Thursday, March 29, 2012

Like Mother, Like (Doggie) Daughter

I'm feeling a lot of kinship with my old doggie lately and her pain problems.  Even aside from our pain issues, hers arthritic and mine post-op, we have a lot in common.  We both need our personal space.  We're friendly and a tad reserved.  We both suffer from reflux, but luckily mine doesn't result in upchucking my dinner.  As of today, we're taking the same neuroleptic medication for pain, gabapentin.  She takes it for arthritis—neither of us tolerate NSAIDs well—and I'm going to take it for this godawful pain I'm still experiencing.

Earlier this week, my reproductive endocrinologist threw up her hands at my unremitting post-op pain and referred me to a pain clinic.  My pain didn't abate after the UTI was cleared up, and she and the fellows were out of ideas.  Gotta love being "that" patient:  the one who's both annoying and scary with their constant need for medical attention.

I had my pain appointment this morning and really liked the pain doc, mostly because she was blase about my case.  The lack of concern was really reassuring.  She gave me a probable diagnosis:  hyperreactive nerves (probably not the medical term), already sensitized by endo and previous surgeries, thrown into a tizzy by this latest surgery.  I'm hugely relieved to get a diagnosis that sounds plausible.

The doctor very much helped my fragile emotional state in an additional way.  My biggest fear lately, other than these post-op problems meaning I'm somehow even more infertile than before, has been that the pain is somehow my fault.  That I wasn't mobile enough after the surgery.  That my muscles got so deconditioned from lying around that they got messed up.  That this is just a side effect from one of the many medications I'm taking.  But the pain doc—love you, pain doc!—reassured me that this isn't my fault.  It's just crappy genes and endo and a sordid history with surgeries and procedures.  And this doesn't mean I'm any more infertile than I already was.  Hooray!

Oh, yeah.  And the pain doc thought I was depressed based on the quickie "do you hate yourself?" survey they have you fill out.  Well, duh.  It's really starting to hit me just how bad the past 3 weeks have been.  A couple of times a week, I'm in so much unrelenting pain that I freak out that we'll end up in the ER.  And we actually did end up there one night last week.  Learned our lesson; the ER is not for the meek.  We waited for 5 hours and gave up being seen at midnight.  At that time, the nurse said other people in worse shape had been waiting for 9 hours without being seen.  Instead of spending the night in the ER, I opted for an outpatient CT scan the next day, which was normal.

Some days/hours aren't too bad, and I make foolish decisions like trying to work at work rather than at home.  I know, radical concept.  Apparently, working from my couch and moving around my house minimally is mostly ok, but driving to work and walking around the office building is not.  The other day, I was shuffling around work like an invalid and working from a couch in an unused office.  Coworkers heated up my frozen lunch for me and my husband had to come pick me up.  Horribly embarrassing to be infirm because of womanly issues and not be able to explain yourself.

Trying to exercise was also a huge mistake.  Exercise should probably be in quotes because of how pathetic my post-op workouts were last weekend.  Like, walking reeeeeally slowly on the treadmill and then lifting one-pound weights.  It felt kinda ok at the time, minus some cramping, and the RE fellow had told me I needed to be mobile.  In retrospect, it was a bad, bad idea.

I have to increase my gabapentin dose slowly over the next few days, and I should be feeling some relief by Monday.  I promise you I will lose my grip on sanity if I'm not feeling at least a little better by then.  Oh, and the pain doc wants me to get off of gabapentin before I get pregnant.  All odds are pointing to avoiding pregnancy next cycle, eventually stopping gabapentin when my nerves have cooled off, and hopefully doing letrozole after that.  Hoping not to be on gabapentin for long.

I'm not doing ICLW this month because of the post-op craziness, but if you happened to stop by for the first time anyway, welcome!  To my bloggie friends—I'm thinking of you all but have had little commenting time lately because I'm trying to get caught up on work. 

In "Fertiles:  They're Everywhere!" news, the pain resident I saw this morning was like 40 weeks pregnant and annoying adorable in her fecundity.  My husband and I rolled our eyes when she left the room.  Also reproducing are three birdie couples residing on various parts of our house.  Bluebirds are nesting in a bird house on the back deck.  Our front porch has finches on the north side and wrens on the south, both on little platforms my husband built for them under the awning.  I think a finch baby was born today because mommy was super active pecking gently on something.  Glad someone is fertile around here!

Sunday, March 18, 2012

I Have Other Organs Down There

I appear to have a UTI from the catheter used during my surgery.  Went in on Friday for my fourth clinic visit of the week and had tons of pain when my main doc pressed on my bladder.  She was thrilled to give me a likely diagnosis and said gleefully, "I can treat a UTI!"  As opposed to any number of non-gynecological things that could be going on. 

Quick recap if the state of my uterus isn't at the top of your list to worry about:  had surgery 3/9 to remove scar tissue and more of my uterine septum, had a balloon put in my uterus, excruciating pain, ER visit threatened, balloon removed, more pain, more days off work, clinic visit times four, pain.

