Hello Old Friend

This Thursday I will undergo a test that is usually one of the first on the menu of assays someone will experience when having a fertility workup.  The dreaded Hysterosalpingogram, or HSG as we have come to know and (cough cough) love it.  Everyone always paints a grim picture of what to expect, a thin tube placed into the uterus, dye injected, lots of pain/cramping as the dye is pushed through your uterus into your fallopian tubes, which may or may not be blocked.  In 2006, when I first had this test, I remember thinking that it wasn't as bad as expected.  Just some mild cramping, the Advil I had taken before the procedure took care of any residual cramping...and the results were that my tubes were not blocked, no obstructions in my uterus.  I remember thinking how relieved I was, unblocked tubes are a good thing!  If my tubes weren't blocked, then the egg and sperm were sure to meet eventually, and therefore fertilize and eventually implant.  At that time I had no idea that fertility or IF was so much more complicated than just blocked or unblocked fallopian tubes.

Last December I was sitting in a meeting with the president of the Hospital where I work, and several other vice presidents from our administration.  In the middle of the meeting I began to experience an intense cramping that I had never felt before, along with abdominal pain and light headedness. I knew something wasn't right, but I didn't want to get up from the meeting.  When I went to the bathroom I saw that I was bleeding (sorry, tmi).  It was the middle of my cycle, I definitely should not have been bleeding.  I continued to ingnore the pain, and event went to a lunch meeting outside of the office...in the snow. Thankfully, my colleague drove. The pain grew worse and I realized that I could not get comfortable at all, I tried not to let on that I was in pain, but it was difficult.  When I got back to my office I called R crying, I told him what was going on and somehow I managed to get myself into the car, to a drug store, and purchased a pregnancy test.  I had a feeling that I was having a miscarriage...I had been through similar situations before, I actually started bleeding in the middle of a cycle when I found out I was pregnant with Smiley...however I had never experienced such pain as I was in at that moment.

I did make it to the drug store, hunched over, picked up a test, and went home.  I took the test and it lit up like a Christmas tree.  I knew that something was very wrong, and called the nurse I had become close to at my RE's office.  I told her what was going on, and asked if she thought I should go to the emergency room, given the pain and bleeding I was experiencing.  She told me I could definitely do that, or, if I could wait until the morning, I could be seen with the monitoring patients.  That entailed driving from my house in the suburbs into DC...but I wanted my RE, not a random ER doc at our community hospital. 

All night I was in terrible pain, I couldn't get comfortable laying down, sitting up, walking...I kept questioning my decision to wait until morning to get to the doctor, but R said that I'd regret going to the ER and having to wait hours.  Stupidly, I drove myself to the RE at 6:15am to make it downtown by 7:00am.  As soon as my RE started the ultrasound she knew things were not pretty.  My abdomen was full of blood, and I had a ruptured cyst on my right ovary.  She told me that I needed to have surgery ASAP, I likely was having a ruptured ectopic, but she wouldn't know for sure until she went in.  R dropped Smiley at daycare and drove down to meet me, and within a couple of hours of getting me registered and over to the hospital, I was in surgery, and my left fallopian tube was removed.

I was very lucky that day.  I could have passed out on the road and had a car accident.  I could have needed blood transfusions.  I didn't even have to stay overnight in the hospital.  But all I could think of was - that was my 6th pregnancy, damn it. And that one took away my left tube...the one connected to the ovary that's more responsive. 

Since my ectopic I've done an IVF cycle that resulted in a BFN.  That was in March.  I have no clear answer to the question - what do we do next? IUI seems like an idiotic move at this point, they have never worked for us before, and now I only have one tube..but it's low tech and it's covered by our insurance, and it may be all I can handle right now, while we prepare to move to a new home, and R begins a new job next week.  I am looking forward to seeing what kind of IF coverage his new insurance may bring...but I am also not sure if I'd even want to do any more IVF cycles if we had coverage.  So many unanswered questions.

So Thursday I will have another HSG to see if my lone right tube is open or blocked...if it's open, we may decide to try a few IUI's, even though the chances of success aren't too high.  If it's blocked, we know IUI's are out of the question, and we'll have to decide if we want to do any more IVF's with my eggs.

I look at my Smiley girl every day and wonder how on earth she exists.  I sometimes even ask her where she came from, and she grins from ear to ear and laughs.  I will think of that beautiful smile and infectious laugh while I lie on the table Thursday, loaded up on Advil, and hoping for an open tube and another miracle.