Odd Dreams

Early this morning I had the oddest dream.  I was holding a conversation with the baby within me.  I couldn't yet see my baby kind of like those dreams where you know you are talking to another person but their face is blurred out.

My baby told me it was a boy and his name.  His name began with an "M".  I can't remember his name.  Wish I could.  I haven't even considered boy names or even names that begin with an "M".  I've been good at picking out girl names for years but I've always left the names for boys up to my husband.  I suppose I'll soon hopefully have a dream where the baby tells me it is a girl and her name as well.  I mean fair is fair and one must mess with my unconscious mind!

In other news, the lab results for my TSH came in yesterday afternoon.  Finally it looks as though my thyroid is getting under control.  TSH was 2.2 and I'm to stay on the 75 mcg of synthroid.  No clue when the next  lab test for that will be.

In January I'll be doing my intake appointment with OB.  For now they are just doing the job of the RE office because of the issue I had with a doctor next door.

Oh and Chris at the RE office was wonderful on getting the TSH report right over to PNW yesterday.  However, Jennifer Frye never did get the ultrasound report sent to PNW yesterday after Dr. Curlin was done with it.

I had to call the RE office this morning and ask Jennifer Frye to send over the ultrasound report.  She was fine with doing that but there was no apology for her forgetting to do it yesterday.  This RE office at Madigan is horrible about sending lab requests to the lab, faxing results to another department let alone an outside clinic or working with their clients on a plan to get pregnant.  More often than not with my treatments I would get the "you know what to do" from them even when I was on bed rest or trying for timed intercourse.  If I knew what to do would I be asking for their help?  If I knew what to do I'd be walking around with a stethoscope and script pad dispensing advice and getting paid for it.  I went to the RE office with the hope that THEY knew what they were doing.

Oh don't mind me.  I'm a bit cranky today as my computer when turned on decided it wanted to do updates today and didn't want to be its normal work horse.  I ended up using my tablet for my Etsy shop, email and initially blogger too.  Not that the tablet isn't handy but I prefer using a full keyboard and not the single finger method when I have a lot of typing to do.  In order for me to use the keyboard that is near full sized with the tablet I have to remove its outer case (otter box) and connect it to a keyboard that then plugs into a wall outlet.  Major pain in the ass when I'm not in the mood to monkey with things.  I would use my husband's laptop if he didn't take it with him to work.  So this is me being a whiny bitch today.  Mostly likely due to a headache and the fact that my first meal of the day was lunch because I was doing laundry and fighting with technology.  Excuses, excuses.

Transferred to OB Early

While this isn't a perfect solution it is a solution that hopefully will work.  Dr. Beasley called my home phone while I was out yesterday getting a tree to let me know that they are going to open an investigation up on Dr. Saunders.  In the meanwhile since she will be the only doctor in the clinic on Monday and my appointment is on Monday Dr. Beasley has moved me over to the OB clinic.

I will be seeing Dr. Curlin at 1030 hrs on Monday for an ultrasound.  He is actually Dr. Beasley's boss or so he said.  I still have a bit of anxiety in moving over to OB this soon as J and I were discussing actually picking an OB off post since the OB on post is crowded with patients that it is hard to get seen, especially if you have a possible high risk pregnancy.

I might not be considered high risk.
Why?  I'm not sure.  After looking over all the guidelines I thought for sure I'd fall into the high risk category under the weight (200 lbs or more) , age (over 35) , asthma, thyroid, and hypertension (long standing at 4+ years of being on meds) issues.  Seems that because they are so over crowded I'd be only considered high risk if I were also carrying twins, of which we don't know if I am or not as of yet for sure.

I am hoping that my pregnancy will get the much needed care it deserves as I'd hate to lose a pregnancy due to hypertension because they can't fit me into their busy schedules.  Yes that is a big scare to me.  I spoke with Maternal Fetal Medicine two years back and they said I had a 50-50 chance of surviving a pregnancy.  A risk I'm willing to take.  So to not be considered high risk just blows my mind.  I'd love to have an uncomplicated pregnancy where I only had to be seen maybe four times!

I am hoping that Dr. Curlin will be willing to send over the results from the ultrasound and TSH blood draw to PNW.  I do have a fax number to give him and have called over to PNW to let them know about the change of time and change of doctor.  They are glad that I'll be seen by a different doctor as they know I've had problems, so have they, with Dr. Saunders in the past.

Finally the Lab Results are in

E2 462
P4 15
HCG 23619


I'm to double the dose of the PIO to 2cc starting tomorrow.

Madigan only forwarded a copy of the report and not the photo of the ultrasound.  PNW can't tell without the ultrasound photo if it is possible to have twins.  However, we are hoping  that Monday's appointment will be able to show things a bit more clearly.

I'm really hoping that I don't end up with Dr. Saunders on Monday or on the 23rd which will be my last appointment with the Madigan RE clinic.  The Army needs less of doctors like Saunders and more of the type of doctor that Dr. Burney is and can be.  At least Dr. Burney, when in clinic, is caring and compassionate along with being knowledgeable.

Okay I need to get some small meal into my stomach to prevent nausea.

I AM NOT YOUR DUMPING GROUND

I cannot say it enough to all that will listen.  Find some place else to drop your load of woes.  Give it to God as I try to do daily.  Give it to your best friend, lover, parent or shrink but don't take it out on me.  I'm pregnant and I have hypertension.

Last week I had a bleeding scare.  Last week I called PNW to find out what should be done because they told me any bleeding was to be reported to them.  They contacted Madigan requesting an ultrasound that day.  It took a week to get me in.  That week was up today.  I was seen today.  However, I need to back track a bit.  Maureen at Madigan's REI clinic called me last week to schedule the ultrasound and said she was putting in a third beta for me as well.  Today the beta was not in the computer.  I'll get back to that in a bit.  I will be filing an ICE report ASAP but this CPU keeps saying the site has a possible virus on it.  I'll try to file the report from a different device by the end of the day.

Yesterday I had my appointment with Neurology at Madigan.  It seems as though they are curious why I hadn't been referred by my PCM to their clinic sooner and why it took the ENT clinic to do the referring.  I know I've mentioned just how competent my PCM is in the past on my blog.  The man refuses to refer
 me out like a insurance doctor refuses to see something obviously wrong with a patient like a broken bone sticking out of a leg!

