back from surgery and other info.

[Guest guest]

Hi everyone!

I am back from my week trip. I wanted to give you all my update and some other info I got from Dr. Indman.

First, my surgery was a total success! If you recall...I had my first surgery 6 weeks ago with two doctors (my RE and my OB/GYN). They tried to fix my totally scarred in uterus but decided not to pursue because my scarring was very hard and vascularized. They couldn't find their way so they used a lap as well to see. They pulled out and said that I either need a surrogate or that I need to see Dr. Indman, and that they couldn't help me. This came from two surgeons that have done numerous Ashermans surgeries!

Last week Dr. Indman performed my surgery. He scheduled a lap (just in case) but didn't need to use it (yepee!). Dr. Indman said that he was able to find his way up to the upper portion of my uterus (the upper part of the triangle and where the fallopian tubes come in) and he found that my uterus was not completely scarred but in fact it had a open compartment at the top. He said the endometrial tissue that was there was normal and that I had a 40% normal uterus! After he found this compartment, he was able to remove the remaining scar tissue back down towards the bottom of the uterus and open it completely. He did not place a balloon into my uterus to keep it open. He said that I have absolutely best prognosis he could give because I have a normal uterus on the top and this is where most scarring re-occurs. He said that when scars are at the top of the uterus and near the tubes, that this is when the scars typically reform. I didn't know this before and thought it was interesting.

He said that he feels I have an excellant chance of having a completely normal uterus again, in fact he went so far to say that I WILL have a normal uterus again. He will keep me on antibiotics and 2 mg oral estradiol twice a day for 2 months. He will keep me on estrogen until I am ready for IVF. I may not even get a period in between!

I am so elated and I just want to share my high with all of you. 6 weeks ago I heard the worst news of my life and now I have hope again. What a difference a skilled surgeon makes. If at all possible I urge everyone to go to an A list doctor. This motivates me even more to gather as many A list doctors as possible and try to get them geographically dispersed as possible.

I also want to offer if anyone wants to stay in the San Francisco Bay Area if they want to go through surgery with Dr. Indman then they have a house to stay in. My parents have an almost empty house (they are rarely there now a days) and thjey would be more then happy to help someone else with Ashermans.

INTERCEED: I asked Dr. Indman about interceed. I am sorry to have to report this because I know that several of you had used it (and with relative success). Dr. Indman was adament that interceed should NOT be introduced into the uterus because it reacts in the presence of blood and will cause more scarring. He said that using interceed is a big mistake. I know that there are many opinions on this and that some of you found it to be successful. But, I must say that Dr. Indman is not one for trying anything unless it has scientific merit and until it has been scientifically proven. He does have reasons to think that interceed will increase scarring and therefore does not pass his scientific merit test.

LASER to reduce collagen response in the uterus (this one is a response to GWEN): Dr. Indman gave a very informative report on why this wouldn't work. He said that you don't want to shrink the collagen because you will be left with smaller but denser scar tissue that is very fibrous. He said that this would be more difficult to remove. He also said that you don't want to introduce any energy (heat) into the uterus because this will have an effect of reducing blood supply and blood supply IS what you want in the uterus for good healing. So, a laser to shrink collagen won't work. He said that the most important thing to getting a uterus back to normal is a skilled surgeon, microscissors to cut scars away (not lasers because these increase scarring and decrease blood supply), keeping a good blood supply in the uterus and estrogen treatment afterwards.

Well, that's all folks. I will be going back to Dr. Indman 1 and 2 weeks after my surgery to remove any adhesions that have reformed. This will be a simple dilatation in his office, with a wiggling of a catheter in my uterus.

Dr. Indman has answered all our questions and I will post these soon. He said that he wants to help us in any way he can. He thinks that we have a great thing going....thanks Poly. He also said that after he read our questions that we have been doing our homework.

Last, he disagrees with Dr. Sher on injectable estrogen vs. oral estrogen. He says that when you check blood levels that it may be true that injectables give higher blood levels of estragen but that oral gives you a high enough blood level and that there has never been a controlled clinical trial trial proving otherwise. From my limited pharmacological background, I tend to agree with him. No one has ever studied what levels of estrogen are needed to promote the growth of good endometrial lining and from Dr. Indman's experience he feels that he gets just as good results with oral estradiol.

That's it for now. Hope everyone is well.