I was nervous going to see Dr. K Wednesday morning. I had a 09:00 appointment to consult on our plan of action. Dr. K mentioned that most consider one miscarriage a fluke, but when you have 2 in a row, you need to consider all your causes.
1. Hormonal imbalance - if I was lacking the necessary hormones, I would be put on vaginal medication supplemented with a baby aspirin to help blood flow.
2. Poor cell division - plain and simple...shit happens.
3. Environment/Lifestyle - hazardous environment, crazy heroin-chic lifestyle...not the case
4. Uterine abnormalities - fibroid, cysts, polyp, septum...surgical removal increases chances of fertility.
Last time we spoke, he mentioned performing a Hysterosalpingogram (HSG) or Saline Infusion Sonogram (SIS). The HSG is performed at a radiology center by injecting a contrast dye into the uterus. It's supposed to give a good view not only of the uterus, but also the fallopian tubes. The SIS is performed in the office by injecting sterile saline into the uterus and, at the same time, performing an ultrasound. The saline shows up as a black area in the sonogram and allows the doctor to view any abnormalities through that contrast. And yesterday Dr. K made a good argument. He said, "I would hate to start the process again and have another miscarriage knowing that it could have been prevented."
I went into this consult not knowing what to expect. I thought he would sit me down and warn me about another miscarriage and then prescribe Clomid again. That didn't happen. I was antsy and blurted out, "Do you have time to do the SIS today? I have the day off and I don't mind waiting all day or leaving and coming back. My only concern is cost becos I now have a high deductible plan and I'm pretty sure they won't cover infertility." I could see that he was speechless. He asked if I needed to think about things and he didn't want to pressure me into any procedure. I told him I was eager to get started and that if this test would help me, us, go into this next pregnancy with a clear mind, then it was necessary.
He stepped out of the room and his mom came in to discuss finances. Just as I suspected, my insurance didn't offer any coverage and I would have to pay the private pay fee of $450. I was ready to pay it, but my first thought was, "I could have a first trimester abortion with IV sedation for the same cost as this ultrasound!" Once I laughed it off (in my mind) his mom discussed that since our doctors were good friends and since a close friend of theirs referred me that I would be getting a discount. I was ever so grateful and hugged her and by now it was 10:00. I waited in the lobby for 30 mins, but I could see that more and more patients were showing up for their appointments. The receptionist asked if I could come back at 13:30 for the SIS. I said sure and went home to eat some lunch.
This whole time, Maund had called in sick to work and was nice enough to take my car in for it's inspection...2 months overdue, hehehe. At home I briefed him on the consult and told him about the ultrasound at 13:30. He offered to come with and I declined. I was told I could drive myself home. I decided to take 800mg of Ibuprofen at 12:45 and hoped for the best.
I arrived 10 mins early, just to be on the safe side and was put into an exam room to undress from the waist down. I waited a little until Dr. K and his assistant came in. I lied down on the exam table and had to sit my bottom near the edge. He inserted the speculum, which was surprisingly uncomfortable, and that discomfort was unusual for me. I never have any issues, but that day I guess I did. Once the speculum was in and open he placed some betadine at the cervix along with a tiny balloon slash catheter. After that was in place he removed the speculum and then inserted the ultrasound probe. That's when the real fun began. He started to inject the saline into my uterus and I felt some mild cramping. It took all of 5 mins, but towards the end the cramping became moderate. The whole time I kept on visualizing someone filling up a water balloon. My uterus was a balloon getting inflated with water, except this balloon had nerves and a mind of its own and didn't want to inflate. When it was all over, I sat up and had a waterfall coming out of my vagina. Even before we began I asked, "So you're putting water in my uterus. Are you gonna take it out?" He chuckled and mentioned that some of the saline would absorb into the body if it escaped through the fallopian tubes, but the rest would drain afterwards and residual saline would also leak for the next day or two.
