Tuesday, March 15, 2011

Post surgery blues and brightness

It's been two and a half weeks since the surgery to remove my left fallopian tube, with ectopic pregnancy. I'm lucky they could perform the surgery laparoscopically, which means I don't have any big wounds. My doctor explained to me before I went in for surgery that because I have a little extra padding (yes, that's what he said) that it may not be possible for him to perform the surgery safely laparoscopically. If he couldn't it would have meant much more invasive surgery, a longer hospital stay and more painful recovery. So when I came out of surgery, I was pleased to find out laparoscopic surgery was possible.

I only had an overnight stay in hospital. By the time I got out of surgery and came to, it was late at night. Matt was waiting for me in the hospital room. The doctor had called him to let him know all had gone well through the surgery. I was zonked out, so Matt went home.

The whole process was very stressful him. My sister had visited in the hospital before the surgery and had organised for Matt to have dinner with her and wait at her place, which is only 1km from the hospital. Matt told me he was okay while he was with my sister and Aunty, but when he went on his own to pick up dinner, negative thoughts started to creep in. Surgery is inherently dangerous and Matt was worried something might happen to me.

Even with just three small wounds I did have a lot of pain for the week after the surgery. I had terrible bruising around my belly button (where the biggest cut is made) and on my arm from the anesthetist but by week two things were settling down. I still get a little twinge from time to time and I still have stitches. My anesthetist may have been rough with the needles, but he was also very generous with the post surgery drugs! He sent me home with the good gear which lead to a few zippy afternoons jumped up on prescription drugs.

As I entered the second week of my recovery I started to take less less pain killers and as I came out of the drug haze feelings of sadness overwhelmed me. I remember how devastated I was when we lost our first pregnancy and the sadness I am feeling this time around is very different. It is sadness about everything, I'm sad to still not have a child. I am sad about how hard it has all been. I am sad that I can't keep up with my work anymore and that for the first time in my life I've had to ask for some leniency as I step up my fertility treatments. I was just so sad.

Coming into week three the sadness is under control and I'm starting to get excited about the next step in our fertility treatments. I am hoping that having recently managed a natural pregnancy - that perhaps our chances will be better with a little medical assistance.

Thursday, March 3, 2011

Pregnancy prognosis - written about 25 February

On Friday morning I leap out of bed at 6am to swallow down a quick breakfast and then go back to bed for the 30 minute progesterone medication wait, now known in our household as tea and toast (despite Matthew never having prepared my tea and toast!)

My pelvic scan isn't until 10am, and I have to drink a litre of water from 8.30 - 9.00am. But before this I need to duck into town to get my blood test. Matt has taken the day off from work to drive me around and really, just in case I do need to go into surgery.

We run into town at 7.30am. Matt grabs a quick coffee while I race in for the blood test. We get home in time for me to start drinking my litre of water. It takes about half an hour and I need to pee....but I can't!! By the time we leave here at 9.20 to get to the hospital and find a park, I am in agony. I think I am going to pee my pants. It takes us a good five minutes to find the women's diagnostic centre. I tell the receptionist about my 1 litre consumption and that I don't think I can hold it. She tells me I can go to the loo, count to 10 and then stop. Oh my!  That was the best 10 seconds I've ever spent on the loo. I was impressed with my restraint and just how much relief I got from the short pee.

When I get back to the counter Matt and the receptionist have figured out my appointment is with the regular Queensland Xray centre. We find our way there and wait. By 10.15 I was busting again. What can I do? I go to the new receptionist and ask permission to pee again! This time I've got a 5 second count limit.

Finally I get into the ultra sound room where the sonographer does an internal and external scan. As he is scanning he isn't saying too much. Eventually he finds the spot that lead to the referral. He explains it does look suspect and starts pushing and prodding in the area and it hurts! I get dressed and the sonographer tells me the result it isn't certain. He is going to have a radiographer take a look at the pictures and the report will be with my doctor in an hour or so.

Matt and I wait for images to be ready and head home to wait for a call from the doctor with the verdict. We figure we've got time to kill so we stop and rent a couple of videos to try and take our mind off everything. Once home we settle into the couch. It was only about 15 minutes into the movie when the phone rang. The doctor already has the report. He asks if the sonographer gave me the result, I explain he was sitting on the fence. The doctor tells me the report says I've got a highly suspect 2cm growth in the tube, which they believe in that clinical setting is an ectopic pregnancy.

Yesterday the doctor had explained to me that ectopic pregnancies can be life threatening. If they rupture they can cause you to bleed out into your stomach. Needless to say, the doctor is keen to prevent any of this and asks me to be at the hospital and checked in by 2pm for immediate surgery. I need to pack an overnight bag as it is likely that I'll be in hospital overnight to make sure I'm okay after surgery.