Neurology determined that my carpal tunnel and tendinitis are becoming aggravated by my moderate spinal stenosis and they'd like to get a new set of EMG testing and MRI done on me to see just how worse it has gotten.  As for the dizzy spells, well it is recorded that I have mild Meniere's disease and migraine headaches.  I found out a new thing, I am one of those types of people that can get migraines without the headache too.  Just plain odd.

So I got home late in the afternoon yesterday after a 1.5 hour exam in Neurology to find that a former on line friend had gone rabid on me.  I was removed from her facebook group.  No loss as a few of the women didn't like my last post about how "WE" are not pregnant but I am in relation to my husband's use of the word over the holiday weekend.  They felt that he earned the right to say "we" even when I'm not present because he is my spouse and even more so because he is a soldier.  UM, no!  Sorry but he isn't a royal.

Anyway the rabid woman left me a message on facebook that I transferred on to the other administrator of the group.  I refused to reply to the message as I didn't want to cause more stress.

Today things just got worse in the dumping ground.  Seriously does no one care that I could have a stroke? Before the exam my bp was 139/70 and that is with me being on Labetalol 200 mg twice daily.  Dr. Saunders at Madigan RE clinic went down my throat and was looking straight at me accusing me of rapping on her back door office to gain access.  I did not.  I was at the lab the whole time.  If the RE office would stop shopping online for a few minutes and actually answer their phones especially when the Lab manager is calling them they wouldn't have my husband knock politely with one knuckle on their door.

So she chews me out.  Then she goes into how their office, I'm Tricare Prime, doesn't have to give me care since I'm using an infertility clinic outside of their network.  Um, hate to tell you doc but you do.  I have verbal agreement with Chow, Beasely, and Burney along with Jennifer that you will give me care and make available to me appointments during your clinic hours.

I told Saunders to stop.  She continued on.  I told her she was going to make me cry and to stop.  She didn't stop and I started to cry and then hyperventilate.  I asked her to leave the room.  She didn't.  My husband had to then ask her to leave.

When she came back in the room she started in on me AGAIN!  I told her to stop.  She said she was trying to apologize.  That wasn't an apology that was her blaming me yet again.  I told her that she scares me and every time, think back to 13 February where she hurt me during the SIS, she does an ultrasound she hurts me.  She has been told to not exam me again by her superiors.

Well enough of that.  You get the drift by now.  Crappy past few days.

*****WARNING*****
Ultrasound photos below

Good news is that I have at  least one baby in utero.  Saunders said there could very well be another one in there but she can't see it just yet.  I know they can develop at different rates considering the two embryos weren't genetically related to one another.

The sac with fetal pole was measuring 5 wk 5 days Yolk sac was .47 cm, CRL 0.24 cm.  Heart could be seen flickering away.  Dr. Saunders didn't see it when I saw it flickering.  She went back to it and saw it the second time around.  Yup J and I have some real hope.  I just need to keep the stress down and this pregnancy might just make it.

Suppression Lab Results

I got my lab report back late yesterday afternoon.  I wouldn't have had the results at all if I hadn't of called my local clinic.

Putting the phone on speaker so that my friend, TM, could hear the nurse we got the excuse that the doctor that ordered the labs wasn't on that day so that they wouldn't have gotten notice of the labs at all.   I swear my local, Army, clinic is full of excuses as to why they are lazy.

Every time I have lab work I make a note of which doctor is listed on my lab papers.  I ask each time I have an appointment which doctors are on duty that day.  When I see the doctor in my room I make sure to remind him and the nurse that I need the information from the labs sent over to PNW!  They say they will do that too.  There are no excuse for this level of incompetence!

E2 (estrogen) 10.7  anything under 50 is suppressed

TSH was 3.14 down 0.5 from last month of 3.19

TSH is not down enough.  I am to double my 25 mcg dosage to 50 mcg daily until the Beta.

Reduced Lupron to 5 units daily.

Applied 2 Alora patches today.

Had to email PNW that I will need a new script as I after counting my pills on hand and noting that it is a 90 day script which means the pharmacy will not refill it until near 90 days I won't have enough.

Oh and that donor embryo I'm getting, well the couple that used them or I should say had them made from his sperm and a donor's eggs put back only two embryo and ended up with triplets.  Yes one of the embryos split.  So that is the reason my clinic, PNW, is so confident I have a really good chance at pregnancy this cycle.  I'm putting back one donor embryo and one embryo of my husband's gametes and a donor egg.  Hoping at least one sticks.

Next scan in two weeks.

Military Medical Insurance

Also known as Tricare.

Oxymoron there since I really doubt they do "try (to) care".

I'm venting again.

Every two years I need to see my ENT at Madigan for the follow up on my Meniere's Disease, audiology to make sure I'm not losing more hearing, and a thyroid scan to hope that the scan shows that the cysts are shrinking or gone.  This means that I need a new referral each time since they are good for only 6 months.  A waste of a doctor visit is required now to get that referral even though my PCM has told me many times I don't need to see him just call his nurse and tell her what I need since I have chronic illnesses.

Guess what?  I have to now go see the man, PCM, that has a god complex.  This is the PCM mentioned above that said to call his nurse.  He is also the same PCM that denied me pulmonary specialist ( I have asthma), dermatology (I've had a skin lesion removed) , cardiologist (I've had a heart attack), rheumatologist (I have arthritis) , neurologist ( I have narrowing of the spinal canal in the neck and have had several TBIs plus fibromyalgia) and now he is trying play God again and determine if I need to see the ENT or not.  The above mentioned specialists are listed on my EFM (exceptional family member) paperwork as being necessary to see.

Oh and because I am slowly losing my vision I also need to see (lol rather ironic) the optometrist and sometimes ophthalmologist too.  I tried to schedule an appointment to see the optometrist for October but they are booked solid and only accepting appointment for active duty soldiers right now.  If one should cancel their appointment and I'm lucky enough to call that day to see if they have openings I might get in.  Other wise I'll be referred out to someone that doesn't know my case, probably billed the excess amount for it too, and have to find transportation to get to the appointment off the installation.

