Wednesday, January 26, 2011

The weird vagina appt

(first of all, the weird vagina is fine. just a small, out-of-the-way septum. boy am I tired of hearing that "s" word.)
I've been saying for a week that there was a meltdown coming around the bend. I wish I had been wrong.

It started in the waiting room. Since I still see an OBGYN, the waiting room was full of big, beautiful, pregnant bellies. The tears started then.

The nurse who checked me in saw I was distraught. She confided that it took her five years to get pregnant the first time. That's when the crying really started. I don't know what part of that she thought would comfort me. Four more years of this? I'll be catatonic.

I nervously brought up the septate vs. bicornuate uterus thing with Dr. Lovely. She told me that I was right, an HSG doesn't diagnose between the two. The diagnosis can only be made surgically, and they don't usually do surgery until "you start having problems".

This is really hard for me to stomach. If I have a septate uterus, the septum can be removed and everything will be fine. We all know that "having problems" is a code word for "miscarrying". I'm really not comfortable waiting for a poor baby to die needlessly to decide that we need to have surgery to find out what sort of fucked up my uterus is. I talked it over with A (through many tears) and he feels the same. We'd rather I go under the knife now.

A lady in my yoga class has a daughter with a septate uterus. Poor girl had three miscarriages, all in the fourth month, before she found out she had a septum. No thank you.

Think about it: say I get pregnant next month. Knowing what I know (that my uterus could be bicornuate or it could be septate) I'll be terrified for months. If I have surgery now, I'll know for sure, and if there's a septum, it can be removed. And if there's not a septum, I can't really look at it as pointless surgery. Because I'll know.

The other bit of information I learned is that I will be referred to an RE after my next IUI. In fact, they're referring me now since it takes months to get in.

It's expected that I'll get my RE consult in May. So I have February, March, and April and only one more treatment cycle with Dr. Lovely. Our plan now is to ask for laproscopic surgery as soon as possible, take Feb and March off, have our final IUI in April and hopefully never have to see the RE (he's three hours away, but has an excellent reputation).

I'm literally going to have to call the doctor's office and fight for my right to have my abdomen cut open, perhaps unnecessarily. My husband and I both feel that this is the correct decision to make. Have we both gone off the deep end?


Heather said...

In short, no. As I said before, I had a septum removed before moving on to IUIs. For us, it was worth the discomfort and money to have the obstacles within our control removed before we proceeded.

Have you had a sonohysterogram? I thought that an HSG was a step up from the sono, but it was through the sono that my RE diagnosed me with the septum. Unless he lied at the time and was just hazarding a guess...?

Still A Guest Room said...

You have to do what feels right to you...we are always our best advocate. I hope the phone call with the doc goes well.

Marissa said...

I was told that HSGs are better for detecting tubal abnormalities, but that saline hysterograms (SIS or SHG) are better for seeing the uterus itself. I would ask for one of those--they can usually be done in your doctor's office (don't need a radiologist).

Or even an MRI, if your insurance will cover that.

Jem said...

Wow, crazy choices to make. Of course you cried in the OBGYN office. Who wouldn't?

Brice Barnes said...

They thought I had a bicarbonate uterus on my hsg. I got an MRI in order to decide what to do and the MRI showed a normal uterus! You should as for an MRI first before surgery.

Denver Laura said...

I've actually turned around the pictures of the ob's grandkids to point in another diretion instead of having to sit there staring at fertility right in my face.

I found that most doctors are willing to go slower so they won't get sued. I think you're right on with the decision to go ahead with the cut & inspection. Either way, it's one more thing to rule out.

Drevas said...

I completely agree with your decision. After having two miscarriages myself, I would do ANYTHING to correct the problem or potential problems. Best of luck with everything!

Rachael Lynn said...

Unfortunatly, I don't have an answer. But I do feel your pain in just dealing. It sucks that we must face things like this so often, while people are getting knocked up in the back seat of cars. You will figure it out, good luck! :)

Warrior Woman said...

I'm not well versed in septums, but from what you're saying here it makes sense to go through with your plan. I hope your doctor listens to you. Good luck!

Lu said...

first of all, just wondered if your blog title had anything to do with the Indigo Girls song - one of my favorite songs of all time.

The fact that you're finding all of this out now is good, then you'll be prepared if you have to "move up the ladder".

Also, I firmly believe that they need two separate sections at OB/GYN offices - the OB section and GYN section. I hate going just for that reason.

Alex said...

I think this is a geat plan!!!

Kathy said...

Excellent plan. Even an SHG isn't a great way to make the differential diagnosis, and an MRI is only useful in some cases when you've got a radiologist interpreting it who is well-versed in the various Mullerian anomalies.

I think you're wise to move forward this way and to have the opportunity to remove any potential obstacles before getting pregnant. Too many of us have had to undergo losses before getting a proper diagnosis, and that is just heartbreaking.

I'm assuming they are doing the hysteroscopy simultaneously -- that way, if it's indeed a septum, they can most likely resect it right on the spot.