Monday, October 12, 2009

finally sinking in

My hysteroscopic surgery is scheduled. It's happening on the 21st of this month. And, as I fully expected of myself, I'm freaking out over it.

I mean, sure, I've been thinking about it ever since the words "you need a hysteroscopy" left my original fertility doc's mouth. But meeting with my new fertility doc this afternoon for my pre-op appointment - and, specifically, having to sign the consent form, which was riddled with words like "complications may include uterine performation, perforated bowel, stopping of the heart, massive blood loss and DEATH" - really made the reality sink in. Deep.

First, it's SCHEDULED now. It's not a theoretical possibility left hanging out in space anymore; it's actually on the books. And I've actually signed a consent form. One with the words POSSIBILITY OF DEATH on it.

Second, I've now talked to the doctor who will be performing the surgery about what said surgery will entail. In detail. And about the risks. In detail. I know pretty much exactly what's going to happen and how it's going to happen - provided everything goes off as expected - and while I'm okay with all of it in theory, the reality is that the only surgery I've ever had is the one that delivered Super Boy into the world, and I really had NO choice but to go ahead with that one because he was stuck.

But the thing is, while I am CHOOSING to have this surgery to give my reproductive organs a better chance of getting pregnant again and sustaining a second pregnancy, there's also a part of me that feels I don't have any other choice but to have the surgery.

I say that because as the doctor and I were taking a close look at my ultrasound results today, and looking at them from several angles and depths, etc., he noticed that there is another unusual thing in my uterus that he now also wants to check out during my hysteroscopy. He thinks it's a polyp.

Of course (and as usual), my mind immediately screamed CANCER! (I'm sorry; I can't help it.) But when I was able to form the question to ASK if that was a possibility with a polyp, my doctor said that yes, it's POSSIBLE, but for a woman my age who is NOT post-menopausal, it's highly unlikely. Won't know for sure until next week though.

And that's why I no longer feel like I have a choice BUT to have the surgery. If I opted not to do it now (purely out of fear, in case that wasn't clear), what if that other thing we see on the ultrasound IS cancer - and I didn't find out now and deal with it? The fear of THAT outcome is greater than my fear of having surgery, no question about it.

I just can't think too much about the risks. For what it's worth, the doctor said that the above mentioned complications arise in less than 1% of people who have this procedure, so that's reassuring. Odds are strongly in my favor that I will go in for the procedure, all will go well, and I'll be out and on my way within a few hours. I'll be visualizing that, anyway.

On another note, in a totally bizarre twist of fate (considering that I was meeting with my doctor for my pre-op appointment this afternoon), while I was waiting for my drink at Starbucks this morning, I just happened to glance at the cover of today's New York Times -- which I NEVER do at Starbucks, for whatever reason. Anyway, front and center on the cover is a story about the risks of IUI for those struggling with infertility.

WHA...?

What are the ODDS of that?!?

I couldn't resist - I had to spend the $2 for the paper so I could read the story and find out more about what I'm getting myself into with all of this.

Big mistake!

Suddenly, instead of envisioning the SLIGHT (7-8%) risk of possible twins instead of a single baby, I'm scaring the pants off myself at the thought of somehow ending up pregnant with quintuplets or sextuplets! I'm optimistic that we could manage with twins, but there is no WAY we could manage with five or six babies.

No. Way.

Needless to say, I had to discuss this article with my doctor today.

Now, let me just say that even I picked up on the fact that the focus of this article was on injectable fertility medication, not on oral Clomid (which is all I've taken - and all I will take). After discussing my concerns with him, my doctor assured me that the risk of more than two babies being conceived at once on oral Clomid is less than 1%, and the risk of twins is about 7%. I can deal with that. I think.

What I did not realize, however, is this: While I've been panicking a bit over the risk of ending up with MANY babies as a result of IUI with Clomid, I didn't know that the odds of IUI with Clomid working for me in any given month is only 20%, because of my age. Without the Clomid, the IUI has a 5% change of getting me pregnant in any given month. Without the IUI, I have a 3% chance of getting pregnant in any given month.

Three percent. No wonder all our efforts over the past three and a half years have been unsuccessful.

Even with IUI and Clomid, I'm looking at a 20% chance. And my doctor said he would try four cycles of IUI on me. In those four cycles, there's a 50% chance I will get pregnant - and a 50% chance I won't.

Am I ready?

I sure hope so.

SW

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