Monday, August 26, 2013

The Flyer Comet


When I was twelve, the scariest thing in the world to me was the roller coaster at our local, historic amusement park. The star attraction at Whalom Park was The Flyer Comet, a classic wooden coaster, perched on the shore of a lake in central Massachusetts, and by the time I was old enough to ride it's rickety tracks and dilapidated cart train, had been in operation for nearly 60 years. The Flyer Comet was a hallmark of New England culture, and the fact that the entire structure shook as you whooshed around the curves, and that the paint flaked off in sheets as metal wheels clacked over the worn track wasn't enough to deter thrill-seekers from riding the ancient attraction. The scariest part of riding the Flyer Comet was a section they called "the black hole," which was a covered portion of track built over a steep drop (often rumored to cover faulty portions of the structure). For a few seconds, the darkness enveloped you, your heart raced, stomach churned, and mind spiraled, before you shot out the other side into brilliant sunlight over deep blue water, arms raised to touch the sky with outstretched fingertips, heart full of exultant joy and body buzzing with adrenaline. 

I feel like I am stuck on the Flyer Comet, trapped in the "black hole," and I can't get off the ride. 

In the past ten days, I have walked away from a full-time teaching opportunity less than a week before school started, created a new plan for employment wholly dependent on substitute teaching jobs, and found out that our problems having a baby may be more serious than we initially thought. I am spiraling, sometimes it feels like without direction, but banking on that moment of shooting out of the "black hole," hands raised joyously toward the heavens, lungs bursting and heart soaring as light overcomes darkness and hope fills my soul. 

For the first time on my life, I am running on nothing but faith. There is something exhilarating and liberating about turning control over to God and opening yourself to His goodness and glory to satisfy every possible need. There is something awesome and humbling about knowing that after doing everything in your power to satisfy your temporal and eternal needs, it will never be enough without His grace. So while I am terrified and stuck on what seems like an endless trip through the "black hole," I know with a faith that burns hotter than any earthly flame, that if we live our faith daily, commit ourselves to Him, see the needed specialists to help us have a baby, and work our hardest to meet our financial needs, He will help us achieve our eternal and paramount goal of a family. There is no way to meet that goal running on our old plan of working 65-70 hours a week teaching and commuting. So we have a new plan. 

The new plan is this-give it our all. Keep our heads up. Be flexible. Be receptive to the Holy Spirit. Move forward with faith. Steel ourselves. And wait for the sun to come back.

We need to find out if I have a misshapen uterus that could challenge carrying a healthy baby to term. We need to find out if I am able to ovulate at all. We are at a point of moving beyond the help that my OBGYN can give us. We are upping the ante. We have our first reproductive endocrinologist appointment on October 8th.  We need to find a way to meet our financial obligations on a reduced income. But I know that he will help us to do all of those things, because more than anything else, He wants us to have a family and to know the full spectrum of experience that raising children will bring us. And He and BJ and I will do whatever we need to do and are inspired to do to make that happen. 

I have a feeling the Flyer Comet and I have a few more rounds to go, but the moment of transformation from inky darkness to brilliant light will make every second of the experience worthwhile. 

So we soar on through the darkness just before dawn. Heads up. Hearts full of love. Hands stretched to the sky. 

Friday, August 9, 2013

A Tale of Five Catheters

I don't know about you, but a speculum is my most favorite medical instrument in the entire world. I was so lucky, that I got to be speculumed twice in 10 minutes today. I also got to experience having no less than 5 catheters threaded up through my cervix. Aren't you just dripping with jealousy? Apologies in advance for the absolute "TMI" nature of this post.

It doesn't matter how many times you put on that flimsy little doctor's office nightgown, pop your feet into the stirrups, and display your lady parts in all their glory for a pap smear-it never gets any less awkward. Now, take yourself out of the comfort of your regular gyno's office, put yourself in cold and sterile hospital environment with people you have never met, and multiply the weirdness of a pap smear by 10, and you have yourself a delightful little procedure called a Hysterosalpingogram (HSG). 

I was terrified to have this done. I know several people who have a had a range of experiences with the HSG, and 98% of people who post about theirs online sum it up with a description like, "it was worse than childbirth," and "I wanted to die," and "I felt like my entire abdomen was on fire." So naturally, as a person with some fabulously convenient anxiety issues, I have spent the last 10 days freaking out about this procedure. I expected the worst pain of my life. I expected to kick the doctor in the face with my rubberized sock-clad foot, leap off the table, and tear down the hallway, knocking carts of medical supplies over as I made my great escape from the hospital wearing only a flimsy johnny. I am happy to report that this did not happen.

It was awkward as all get out. I would even venture to say that next to the bladder infection/UTI from hell last summer, it was my least favorite medical experience ever. But I did not want to die, or have a flaming uterus, although I did come close to kicking the doctor in the face. Thank heavens I didn't actually do it. But it was sort of a comedy of errors, bordering on, "you have got to be freaking kidding me!" 

