Oxford study on Uterine Septums and Endo
Abstract CONCLUSION: Our results suggest a higher incidence of endometriosis in patients with a septate uterus. If it can be confirmed by others, the initial finding of a septate uterus in infertile patients should be followed by a combined hysteroscopy and laparoscopy.
So according to this study, it should have already been done. I could have had one hospital stay, instead of three...
And as I thought my sister E (the uber fertile one) was dx w/endo @ 16. Don't even get me started as to why/how I was never taken to a dr. with my problems that started around the same time (13). :(
I drew a fun chart last night from my research, and in lieu of Visio...
My uterine septum was removed because they often cause recurrent m/c in those who can get pg, and if you can carry to term it causes malpresentation, premature birth, high BP, etc. The septum is also related to endo, which is more likely to cause IF, than m/c. The septum is also connected to urinary malformations and I'm a UTI queen. And then there's the polyp (also related to septum) for good measure. All the pieces are starting to come together... I'm basically just defective, or as my dear sweet H says, I'm just "special". ;)
I think we need to figure out how to get a lap covered under our regular insurance and not our IF treatment benefit (like we did for my septum surgery, which was a congenital defect). Then we would still have our $11K left of our $15K lifetime benefit to do additional treatments if we need them (though that isn't enough for even one IVF cycle). The main reason we are hesitant to use our coverage for IVF now is if we do and it fails (which it does more often than not), then it's game over and they can send me right to the funny farm.
(Made a consult appt. for next Thursday to talk to my RE about next steps.)
Thursday, June 3, 2010
Wednesday, June 2, 2010
Endo? (update)
Dr. David is the first doctor I've ever spoken to to even hint that I might have endo, which is odd since I have pretty much all of the identified symptoms (and often those with endo have no symptoms at all). Yet another thing to ask my RE about...
From medicinenet.com
What are endometriosis symptoms?
Most women who have endometriosis, in fact, do not have symptoms. Of those who do experience symptoms, the common symptoms are pain (usually pelvic) and infertility. Pelvic pain usually occurs during or just before menstruation and lessens after menstruation. Some women experience pain or cramping with intercourse, bowel movements and/or urination. Even pelvic examination by a doctor can be painful. The pain intensity can change from month to month, and vary greatly among women. Some women experience progressive worsening of symptoms, while others can have resolution of pain without treatment. Other symptoms related to endometriosis include:
lower abdominal pain, (check)
diarrhea and/or constipation, (check)
low back pain, (check)
irregular or heavy menstrual bleeding, (check)
or blood in the urine.
...most cases of endometriosis are diagnosed in women aged around 25-35 years
Endometriosis is more commonly found in white women as compared with African American and Asian women. Studies further suggest that endometriosis is most common in taller, thin women with a low body mass index (BMI). Delaying pregnancy until an older age is also believed to increase the risk of developing endometriosis.
...the only accurate way of diagnosing endometriosis is at the time of surgery, either by opening the belly with large-incision laparotomy or small-incision laparoscopy.
My RE's e-mail response...
"As for endometriosis, I would not be surprised if you have endo. There is an association between endometriosis and uterine malformations. There is some data to suggest that treating mild endometriosis can improve chances of getting pregnant, though the data is highly controversial. Most data suggests that IVF is the best treatment. We can discuss further, I would be open to doing a laparoscopy, but you have to weigh the risks of surgery vs. risks of IVF."
Because two surgeries isn't enough, why not another, right? Don't you just love how IVF is the answer to any and all IF questions? The funny thing is that if it doesn't work, it'll just be "let's try it again!". This is completely insane.
From medicinenet.com
What are endometriosis symptoms?