As it is we have a perfectly good ultrasound department here at Madigan. But I get referred out to the economy for my appointments because they need to make sure the machine is available at all times for the soldiers which means many time slots go unused.  Those time slots are listed with $$ signs in the computers as that stands for soldiers only.

I live right behind Madigan.  I purposely picked this village in the installation so that I could walk to my appointments at the hospital and not be a burden on my spouse.  We cannot afford two vehicles.  He cannot afford to be taking time off of work to share the vehicle with me either.  Even though he does primarily office work he still needs the vehicle when they are doing field operations because not all of the field exercise is in the field...figure that one out!

Tomorrow I have an appointment with another doctor, a co-worker of my PCM for a second opinion.  I do not remember ever seeing this doctor before and I can only hope he doesn't have the same god complex that my PCM seems to have.  Though my PCM is a nice person with a good bedside personality he isn't competent to be making health care decisions for a specialist in my opinion.  I remember back to when I had the ovarian cyst pain really bad before surgery and my RE office was booked solid.  They referred me to my PCM for pain medicine.  My PCM said he won't prescribe pain medicine as he is not of the school to provide narcotics for pain relief.  Sure doc what ever you say as he pokes my pelvic region with his hands not believing how much pain I was in  just days before I went in for my surgery.

With any luck tomorrow's doctor appointment, a waste in my opinion of a time slot someone ill could be using since all I need is a renewal of my referral, I'll have my new referral in the system.  But I've been warned by Steve on the phone that they are doing away with referrals because the specialists are overwhelmed with the realignment of the bases and the fact that Madigan now serves not just the Army but the Air force, Navy and Marines with it now being a regional medical facility.  Oh and let us not forget the retired military community.  I can only imagine that if I'm having difficulty getting an appointment as a spouse of the active duty service member that it must be nigh impossible for them to get care here too.  For those of you from my hometown Madigan is about half the size of CVPH and serves at least twice as many people.

Maybe I'll have them take a look at my foot while I'm there since it is getting blacker by the day at the injury site.

Military medical insurance isn't what the public sector seems to thinks.  We don't get appointment easily; medicine and treatment is often denied to family members who really need it.  Medicaid seems to be better and I would know since while I was going through my divorce, working and in college I did use it for a year.

Oh and side note: Steve on the phone said he was playing phone tag with me today.  No he wasn't.  I was home all day and the only two calls I missed were Equity and my friend Kim of which I returned their calls shortly after they left messages.  Even  my incoming call log denies that Steve called.  I don't deal well with LIARS.  I called my PCM's office on Monday.  I called my PCM's office on Wednesday.  I called my PCM's office today before they decided to call me back.  So much for leave a message and we'll get back to you within 24 hours.  Is that 24 working hours or normal 24 hours in a day?

Biding My Time

While I wait for the next suppression check I'll be working on a large order from my Etsy shop.  I just had a FRG leader put in an order for a particular military key chain pattern that I make.  I'll get started on filling that order this day.

Yesterday I was putting together a puzzle while I waiting for my local RE office call back like they said they would.  Not hard to believe that they never called me back right?  They called this morning, no apology for forgetting me, to schedule my ultrasound for 1030 hrs Thursday. 

My local RE office also screwed up my Lupron order from PNW last time.  They didn't put down that I had one refill on the Lupron left.  I had a copy of the fax of the prescriptions sent to Madigan so I knew they made the error as it listed my refills on there.  I looked at my box of Lupron and it said zero refills.  My RE office admitted they made the mistake and put in a new order for the Lupron of which I got today.

Can you see why I need to distract myself?  If I dwell on the shit going on I'll go nuts!

****TMI***  So don't read if you don't want to be grossed out!

Last night after some extracurricular poking, SEX, I was able to have my "normal" silver dollar sized clots pass.  I should have a slimmer lining come Thursday morning.  Much as I hate sex during my period this is one time I'm happy for its effects on my lining.  You can bet I'll be doing the same tonight so that I don't have to wait too much longer for the Alora patches.  I joked with Nicole at PNW about how I'd get things going and she thought it was a wonderful idea.  She too thinks that I'll be right on track for the lining check come the 30th since my E2 level was where it should be yesterday at only 20.  I am suppressed but the lining was the real issue.

Two Hearts; not always better than one

There are days I just want to have a hissy fit.  Today might just be one of them.

0845 hrs J drops me off at Madigan so I can get my blood work done then go to my appointment at the RE clinic at 1040 hrs.

Lab runs me through quickly which was rather surprising.  At 0915 hrs I'm at the clinic.  I tell the receptionist that I know I'm early but I'll wait since I had to get blood work.  She puts my folder up on the top of the desk.  I get called in next.  Okay so much for waiting.

At this point it doesn't matter about the blood work.  I know I'm not pregnant and I know with the pain, diarrhea, and nausea I've been getting things aren't good.    In comes Dr. B.  In goes the probe.  Up on the screen he marks where I'm shedding my uterine lining and mentions that I've probably got a few more days to go with that.  I knew that too. 

Now for the bad stuff.  Yup the cyst is still there.  Its not smaller.  Still same dimensions just a different shape.  Its shaped like a heart.  A 5 CM HEART!!!

So no letrozole for me. 

No pass go and collect extra follicles this cycle.

Sex only  with extra caution and no deep penetration because we might just twist the ovary.  I'm not winning folks.

The only good thing that Dr.B. said was that I'm ovulating on my own.  He said that unfortunately I'm not producing quality eggs.  This I knew.

Again I chat with him about the Donor Egg Program in Seattle.  J isn't with me, he is at work.  I'm waiting on his re-enlistment when his profile has expired.  That is if they'll let him re-enlist.  Talk about stress.

I walked home from the hospital.  Its less than a mile and I can use the exercise.  I've only lost a pound this week.

Yes, we are done with my DNA unless a miracle occurs. 

We are done trying totally unless he can re-enlist.

We can't do donor eggs until we get my cyst issue under control.  That means birth control, most likely, once it is resolved.  We need to prevent further estrogen producing cysts which would muck up a donor egg cycle.

