I went back to the fertility clinic a few weeks ago. Same waiting room. Except that this time I was all alone. No Mr. A. No Gummy. Nobody else, in fact. My appointment for the sonohysterogram was at 10:15, after the morning blood work and u/s rush.
The last sono I had at my clinic was on the painful side of uncomfortable. It felt like about 6 litres of saline was inserted inside my tiny, pre-baby, never stimulated uterus, causing a shitload of pressure. I had another sono at the US clinic, and that one was more like going to the spa. My uterus was soaked ever so gently with a small amount of green tea and lemongrass infused saline while I reclined and watched it all on my personal screen. Oh, the beautiful mild arcuate.
Since this was at my north of the border clinic, I was expecting the 6-litre treatment. However, I think they've revised their practices OR my uterus can now handle its liquor, so to speak, because it wasn't so bad. But of course, I was anticipating PAIN and so had the accompanying mucho anxiety.
Dr. RE somehow didn't get the message that I was in with the nurse and so we waited for him for a while, me in my bedlinen skirt, she in her scrubs, busying herself with tasks. We chit chatted. And then she asked about the birth. "WELL, you might want to sit down for this". Turns out she had been an ER nurse before starting at the Fertility Clinic and found my whole story quite fascinating. Because we were talking about a different hospital, she was at (greater) liberty to say what she thought. She agreed that errors had been made and encouraged me to write to the hospital* She also thought this should be a teaching case because the retained products should have been suspected given that my blood pressure kept climbing after the birth. But when you show up at the ER in hypertensive crisis and the OB on call is an asshole, that gets missed. I appreciated being able to debrief this story with her, and appreciated her encouragement to do something about it.
Interesting outcomes of the sono included:
- My uterus is in excellent shape**. Dr. RE actually admitted that he was expecting I had Asherman's Syndrome, hence why he mentioned I probably would need a couple hysteroscopies during my last appointment. But no, that won't be necessary. Augusta's uterus takes a bow.
- There was a tiny bit of what he called 'debris' and he cleared it all out with the saline.
I asked him the same question I asked my OB at 6 weeks postpartum: what's the likelihood I would die if I have another baby? He basically told me what I knew already, but it was comforting to hear from someone who actually knows:
- I'm at risk for experiencing placental disorder with any subsequent pregnancy.
- (I actually have multiple risk factors: previous D&Cs, IVF, previous placental disorder, c-section scar.
- I know this and so would be alerting any medical professional following me during pregnancy to the facts.
- Hence, if the placenta is burrowing into my uterus (or beyond), this could potentially be diagnosed before the birth (although Dr. RE didn't express any confidence in diagnostic tests for placental disorders).
- Regardless of pre-birth diagnosis, this would be an expected possibility, and I would most likely deliver at Large University Hospital instead of Pleasantville General Hospital.
- Dr. RE paid me a huge compliment and said that because I am who I am, this could not get missed***
- Death would most likely occur if the placental disorder came as a surprise, and our small regional hospital was suddenly unprepared deal with a post-partum hemorrhage (and the need for an emergency hysterectomy)
- While he seemed to think death was unlikely, I gathered that a hysterectomy was much more likely. Fun.
Aside from that lighthearted line of conversation, we also talked about HRT. He's been highlighting that he doesn't want me to take extra.ce orally as a long term strategy. The effects on the liver is concerning. So, he's trying to sell me on patches. Mmmmm, estrogen patches. What fun. Not only do I have to shove prometrium up my hooha for 11 days per month every month, now I will also need to stick patches on fleshy parts of my rump and backside. Looking forward. He also expressed the worry that too much estra.ce could negatively impact my cardiovascular system. I told him that my blood pressure problems were unique to my pregnant state, and that I normally have normal to low bp. "take it right now," I said "you'll see."
Famous last words
My blood pressure was HIGH.
Except that OF COURSE my blood pressure was high: I had just talked at length about Gummy's birth and ensuing circus, which, as you know, REALLY rattles me. And then I had a procedure which made me anxious. All that on a tiny breakfast (as per instructions) and without pain meds (contrary to instructions). So, this made Dr. RE nervous. I took my bp later that day and it was back to normal.
The two conclusions from that appointment are:
1) I'll have a follow-up appointment in March to finalize our long term HRT plan. The plan will include patches. Bleurgh.
2) The ball is officially in our court in terms of transferring the second blastocyst from our DE cycle in June 2012. My uterus is ready to host and grow another embryo/fetus.
The only thing with point number 2 is that I cannot begin to fathom having another child. And that would be another post altogether.
*I've started that letter, but it's a hard one to write.
** Considering what its been through.
*** I think he said "You're a psychologist, so you can judge character. If an OB is not taking you seriously, you would go to someone else."