My last few weeks have been full of it. Last week I finally saw a therapist for the first time, and the only time she could meet me was in the middle of the day. I went from a Skype meeting with a collaborator about exciting science, directly to the therapist’s office where I relived the whole experience around my baby’s death while sobbing through her tissues, back to campus to meet with a wonderful colleague to strategize about helping one of my advisees (who is Native American and low-income and really wants to get involved in research this summer but is having trouble finding a spot in a lab), to a tense meeting with a senior member of my department who chewed me out for an email I sent last week, to a really nice gathering to celebrate the achievements of several members of our department, including one of my students who got into grad school… highs and lows, I tell you.
The lows have been pretty low lately (I’ve written about some of them here), but yesterday I experienced yet another bout of emotional whiplash, and suddenly I’m back up higher than I’ve been since our baby died in September.
Brief recap… after our baby died and I experienced a painful and prolonged labor, I had retained products of conception and needed to have a D&C two weeks later. We waited a month for my cycle to reestablish itself, then started trying for a baby again for a month, then shut that down after the MFM recommended waiting for a test at 3 months after the D&C. Then the test (a sonohysterogram, for the connoisseurs) was abnormal. My OBGYN recommended another D&C with hysteroscopy, which she would have done the following week. But I was worried about the potential for adhesions (scar tissue), given my history, so I did my research and found a minimally invasive GYN surgery center (thankfully covered by my insurance) that would likely be able to fix, or at least diagnose, the problem with in-office hysteroscopy.
I had a lot of worries going into this appointment. Going this route already involved waiting an extra month, which was really hard. I was afraid that they wouldn’t be able to fix the problem at my initial visit, and that I’d need to wait even longer for surgery, plus some unspecified time for healing before we could even start trying again. I was also worried because the hysteroscopy D&C option involved general anesthesia and a significant recovery time, while this alternative surgery involved no anesthesia whatsoever and the office kept telling me that whether or not the doctor could correct the problem would depend largely on my “tolerance.” (Um, surgery without anesthesia, really?!) The northeast also got slammed with another huge snowstorm yesterday, and the hospital is a 2-hour drive away. First I was afraid we wouldn’t make it to my appointment, so we did the drive the night before and stayed with my cousin who just happens to live near the hospital. Then, as we drove, they canceled approximately every school in New England and my facebook feed was full of people whose work had been canceled because of the snow, so I was afraid they were going to shut the office and I’d have to wait another month for the initial visit. I hardly slept the night before.
Emotional whiplash! The office was open and the appointment was awesome. (Surgery without anesthesia = awesome?!) The procedure took a grand total of three minutes, and was a total cakewalk. Whatever the 1cm mass was that they saw on the sonohysterogram… was no longer there. The doctor said maybe it was a blood clot that had passed late in my cycle. He did find some scar tissue, which had blocked up about 10% of my cavity, but he snipped it away with tiny scissors while I watched on the screen that they had helpfully placed nearby, and I was so fascinated that I didn’t even notice the totally minimal discomfort. And as soon as he was done, he was like “OK, you’re all better” (not in exactly those words, but that was the gist). I was like… wait, don’t I need to wait to heal? Are there restrictions on when we can start trying? And he was like, nope, you can start trying tomorrow if you want. Oh, and by the way, here’s a color photograph of your almost totally normal uterus in case you don’t believe me.
I was SO glad I went this route instead of having another D&C. For one thing, it clearly would have been unnecessary, and more importantly, it might well have made the scarring (which they didn’t see on the sonohysterogram, perhaps because they were so intent on imaging the apparently nonexistent mass in my uterine cavity) worse instead of better. Score one for my obsessive researching. For another, this in-office hysteroscopy was so much easier on my body: no general anesthesia, minimal pain, no dilation, no recovery time whatsoever. I feel like I should go evangelize for this minimally invasive surgery center — it’s hard for me to understand why this procedure isn’t more mainstream. D&Cs are so common, but apparently they’re totally unnecessary much of the time, and like any surgery they carry risks (including the risk of scarring, which in fact happened to me, although thankfully not as badly as many other women who have late postpartum D&Cs like I did — for D&Cs 2-4 weeks after a late pregnancy loss, there’s about a 20-40% chance of developing significant scarring, which is a statistic that most OBGYNs seem to be blissfully unaware of).
So, in 3 minutes of a nearly painless procedure I ended several months of waiting and a full month of fretting about the unknown mass in my cavity that wasn’t there after all, plus the uncertainty about healing time (which my MFM had said might be 3-6 more months), and all of a sudden we’re cleared to try to conceive again. Emotional whiplash indeed. It really does feel like the first good news we’ve had since our daughter died in September. Finally I have hope that we might (just might) finally be on the road to adding a second baby — perhaps even a living, breathing child — to our family.