I have to say I'm disappointed with the cyst still being there but I knew it was there from the symptoms I've been getting.  However, I am excited, but I don't want to get my hopes up that we can move on to donor eggs.  I want to do donor eggs.  I'd rather eliminate the possibility of passing on some genetics that are mine that could be bad (IE: endometriosis, fibromyalgia, heart disease, diabetes on both sides of my family) and go with the "rock star" eggs.

Keep me in your thought and prayers if you would.  Next RE appointment is slated for 4 September.  We'll see what the next scan shows in a month.

More About The RE Visit Yesterday

After I got home from the RE appointment yesterday I had some cake and got sick.  I think perhaps I had a bit too much sugar as I was the only one that got sick.  Oh and I stayed sick all day and night.  I didn't go out for dinner.  Today's plans for the Highland Games were cancelled. But that is okay because my bestie and her family, and my cousins had to cancel too.  No fun going with just my spouse as for clan gatherings we like to huddle together under the tent marked with our clan name.

Back to the rest of the RE update.  First off I forgot to mark the weight loss on the blog yesterday.  I've lost 6 pounds since my last weigh in on the 17th.  Nothing to sneeze at since it was only 10 days I lost that in.  I'm far from starving myself.  I am confusing the hell out of my stomach by varying the caloric intake vastly every three days and its actually working.  For about three days I take in about 2500-3000 calories then drop back to 1200-1500 calories for three days.  I lose weight with either amount of calories I take in and have proven it to be so already.  Maybe I found something that will finally work for me?

After the post yesterday the blood work results were in.  My Estridol level was about 150 if I recall clearly.  I forgot to write it down.  But still its down considerably since the first measurement on the 17th.  The HCG beta, of course, was negative.  I started the Provera right away.  I'm now on day 2 of that drug.

The uterine lining was 2 mm less than the 17th.  Funny, but I didn't bleed.  The RE said it can vary daily without a bleed.  I didn't know that particular bit of information.  It is now measuring 10 mm.

Lt.Col. B. was informed, by me, that my TENS Unit died.  I think its the battery.  My work comp insurance supplied it to me for an injury sustained at work in NY back in 2006.  Now that I'm out-of-state no one wants to deal with NY state work comp insurance claims here in WA.  I guess they want their money right off and NY likes lots of red tape.  So the likelihood of me getting a new battery or the machine fixed through work comp without having seen a doctor for the injuries, other than an Army doctors of which refuse to testify or supply medical records for work comp cases though they will treat me for the problem, is close to zero.  However, the TENS Unit is for pain control and often used for those that suffer from adenomyosis and endometriosis besides the other reasons why its prescribed for like torn muscles.  With all that said, Lt.Col. B. is putting in a referral for me to the Pain Management Clinic here at Madigan.  YAY!  I might just finally get some help.  My PCM is an idiot, good bedside manner, but alas an idiot that refuses to refer me to anyone other than the initial appointment to GI but that was already in the computer from years ago, before he was my PCM, so he had to let me get re-referred to them.

Okay enough blathering.  To cut to the chase, I'm going to get my pain taken care of at last!  Hip, Hip, Hooray!

Next week Friday I should be able to call for an appointment with the Pain Management Clinic.  It still might take a while to get the appointment but I'll be on the list to be seen.  Its a start.

The Big Reveal

Its no joke.  I've been waiting a long time for another one, a year to be exact.  I really needed this too; especially today.

Let me start off by the visit to the RE today.  Lt.Col. B. has some mixed news for me today.  He is excited about J and I wanting to pursue donor eggs but understands that we will only do so if he is able to re-enlist.  If he can't re-enlist then there will be no children for us.  Sorry but we can't afford to fork over almost 20k and have no income.  We need to have our nest egg if he gets out.

So yes, I still have a cyst.  It did shrink a little.  I've been trying to follow a good diet and maybe its helping to reduce some of estrogen in my body because it shrank to 5 x 5 cm...maybe its not a cyst but a wooden building block?  I guess I'll forgo getting a puppy since the tennis ball is deflating.

The nice doctor is however worried.  I shouldn't have the cyst.  It seems that the next step in the process, if I don't respond to the chemical treatment, is going to be surgery to remove my ovaries.  Well and good if I weren't still wanting to have children!  Lt.Col. B did agree that we might still have a slim chance with the Femera but its doubtful considering how my ovaries are now performing.

Now I'm waiting to hear back from the RE office as to the blood results on the HCG beta and Estridol.  If the first is negative I'll be starting the Provera today.

Fun side note:  Provera has another brand name called AMEN.  I kid you not.  I think perhaps a female waiting and waiting, its CD 92 for me today, for her AF to start might have had a say in naming that particular brand name.

Without further to-do here is the big reveal.....

From Harry Potter...the Monster Book of Monsters cake!  Now I just need to decide where to put the candle.  Just one this year.  Its a special wish too.  Last year I picked out a design for a Tardis Cake this year I searched long and hard to decide what I wanted my cake to look like finally deciding on one I saw on a search engine query.  I love Harry Potter and I love Doctor Who.  Now time for cake.

Last year's cake.

Recovering

J had his 1 week follow up today and the doctor had only good things to say about his recovery.  I did the best I could by him but we all know that he likes to be babied, he is a man after all.  (yes I realize that not all men are like that but the majority of the ones I've know are indeed wanting extra special treatment for every cold, boo-boo, or chore)

J was worried, didn't listen to me telling him that he is quite normal, and feared the worst because his incision sites still hurt.  Yes, that is okay too.  Now that the pretty female doctor told him he can now lift 25 pounds but still not push or pull things for another two weeks he is set.  This means he can help me out around here but no vacuuming as of yet.  I'll do it slowly maybe a room each day.

J stressed out yesterday, acted like a jerk too, in anticipation of his appointment today.  If only he had listened to me.  Really I swear that we never listen to those close to us.  Maybe I should have had my friend S talk to him as she went through surgery in January.   His behaviour really is quite typical considering he has been blessed with good health for many years so that he doesn't quite know what to expect and the fear the unknown eats at him as it can with anyone.

