- twighlight anesthesia and scarring

[Guest guest]

Ok I got the scoop of what Dr. Indman will do to me. I will first have an office hysteroscopy on Nov. 20th. He wants to look inside me and perhaps take a biopsy (I haven't confirmed this with Dr. Indman, but the receptionist told me this). I think he wants to have a looksy before he goes in for the big surgery (hysteroscopy/laparoscopy) on Dec. 6th.

The office hyst will be conscious since he is only going in to look. Has anyone done this? Does it hurt? My only pain relief will be ibuprofen taken before the procedure.

Then the hyst/lap will be done under a general and will be 1 to 1.5 hours long.

The reason he is looking at my uterus prior to the operative hysteroscopy is this...I have a very bad case and I can best describe it by using that old pumpkin example. Imagaine that pumpkin that someone so elegantly described as our uterus a while back. Let's say that a normal pumpkin has a wall and a cavity, with the lining (a very thin one) being the endometrial lining. Then fill it up with tissue that is similar to the pumpkin tissue (and in my case very hard vascularized scar tissue.) Then imagine if you are the surgeon and going in to this mass of tissue and not knowing where the bad scar tissue ends and the original cavity begins. Then trying to cut away the bad tissue (the scar tissue) and opening a cavity that resembles the old cavity and revealing the delicate and thin good tissue lining of the normal pumpkin. This is very difficult to do because it is hard to distinguish the good tissue from the bad scar tissue (in my case, for others it's much easier to see the difference between the tissues). Dr. Indman says that when a uterus is so filled up (as in my case) and it is difficult to see, and it is a difficult operation. Unfortunately, since our uterus's are NOT as big as pumpkins, he has to make sure he is in the right plane and starts snipping away the bad tissue only. The chance for uterus perforation is high in my case and this is why for safety reasons he is having an assist (another surgeon) for the laparoscopy. The other surgeon will tell Dr. Indman when he is getting too close to the wall of the uterus. He can see this by seeing a bulge in my uterus from the outside.

So, since my surgery will be difficult he wants to look into my uterus ahead of time so it will help him figure out how to approach my operative hysteroscopy. He may be doing the biopsy so he can know what kind of tissue to expect when he starts.

I wish I had non-vascularized scarring and/or partial scarring of my uterus. But, mine is almost the worst kind. My uterus is completely filled with hard vascularized scar tissue and I don't know whether it is calcified or not. So, if he can fix me, there is lot's of hope out there for most of us.

I am anxious to see what Dec. 6th will bring.

: The anesthesia they use for egg retrieval is what they call "twilight" anesthesia. This means that you are not "out" or asleep at all, but under both local anesthetic and IV sedation that falls short of being "asleep" but also falls short of being fully alert or awake. I guess you might think of it as being halfway between asleep and awake - thus the term "twilight".

Gwen