A urinalysis was normal on Friday but a culture came back on Saturday growing a common UTI bacterium, so I started antibiotics last night.  Pyridium seems to be helping a bit.

If this is indeed a UTI, it's my first.  What a horrible feeling.  I never would have expected this level of pain.  On Friday night, it was particularly bad and I went to bed planning my funeral.  I had taken Ambien to help me sleep, and was afraid I'd die during the night without realizing it because I was knocked out.  I told my husband to check my breathing before he went to bed and asked if he thought my doctor would attend my funeral.  Because it might be awkward, you know, as the attending physician.  For the record, I love her and would be happy for her to come.

I do not love one of the fellows who is in training.  First it was the mixed messages, telling me not to take narcotics one day and then later instructing me to take more narcotics so I can increase my mobility.  I'm fairly medically inclined, but with all the pain, meds, and stress of the past week, I needed some clearer communication.  This physician also told me, the day before my main doc suspected the bladder stuff, that I should take hot showers for the pain and stop bothering him.  Not in so many words, but that was the gist.

I'm tired of having to page the fellows on call.  I mean, I've enjoyed getting to know the hospital operators—we're on a first-name basis—but I really just want to be back at work.  I'm definitely leaving that sentence in so I can reread it when I'm hating work. 

I'm afraid I'm not out of the woods yet.  My doctor said she's perplexed still.  My urinalysis should have come back with increased leukocytes or whatever if this is a UTI.  If the infection is in the very early stages and my leukocytes haven't kicked in yet, I shouldn't be in this much pain.  My bladder could have been irritated by the fluid they injected for the procedure, but should be getting better by now.

Another theory before the bladder stuff emerged is that this is an endo flare caused by the hormones I've taken in the past month, but it doesn't feel like any endo pain I've had before.  I know that doesn't exclude endo, because it can surprise even us veteran sufferers, but I'm just not having any of the uterine crampy pain I typically have with it.  I think I was crampy while the balloon was still in place, but not since it was removed.

Someday I will blog about something other than pain, but for the time being, it's my world.  That and Netflix.

Thursday, March 15, 2012

Perma Potato: Taking Couch Potato-ness to the Next Level

Hi guys.  I'm kinda miserable here.  I'm still not able to go to work today because of post-op pain, which is my fifth day off if you count the surgery day last Fri.  I'm not really able to sit up at my desktop computer and my laptop is at work, so I'm kinda hunched down in my desk chair with my feet on the desk as I type this.  I've been stuck on the couch, rereading Hunger Games (8 days until I see the movie!) and watching the entire series of My So-Called Life.  I'm on a YA kick these days, apparently. 

The pain has been bad.  I've been to my fertility clinic three times since my surgery Fri, and they're doing their best with me.  The most popular explanation for my horrible recovery is that the balloon really aggravated my uterus, causing inflammation in there.  Even though the balloon was removed on Monday, the ute still hasn't forgiven me.  I'm buying the balloon theory since a similar surgery in December, minus the balloon, gave me very little pain and a speedy recovery.  They're threatening to do a CT scan if I don't improve soon, and I'm willing the ute to heal before we have to do that.   

I'm gearing myself up for my daily call to the doctor wherein I tell them that yep, still in horrible pain.  Still taking narcotics but not constipated.  No fever.  Etc.  They'll try to reassure me by telling me things looked great yesterday, felt ok on the internal exam, and it will probably just take another day or so.  But I'll hear the concern in their voices.  And with the weekend is coming, I wonder if we need to take some further action by tomorrow.

Being a couch potato isn't my natural state and I need some entertainment suggestions.  What are your favorite shows?  Bonus points if they're available instantly on Netflix.  I am open to anything, barring scary.  A Halloween episode of My So-Called Life that was pretty much the limit of what I could handle.  Other shows in my Netflix queue are Downton Abbey, Chuck, Arrested Development, Portlandia, Nurse Jackie, and United States of Tara.

Saturday, March 10, 2012

The Balloon from Hell

Yesterday started with an innocent enough mix-up.  I got up at 5:00 to get ready for my surgery, showered, and woke my husband up.  That's when I realized it was actually an hour earlier than I'd thought and my alarm clock had Sprung Forward two days early.  Somehow it had the date wrong, wrong year and everything.  Ok, fine.  Took a nap for an hour and thought it was no big deal.  Maybe it was a sign of worse things to come.

The procedure itself was fine.  My veins behaved beautifully for the IV insertion, I passed out pleasantly (isn't it always pleasant?), and wasn't in too much pain afterward.  My doctor removed some more scar tissue and needed to insert a balloon to promote healing, so had to trim back my septum farther.  The balloon was inserted and 5cc of fluid put in to prevent the uterine walls from fusing back together and forming more scar tissue. 

My husband recorded his conversation with the doctor afterward, and I have yet to listen to it.  I've looked at the detailed drawings, timeline, and uterus pics, though, which is about all I can handle right now.  Looks like I'll be taking estrogen and then estrogen/progesterone this cycle, having a period, and then having another saline infusion sonogram.  I have the option of doing letrozole at the same time as the 3D sono, but I'm not sure where I stand on that.