Today I got copies of my surgical report from the records room.  I found out a few things when reading it through today.  First they have me listed as hispanic.  Okay that is new to me. I know I'm a mutt but as far as I've been told I have no Spanish or Hispanic blood in me....maybe a drop of Portuguese because of the black Irish but not Hispanic.  Second, I have a fibroid on my uterus.  I think the doctors neglected to tell me this tidbit.  Because its less than 1cm as of June 6th they didn't remove it.  From notes: Small (less than 1 cm) subserosal fibroid on the anterior wall of the uterus not excised.  Last I found out through the notes that I had three surgeons working on me.  Dr. P., Dr. B. and Lt.Col. B scrubbed in as well.  Nice to know I was in such good hands.

Oh heck I'll just share their findings with you all. 

Operative findings:  Normal uterus/cervix.  Left adnexa notable for approximate 7 cm cyst.  Cyst wall interrupted upon initial manipulation, and clear fluid evacuated with suction and irrigation.  Cyst wall removed.  Small left ovarian endometrioma also noted.  Adhesions noted between the left ovary to the left sidewall and pericolic adipose as well as in the posterior cul-de-sac.  Implants of endometriosis on the right uterosacral ligament and bladder were present.  Small (less than 1 cm) subserosal fibroid on the anterior wall of the uterus not excised.

Oh and further on they in the description of how they did stuff I find that they used Endoshears to remove a section of the peritoneum for biopsy.  All is good there no cancer.  YAY!

Some how included in the surgical report was a copy of my appointment last week with the RE.  I don't mind having it as now I know the full dimensions of the cyst on my right ovary.    My newest play toy is 6.32 cm x 5.07 cm with an EMS of 12mm ( I believe they are talking about the endometrial stripe there but I could be wrong though it was the same number they gave me when I asked about the lining thickness at the appointment)

So with my smallish sized tennis ball perhaps I should get a puppy and we could play fetch.  When the dog loses the tennis ball I could, or though it seems, provide an endless supply of them since I'm so good at growing them even without the use of hormones!  HaHa!

In two day or so I'll blog with photos, I hope, of the birthday cake I had made by the commissary bakery.  I just didn't feel up to making a cake this year for myself.  My endo diet book arrived yesterday,  thanks mom for the birthday gift, and I'll be starting up the real diet when the cake is gone from the house. 

Two days til the next RE appointment.

Surgery and the RE

Well I think I'll start off with J and his surgery.  It went well.  It was severely delayed.  I'm guessing that there were emergency surgeries that cropped up.  J was supposed to go into the OR at 1200 hrs but finally went in at 2035 hrs.  Out of recovery and home at 0330 hrs.  Yup you saw that right.  I've yet to go to bed.  I'm doing laundry.  J is in pain. 

I explained to him that his surgery was uncomplicated and rather simple in comparison to mine so just imagine how much pain I was in then if you think you are in a lot of pain right now.  He had two male attendants to dress him, no one dressed me last month...no I had to do it all by myself.  I made sure to ask for help for J and I got what I needed for him tonight.  I made sure he was well drugged and I fetched juice and water for him close to 20 times.  He was really dehydrated from not eating or drinking for over 24 hours.  But at least he is home now.  His doctor said I'm to give him tough love and not baby him when he gets home.  Fine by me. But I will for the first 48 hours dish out his meds to him and help him as needed with his walking.  Right now he is using one of my canes to help him ambulate.

J apologized to me just before surgery.  He said things will change.  After surgery he again apologized and said that the old life is over he is done with it.  I can only hope that this will work out for him.

For about two weeks I've been complaining about pelvic pain here on my blog rather off and on.  At home I have told J that it hurts.  He has been dwelling upon his own surgery of which I can understand.  However, this past weekend when he made a comment to me of: "well obviously it doesn't hurt that much since you aren't doubled up in pain like you were before", I got my feelings hurt.  So with that said I went to the RE appointment today at 0900 hrs.  Yes, I've literally spent all day inside of Madigan hospital.

So Dr.B (major not LT.Col one) tells me before the exam that the pain that I might be feeling might not be OB/GYN related.  He said it could be the back pain flaring up or the bowels could be irritated.  He said that I should make an appointment with my PCM.  He insisted that it was highly unlikely that it could be anything relating to his specialty because he did the surgery and cleared it all out.

Well guess what?  Not long after he measured my uterine lining at 12mm he saw within seconds the cyst.  You heard me right.  I have a 6 CM CYST on my right ovary.  Dr.B. was aghast.  He checked around to make sure there weren't any other cysts.  He asked to make sure that I haven't been on any hormones of which I haven't then we talked.  I have a follow up appointment on Friday next week.  I'm wondering because of the pain if the endometriosis might already be growing back.

Oh and we did bloodwork.
E2 is 193
Progesterone is 0.37

I hate to say it but...I WAS RIGHT!  Eat that idiots.  When are folks, including doctors going to start believing me?  Dr.B. turned to J and thanked him for taking me in today.  J said it was all mine and Nurse M's doings.  Of which it was.

So yes, even though Dr.B. didn't tell me the same spiel we know it by now (take it easy we don't want ovarian torsion) and he offered up pain killers immediately.  I said No thanks because I still have a full bottle of percocet at home and the tramadol too.  I'm good. I only use acetaminophen for most every pain anyway.

Well its time to help J off to the bathroom again.  More in a day or so.

Rainbows on the Horizon

I'm looking forward to the future.  I have happiness inside of me. 

Today I saw my RE, Lt.Col.B., and he had good news for me.  No more Gatorade!  Yay!  Well he didn't say those words but he did say that I can now do  80/20 for stuff as I feel able.  Sex when I feel ready as long as their isn't pain.  And for the best news, whenever AF rears her ugly head I'll get my script of letrazole.  

Now as for the pain, its inflammation because so much was moved about inside of me.  It could be the endometrioma coming back since all they did was drain it.  The location of it wasn't optimal to removal as it was wedged between the bladder and uterus.  It really was hiding!

The adhesions I had thought were on the uterus were actually on the bowels.  Fun there.  At least I can now relieve the bowels without pain too.  My tubes looked great.  Lt.Col.B. thinks that the letrazole might actually work well for me.