Most women who have endometriosis, in fact, do not have symptoms. Of those who do experience symptoms, the common symptoms are pain (usually pelvic) and infertility. Pelvic pain usually occurs during or just before menstruation and lessens after menstruation. Some women experience pain or cramping with intercourse, bowel movements and/or urination. Even pelvic examination by a doctor can be painful. The pain intensity can change from month to month, and vary greatly among women. Some women experience progressive worsening of symptoms, while others can have resolution of pain without treatment. Other symptoms related to endometriosis include:
lower abdominal pain, (check)
diarrhea and/or constipation, (check)
low back pain, (check)
irregular or heavy menstrual bleeding, (check)
or blood in the urine.
...most cases of endometriosis are diagnosed in women aged around 25-35 years
Endometriosis is more commonly found in white women as compared with African American and Asian women. Studies further suggest that endometriosis is most common in taller, thin women with a low body mass index (BMI). Delaying pregnancy until an older age is also believed to increase the risk of developing endometriosis.
...the only accurate way of diagnosing endometriosis is at the time of surgery, either by opening the belly with large-incision laparotomy or small-incision laparoscopy.
My RE's e-mail response...
"As for endometriosis, I would not be surprised if you have endo. There is an association between endometriosis and uterine malformations. There is some data to suggest that treating mild endometriosis can improve chances of getting pregnant, though the data is highly controversial. Most data suggests that IVF is the best treatment. We can discuss further, I would be open to doing a laparoscopy, but you have to weigh the risks of surgery vs. risks of IVF."
Because two surgeries isn't enough, why not another, right? Don't you just love how IVF is the answer to any and all IF questions? The funny thing is that if it doesn't work, it'll just be "let's try it again!". This is completely insane.
Empire state of mind
In New York...
These streets will make you feel brand new,
The lights will inspire you,
Lets here it for New York, New York, New York
We've booked our trip to NYC! I've got meetings on Wed & Thurs and then S is coming in for a three day weekend. Can't wait to see and catch up with my old roommate and maybe my step-sister and just soak it all in. I just love walking the city, and eating, and shopping, and shows. I better get busy planning... ;)
Tuesday, June 1, 2010
Goodbye M&O
I have to wonder how many times mass clothing chains are going to try the "upscale"/older women's clothing store model before they realize they can't seem to make it work, at least in this economy. At our local mall in the last few years, Gymboree(also parent co. to Janie & Jack) opened and closed a women's clothing store called Janeville. Gap opened and closed a store called Forth & Towne. Now Martin & Osa (owned by American Eagle) which has only been around a few years, is going out of business. :( I miss them all!
A few final purchases, since this weekend was 50% off...
Havaianas
Giraffe print scarf in pink
and in gray...
And a chain link necklace that is already sold out now.
Get your last picks while they last...
A few final purchases, since this weekend was 50% off...
Havaianas
Giraffe print scarf in pink
and in gray...
And a chain link necklace that is already sold out now.Get your last picks while they last...
June!
May was quite a month... And even though it has felt like summer for weeks, when the calendar switches to June, you know it's for reals.
Just a quick rewind, since we had such an amazing time in Lake Geneva. We've been going there for over five years, but somehow never made it to the Grand Geneva. It was perfect! We hiked, we swam, we (almost) went horseback riding (we decided at the last minute it was way too hot), which sounds like an old Tampax commercial (apropos since AF decided to show on the drive up :( ).
It is a lovely prairie style resort (think Frank Lloyd Wright), which made it all that much more surprising to learn that it was originally built as one of the two Playboy resorts (of all things) when Hef hung his hat in Chicago. It even has its very own airport and ski "mountain". After several decades hosting a who's who, it's been a more family friendly place now for about as long. I could live there, seriously.
more chandie love...
I was pretty excited to have had lost about ten pounds over the last several months, yay me. Well now some of that has been replaced by our trip to their dinner buffet, where I managed to eat my weight in crab legs and shrimp cocktail. Wish I could blame it on the awesome live jazz, or my first glass of wine in ages. Just a thought, a buffet may not be a good idea when you go from being jacked on hormones to bleeding like you've been gored at Pamplona.
the perfect terrace to enjoy the full moon (+one day)
They even had great shopping. How often can you say that about a resort? The clothing store was almost all Lilly, with several items that I bought in recent seasons (on sale, of course), and had even brought with me. Felt like I was walking through my own closet. I really liked this super cute silk dress, but at $370, I fought the urge to try it on.
