Day 3... Results are in!

My results are in,  (drum roll please! haha)...

Estrogen:  35.  They would like it to be below 50.

FSH:  11.9. This is just a bit elevated over the 10 they would like to see - YIPEE!!

LH: 9.1.  She said this should be about 1/2 of the FSH level. (Which obviously it's not). The nurse said that this gives the doctor an idea of what type of protocol to put together.  I'll need to find out more about this later.

I love how without asking the nurse just gives the reference range for a result.  It's awesome.

From here, she will ask the doctor to put a protocol together.  They will determine if they will use this cycle or the next.   Oh my gosh! I didn't even think this cycle would be an option.  Happy dance!!!

She discussed Dr. Dandruffbeard's desire to have a sono-HSG before doing the laproscopy.  The nurse said, "let me just think of the polite way to say this".  I told her "there's no need, you can just tell me what he said".  She told me that Dr. Schoolie thought it was an "idiotic" thing.  She explained further to me, that it would be like having an MRI and seeing you have a tumour, but then saying that you need to look at someone's eyes before doing surgery.  Or, that if you had a mammogram and found a mass, but then wanted to do a breast exam.    She said he thought it would be a waste of time, using a less sophisticated technology and and that it would give us no more information then we had now.

She said if I needed to do the sono-HSG to follow the rules of the Canadian health care system, then to do it.

I asked her if I should be worried about being under his care?  Should I have someone else do the surgery?  Now I'm not so sure.  Ironically, I'm no longer trusting Dr. Dandruff's opinion.  Oh.  And did I mention that Dr. Dandruff is the head of his department at one of the larger hospitals in my area?  Now I can't get the thought of 20 year old equipment and dirty operating rooms out of my head. Yikes.

I might reconsider paying the $3,500 it costs to have the laproscopy procedure done at CCRM.  Maybe they could do it after my egg retrieval if we get that far?.

Dr.  Dandruff had also told me that if there was no hydrosalpinx shown that there would be no way for fluid to be moving in the direction of uterus.  That fluid is pushed out of the tube towards the ovary.  I asked the nurse for Dr. Schoolie's opinion on this.  She said that it is nonsense.  I asked why, she said that some doctors just believe different things.

Tubal Ligation Preoperative Consult

Well, it seems things are going to get a teeny bit more confusing before they get simplified.

I'm hoping it's like when you spring clean and need to spread things everywhere and make a big mess before putting it away neat and tidy.

I had my preoperative consult with Dr. Dandruffbeard.  Although strangely, today he didn't have any dandruff.  I wanted it to be simple, for him to concur with Dr. Schoolie's opinion, and book the surgery in early January.  The surgery was for what I described here, a laproscopy and possible tubal ligation.

Blah.  But not so fast.  I forgot that this surgery is "optional", and not 100% indicated by my previous tests.  It's just to basically rule a possible problem out, for the best chances of implantation.

Dr. Beard said that in Canada they do a sonohysterogram to determine if there is a hydrosalpinx that requires ligation.  He said they don't go by the x-ray (the HSG) because it is an imperfect test.  The rule in Canada is that if there is no accumulation of fluid shown in a sonosysterogram, they don't do a tubal ligation.

I didn't have a sonohystergram.  But I made a big oopsie and told him I had during my ODWU.  Now things are confusing because my whole consult was based on Dr. Beard reviewing the sono, then talking with Dr. Schoolie briefly, then doing the surgery.

I've messed things up.  :( So now I'm back tracking.

One unexpected perk was that the appointment served as a second opinion on the procedure.  Dr. Beard said that basically if there is no balloon of fluid in the tube aka. hydrosalpinx, that there is no way for fluid to leak back down into my uterus.  And that he doesn't think I have this problem anyways because I've had implantation at "a reasonable rate".  He said the fluid leaking out of the tubes causes an implantation problem, not a miscarriage problem.   He offered though to do what he could to help me.  Hmm, interesting.

Then we had a semi-awkward conversation about trust, that I'll have to write about another time.  I'm off to my exercise class.

Surgery it is

 *image from goivf.com

It took a few phone calls and a couple of days, but I've made a decision to have the surgery.  Checking another thing off the list.

After pressing for more information, Dr. Schoolie says that it is only a three day recovery and that without it he would reduce our chance of a normal embryo implanting by 50%, to only 25%.