Dr. K and the assistant stepped out for a moment to let me get dressed and he came back to discuss the findings. What he showed me was not what I was expecting. I assumed my issues stemmed from some kind of hormone deficiency, not a mass in my uterus. He showed me 3 uterine/endometrial polyps. Two were small and barely noticeable, then he showed me the one prominent polyp. He explained that most polyps were benign and rarely cancerous, but if removed we would send a sample out for testing. I wasn't too familiar with polyps so I asked what it was. Was it a mass of tissue or more like a cyst filled with liquid? How do we get rid of them? Medications? Surgery? Once removed, will they grow back? Have there been women who successfully carry a pregnancy with polyps?
Yes, it's a mass. If cancerous, a hysterectomy is performed. To remove polyps he suggests surgery, not a D&C, but an outpatient day surgery under general anesthesia. From what I understood, he would lasso the polyp and slice it off. I pictured a tiny lasso made of piano wire. I would be completely under and return to work the following day. My restrictions would include nothing inserted vaginally for 2 weeks, then we could start medications and attempt conceiving once again. Dr. K mentioned that the removal would increase my chances of a successful pregnancy. He said, "I don't worry you won't get pregnant, we just need to keep you pregnant."
All this was just the consult and test. I cried a little during the consult. I cried a little during the results. I now had to think about Dr. K's fees, facility fees, anesthesiologist fees. What ball park am I looking at? $2,700 or more like $22,000? The ambulatory/surgical center gave me an estimate of ~$3,300, Dr. K said ~$1,400 but his mom said she would give me a discount, now I have to check with the anesthesiologist.
The other option is to take Clomid anyway and hope that I don't miscarry again. But even with the surgery there's no guarantee that I won't miscarry. There's no guarantee that I won't have to do the surgery again. Most women who experience polyps are in their 40s and 50s. I know I joke that I'm an old woman, but this really takes the cake!
I sobbed all the way home. I sobbed when I saw my husband. I sobbed for a good part of the afternoon until I cried myself to sleep. I woke up shortly and watched TV and started feeling not so defeated and then dozed off again. I woke up to Maund's phone ringing and all I heard was, "nothing, just watching TV...*silence*...tabrik," and he got up and walked out the back door. I picked my head up and stared at the back door. I waited awhile for him to come in and when he did he refused to look at me. I asked, "what's up?" He said Ang, his sister, had called. He hesitated badly and said, "I guess she's 8 weeks pregnant." I held it together as long as I could, but it was no use. I cried and cried. I was so angry! I saw red and other crazy colors. I eventually calmed down and called her back to tell her congrats, but she didn't pick up.
After awhile of over-thinking I got mad becos I just partied with her on Friday and she didn't say a goddamn thing! If she had told me any other day prior to Wed, I would have been fine. Why did she wait for the one day when I find out that my struggle to have a baby that began in 2008 still has no end in sight?!?!?! And why does she get to have the Feb/Mar/Apr baby I have been dying to have? She knew very well that May/Jun/Jul were my target conception months!
I'M JUST SO ANGRY! Am I such a shitty person that this keeps on happening? Why? What did I do? What lesson am I supposed to learn? Is this survival of the fittest? Are my genes not supposed to live on? I don't get it!!! What's the point? I told Maund I wanted a divorce. I told him it would be best. He could find someone with better genes and continue his legacy. I told him it would probably be cheaper in the long run to adopt or be okay with the idea of being the spinster aunt and uncle. I told him I didn't want a baby anymore.
He smiled and hugged me and said divorce was outta the question. He said he wanted a baby with me and knew that so did I. He said adoption was way too expensive and didn't care if he had to apply for more credit cards or a loan or borrow against the house in order to have this surgery. He said, "MAN UP! We're gonna have a baby, you just have to be optimistic!"
I just hate to be dependent on credit. I wanted to pay down my debt and get a new car and then help my husband pay down his card. I don't want to delay things any more and it feels like a gigantic clock is ticking away the seconds. Going along with Maund's advice and the macho theme, I guess if we're gonna do this, we're going balls out. There's no other way.
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