Of course, I can't find them anywhere, but the chaise loungers by the pool Ibiza by Smith & Hawken were AMAZING.
It was super relaxing, think hammocks and Adirondack chairs everywhere, a mojito at the tiki bar, a super friendly Wisconsin staff, and the weather was so perfect. All for $69/night (ty Travelzoo!) We can't wait to go back!
Just a quick rewind, since we had such an amazing time in Lake Geneva. We've been going there for over five years, but somehow never made it to the Grand Geneva. It was perfect! We hiked, we swam, we (almost) went horseback riding (we decided at the last minute it was way too hot), which sounds like an old Tampax commercial (apropos since AF decided to show on the drive up :( ).
It is a lovely prairie style resort (think Frank Lloyd Wright), which made it all that much more surprising to learn that it was originally built as one of the two Playboy resorts (of all things) when Hef hung his hat in Chicago. It even has its very own airport and ski "mountain". After several decades hosting a who's who, it's been a more family friendly place now for about as long. I could live there, seriously.
more chandie love...I was pretty excited to have had lost about ten pounds over the last several months, yay me. Well now some of that has been replaced by our trip to their dinner buffet, where I managed to eat my weight in crab legs and shrimp cocktail. Wish I could blame it on the awesome live jazz, or my first glass of wine in ages. Just a thought, a buffet may not be a good idea when you go from being jacked on hormones to bleeding like you've been gored at Pamplona.
the perfect terrace to enjoy the full moon (+one day)They even had great shopping. How often can you say that about a resort? The clothing store was almost all Lilly, with several items that I bought in recent seasons (on sale, of course), and had even brought with me. Felt like I was walking through my own closet. I really liked this super cute silk dress, but at $370, I fought the urge to try it on.
Of course, I can't find them anywhere, but the chaise loungers by the pool Ibiza by Smith & Hawken were AMAZING.
It was super relaxing, think hammocks and Adirondack chairs everywhere, a mojito at the tiki bar, a super friendly Wisconsin staff, and the weather was so perfect. All for $69/night (ty Travelzoo!) We can't wait to go back!
Saturday, May 29, 2010
Interesting article
Four Addictions that destroy your dreams
The Four Addictions (by Tom Ferry)
I've discovered four addictions we all have that destroy more dreams, more hopes and more lives than alcohol, drugs, food, gambling or sex combined. When I refer to addictions, I am not focused on any of these. To me, those are habitual symptoms or effects brought on by four much larger causes that are the root cause of those symptoms.
They are:
1) The Addiction to opinions of other people. As a society, we're addicted to what others think about us and how others' views of the world affect us.
2) The Addiction to drama. Some people are drawn to and consumed by any event or situation that occupies their thoughts and fills their mind with negativity, which often brings attention to them in unproductive ways.
3) The Addiction to the past. These people have an unhealthy attachment to events or situations that have occurred in the past. They're stuck in how things used to be.
4) The Addiction to worry. This addiction is comprised of all the negative and self-defeating thoughts that make us anxious, disturbed, upset and stressed, that hold us back in life.
Too bad that I make up for my lack of drama with worry... ;)
The Four Addictions (by Tom Ferry)
I've discovered four addictions we all have that destroy more dreams, more hopes and more lives than alcohol, drugs, food, gambling or sex combined. When I refer to addictions, I am not focused on any of these. To me, those are habitual symptoms or effects brought on by four much larger causes that are the root cause of those symptoms.
They are:
1) The Addiction to opinions of other people. As a society, we're addicted to what others think about us and how others' views of the world affect us.