Oh and because of all that and the package that arrived today I'm in a really good mood.  I delivered to the REI clinic 5 dozen white and milk chocolate macadamia nut cookies.  They were happy and surprised that I made them.  I was asked for the recipe on my blog.  Its easy...look at the back of a milk chocolate toll house bag and use just one cup of the milk chocolate morsel and one cup of the white chocolate morsel.  When it says nuts use the macadamia nuts.  Yes, that easy. 

As for the package, its Taylor Ham.  J grew up on it living on the Jersery border.  He loved me ever so much for ordering 6 pounds of it on Monday.  To show his affection he is coming home for lunch to make some Jersey sandwiches.  YUM!  Taylor ham, fried eggs, cheese on a hard roll with ketchup, salt and pepper!  If I remember I'll take photos for drool purposes.

Purple, Red, and Blue

That bruise if from the guy trying to start an IV line and instead puncturing through the vein blowing it.  Lovely huh?

I have more bruises that I had J take photos of.  Remember if you don't want to see the next photo then don't look.

I had but four small incisions and I knew I would bruise a little but not this much.

One in the naval.

One on the left side where an ovary is.

One on the right side where an ovary is.

One way below all that bruising to access the top of the uterus where the worst of the endometriosis was.

In this photo my abdomen is still all bloated from the gas they pumped into me.  I still have some of it today along with the fluid retention too.  Its amazing what 4 pounds from surgery will do to make it so none of the clothing fits.

My only real worry is for J.  J is getting chewed out by his SSG today for following the orders that two of my doctors, one a major and the other a lt.col.  set forth for my care.  The SSG called no less than three times after I was home during the 24 hr period demanding that J go back to work.  Had J gone back to work and I got hurt I would have sued the SSG and I told the SSG as much.  Of course the SSG started ordering me about which was twice in a three day period.  Does the man not realize that I'm a civilian?  I'm following my doctors orders and the doctors out rank the SSG.  The man is on a power trip.  I went over the SSG's head to the MSG and the MSG back me up. 

BAD NURSE

Its 0511 hrs right now on the day after the aftermath of surgery.  Now I need to fill in you, my friends, on all that happened.

YESTERDAY

0400 hrs I'm up taking my medicine and cleaning up with the pre-op wipes

0550 hrs report to the pre-op sign in

0555 hrs sent down to Admissions.  Why?  Well they forgot to have to me do it the day before as a just in case.

0610 hrs  Back at the Pre-op desk and I'm cranky at this point

0640 hrs I get called back to Pre-op with my spouse and one other patient a Col. who decided to break the rules and bring not one person with him but three.  I guess he thinks he can break the rules.  They let him.

0700 hrs I'm changing into my gown, footies, and surgical hat.  Col's family is breaking more rules and using their cell phones to not only text, and make calls but to take pictures.  I inform my nurse, Pearl.  She was a nurse of mine with my old PCM when I first got here.  She is a no nonsense gal with a bad bed side manner but excellent at what she does.  She makes everyone at this point remember, though harshly, to shut off all electronic devices.

0720 hrs.  Surgeons, Dr.B and Dr.P, have come and gone to check on me.  At this point I've now been stuck 4 times in the attempts to start a line.  I have good veins but one inept male first punctured through a vein  on my left forearm blowing it, couldn't get the back of my right hand threaded and couldn't get my best vein on my left arm threaded either.  In they send the best guy to try.  He numbs the back of my left hand of which the other guy didn't do with the other hand and threads it immediately.  He couldn't believe the trouble the other one was having since my veins were obviously quite visible and easy to get.

0730 hrs.  I'm set, I've been joking with the staff for about an hour now in my attempts to remain calm.  When asked what I'm allergic to besides the Penicillin, Sulfa drugs and Azithromycian I state "humans, because you all make me sick"...Hahaha..we all laugh.  Well its true right?  We cough on each other spreading germs making one another ill.

1100 hrs I'm rudely woken up by the nurse from Hell.  I still don't remember her name but I won't forget the treatment from her.  After only an hour in post op, I'm allowed 2 hours to recover, she rudely shakes me awake saying that I need to wake up and leave now.

1120 hrs I ask to go pee.  No bed pan please.  She tells my husband where to take me to the bathroom as its in a different place than pre-op.  She then deserts us.  I find out I'm passing blood clots vaginally.  This is not okay.  I was told to get dressed while in the rest room and leave after.  I told the nurse, after we could find her again, that I'm not only bleeding but passing clots.  She dismisses it.  I ask her about my discharge instructions while J helps me on with my shoes.  She tells me that the doctor has already spoken to my husband.  Yes but my husband is still sleepy and didn't take notes.  I ask to speak with my surgeon.  Bad nurse tells me that he is in surgery and it will be another hour.  I was fine waiting I told her.  She insists that I leave.  Fine!  I start taking the tape off the pic line in the back of my left hand and she finally realizes that she forgot to take out.  Bad NURSE!  No cookie for you.

So it got worse.  I check my meds that J picked up.  I was given two meds that I cannot take.  Ibuprofen will eat a hole in my ulcer quick.  Bad nurse is getting testy with me for first wanting to stay longer, second for interrupting her conversation about another nurse's shoes.  She wanted a pair just like them and I was obviously bothering her.

I said okay I'll leave.  She offers me a chair I say no I'll walk.  I'm pissed by this point.  I did walk.  I wanted to be left alone.  I walked down to my clinic and told my nursing staff there what happened and I didn't have my ID card yet, J had it and he was getting the car.  I asked for new meds but of course without the ID card I can't pick them up.  They were upset at my ill treatment by bad nurse.  (I left out some of the worst of my mistreatment by her in this post). 

I walked the less than a mile home.  I had to cool off.  Walking home wasn't that bad.  They sent an ambulance, fire truck and MP patrol after me.  They got to me just one block from home.  Really nuts if you ask me.  I showed them my four bracelets and my discharge papers.  They let me go.  I pointed where I lived as it was easily seen by where they stopped me at.  I explained to them that they were making a spectacle of themselves.  (think keystone cops flic if you will).

1245 hrs I got home and my surgeon Dr.B. calls me.  He is worried and upset.  He wants to make sure I'll have someone at home for me.   J had a class in just 15 minutes he had to attend.  So I assured Dr.B. that someone would be with me.

