Showing posts with label Uterus. Show all posts
Showing posts with label Uterus. Show all posts

Wednesday, 13 December 2017

The Two Week Wait

Today marks the halfway point of my 2ww before I find out if I'm with child for the first time ever. While I'd like to report I've been blooming and a joy to be around, this would be a barefaced lie. It's been mental torture and the progesterone supplements I've been prescribed are HELL.

Progesterone, often called 'the pregnancy hormone' (or horror moan as I've renamed it), is produced by ones ovaries after ovulation and it's job is to prepare the lining of the uterus for implantation. Ladies going through assisted reproduction treatments are prescribed progesterone supplements because the egg retrieval process removes cells that would normally create progesterone. The supplements, usually in pessary form, are needed to thicken the lining so the embryo will hopefully implant and grow.


I started taking progesterone pessaries (1 x 400mg Cyclogest, morning and night) from the day of my EC and the next day I was already feeling unsettled. This might me a little TMI for some so feel free to skip this paragraph, but pessaries are messy little buggers and I'd been using the back door to try and limit the pants puddle. Unfortunately this has played havoc with my stomach and the pain from trapped wind and bloating has been excruciating at times. To cut a revolting story short, I’ve tried alternating but now I've had to switch to using solely the front door which has relieved my symptoms a little, although creates a lot more mess. It's the lesser of two evils, though for me it's a close call. The great pessary debate is something that's always discussed within the #ttc community online but ultimately it comes down to personal preference. While there are pluses and minuses for both arguments, I think you just have to suck it (or stick it in) and see, there is no right or wrong orifice!

The other twisted and perverse thing about progesterone is that the side effects mimic early pregnancy symptoms. So far I've experienced intense cramping which is similar to period pain so I'm on constant knicker watch, bloated tummy, sore boobs and the one that tops the rest - thrush. This really is not convenient when you're trying to shove pointy, waxy bullets through an area that feels like a furnace, shoot me now.

This has all been a bit of a head f**k, but I've also had some news from a friend which has quashed my already waning positivity. For the last few weeks I've been in regular contact with a couple of ladies going through the 2ww around the same time as me. While this is good thing because it really is a massive support to be able to vent about symptoms with women who know, it's also really sad when the first one to test gets a BFN. Unfortunately, three days ago, this is what happened to my friend Sarah, though she had her suspicions a few days before. You have all these ideas that we're all going to get our BFPs and we're going to go on to be pregnancy buddies but then reality kicks in - this might not work. My other pal, Vicky, is due to test the day before me so I have everything crossed for her. This process really is torture.

So apart from emotional trauma and pessary issues what have I been up to during my 2ww? I've actually been trying to keep things as normal as possible. I took the day off after transfer and went for my third acupuncture appointment in Kingston, Victoria focused on blood flow this time and I nearly drifted off to sleep during the Zita West meditation. I felt so floaty after my session, I decided I was in the mood to do a little bit of shopping and even allowed myself to feel a little bit festive (very unlike me!). The next day (after feeling guilty about over doing it walking round the shops) I went back to work, partly because I wanted to get back to normality so my mind didn't implode but mainly because I had no holiday left.


Last weekend we bought a Christmas tree and decorated the house, which is very early for us! I enjoyed a lovely (alcohol free) dinner with friends at Côte in Wimbledon which was a welcome distraction from symptom checking and the negative thoughts that have started to creep into my head. Over the last couple of days I've been analysing every twinge, cramp or peculiar feeling as my period is due any day now and I've started to go into panic mode; rushing to the loo to check everything is in order every five minutes. Poor Jon must be really fed up with me now as the more anxious I've been getting, the more clingy I've become; my need for cuddles extreme! I've also been having completely irrational thoughts, such as thinking my bloated tummy is crushing the embryo. What fun!

One week until test day.



Wednesday, 6 December 2017

Embryo Transfer

Wednesday 6th December 2017
King's Fertility
King's College Hospital, London

I am officially PUPO! This is the closest I've ever come to being pregnant (as far as I know) and I'm not going to lie, it makes me feel a little warm inside. Initially, I was concerned about the two-day transfer as I'd not heard of this before, everyone talks about 3dt or a 5dt but never a 2dt. Why did they want to put it back so early? The reason, we found out during the transfer, was because we only had one egg and the best place for it to continue to fertilise and grow is back in the uterus. If you have more eggs to play with, they will try and nurture them in the lab until day five as they say you have more chance of pregnancy success with a blastocyst. The embryologists can also learn more about the quality of the embryo if it makes it to this stage. I guess they didn't want to risk losing my egg in a petri dish so decided to put it back where nature intended.

For me, the transfer itself was the least stressful stage of this process. I think I was so happy to have made it this far, I was glowing and couldn't wait for our embryo to be back where it belonged - I was even belting out Queen songs on the way in the car! Mr B on the other hand, did not find this part enjoyable at all. After a stressful wait to get into the tiniest hospital car park, I could feel the tension in our cubicle as we were delayed another hour on the ward at King's College Hospital. The nurses seemed a little disorganised and in a muddle about who was supposed to be going into theatre next which only added to his angst. Jon was also quite emotional which I think surprised him (and me!), he was really suffering in the run up to our transfer. I was just keen to get on with things as I had a full bladder that was getting extremely uncomfortable.