2) The Addiction to drama. Some people are drawn to and consumed by any event or situation that occupies their thoughts and fills their mind with negativity, which often brings attention to them in unproductive ways.
3) The Addiction to the past. These people have an unhealthy attachment to events or situations that have occurred in the past. They're stuck in how things used to be.
4) The Addiction to worry. This addiction is comprised of all the negative and self-defeating thoughts that make us anxious, disturbed, upset and stressed, that hold us back in life.
Too bad that I make up for my lack of drama with worry... ;)
Our consult w/Dr. David
Though it seems like forever ago (that's how great the Grand Geneva was), we had our phone consult with Dr. Sami David just yesterday. And since we ran off right after, I'm just now organizing our notes of all that we discussed. For background on how I came to find him, read this post. If you are not familiar with him or his book, you can check out his website, but in short he was the very first RE to perform IVF in NY, and he was spent his career since trying to help couples exhaust diagnostic options before turning to IVF.
So after multiple rescheduling on both sides, we finally sat down to talk yesterday morning. He was overall not impressed with my first RE (good start). He was very impressed that my new RE was not only concerned about my septum, but removed it. He also liked her latest regimen of low dose Follistim, IUI, and Crinone. But since I had just received my negative beta, this didn't work (at least on the first try).
We talked about everything, well all that can be talked about in an hour. I had sent my 50+ pages of medical records to him several wks ago and he had obviously reviewed them thoroughly. Plus he asked us a million questions. He is concerned about implantation failure on my side (a reason he was pleased that I had asked for a P4 test and been put on Crinone), given some of pg symptoms I've had while we've been TTC (but always getting AF on time). He also said that I should be tested after I begin Crinone again to see if it's actually getting absorbed adequately, and if not switch to another kind of P4 supplement. We also talked about why my P4 might be low. Stress suppresses P4, so we'll see what we can do about that. Also the "endorphin rush" from exercise also suppresses P4, so I need to make sure I don't get in "the zone" when I exercise, which hasn't been a problem lately. ;) Sleep deprivation can also cause low P4. He recommended taking Quietude, a homeopathic sleep aid, to help me sleep through more of the night. And also to practice relaxation exercises, which I've been very lax about doing. He was very happy that I've been doing acupuncture.
He was also concerned that I'm not getting enough vitamin D based on what's in my PNV. And while I'd love just to get sunshine therapy, he recommended taking another supplement of 1000IU.
On the SA front, he was not satisfied with the one that we had done last April. Based on the evaluation, he deduced that it was not correctly performed. Our RE had just told us to go to the local hospital's lab, but he told us to either have a new specialty lab perform one or overnight a sample to him in NY. Sending it to his lab would be sufficient because he is concerned about the shape rather than the motility, so even if they are all dead, he can still find what he is looking for. He is also concerned that the WBC count was high. This could be influenced by natural contamination (from producing the sample hours after showering at the lab instead of at home just after showering). But he said he sees so many people who are struggling to TTC, when their problem is really a low grade infection, that it really needs to be tested. He wants the SA to test for simple bacteria, urea plasma, and mycoplasma. This he would treat with antibiotics (which while they are routinely given for IVF, the tests are seldom done on anyone before IVF...)
On a similar front, he wants me to be get a cervical mucus culture for bacteria as well. So I'll be asking my RE to go in around O time when there will be plenty to test.
If none of these tests turn up anything, he suggested possibly sperm antibody testing (in case I'm allergic to S's swimmers or he is (??)). Finally he would consider doing a laproscopy before pursuing IVF.
He recommended not cycling this month, since we did last month. He thought I should give my ovaries a break and take the month to get all of our additional testing done. I have yet to talk to my RE, but since AF showed yesterday, it doesn't look like we'll be getting CD3 testing done (on Sunday) or stimming as early as we did last month. She also didn't convey what dosage she wanted me to use this month, just that it would be higher, when her nurse called with my beta results. So, I guess I might just be taking June off...