J drove home and stayed with me but....here is the great part.  His SGT called and told J he had to leave me here alone and go to his class!  Yeah he did say that.  J after telling him no (Dr.B. is a major and outranks the SGT) hung up and realized that yes I've been treated badly by his chain of command and the nurse at the hospital. 

I've said before that family comes last in the Army and I proved it.  Not only did the Col. who was going through surgery violate the rules but he got better treatment than I did.  And lets not forget the SGT that thought that I could be left alone when I'm not supposed to be for the first 24 hrs. 

J will report back to work today after lunch.  He is going to follow the orders of my doctors.

I could have gone into more detail but then I'd would be violating OPSEC, PERSEC and probably a few other things.  Suffice it to say that I'm going to try to never have surgery at Madigan ever again.

Now for the surgery; I'll make this brief.  They removed the cyst on the left ovary.  They removed the endometriosis that they could find and made a fourth incision to get to the one on the top of my uterus.  I have stages 1 and 2 of endometriosis.  Depends on where its located in me as to how severe.  The stage one was on the left fallopian tube and removed with a laser cauterization technique.  The adhesion endo was on the top of my uterus.  If there is more in there it can wait since I'm not doing a laperotomy to get it done for a while.

Well I'm nauseated and dizzy not a good thing so I'll stop for today.

Surgery TOMORROW

Yes, the surgery has now become emergency.  Dr. B. walked into the surgical prep area, asked where I was, found me with the nurse getting the information set for Thursday and said that my surgery is being moved up to 0600 hrs tomorrow!

Yikes!  I guess I won't be dying my hair tonight like I had hoped.  I joked with him that he'll just have to deal with the old grey mare look.

So I'm nervous to say the least.  I haven't been cut open since I was a kid.  D&C, IVF and endoscopy doesn't count.

Dr.B. is going to do the three small incisions and if need be take my left ovary too.  Possibly a full laparotomy will have to be done or so I was warned.  I guess it all depends on what they find.  Oh and yes they are going to try to go after the endometriosis if possible.

Ugh!  What the heck did I get myself into this time?

J and me made a few calls when we got home this afternoon.  I had to reschedule a house inspection that was set for tomorrow.  Yearly crap that our Army post inflicts upon us.  I guess its actually a good thing.  J was going to get xrays tomorrow for his back.  Why not an MRI since its not skeletal but rather muscular I don't know and won't bother wasting time trying to figure out their logic?  So he might have to reschedule that.  He also has a class tomorrow that I told him as of now not to miss but we'll see what the discharge instructions say since I don't think I'm supposed to be left alone for the day. 

Tomorrow before I leave for surgery I'll be posting my blog about the book giveaway.  Please enter if you'd like a chance at winning a free copy of the book.

Poke, Prod, Pain

So I got up early this morning and gave myself the shot of Ganirelix.  Two more days of that shot.  I didn't eat.  I wasn't allowed to eat. 

Next off to the lab for the blood draw.  I wore a black t-shirt I bought in Forks, WA.  Its a happy face with vampire teeth.  Yes, the lab techs loved it!

Off to ultrasound for an abdominal ultrasound.  I'll find out what my asinine PCM has to say about the results. Marla, a really nice ultrasound tech, told me my gall bladder and pancreas were fine. She took a look at the area of pain on the left where the kidney sits and told me I need to follow up with the PCM.  That is where she wouldn't tell me what is wrong.  I asked her what is over there and she said spleen and left kidney.  Okay now what the hell is wrong with me?  I swear if its not one thing its another.  I need more chewing gum and glue to hole me together because the duct tape is obviously peeling off.

Finally my appointment time for REI arrives.  I get in there and get stuck with Nurse J.  Lt.Col. B. is out of town for the day so I'm stuck with none to gentle with the probe Dr. B.  (he is a major).

E2 is down from 500 to the 160's he said.  He won't give me exact numbers on anything nor show me the screen.  He printed out the picture of the cyst and I demanded to see it.  I saw the numbers.  Its not shrinking.  But the good news is that the E2 is down. So the shots are sort of working.

Dr. B. said another 2-3 weeks of bed rest.  Ugh!

He also said that it could still twist at that size or even grow more and I'm to go to the ER if I'm in bad pain.

He also informed me and my spouse if it doesn't start to shrink soon that they are going to have to go in and surgically remove the cyst.  Oh and he didn't think that Monday's follow up plan with Lt.Col.B. was necessary.  I beg to differ.  I told him I was keeping that appointment as I was told it was necessary.

Dr.B. is on my crap list today.  He didn't have to hurt me with the probe. 

Oh on June 6th I'll be running a contest to give away a prize.  Look for the post on that day and sign up for a chance to win.

Surgery Avoided So Far

Well okay things are on hold.  I made that choice.  I had three options after what Lt.Col.B. found today. 

1) Surgery for tomorrow which is still an option if things get worse tonight pain wise.

2) He could drain the cyst in the office.

3) Ganirelix Acetate Injection to combat the estrogen.  I'd be a guinea pig for them and if it worked I'd set a new precedent he said for treatment.

I opted for #3 for right now. 

Friday I go back to the REI clinic at Madigan and will be seen by Dr. B as Lt.Col.B is out for the day doing training.  I will also finally have my full abdominal ultrasound that Gastroenterology ordered for me back in April on the same day.  More lab work for the REI clinic and hopefully some answers.

If the non functional estrogen producing cyst is shrinking I'll be able to put off surgery for a while.  Lt.Col. B. is hopeful but he said it could go either way.    He is still thinking that I'll need surgery but is happy that I'm willing to give hormone therapy a go too.

Maybe I'm a fool?  Have any of you ever used ganirelix before?  If so what are the side effects your experienced.

The clinic had on hand three of the shots and ordered five more with only a small co pay on my part.  Probably less than $20 for all 5 is their guess.  When they arrive I get to keep two and give them back the three that they gave me to use.  I guess that is fair enough.

I administered the first of the shots myself when I got home.  Its a walk in the park after IVF.

E2 level was down to 500 from the 624 the other day.  Remember this is CD34 for me.
Progesterone, LH and FSH were almost non existent he said.  Oh joy!  Lt.Col. B. said my hormones are messed up.  Oh and no these shots won't get my period started either.  I'll still have to wait for that one.  UGH!!!

