What Now?

It has been over a month since my emergency surgery, and thankfully I am healed physically and feeling emotionally okay. It all seems so surreal, but I have the scars to prove it.

At my post surgery follow-up, Dr. E did a run-of-the-mill check of my metal and physical state, then reviewed the surgery pictures with me. Turns out that "something" Dr. E mentioned to J about my ovary is Endometriosis. Probably Stage 3-4 Endo. While it could still impede my fertility, it looks confined to the right side (ovary, outer uterus, the tube that ruptured). There is quite a bit of scarring, and so far the intestines are not adhered to the ovary, but they're "sticking" together a bit. Luckily the liver didn't appear to be involved. I don't remember exactly everything Dr. E said, and since she wasn't in there to do a lot of exploring she just has a basic idea of the situation. I'm thinking it is more Stage 4 considering the rectal pain I have during ovulation and menstruation. We're going to leave well enough alone at this point, and feel that the endo explains the blockage (and also why right side ovulation is more painful for me). However, I am going to see a couple of REs to get some opinions on what our next steps might be.

I also asked Dr. E what she think happened- why did it keep growing? She honestly had no answers. She told me that she contacted other docs, including a highly regarded mentor, who were all at a loss. It just didn't make sense that my hCG was decreasing but that the embryo/sac grew. No one had ever heard of such a thing happening before. Dr. E was clearly apologetic and sympathetic. She asked herself if she would have done anything differently, she asked her colleagues if she should have done anything differently, and the answer was 'no.' Everything appeared to be on track with no red flags of concern. For whatever reason, it just happened. It was an extreme anomaly.

I was a bit pissed that none of my previous GYNs has ever suspected endo, considering the painful ovulation and rectal pain I experience, but then I realized I've been on the pill most of my adult life- from the ages of 18 to 28 with only a few windows of time when I wasn't on it. It wasn't enough time to for a puzzle to appear. Then I became an army patient without the benefit of a stable provider who gets to know me and my history, so the pieces were never put together. I still think the RE I saw in WA should have been more concerned about my HSG results. Oh well, can't go back in time and do anything differently.

The other loose end is how long to wait until trying again. I had a blood draw done after the follow-up appt and my hCG level was a 3, and I'm pretty sure I ovulated the next day (which is confirmed by starting my period 15 days later, per usual). Dr. E left the decision to me, but after I learned more about MTX and how it cannibalizes the body's folate (extremely important for a developing baby), and given that I had two rounds of the stuff, J & I decided to be conservative and wait the 6 months. Which means we *might* have one chance before he deploys and is gone for 10 months. In the meantime, I went back on the pill for safety's sake. I'm hoping there will be some added benefit of keeping the endo in check, but probably not since it's only for a few months (I'm thinking being on the pill those 10 years might have been keeping it in check during that time). We'll see what the REs think too.

Now I'm dealing with the idea that there will be no baby this year, probably no baby next year and possibly not even the year after. I've been playing the 'Would be' game again... I would be 15 weeks along. My attempts at optimism are feeble ;)

Though I have so much to be thankful for- Ally's 2nd birthday was last week. Unbelievable! And I relished Mother's Day this year with my little lady. I am so lucky. Hopefully I will have pictures up soon to share!