We decide it's time for us to ring our family and let them all know. I start getting a bag packed. I have to ring work and let them know that I will out of the office for a week or more. It is like a whirlwind and we are back in the car and headed back to the hospital.

I'm sad. Matt's sad too. But I'm also glad it's over. No more uncertainty.

Our first pregnancy scan - written on 24 Feb

Today, following doctor's orders, I managed to speak to the fertility specialist to let him know my spotting had progressed to quite heavy bleeding on Wednesday, but had then gone back to being mostly just spotting again.

The doctor initially said there isn't much to do about it that I just have to wait for it stop. He then asked when my last period started - which I think was 25 January. The doctor is stumped, and said that can't be right because I couldn't have got a positive result when I did if that's the case.

I'm sure on my dates, but because I was taking my three months test free, the doctor hasn't seen any blood tests from me, confirming ovulation etc since December.

In the end, the Doctor said why don't you just come in for a scan at 5.30. I was so pleased about that. The doctor was sure with my numbers we'd be able see something. I was sure with my dates that it must still be too early.

Matt came in for the scan too. The latest pregnancy has been taking a big emotional toll on him too. We've both had a lot of anxiety.

We head in for the scan which  is always a little embarrassing. I've got to strip from the waist down and cover up with a sheet. Matt is in the room with me, we are both laughing a bit as Matt is trying to figure out where to stand. When the doctor comes back in he makes a few jokes about all the condoms and lube he goes through as he get the ultra sound probe ready. The doctor inserts said probe and starts to talk to us through what we looking at on screen. The uterus and lining are there - but suspiciously, nothing appears to be in the uterus. The doctor explains with my numbers that we should at least be able to see a pregnancy sack, even if we can't make out an heart beat or anything else. He starts to poke around looking at my ovaries etc and points out a lump in left side, which he thinks looks sus.

I get dressed and we sit down with the doctor to discuss what it all means. The doctor says there are three possibilities:
1. Given what I think the dates are it is too early to see anything
2. Given the bleeding etc I have miscarried and that is why we can't see anything in the uterus
3. The pregnancy is implanted in my fallopian tube and that is the lump we can see.

To determine if the pregnancy is ectopic the doctor tries to get me in for a full pelvic scan, but it is too late in the day. He books me in for earliest available appointment on Friday morning. He also wants me to get a blood test at the Queensland Fertility Group lab so he can have my HCG and progesterone levels first thing in the morning. The doctor tells me that he is in surgery on Friday, which means that if the results of the scan and blood test suggest the pregnancy is ectopic that he will be able perform laparoscopic surgery immediately. So other than the 1 litre of water of need to drink the hour before my pelvic scan, I'm not to eat or drink anything after 6am while we wait for the result.

As Matt and I drive home on Thursday we are both in a bit of a daze. I'm a little relieved to be having the symptoms investigated and hope that tomorrow we will have some definitive answers.

One week of waiting - written about the week 14 -20 February 2011

Unlike the first time Matt and I had a positive pregnancy test, we are not joyous. I'm anxious and as a result, so is Matt. Like our first pregnancy I'm experiencing a lot of spotting, which apparently is experienced by quite a few pregnant women but it just makes me worry that I am going to have a repeat of the first pregnancy, ending in miscarriage.

The fertility specialist asked me to get a second blood test on Tuesday to make sure my levels are back on track. He was happy with the result with my progesterone level now very high, but my HCG level increased by 50%. At this stage you are generally looking for HCG levels to double every 48 hours, so the 50% increase isn't a great sign. The doctor asks me to go again in two days and repeat the test.

At this point I come down with an ear, sinus and chest infection. I ended up at home on antibiotics for four days. Being sick forced me to rest, which I think was a good thing.

I did another blood test on Thursday, and again my HCG had increased by 50% and my progesterone was high.  The spotting is still coming and going. When I rang the doctor for my results he told me the results are acceptable, to hang in there and make an appointment for a couple of weeks to come in ultra sound.

When I tell Matt the doctor said hang in there, Matt asked what the hell does that mean? I try to tell him that my numbers aren't progressing as well as we would like, but that the doctor seems to think everything is okay and that we just have to wait.

I've used my last pre-printed blood test form, so even if I want to I can't just go in and have a test. By Friday afternoon I'm freaking out and ring the doctor's surgery to ask them to send me another form so I can get another test on Saturday. They fax a form over to Holland Park for me. The doctor tells me to ring him at 7pm on Saturday on his after hours numbers for the results.

