hearing a presentation on it at the FertilityCare conference last summer and figured now was as a good a time as any to have it checked.  :)  I've seen several articles that say most of the population is deficient, so we'll see how bad my level is.  I just might have to prescribe myself some time in the sun!

Unplanned Lenten sacrifice

Happy Lent!  The last few years I have really looked forward to the beginning of Lent.  I need the discipline.  I need to sacrifice.  I need to become less attached to material things.  This year is no different.  My Lenten resolutions are definitely challenging me so far, but I'm hopeful for the spiritual growth that might result.  :)  DH and I are sharing one (prayer-related) resolution, so it's nice to be able to do it together as a couple.

As for my post-surgery recovery, I think I finally stopped bleeding.  (I'm sure you all wanted to know that.)  ;)  It's been three weeks of mostly light with the occasional moderate day.  One of the nurses said some women bleed for four weeks after surgery, so I guess this is in the normal range.  I think starting Provera on Sunday may have something to do with it.  Starting the Provera means I'm done with the Premarin.  Hooray!!  DH and I were counting down the days until I finished that prescription.  The effects it had on my mood were not pretty.  I think in my last post I said it made me "slightly more irritable."  That was putting it mildly.  Things definitely got worse after that.  It was like I was looking in on myself, seeing rather intense negative emotions but feeling powerless to make them go away.  The smallest things would make me fuming mad.  I was aware that I was being completely irrational but couldn't do anything about it.  I'm sure the insomnia I had didn't help matters either.  Hopefully that is all behind me!  I do look forward to being done with these medications, but I suppose an infertile girl is never too far from more medications...  ;)

By the time I'm finished with the Provera, it will be four weeks since my surgery.  I had wondered back before surgery how long the doctor would want us to wait before TTC again.  I had hoped maybe it would be as soon as the Provera was done.  We weren't told on the day of surgery what our TTC timeline would be, but the discharge instructions did include this: no intercourse for six weeks.  That was a surprise.  It makes sense that my uterus needs to heal for a while after the "remodeling" (as I call it) that was done, but I wasn't expecting six weeks.  It's doesn't completely coincide with Lent, but the length of time is the same...would you call it fasting even if the doctor is making us do it?  ;)  In reality, I don't think it will be as hard as it sounds.  I suppose it's easy for me to say that now, right?  Only 2.5 weeks to go!  ;)

On the mend

Recovery from my surgery has been going well.  The incisions ache off and on, but it's pretty minor.  I can bend over (creatively) and pick something up from the floor.  I can get in and out of the car nearly pain-free.  Sneezing and coughing scare me (because they make me feel like my incisions are going to burst open), so I try to avoid those if possible.  ;)  After a doctor-ordered week in the passenger seat, it's nice to be able to drive again.  I still cringe a little driving over bumps in the road.  Maybe it's just that the seat belt is positioned right over my incisions...  I have a newfound love for recently paved roads.  :)

Somehow I managed by myself to take out the stent (balloon) that was keeping my uterus open (without passing out!).  It turned out to be no larger than a half-dollar in its deflated state.  Of course my uterus protested quite a bit at having to shrink back to its usual size requiring me to take both pain medications again.  It was very similar to what I felt after the endometrial biopsy, but it lasted a lot longer.  I should have known and premedicated!  Oh well.  Instead of going to a church-sponsored social event that night, we stayed in a watched a movie.  I love staying in—don't get me wrong—but I was a bit bummed to miss the event.  On the bright side, I woke up the next morning feeling FABULOUS.  Seriously, fabulous.

My ability to walk normally is improving.  We stopped at the grocery store after Mass on Sunday, and DH grabbed a shopping cart in the parking lot.  He said I could use it as a walker.  hahaha  I had been joking a few days prior that I needed a cane the way I was hobbling everywhere.

I am down to taking just one medication—Premarin (estrogen).  It seems to be making me slightly more irritable that usual, so I'm glad I only have a week and half left of it.  I also seem to be more aware of how DH smells, which is an odd observation, I know.  More precisely, I have been more repulsed than normal by how he smells when he comes home from work.  His workplace has an odd smell, so his clothes absorb whatever that smell is, and it's not so pleasant.  Yesterday when DH came home I couldn't stand to be near him as he greeted me because of his smell.  I immediately sent him away so he could change his clothes, which in retrospect is not the nicest thing a wife can do when her husband comes home after a long day.  Maybe it's similar to the phenomenon that when you take the bi.rth cont.rol pill, it changes the pheromones you're attracted to in a man—so much so that you become attracted to the opposite pheromones than you would have been when you are not on the pill.  It's fascinating stuff.  See this article for more info.  Is the estrogen changing my pheromone preferences??  I am trying to be extra affectionate with DH in an attempt to counteract this whole smell issue.  I've also been telling him that I love him, but not his pheromones.  ;)

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...  ;)