Re: Alison

[Guest guest]

Alison

(hahaa...I spelled your name correctly this time. My apologies for

before)

> Much as I hate to think of

> anyone else going through this, there is some small comfort in

> hvaing someone understand the experience.

That is what has been so wonderful about this site. I never would

have known as much as I do or had the confidence to keep pushing for

more answers without the support I found here. It is wonderful to

have this forum. I'm sure dh would have had me *committed* a long

time ago, and I probably would have agreed with him - LOL!

I misunderstood your first post and I think I just assumed it was an

HSG that you had post-op, but you clearly describe the 3DUS. I guess

I was just fixated on HSG being used for follow-up.

Personally, I have never had the pleasure of viewing a 3DUS. Looking

at your post op 3DUS, I would agree that it still looks subseptate.

Your pre-op HSG looks very much like my pre-op and like my surgery #1

post op. I WISH I had a copy of the final surgery #2 post-op that

shows the nice roomy upside down triangle uterus that I allegedly own

now. But, I did not get a copy because he took it during surgery (I

always asked for a copy at the time of the HSGs) and the process for

obtaining my own copy was quite complex. I was just relieved it was

gone.

But an HSG is only 2 dimensional. And in that way, I like it because

it was not confusing for me. Dr #1 told me that my uterus was flat

on the outside, so any indent must be septum. Dr. #2 used only hys

based on the findings of Dr #1 and he successfully resected

everything else hanging down (there were a few frayed pieces, but he

said it may be pieces that would disappear with the next cycle and

endometrium may grow over them. The frays were near the tube

openings and he said that he never chances going too close to those.

>>>He then proceeded to scare the hell out of me by telling me

> he could see a strange area on the scan which he felt needed

further

> investigation as it could be detrimental to a future pregnancy and

> may need to be " dealt with " (I presume he is alluding to yet

another

> D & C).

Oh wonderful! Just what you needed.

I agree with Beth that if the US was done later in the cycle, the

thick endometrium (especially all plumped up on estrogen) could make

it look worse than it really is. Perhaps there is a small remnant

and if the US was done early in the cycle you would notice the change.

> probably a big bit of endometrium after the oestrogen therapy, I

> suspect (although it is yet another thing bothering me now). As I

am

> on CD6, and I guess there isn't much point in doing a hyst unless

> there is also the opportunity to do some more resection if

required,

> then I'd need to do that early next week or have to wait until next

> cycle.

I think I would like to meet with your original sonographer before

scheduling a hys. I know that means that you will have to wait

another 2 weeks, but it is a noninvasive route and may give you some

reassurance about what is going on. Any chance your surgeon would be

present for this next 3DUS? That might be helpful. I just don't

know if he could make arrangements to be there.

I know that it looks ominous from the US, I just don't have enough

expertise to explain 3DUS. But from my own 2DUS, I know that the

techs still see a split uterus. When the first one found it during a

check for my follicles while doing inj/IUI, I just about freaked

saying, " What do you MEAN you see a split uterus!! " The RE even said

that if that cycle wasn't successful and I needed reassurance, he

would do a saline US to show me it was gone, but he didn't think it

was necessary. It was probably just the fibrous remnant laying

against the wall and it still shows up on u/s. I felt that he was

probably right.

>>>(I hope cycles will be pretty regular post-op...are they

> ususally, in general, do you know - I've been told after oestrogen

> therapy (which I was on for 6 weeks) then can go a bit haywire?)

My cycles were not haywire post-op; either with or without hormones.

However, some members have reported really long cylces after

surgery. It doesn't always seem to be related to hormones either. I

have heard just as many examples from patients not on hormones.

Based on how you bounced back from your m/c's you can probably tell

how your body will bounce back from surgery. Mine is always a little

slow to recover from trauma.

I'm also wondering, as you have mentioned, of the possibility that

you have a BU/SU combo. Perhaps the part hanging down is very

muscular. The hys would be able to tell that. I like that your dr

has offered the hys with dh present. I'm sure he would do anything

in his power to reassure you and dh by showing you what he was

looking at. I hope that dh has a strong stomach for the medical

world...my dh would faint.