I have to say that Dr. David was even nicer and more down to earth than I even imagined from reading his book. On a related note, I have to say I tear up when REs remind me how young I am and that I have a good decade of "fertile years" left, since I don't feel this way 99% of the time. They are used to seeing women who are much older than me most of the time, I guess.
So I've decided a few things over the last few days... We probably aren't doing IVF in July/August and I'm taking some time off the boards. So if you don't see me around, I'm thinking of you, but taking some time to focus on getting my act together.
So after multiple rescheduling on both sides, we finally sat down to talk yesterday morning. He was overall not impressed with my first RE (good start). He was very impressed that my new RE was not only concerned about my septum, but removed it. He also liked her latest regimen of low dose Follistim, IUI, and Crinone. But since I had just received my negative beta, this didn't work (at least on the first try).
We talked about everything, well all that can be talked about in an hour. I had sent my 50+ pages of medical records to him several wks ago and he had obviously reviewed them thoroughly. Plus he asked us a million questions. He is concerned about implantation failure on my side (a reason he was pleased that I had asked for a P4 test and been put on Crinone), given some of pg symptoms I've had while we've been TTC (but always getting AF on time). He also said that I should be tested after I begin Crinone again to see if it's actually getting absorbed adequately, and if not switch to another kind of P4 supplement. We also talked about why my P4 might be low. Stress suppresses P4, so we'll see what we can do about that. Also the "endorphin rush" from exercise also suppresses P4, so I need to make sure I don't get in "the zone" when I exercise, which hasn't been a problem lately. ;) Sleep deprivation can also cause low P4. He recommended taking Quietude, a homeopathic sleep aid, to help me sleep through more of the night. And also to practice relaxation exercises, which I've been very lax about doing. He was very happy that I've been doing acupuncture.
He was also concerned that I'm not getting enough vitamin D based on what's in my PNV. And while I'd love just to get sunshine therapy, he recommended taking another supplement of 1000IU.
On the SA front, he was not satisfied with the one that we had done last April. Based on the evaluation, he deduced that it was not correctly performed. Our RE had just told us to go to the local hospital's lab, but he told us to either have a new specialty lab perform one or overnight a sample to him in NY. Sending it to his lab would be sufficient because he is concerned about the shape rather than the motility, so even if they are all dead, he can still find what he is looking for. He is also concerned that the WBC count was high. This could be influenced by natural contamination (from producing the sample hours after showering at the lab instead of at home just after showering). But he said he sees so many people who are struggling to TTC, when their problem is really a low grade infection, that it really needs to be tested. He wants the SA to test for simple bacteria, urea plasma, and mycoplasma. This he would treat with antibiotics (which while they are routinely given for IVF, the tests are seldom done on anyone before IVF...)
On a similar front, he wants me to be get a cervical mucus culture for bacteria as well. So I'll be asking my RE to go in around O time when there will be plenty to test.
If none of these tests turn up anything, he suggested possibly sperm antibody testing (in case I'm allergic to S's swimmers or he is (??)). Finally he would consider doing a laproscopy before pursuing IVF.
He recommended not cycling this month, since we did last month. He thought I should give my ovaries a break and take the month to get all of our additional testing done. I have yet to talk to my RE, but since AF showed yesterday, it doesn't look like we'll be getting CD3 testing done (on Sunday) or stimming as early as we did last month. She also didn't convey what dosage she wanted me to use this month, just that it would be higher, when her nurse called with my beta results. So, I guess I might just be taking June off...
I have to say that Dr. David was even nicer and more down to earth than I even imagined from reading his book. On a related note, I have to say I tear up when REs remind me how young I am and that I have a good decade of "fertile years" left, since I don't feel this way 99% of the time. They are used to seeing women who are much older than me most of the time, I guess.
So I've decided a few things over the last few days... We probably aren't doing IVF in July/August and I'm taking some time off the boards. So if you don't see me around, I'm thinking of you, but taking some time to focus on getting my act together.
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