While I'm not looking forward to having the surgery (who would?), I feel good that I got the information I needed to make the decision with confidence.

Dr. Schoolie says that it is a pretty basic surgery and he would be comfortable with me having another surgeon do it.  So, I am going to try to have the surgery in Canada to avoid the cost by traveling to Colorado and to avoid paying for this procedure (I suppose I guess I do pay via my tax dollars, but I digress).  I would also like to recover in the comfort of my own home.  I'll be traveling only 2 hours away and under the care of Dr. Dandruffbeard.

By some fluke of the Canadian medical system, on Friday afternoon I was able to get a Monday morning appointment for the surgery consult!   I appreciate socialized medicine for many things, but wait times for specialists is not one of them.  I'm considering this a mini-miracle.   The receptionist said that if the doctor agrees to preform the surgery that I could be looking at a January surgery date.  Perfect!

Dr. Dandruffbeard did request a letter from Dr. Schoolie, and the CCRM nurses amazingly emailed me one within an hour of my phone request.  The letter said:

"...During her testing she had an HSG that revealed delayed spillage and questionable hydrosalpinx in her left tube.  It is our recommendation that she needs to have a laparoscopy to evaluate her tube and if there is a hydrosalpinx noted, she needs to have her left tube ligated."

The letter makes things sound simple.  Getting to this point of understanding about this procedure has not been that simple.  I'm realizing that CCRM isn't perfect either.  I am however still very appreciative of their care.

I'm trying not to think (several times a day) about the possibility of this not working.  My mind just goes there, so it's difficult.  I'm also second guessing our decision to do OE IVF vs. donor, but not enough to change my mind I think.

JS

PS)  The exercising has been gratifying but... ouch! Muscles that were happily withering away are now mad at me in droves.   And I'm happy that today I discovered a warm, sweet drink that I can have sans-caffeine.  It's warmed milk with a little (or a lot) of my favourite french vanilla creamer.   I'm semi-lactose intolerant, so I'll have to do this in small doses.

Post-consult

I'm back. 

Colorado was great.  It was everything we hoped it would be.  I kind of felt like it was a fertility-wonderland, complete with a waterfall.  The staff were very professional and we felt that we got some new information.  I'm happy that we went.   

We still haven't made a decision on donor egg vs. trying our own egg.  Honestly, I'm still on the fence.  If money weren't an issue, I would 100% give an IVF with CCS a go for two cycles.  But, being real, money is an issue.  If we spend $60,000 (the rough cost of trying two IVFs) and don't end up with a baby I'll be feeling really depressed and kind of stupid.  The only reason why I prefer own-egg is because in many ways it just feels simpler.  No explaining one day of where they came from and no issues of loss for the child.   I suppose I just don't feel very confident in my parenting skills, because I haven't got the chance to practice them yet. 

It's funny to me how we are back to (almost) the same decisions that we were making over years ago when we decided to adopt the embryos.  

It's very frustrating and difficult to make these decisions. I just want to be done with this part of my life and move on to the part where I am a mommy. 

Some of the things I really liked about CCRM:

- They are organized.  Check in at the desk, have a test, check in again, have another.  We had back to back appointments all morning and things went very smoothly. 

- I felt Dr. Schoolie was kind and was honest with us about our options. 

- The staff seemed to be really well trained and experienced.  I liked that many of the technicians really took time to explain the procedure they were doing, and what they were hoping to see.  

Some of the things I don't like:

- They messed up on drawing enough blood for a thrombosis panel.  I had 16 vials of blood taken, and that still wasn't enough.   16 vials tops my previous record of having 13 drawn at once.  I wonder what my fertility-lifetime total would be? 

- They called me back and said that they doctor isn't sure about whether to recommend a laprosopy and tubal ligation for my left side.  It seems that my HCG showed some hydrosalpinx (sp?), but there was some spill (which means that there is no blockage) however they weren't 100% sure if there is a blockage or not.  Basically the doctor said it was my call on how to proceed with this.  After a few days of marinating on the topic, I've decided that this isn't enough information to make the decision.  I need a doctor's recommendation.  Isn't that what I'm paying  for?!?  I'm honestly a little flabbergasted that they haven't given me more information on this to make the decision.  Oh well.  I guess no clinic is perfect.  That's why I've called back for more information. 

I'll write more later.  I just wanted to break the silence, and get some of my thoughts out. :)