Thursday, May 31, 2012

Why I had a Diagnostic Laparoscopy

It has been a couple of weeks since my laparoscopy. Immediately after it I did not feel like typing up a post. Then catching up on things after the surgery kept me even busier. So I am finally getting to it now. This post is meant to discuss why I had a laparoscopy in more detail. I will describe the procedure in another post to follow. I felt like before I talked about the surgery, you should know why it needed to happen.
     I have posted a little about my journey up to this point but will recap that and add a little more info about that here.When I was young, in high school and early college years I took birth control to regulate my periods and help make the cramps less painful. This oral contraceptive also made my period lighter so I was no longer soaking a pad and tampon every month. My doctor at the time felt I might have endometriosis but did not feel that I needed surgery if the birth control worked well for my symptoms. I concurred as well as my mom and dad. I began taking birth control and remained on it from the time I was fourteen until I was 25. My current OB/GYN is aware of all of that and has been from day one. When my husband and I finally reached that exciting time of being ready for a child, I stopped taking birth control and saw my doctor. Everything was in order. We didn't get worried for the first few months because I knew it would take a while for the birth control to leave my system. After a few months I got impatient so we began using ovulation predictor kits (OPK's for those using infertility speak). I also received a diagnosis of a cyst on my left ovary during this time. By this time an entire year had passed. I went to see my doctor. He ordered a progesterone level and a hysterosalpingogram. (there will be a post discussing this in detail in the future). Both results were normal. We tried for an additional three months. This brings us to the Lost Month which I have already discussed and won't bore you with again. It also takes us through the awkward moments in which I found a former nursing student to be my physician's new nurse.
      On the second try, I actually got to meet with my physician. He was not called away from our appointment to assist in anyone's cesarean or deliver a baby. We discussed our options. The two major ones laid on the table were starting a medication called Femara or having a laparoscopy and then beginning Femara. We chose to do the laparoscopy since we didn't know if I had endometriosis and taking another round of medications would be fruitless if the endometriosis was causing the infertility if it existed.I didn't want to waste three months taking medications and then have to waste cycles waiting for surgery and to recover from the surgery. We discussed the possibility of trying intrauterine insemination ( IUI - a form of artificial insemination). My husband, my physician and I were all in agreement that we needed to wait for the surgery to be complete before we moved to that step. The decision for the laparoscopy was made. I felt some anxiety related to surgery but ultimately peace, feeling that God was with us in this decision. Also feeling so grateful for the physician God has allowed me to work with. I knew I would be in good hands with him. The date was set, my instructions given and we were on our way. I will soon post about the day of surgery and then separately about the recovery from the surgery. Please feel free to ask questions or comment. I will answer to the best of my ability and would love to hear from those reading this blog.

Monday, May 21, 2012


  In my previous blog post I mentioned my Doctor's appointment. Life got very busy following that post and it has taken a while to get caught up. I am going to start with the visit that got cancelled.
  I was scheduled to go in for a consultation since the clomid did not produce a pregnancy. The clinic was booked far enough in advance that I could not see the doctor until after my ovulation cycle. When I reported at the clinic do see my physician I was informed that he had been called away to assist in a cesarean section with another doctor. I was told he would be on a few moments late. During this time I was called back to a room to speak with the nurse. At this time I discovered that my nurse was former nursing student of mine. I was wondering how this was going to work, when you taught someone in nursing school, having them assist with a pelvic doesn't exactly seem like a great idea for either of you. She was nervous, I was uncomfortable with it as well. Just a short time later I was informed that my doctor needed to reschedule me. At this point I regrettably allowed my frustration to drive. I agreed to the reschedule only as long I knew it wasn't going to be another three weeks. I really did not want another wasted cycle. Three days later I received a call rescheduling me.
    When I got there for that appointment, my former nursing student was there. She had forgotten her watch and was acting very nervous. I felt bad for her and a little awkward myself. But she did a wonderful job and really seems to enjoy her field. It was at this appointment that options were laid out for us. We chose to have a diagnostic laparoscopy. More on that later.

Thursday, May 17, 2012

Laparoscope Images

Well, I told you that I'd put up images if I could get her consent, so here they are. Instead of trying to explain them all here I just put captions at the bottom of each image. If you have any questions leave 'em in a comment and we'll try to answer them the best we can.
liver viewed by laparoscope
This is her liver. No endo here.

appendix viewed by laparoscope
This is her appendix. No endo here.
endometriosis behind uterus viewed by laparoscope
The endo is circled here behind the uterus.
endometriosis on bladder viewed by laparoscope
The endo is circled here on the exterior wall of the bladder.
endometriosis on right ovary viewed by laparoscope
The endo is circled here on the outside of the right ovary.
endometriosis on left ovary viewed by laparoscope
This is the left ovary. It is significantly larger than the right ovary due a cyst that was previously thought to be a "normal functional" cyst.

ovarian cyst viewed by laparoscope
This is a better picture of the cyst on the left ovary.

endometrioma (endometriosis cyst) viewed by laparoscope
This is a picture of the doc draining the cyst which has now been identified as an endometrioma (endometriosis cyst). Once drained, he removed the cyst (cystectomy)

- Him


So after we went to the doctor last month, we had some decisions to make. We were introduced to some knew infertility meds (most of which I am unable to pronounce without a little coaching). The doc said one of the next options could be a laparoscopy if we so choose. As my wife has written before, she's wanted to have this surgery for a while, just to know.

As I'm writing this she is in PACU (Post Anesthesia Care Unit) recovering and did indeed have endometriosis.

What this means to us is, as of now, we are not diagnosed with "unexplained infertility". We're praying that this procedure has removed any blockages and/or issues that could have been causing us to not get pregnant. I am VERY thankful to God that:
1) The surgery went great.
2) They found and successfully removed the endometriosis.
3) We have a renewed hope of having children.

Once she is coherent again, I'm sure you'll be seeing a new post written from her perspective. Also, if she'll consent to it, I'm going to make a post with the images (from the inside) and some explanations from the doctor about them (in hopes of maybe making the choice to have this surgery for someone else a little easier).

- Him