BJ took the day off from work and came with me. Which was both for support, and necessary, since I was buzzed on 1000 mg Ibuprofen, 1000 mg of extra-strength Tylenol, and a 1 mg of Xanax. My OB realized how completely freaked I was about doing this and was very willing to help me be as medicated as possible. By the time we got to the radiology department at LDS hospital, I was enjoying not being able to feel my lips or tongue, and definitely grateful that every attempt by my stomach to do flips was quelled by the effect of benzodiazepines. Thank you, drug companies the world over for that little slice of heaven. As soon as I was called back into the changing area and instructed to put on the johnny, scrub pants and grippy, rubberized socks, I was keenly aware of everything that was going on. Instead of having a panic attack freak out, I just got super emotional and started streaming tears down my cheeks. The cute x-ray technician was very sweet, offered a lot of comfort and support, and fetched hubby from the waiting room to accompany me through the rest of the procedure.

My OB was supposed to perform the HSG, but was called out for a delivery, so a PA in the radiology department did it, assisted by the nice x-ray tech, Toni. They were incredibly gentle and sensitive and explained everything that was going to happen and were incredibly respectful of my modesty and obvious discomfort. But it doesn't matter how many times you have someone use a speculum on you-it never, ever becomes less awkward or unpleasant. And today was no exception.

After the first speculum insertion, they went ahead and inserted a long, thin catheter with a balloon on the end that is used to push the dye into the uterus. As the PA worked with the catheter, she said that "my cervix wasn't happy about this." Um, yup. Definitely not. Last time I checked, no cervix is too happy about getting snuggly with a catheter. Ugh. So the catheter goes in, causes a bunch of super-uncomfortable pressure and cramping, and then, the balloon on the end breaks. Oh yes. That's right. So out it comes, and in goes another. Everything is good, the dye goes in, speculum comes out, I am slid under the x-ray imager, there is a lot more cramping and discomfort as I feel the dye surge up and through my lady parts, and as I watch the screen above me, my uterus fills with the contrast dye and the left tube fills and spills beautifully. I can see my ovary and tube perfectly, and it's great. The PA adds more pressure to force dye into the right tube. I clench BJ's hand because it hurts and cramps like the dickens, and what happens? The catheter comes out. Just pops right out. The pressure chose the path of least resistance, and just popped the danged thing out of me.

The PA apologized multiple times, said the tube filled partially, but she would like to do it again to see if it can fill and spill completely. She asked if it is ok. I am laying on a table, gown hiked up, husband holding my hand, cramping like the worst period of my life times 10, and she wants to put that danged speculum back in and try again? GAHHHH. Of course, I said yes, because I was NOT coming back for another test unless hell froze over. So a bunch of pillows get stuck under my back to change the angle, the speculum goes back in, the catheter is reinserted, and it breaks AGAIN. Another catheter goes in. Breaks AGAIN. I flippin' kid you not. At this point, I am starting to cry, my uterus hates me, and all I want to do is kick the very nice PA in the face (and she was honestly so, so nice) and leave an imprint of the rubberized sock on her cute face. 

The PA asks for a different type of catheter that is smaller and has a c-shaped clamp on it to make is stay inside of my cervix. I felt that one going in like a razor blade. But it stayed. Out goes the speculum, in goes the dye, the cramps and pressure surge again, and my right tube spills. It wasn't as intense a flow as the dye through the left tube, but it was spilled and both tubes were declared open. The PA said there could have been a mucus plug or something blocking it, but it was flowing freely when we were done. Out came the catheter, and the cramps surged for several minutes while I lay on the table, totally exhausted. She explained that because of the clamp on the last catheter, I would have some significant bleeding. They covered me with a nice, warm blanket, swaddled my bottom area with a Gandhi-like towel diaper, and went over the images with me. 

My left tube looks great. The ovary was visible and nicely shaped. The right tube is also open, but took a lot more effort and pressure, and may have been cleared by the contrast material. The ovary doesn't look as well-developed, and that could be playing a role in my irregular ovulation. Both tube structures looked great. Your uterus should look like an upside down pear, and mine had a dip at the top. She said she needed to do an official measurement as she wrote her report for my OB, because that can be problematic, but that it was mild and more likely than not is nothing to be concerned about. If it is a concern, it would make my pregnancy a bit more risky and I would need closer monitoring and possibly a C-Section for delivery. It all depends on that official measurement. I will know more about that next week.

After resting on the table for a while, I sat up and let some of the dye work it's way out. Then it was off to the bathroom in my Gandhi-getup to deal with the blood and dye, and to get dressed and put on a lovely diaper-like pad, which I get to continue sporting for a good 24-48 hours. Awesome. 

Overall, it was less horrible than what I was prepared for, but it was no walk in the park. I am so thankful for my supportive husband and proactive doctor. I am beyond grateful for answers. I know my tubes are functional. I probably have one that works better than the other. We have information to move forward with a cycle of Clomid in September/October. I don't have any adhesions, growths, or anything majorly wrong. I can deal with having a twice-inserted speculum, five catheters, some bleeding nasty cramps, a diaper to soak up the leaking dye and Xanax haze if it helps us get closer to having a baby.

I received a number of blessings from my husband and a good friend to help heal and comfort me before the procedure. I totally loaded up on the drugs. I hate to think about what it would have been like without them. I am still feeling the effects of the Xanax and have been popping ibuprofen all day to help with the residual cramping. My best friend received the next best thing to a drunk dial from me after the procedure, and as she said so eloquently, I was clearly trying to outdo Lindsay Lohan with my pill consumption. I definitely felt like a loopy, drugged up person for the afternoon, and slept for several hours when I got home.

So, HSG. I fought you, and I definitely feel like I won in the final moments of the battle. But I NEVER, EVER want to do that again. Five catheters. Five stinkin' catheters. Blech.