Thank you all so much for checking in on me. I've been OK but today is the first day I've felt able to sit up for more than a minute or so at a time, and I just can't bring myself to type in a post from my blackberry.
The operation went fine, as operations go. Thanks to all your advice, I did have a chat with the anaesthetist in advance, and it worked to the extent that she allowed me to drink water up until I went down for the op, so I wasn't too dehydrated to start off with. This was a particularly good thing since despite showing up promptly at 0730, I didn't go down to theatre until just after 11 so I would have been really struggling if I hadn't been allowed to drink for all that time. When I woke up from the operation I felt I was recovering more quickly than last time, too, but after a long afternoon, first drifting in and out of sleep while people constantly came in to check my blood pressure and to encourage me to eat something, then a long session with Dr Candour (see below), then finally thinking we could go home at 4pm but having to hang around until 6pm because the pharmacy was slow dispensing my antibiotics, then getting home, then lying on the sofa for 2 hours, then eating some soup, I was exhausted and nauseous so I'm not sure that I really felt any beter than last time. My mouth still felt horrible and dry and everything tasted bad. I did manage to eat some cucumber - fruit tasted too strong but the cucumber was nice and cool and mild.
I ended up going to bed at 2030, and falling asleep listening to one of the Buffy podcasts I'd carefully downloaded on Sunday night to keep me entertained. I woke up at about 0420 and listened to another podcast, then managed to sleep again til about 0800. Yesterday I was feeling pretty delicate but by the evening felt well enough to eat one of H's valentine's chocolates, as well as some grilled fish and artichokes for our valentine's dinner. Not one of our most thought-through valentine's ever, but still, you do what you can. Today I feel quite a bit better, but sitting up is still not a great position.
So that's the mechanics, what about the answers? Well, before I get there I thought I could entertain you with a little insurance drama. I had called through to my insurance company on Friday to check that all the paperwork was in order for the operation, and to check up on the rest of my claim. On the latter front, I found that they had basically been ignoring any receipt that wasn't either a formal receipt from the drug company or from the hospital. They hadn't asked me what they were for, no, they'd just simply ignored them. So all my Puregon refills, and the HSG receipt and the receipt for embryo freezing they had just breezed right over. The agent I spoke to assured me that he would make sure that this was seen to immediately. And he told me that they had faxed approval for the operation through to the hospital. I asked if they'd received acknowledgement, and he said no, so I asked him to fax me what they'd sent the hospital, just in case. I was glad I did, as there was a form that I was supposed to sign as part of the package. Then the real dramw occurred on Monday morning when the business services lady came round to see me in my hospital room when I was already in my gown for the operation. She was very puzzled by what had been approved. They had approved the operation for Feb 13 2005. read that sentence carefully, please. So I called their 24 hour number, and the agent promised to send another confirmation with the correct date immediately. Phew, drama over.
So, the operation. I was under for an hour and a half, which was longer than anticipated. The reason was that the endo was back with a vengeance. Dr Candour came round and spent about half an hour with us mid-afternoon to show us everything. Some lovely pictures that you are spared since he didn't give me copies. The left ovary was starting to adhere to the wall of the abdomen again (9 months ago it was completely stuck), and both ovaries had substantial endometriomas, as expected. On the right, the endometrioma had swelled the ovary by another 60% of its volume, on the left by about 40%. In addition, the right ovary had a lot of growth round the outside of the ovary. At the last lap the right ovary was relatively unaffected. Finally on the bad news front, one of the fibroids on the outside of my uterus has grown substantially and is very close to the urethra. They haven't done anything about it, but think it is worth keeping an eye on. (not sure how they do that. Will have to ask).
On the good news front, my fallopian tubes miraculously seem to be endo-resistant and are clean and clear and free floating, and the inside of my uterus is pristine and fibroid free, with no sign of any damage where they removed that fibroid last time. Also, what's left of my ovaries looks good. They are quite big and with a lot of healthy tissue so Dr Candour feels that I am not running out of eggs any time soon.
Dr Candour is not entirely sure what to do next, except that it has to be IVF as soon as we can, and it needs to involve suppression to make sure that implantation results are as good as we can get (affected by the recent article). He is leaning towards three months (THREE MONTHS!!!) on birth control pills, followed immediately by an antagonist -i.e., short - protocol. The three months are to give the pills the chance to completely knock out any endo on my ovaries that wasn't removed by the laser, and to make sure that while I'm resting there is no regrowth. He is clear that my endo is very aggressive and he wants to both knock it on the head, and give my cycle the best chance of succeeding. The alternative is to do bcps just for one month, then go straight to IVF, or even just start the protocol next month. However, both those options involve stimulating my ovaries pretty soon, and since he likened them to a deflated crisp packet right now, that might not be a good thing morphologically or in terms of stimulating the endo to grow again.
Given that the last lap was on 19 May 2005, and by October I already had two endometriomas, it seems clear that the stimulation of my normal cycle, exacerbated by the failed IUI in July, served very well to kick the endo into gear. We now need to give my ovaries a chance to recover, plus keep the endo in check. On Monday when that three month wait was suggested I, of course, burst into tears, but now I write this I'm thinking that maybe this is the best chance for us to get pregnant, and of course that's the chance I really want to take. We'll take the decision when we go back see Dr Candour and have the stitches out on Friday. Until then I'm heading back to Buffy and the sofa. Tomorrow I have calls to do with each of my teams to catch up, but I'll do them from home in my yoga pants. Although I am feeling a lot better today than yesterday, I'm really starting to hurt now that I've been sitting at the computer for an hour, so I'm going to give myself every chance to rest.