The latest on the reproductive issues

Oh where to begin... first I have to say thank you to the best friends and family in the world! I appreciate all of your love and support more than you know! I know there are so many people out there with harder things going on in their lives than this, but you all have been so sweet and supportive.

I am going to go ahead and give the background for those that aren't sure what I am talking about. Guys - some of this might be TMI.

Well, I hadn't had a period since Sept of 2005 (yes 2005, that is not a typo). That is when I got pregnant with M. At first this didn't seem too odd because I nursed M until he was 2.5. But, he weaned dramatically last fall and still nothing happened. In December I had really bad cramps and what I would consider a "cycle" without the period... I had the pain, fatigue, hunger, bloating, etc. I called the doc and went in because the pain seemed abnormal and I still hadn't started. They did a cycle of progesterone at this point to "kick start" things. M also totally weaned at this time. Nothing ever happened after this though. Then 2 months to the day later, the pain and symptoms returned but still no period. I called the doc again and this time they did a cycle of estrogen. The estrogen didn't do anything either. So, they did an ultrasound, pelvic exam and bloodwork. Everything came back normal. So, we tried a month of birth control and the doc said if it didn't work we would head to surgery next to do a hysteroscopy. The BC caused changes like breakouts, etc. But at the 2 month mark from the last episode, the pain returned with no period. This was the weekend before last. This time the pain was off the charts. It was almost bad enough for me to have aaron take me to the hospital. It was absolutely horrendous. The pain during these times is basically nonstop cramping. It makes all of the organs and muscles in my stomach and pelvis sore and achy. It even hurts to use the restroom because all of the muscles required to do that are so strained. Even with percocet I was feeling the pain. So, on Monday (a week ago) I took the advice of a friend and called a reproductive endocrinologist. Dr Henry is wonderful and saw me that same day. He did an internal ultrasound (which has always been easy and not painful) and as soon as they touched my cervix I was crying. He didn't see anything abnormal so he decided to bring me back in a week for an HSG (hysterosalpingogram where they inject dye into the uterus to look for blockage or damage under an XRay). That brings us up to today....

So, at 11:00 I checked in for the procedure. When it was my turn to go in I was really nervous; I had heard the gal before me yelp in pain. I had taken a percocet and advil, but as soon as he began inserting the catheter I was in incredible pain. He was able to get it in somewhat, but not as far as he needed it to in order to get a seal to keep the fluid inside. He tried two catheters and couldn't get past a certain point. So he ended the procedure and took me up to his office to have an ultrasound procedure. During this they injected me 4 times with a local anesthetic in the cervix to numb it. Then he used progressively larger catheters to dilate the cervix and the canal while watching on the ultrasound to see his placement. It was during this that they discovered that I have an incredibly small uterus that is shaped in a way that makes it very shallow. Also the canal to it is VERY thin. He felt as if there may have been a blockage (scar tissue?) at the base of the canal that he broke through. That alone may have made a difference for me. After all this it was time to go back to try the HSG again. We did that and he got it to work, but not as well as he would have liked. It was still incredibly painful. He reviewed the films with me and we discovered some things. There is a large growth at the top of my short uterus that makes mine a V shape instead of a triangle. This could be either a septum (where a woman is born with her uterus divided in two, but he doubts that - or it is scar tissue from my 2nd D&C I had - the one after I had M). He also got a better picture of the shape, size and how small the canal is. It was rather stunning to see.

So, after all this, we met back in his office to discuss everything. Basically, he has no difinitive answers. There are only educated guesses at this point. From all the evidence, he would guess that it is scar tissue and that there was/is a blockage that has caused me to not bleed. The pain would probably be the uterus constantly contracting to try to push out the blood, the blood being reabsorded, and possibly it spilling back up the fallopian tubes and into the stomach cavity and causing irritation. Our options are
1. do nothing and see what comes with my next "cycle". It is possible that what we did today broke a blockage and things could be "fixed". the good news with that is no more crazy pain and getting my cycles back to normal to get pregnant. The bad news with that is, if that large area is scar tissue, if a fertilized egg were to implant on it it would cause a miscarriage so my chances of miscarriage are much greater.
2. do a round of estrogen followed by a round of progesterone... not sure of pros and cons other than more hormones etc
3. do surgery. This is something that he doesn't want to do unless we have to because he is concerned about the anatomy of my uterus and about puncturing the top of it accidentally and causing more issues.
4. go on birth control until I am of an age to not care and then have a hysterectomy... not really an option for us.

So, we have chose to go with #1. We will wait and see what happens. He said if I end up with pain he will prescribe meds to help that and then we will look into it immediately. Then he would feel more comfortable with the surgery because we would have tried all we can. The bad part of that is that the 2 months since the last "cycle" is right when we are on our way back from Florida... fun.

He was really wonderful and I feel I am in good hands. It is so frustrating though. I just want answers. The prospect of facing the pain I felt last week is terrifying. And the idea that even if this all works itself out I may have a really hard time getting and staying pregnant... not fun either.

I am trying to be patient and trust my body. After all, it sustained another life for over 2 years... I need to trust that it will do as it should. I am glad that today is over. It was supposed to be a simple, even if painful, 15 minutes and it turned into a VERY painful 5 hours. Thank god for the love and support of those in my life!! Love you all.