I don't know if you should wait for the scan first. I would if you

think you can handle it, but I completely understand if you are too

impatient. It's too bad that they can't do the in-office hys. Makes

sense why they don't do it. Even though others have had it done on

this board, personally I cannot imagine getting the hys in there

without anesthesia (ouch!).

>

> If I do go in for a 2nd resection...should the laparoscopy still be

> used?

I don't think so. ESPECIALLY if you have the same surgeon. He

should know the terrain well enough to know if your uterus dips on

the outside or not. I was nervous w/ Dr #2 not using it because I

didn't trust Dr #1's operative report. But Dr #2 reassured me he

would resect slowly and stop if bleeding occurred.

> I totally know what it must have been like for you - it's bad

enough

> seeing the septum still there...but for no-one else to acknowledge

> it makes you feel you are either mad or that there's a massive

> conspiracy!

Exactly. It's horrible when you feel like you are your only

advocate.

>

> Do you think I should be looking for a 2nd opinion from another

> surgeon?

At this point I don't think so. I'm glad that he is willing to do

the hys to see what is going on. It seems that he knows he has some

reassuring to do. And he sounded sensitive enough and educated

enough to find the problem in the first place. He seems to want to

work with you more to get to the bottom of this and I would be

inclined to let him try because he sounds competant. My situation

was different. Even though Dr #1 was very well known and the other

REs couldn't believe he would not admit to this failure, the big jerk

refused to acknowledge that there was an elephant in the room (or a

septum on the post-op HSG). If he would have been willing to work

with me, I probably would have stayed with him. Maybe it's good he

was a jerk so that I would find another surgeon to do #2. One of the

specialists I went to was so surprised at the poor job that he even

said that off the record he had suspicions about Dr #1 letting a

student assist (which was horrible because that was one of my

suspicions to because there were 2 of them that introduced themselves

to me before getting anesthesia and I made sure to make the point to

everyone that only Dr #1 had my ok to do this procedure. They

reassured me that they were only observing. It was a teaching hosp)

> I haven't had HSGs (I had one once, pre-surg) but have had

> sonohysterograms (3D US). I don't think I have the possibility of

> getting an HSG done at the time of hyst as I don't think where I

> currently go has the facilities to do that, unfortuantely.

Probably the hys will be best anyhow. Then he can tell if it is

septum or myometrium (BU/SU combo).

> Did you have previous fertility issues before your

> resection surgeries that made you go straight to IVF, ir was it an

> age thing?

I didn't think we had IF issues, but it took us about a year to get

pg w/ #1. THat ended in m/c and the discovery of my MA. But that 1

year to get pg also included coming off of 13 years of birth control

and only charting for 6 of them and doing OPKs that last 4 mos. But

after the m/c and 2 surgeries, my RE that did the 2nd surgery said

that we had unexplained infertility or subfertility (no tests done on

me other than the surgery and dh had the SA, but that was it) so he

suggested doing treatments to *speed up the process of getting pg*.

I was all for it - I just wanted to get pg. We started w/ one cycle

of IUI only, then 3 of clomid/IUI, then 3 of inj/IUI where the last

cycle I got pg. I was pretty upset about it taking 7 cycles and we

were all ready to do IVF for cycle 8 but then found out I was pg. I

felt that with OPKs and charting we could have done just as good

ourselves without all that stress. Much to our delight, we are also

expecting baby #2. Although I needed hormones to bring af back after

delivery of dd, and despite my cycles becoming very long and wacky

after having dd, I got pg on cycle #3. Either our subfertility was

cured or we got extremely lucky. Maybe we just got better at our

timing ;o)

My heart goes out to you. I was devastated by one m/c and then this

mess of trying to get someone to listen to me. I'm sorry that you

have had 4 losses and are still trying to get to the bottom of it

all. I know that you didn't choose to be the poster-girl of

strength, but you are doing a good job and I don't want you to lose

hope yet. I have a lot of faiththat this surgeon will take the time

to check his work and offer you an explanation or more surgery. I

still see the possibility that surgery may not be necessary (remnant

left is laying against uterine wall or is muscular and well supplied

by bloodflow). Please keep us posted on your progress. >

Hugs,

Sara

SU resected x2