Back to yesterday.  I hadn't picked up my post-op prescriptions yet because my work week had been busy, so we stopped by the pharmacy.  The resident who'd written the prescriptions hadn't written a quantity for oxycodone, which started a drawn-out drama of trying to get it fixed by phone while we were waiting.  About an hour later, meds in hand, we were able to head home.  Pain and cramping started to set in for real.

Thirty minutes later, I was writhing on the floor in agony.  It sounds totally melodramatic but I'm actually not exaggerating.  Pain meds weren't helping so we headed to my doctor's office 30 minutes away.  Seriously do not know how I made it through the trip, I was so out of my mind with pain.

I saw a fellow, who with my main doctor's blessing removed 2 cc's of the fluid from the balloon.  It gave me immediate relief but not enough, so he removed another cc.  I started bleeding, and the doctor said some of the pain had been from blood building up that couldn't be expelled.  I went home feeling much less pain and no inclination to writhe.

That's when the bleeding picked up.  A couple of hours later, I called the fellow again, and he said I'd have to go to the ER if the bleeding continued to be heavy.  That definitely freaked me out—did not want to go there.  Thankfully, the bleeding tapered some by bedtime and I pretended to sleep.  Couldn't sleep more than 30 minutes at a stretch.

Called the fellow again this morning and the current plan is to removed the balloon tomorrow morning.  We'd planned on removing it on Friday, but I can't deal with this level of pain for that long.  I wouldn't be able to work, for one thing.  The doctors say it's probably been in long enough to do some good, anyway.

I haven't really been able to process the fact that we'll be waiting at least one more month, if not more.  I can't say I'm surprised, though.

Quick Blogger question that's been driving me crazy:  some of the blogs I've followed through Google Friend Connect don't appear on my main Blogger Dashboard page or my Google Reader.  I end up missing those posts and it makes me sad.  Any ideas what's going on?

Friday, March 2, 2012

Walking Infertility Encyclopedia

I told my uber-fertile sister-in-law about how I'm taking testosterone to thin my lining for next week's procedure.  Although I'd also recently told her we were in a holding pattern of procedures that were not treatments, she said, "OOH!  It sounds like they'll be putting something like sperm up there!!"  Actually, soon-to-be mother of five, you'd hope to thicken your lining for that.  Not that she should know that, but why do I have to be a repository of all things reproductive endocrinology-related?  I forget that not everyone thinks about their FSH and AMA levels on a daily basis and yet they still manage to make babies.

Although I'm not on a quest to educate people about the female reproductive system, I keep getting the awkward opportunity to educate young guys about it, and not in a sexy "Here's an anatomy lesson, you young stud" kind of way.  Yesterday, the cashier at Whole Foods asked me what the B6 in my cart was for.  I muttered that I didn't know but he didn't look satisfied with that, so I said, "It's for...woman stuff.  Wouldn't be relevant to you!"  <awkward laugh>

Another time, I got frustrated (read:  extremely hormonal) when I couldn't find the basal body thermometers in the drugstore.  What if I missed taking my temperature the next day??  The horror.  The pharmacy employee, a guy in his early 20's, could not figure out why I'd want anything other than a fever thermometer.  I unsuccessfully tried to describe it using scientific terms until finally I blurted out, "YOU KNOW, FOR WHEN YOU'RE TRYING TO GET PREGNANT."  After thereby broadcasting my status to the nearby aisles, he finally understood and directed me to the ovulation/pregnancy test section.  (Well, duh.  Should have guessed.)

In other hormonal crazies news, I think testosterone is making me rage-y.  In the span of 10 minutes the other night, I managed to pick about 10 fights with my husband.  He looked like he didn't know what had happened.  Is this what it's like to be a man, to have this much testosterone coursing through your veins 24/7?  Thanks, but no thanks.  I'm also starving all the time and craving baked goods. The weight will come off after I stop taking testosterone, right?  The other main symptom I've noticed is that I'm having vivid dreams.  Last night, I had a nightmare that I had forgotten to fast before my procedure, which is a legitimate concern.  Eating breakfast right after I wake up is hardwired into my DNA. 

While my uterus is plodding along through various hormone treatments and procedures, the rest of my life is moving quickly.  I'm about to turn 35.  Where did the past year(s) go?  How did I become advanced maternal age?  We started trying when I was 32.

This week has moving crazy fast, too.  In a rare display of Detour family decisiveness, we bought a used Camry after only researching it for a few weeks.  Although it's is not the minivan we'd dreamed of having by this point, it's pretty great.   I have a strict "No Baby, No Minivan" policy, so we'll have to figure out some other way to transport lumber back from Home Depot.

You know the individually wrapped chocolates that have short sayings in the wrappers?  Sometimes the saying makes me feel optimistic.  Other times, it makes me very, very angry.  The wrapper I just opened says, "Feed your sense of anticipation."  Enter testosterone-boosted ANGER.  Oh yeah, chocolate wrapper?  I've been feeding my sense of anticipation for having a baby my whole life.  Tired of being on the anticipating side of things, ok?