So that is where I stand.  I might still need surgery tomorrow or next Thursday.  They only do surgery on Thursdays for non emergency.  I'll know more as the hours pass into days.

The pain level just sucks.  I'm still on modified bed rest.  Stupid me decided to try gardening yesterday.  I thought I was going to pass out from the pain of being in a squat position and bent over to transplant flowers from one garden bed to the other one.  Someone slap me if they see me doing that again while I'm supposed to be resting!!

Oh and no the cyst is still 7 x 6.7 cm.  No growth thankfully but he said the cyst did twist a  little with the gardening blunder.  But the blood flow is still good.

Oh Things Get Better

Insert lots of sarcasm with the title please.

I'm in pain.  The tramadol is not working.  Well okay it works for a few hours to knock the pain down to a 5 but there after its back to knife stabbing pain that then leads to throbbing radiating pain.  Fun times!

I called my RE office today.  All doctors are off site.  Nurse S tells me that since I have an appt. with my PCM today for  a dermatology consult to ask him about my issue.  Yeah sure.  Okay.  Like I want my PCM coming near my pelvis.  They office has no ultrasound but it does have an exam table with stirrups.  What can he see with just a light and a speculum?  Not the ovaries for sure.

So Nurse S tells me then I need to go to the ER.  Really?  Only if I'm dying lady.  Last year I took their advice and went to Madigan's ER for a ruptured cyst.  Not only was the medical treatment crappy the time was absurb.  They left me in the room for an hour before coming to check me out.  The problem was that they forgot me.  Lovely.  Then one of the medics knows that I'm in bad pain and she gets someone to give me a script for a shot of Diluadid. Finally a little relief.

The doctor then decides to ignore my ovaries and look at the uterus with a speculum.  Really doc?  I said that I need an ultrasound. He listened after I yelped when he pressed on my ovaries with his hand.  Sure enough the ultrasound had shown I had one rupture.  He didn't prescribe pain meds.  He didn't prescribe antibiotics.  He just printed out a medical flyer telling me my endometrioma, the 9 cm one, had ruptured.

So do you really think I want to go back to the same ER?  NO WAY!

I will if I have to I said to Nurse S after telling her the above story.

She calls back while I'm on the phone with my spouse.  She said that even though they are double booked with all the IVF for Thursday that Dr. B (not the Lt. Col. but the Major) would be willing to see me tomorrow if my PCM can't do anything for me today.

I then told her what Lt.Col B. said about having to do surgery if they reach 8 cm.  I explained that the cysts are large enough that they are touching and Lt.Col. B. couldn't be sure which ovary they were on.  She said, "EWWW".   As in that's not good, not the yucky eww tone.  Basically the same.

So there is where I stand as of today.  I'm waiting.  I'll still need to be seen tomorrow.  That is a given.  Whether or not my PCM gives me pain pill is irrelevant I know I'll still need to see the RE because of the possibility of the cysts growing since last week.

*****UPDATE*****
Just got back from seeing my PCM. 

He said, "I am not of the school to prescribe narcotics.  I will not prescribe you pain medicine.".

So I called my RE office and talked to Nurse S again.  She said she will make a note to herself to talk to Dr. B. about getting me in tomorrow or at least to see what they can do for me if they can't get me in.

Nurse S was aghast  at what my PCM said.  She said, "...your medical conditions are well documented.  Its not like you have a drug seeking behaviour.".

So with any luck something will be done for me tomorrow. 

Again though, Nurse S said, "If the pain gets worse please go to the ER.  I don't like the ER either.".

Pretty bad when the nurse doesn't like our ER!

RE Report

Well I'll start with the fact that I'm writing this blog post from my husband's lap top and not my normal computer which is a desk top.  I'll most likely be writing from this computer for at least a week.

I saw Lt. Col. B. this morning.  He is the RE I prefer.  Its not the best of news but he still gave me hope.

The blood cyst is now 6.7 CM in size.  The cyst that I ovulated from is also just under 7 cm.   He said that at this point its hard to tell which one is on which ovary. 

So yes the four pounds that I have gained this cycle are indeed from the cysts.  I look pregnant and I'll be finding out soon if I am.  Lt.Col. B seemed hopeful, there are times I wish he wasn't so hopeful as it gets me hoping too, that I might be pregnant.  He said that he would do surgery to remove the two cysts but if they are producing progesterone to support a pregnancy he doesn't want to take the chance.

He ordered a HGB A1c (test for my sugar levels.  probably because I'm obese, hypoglycemic and have two parents who are diabetics), CBC, and progesterone.  I thought he was going to order a HCG beta too as its now 17 dpo.  He didn't because he was going by the CD21 theory that its too early.  Well it probably is too early but I did a HPT at 14 dpo and it was negative.  I did tell him about the pee test. 

After getting my labs drawn I went back to the clinic and asked Nurse M about the test for hcg not being included and she stated the CD21 thing.  But said that she would have the lab draw it off the progesterone test anyways.  Well I'd rather be sure because I don't want to have to have these huge cysts rupture if they can just be drained if not needed is my own theory.

Oh and I'm on complete pelvic rest for the next week.  Lt. Col. B. is hoping that in the next week I'll have a reduction in size of the cysts.  It didn't work last year and I have my doubts about it working now but I'll try.  So I have a general list of what I'm not allowed to do:
NO lifting
NO sex
NO standing
NO Tampons
NO douching (I don't anyway)
I'm to be either in bed or in my recliner except when I need to use the bathroom or get a meal to eat and I'm not to be preparing big meals like I did last night.  Maybe he is worried about the cysts twisting the ovary since they are the size of tennis balls?

Fun times for J ahead.  He was there at the appointment.  I looked at him and said, "you know you are going to have to tie me to the bed because I can't sit still long."  He said, "good thing I have plenty of 550 cord at the house!".  We all laughed at that one.

I was prescribed for pain Tramadol 50 mg one tablet 4 times a day.  I've never heard of the stuff.  Have any of you ever used it?  If so let me know what the good, bad, and ugly of it is.

If the pain gets worse Lt. Col. B. wants me to head directly to the ER and no waiting on getting an appointment with the clinic.  Yes, Sir!