In my last post, I wrote about how Round 2 of IVF was a bust. We were able to create a single highly-graded embryo, but genetic testing showed that it was not viable due to chromosomal abnormalities. (There's nothing quite like bad news right before the holidays to see how good I really am at compartmentalizing things.) Instead of diving right into our third -- and last pre-paid -- round of IVF, I wanted to talk with the doctor to see what he thought. The office was able to schedule me for a phone consult three days after I received the bad news. The phone consult would be two days before my doctor went on a (well-deserved) two-week holiday vacation, so I was hoping that whatever we talked about, a plan of action could be determined before he left.
He called me at precisely the scheduled time and didn't really tell me much I didn't already know. Although I respond well to the stimulating medicines, it's difficult to get a higher number of mature eggs and even more difficult to get high-quality eggs simply because of my age. There's nothing he would do differently in terms of my medicines since they're doing what they're supposed to be doing, and it will be a matter of luck in terms of ending up with a normal embryo. It's not what I was hoping to hear, but it wasn't surprising, either.
During the conversation, I brought up my fibroids, as I was told that one of my ovaries wasn't able to be accessed during the last egg retrieval due to the size and placement of a fibroid. Apparently that's not what the notes in my chart say, but I can't argue with a medical chart (or at least it wasn't worth it in this case). My doctor did tell me that if we would consider trying for another three rounds or consider using a donor egg if this next round did not work, he would rather do the fibroid surgery now, before the next round. His rationale was this: I'd eventually need surgery anyway due to the size of the fibroid tumors, and if we decided that three rounds was all we were able to do, then he'd wait to see if the third round was successful because if it was not, and we decided that was the end of trying for pregnancy, I'd probably end up with a hysterectomy (complete removal of my uterus) due to the size of the fibroids. If it was successful, I'd need the surgery to remove my fibroids before any embryo could be transferred. The doctor wanted my husband and I to decide what we would do if Round 3 was not successful: accept the results and think about how we wanted to proceed or try for another 3 rounds and/or use of a donor egg. That was how I ended the phone consult with the doctor two days before his vacation.
If you know me, you know that I'm not so good at waiting, but I waited for my husband to wake up so we could talk instead of shaking him awake (he was on vacation, after all). We talked, and decided that, assuming Round 3 is not successful, that we would try for another 3 Rounds and/or a donor egg. I called the office back with this information and waited for the doctor to call me back so I knew what to do next. To my surprise, the doctor called me back within two hours (I'm impressed), told me that with that information, he'd want to do the surgery as soon as possible, but now I had to decide on the type of surgery: laparotomy (an abdominal myomectomy, kind of like a c-section) or a laparoscopic myomectomy (small incisions, including one that inserts a camera). My doctor does the laparotomy surgery with another doctor at the clinic, and a colleague doctor (who I've also seen several times) does the laparoscopic kind. Our second phone call of the day ended with him telling me to decide which surgery I wanted, and to call back and ask to speak with their surgery scheduler once we knew. (More information about the surgery types is available here.)
For various reasons, I decided I'd rather have the laparotomy. It'll mean 2-3 nights in the hospital and a longer recovery time, but it also means less time under anesthesia. So I called the office again (the receptionist must have been sick of me) and left a message with the surgery scheduler explaining why I was calling. I had hoped to hear from her quickly -- they're usually pretty good at calling me back -- but when I hadn't heard back by the next day, I called again to confirm that she was in the office and not on vacation (this was now the day before Christmas weekend). The front desk receptionist confirmed that the surgery scheduler was in the office and that she usually called people back within 24 hours, but when 4pm rolled around that Friday afternoon, I knew I'd have to wait several days since their office was closed Monday/Tuesday for Christmas.
To my surprise, I had a voicemail from the office on Sunday -- Christmas Eve -- from my doctor (who I thought was on vacation) telling me that he'd gotten the message that I decided on the surgery method, and that he'd leave a note for the surgery scheduler to set that up. I didn't hear anything on Wednesday, and so this morning (Thursday) I couldn't take the waiting any longer and left another voicemail for the surgery scheduler. I was really hoping I wouldn't have to wait until the doctor's return on Jan. 4 to get everything scheduled because I need to make plans with my client, my husband needs to make plans to get his classes covered, my mom has to book a flight to come down to help take care of me while my husband is at work, and frankly, I really can't stand not knowing.
I finally got the call I had been waiting for this afternoon, and I now have the pre-op date (Jan. 15) and the surgery date (Jan. 23); both take place in Jacksonville at my doctor's main hospital. I can't say I'm looking forward to a four-hour drive a few days after surgery, but I'd much rather have the surgery done by the doctor who I've been seeing regularly for the past several months at his home hospital than elsewhere with a different doctor. So, it'll be 2-3 nights at the hospital, two weeks at home with minimal activity (when the nurse told me that included no vacuuming, I laughed and said that probably wouldn't be a problem), at least six weeks before I can start doing more physical activities, and 8-10 weeks before I can start another round of IVF. Of course, like any surgery there are risks that I'm trying not to think of, and there's always the chance that something will go wrong and they'll have to remove the entire uterus, but, except for the constant sniffles and cough I've had since coming up north to spend the holidays with our families because it's SO MUCH COLDER here than at home, I'm in pretty decent shape and it's a fairly common surgery, so things should be fine. My husband keeps joking about how I'll react to the painkillers because I can barely tolerate children's Claritin and I take children's cough/cold medicine since adult medicine is too strong for me. So, barring any weird results at the pre-op check on Jan. 15, or weird things with my insurance, I'll be having surgery on Tuesday, Jan. 23.