On Saturday I head over to the Sullivan Nicolades, the line is massive and I have to wait over an hour to be seen. When I get in to the room the lady botches my arm and has to swap to the other. I get home and Matt is in full swing cleaning and getting things done and all I can manage is to lie on the bed. Matt asks me what I'm doing and I start crying. I feel bad that Matt is doing everything but I just can't swing into action. Matt doesn't know what to do with me anymore, but he isn't angry. We talk it through. Matt is staying positive and thinks I shouldn't give in yet. I explain how even if this pregnancy doesn't work out, the fact that we managed to get pregnant again is good.  I can see the positive elements, but the uncertainty is making me anxious. After a while Matt has got a plan of action for the day and I manage to get up and engage in the day.

Matt was working overnight at the crisis shelter, so I was home by myself waiting for the time to tick over so I could call the fertility specialist. Finally the clock hits 7pm and I ring. After following all the after hours instructions the doctor calls me back. He has already left the house and doesn't have my numbers in front of him, but remembers they looked good, perhaps double the last results. I was pretty excited about that. The doctor says he'll have a look and call me back.

When the doctor calls back he says my HCG is nearly double, in the mid 4000 range. I ask him what should I do now? He says I should get off the blood test round about and make my appointment for a scan in few weeks. He says my numbers are looking good and I should relax. He says if I get any pain or heavy bleeding then I should call, but otherwise relax.

I'm really stoked when I get off the phone. It felt like it was my first positive result. I ring Matt and tell him the result and that I've decided that from this point on I'm going to treat this like our first pregnancy result. There were no blood tests or ongoing appointments, I was just pregnant, until I wasn't anymore. But the four/five weeks of being pregnant were great, not sad and anxious.

Matt was excited, but said he wasn't going to get his hopes up until the scan.

The scan was two weeks away.... so much more waiting.

A taste of success - Written about 6 Feb the week 6 - 13 February 2011

I'm cheating on my blog because for the last week I've been dealing with having a positive pregnancy test. Obviously, given that I was on my 3 month break, I really didn't expect to get pregnant.

What happened is this... I've been using my at home ovulation detection tests. I have NEVER had a positive test from one of these tests. I have had a couple of semi results, with pale test lines, which the instructions tell you is still negative.

I decided to start testing a little earlier this month, as my cycle was a bit shorter last month. My first test came up with a pale line, negative. But I decide to test again the next day, I got a positive. I was pretty happy about that and made sure Matt and I captured the window. On the following day I decided to test again, and it was positive again. Hmmmm.... I hit the net and try and find the answer, which is that I probably picked up my LH (luteinising hormone) spike on the way up and way down. Okay, happy with that, but just can't help myself and test again the next day - that is positive again. And the next day, positive again! In the end I had five positive tests in a row. I'm beginning to wonder how it is ever possible that I got a negative from these tests. Of course I hit the net trying to find an answer, and all I find are discussion groups, one of which says, perhaps so many positive LH tests could indicate pregnancy? How is this I wonder? I know the pregnancy tests look for HCG. But it is too late, the seed has been planted in my mind and begin to consider doing a pregnancy test.

I know in my heart it is too early for it to be picked up, but I convince myself that I would be better off doing one to be sure before I have my first medical appointment with the new weight loss program I'm joining (this program costs a bomb, and I don't want to have the money spent on it, only to not be able to lose any weight while in the program). So not even a week after the first positive LH test I do a pregnancy test. You can imagine my surprise when it was positive.

It was too early to be really excited. I waited calmly for Matt to get home from his night shift and told him the good, but not to get excited about yet, news. I tell Matt that I'm going to get a blood test, just to make sure all my hormone levels are okay. Also of concern is regular spotting I've had since the fallopian tube test.

That night I get a call from the fertility specialist - the one who I've been ignoring for 2 months.... He says, what's going on? Clearly you've gone and done a pregnancy test, which is positive by the way, but why did you go and do it? I explain my story to the Doctor, tell him about the spotting and say I just wanted to be sure all my levels were okay. He says my HCG result is strong, but my progesterone is low and that I need to start using some of those wonderful pessaries immediately and take a test again in a couple of days.

Matt and I freak out. During the recent flooding we lost power for 2 days and the progesterone medication was one of the things that had to get chucked. It is a Sunday night, and progesterone pessaries just aren't that easy to come by, even with a prescription. These suckers need to be made by a compound chemist. To give us the best chance we both want to get some to start that night, otherwise it is full 24 hours before I'll be able to get the opportunity to administer a pessary - it's not like taking a pill.

Matt is making me ring 24 hour chemists. I'm telling him they won't have them. A thought hits me, I know quite few women going similar fertility treatments, maybe one of the girls will have some? I start texting and within 30 minutes we have hit the jackpot! Matt and I do a mercy dash and pick up enough for three days supply, which will make sure I have time to get my own.

Then, the waiting begins....