Eventually, after much confusion, we were called into the theatre room. I was surprisingly nonchalant as I clumsily climbed onto the bed and put my legs into the stirrups. It felt like I was in this graceless position with my nethers on show to the whole room for an awfully long time while the consultant went through the procedure, but she did make everything as relaxed as possible for both of us and I felt an incredible calmness. There was a screen on the wall where we could see live images of our embryo in the petri dish in the lab next door, she told us that it looked good (four equally divided cells) for a two-day embryo with little fragmentation. Both of us were completely overwhelmed at this point as reality sunk in that we had made this microscopic seed (with the help of a little bit of science) and it could potentially grow into our very own human. We watched the little dot being sucked up into what looked like a long pipette type receptacle and and a few seconds later, the embryologist emerged from the lab carefully holding the catheter containing our embryo.

I was expecting to find the procedure as uncomfortable as the trial embryo transfer I had experienced a few weeks ago, but I hardly felt a thing as they passed the tube through my cervix and placed the seed into its new home. I knew it was silly but I still asked the consultant if there was any danger of it falling out, to which she said, think of it as a sesame seed stuck in a peanut butter sandwich! After we watched the embryologist check the catheter under the microscope to check it hadn't gotten stuck, we were given the all clear to go.


As soon as we were back in our cubicle, Jon was overcome with emotion and it was a really poignant and touching moment. I was just grinning like a Cheshire cat who desperately needed to pee!

On the way home we stopped at Maccy D's, it's an old wives tale that the salt on McDonald's fries help implantation and some women swear by it. I have no idea how this superstition is supposed to work but do I care? No, it was guilt-free excuse to visit the golden arches if nothing else!


Tuesday, 5 December 2017

Egg News

I've been sick with nerves all morning while waiting for the call from Jon. He's just spoken to the embryologist and...



Our precious little egg has fertilised!

Another hurdle crossed. Another box ticked. Another stage completed. How we've ever got this far is beyond belief, but we're here and I've been called in to King's for transfer tomorrow. Hang on a minute...

Tomorrow?

Monday, 4 December 2017

Egg Collection

Monday 4th December 2017
Kingston ACU
Kingston Hospital, London

I was trying not to stress while we were sitting for 50 minutes in rush hour traffic on the way to Kingston Hospital this morning. Luckily we'd left plenty of time to tackle the short 4.3 mile drive and we still arrived at the ACU on time. I decided to listen to my Mindful IVF app whilst we were in the waiting room, to try and divert my thoughts from the upcoming procedure to... well anything else really. We'd had a really tough couple of days, it was difficult to take our minds off the upcoming hurdles that we were facing this week, no matter how hard we'd tried to keep busy. My mum came down for the weekend and went to see Paddington 2 at the cinema, it was good to absorb ourselves in a charming CG world and away from reality for a couple of hours.
Five minutes into focusing on my breathing, we were called into the recovery ward where we met a nurse called Hayley. I was first up (again) so I was the only patient on the ward for twenty minutes or so. Jon helped me change into the flattering hospital gown, fumbling with the ties as usual, and we were greeted by the consultant Mr Tom Brooker. He was overly zealous but reassuring as he made sure we were happy with what would happen during the impending procedure. It's a minor op which involves a needle being passed through the vaginal wall and into the ovary to retrieve the egg. The anaesthetist then did his rounds and of course he was charming, anaesthetists really are the loveliest people on the planet!

Half an hour after I'd walked into the theatre room, I was back on the ward and as I started to regain consciousness, I started to feel groggy and restless. I wanted to know where my husband was and the nurse gently informed me that he was already gone. He was on his very own Challenge Anneka type mission with our silver box, which could only mean one thing... they managed to retrieve an egg! Unbeknown to me, I had already had a totally gibberish conversion with him before he left and I had specifically asked him to take a photo of the box on the train! I have no recollection of seeing him, nevermind any chat, but he is a good husband and he duly obliged!



My euphoric state lasted a few short minutes before I was back into panic mode again. What if he couldn't produce the goods on the day? I thought about texting him but decided against it as it probably wouldn't help his pre-performance nerves.

The IVF process is hard for partners, they largely get overlooked as it's mostly all about the lady. Until now. It's a huge chunk of pressure to place on a man, if he gets stage fright, the whole cycle fails. I started to think that we should have thought about freezing some sperm as back up in case he fluffs his lines. Having proved I was recovering nicely from the sedation by drinking adequate amounts of water and eating a dry biscuit, I was now back in the waiting room watching my phone in anticipation of a call from the boy. It was an agonising wait and one by the one the other ladies started trickling back in from the ward, looking spaced out and as equally anxious.

Two hours after my egg collection I finally received a message saying all was well and he was waiting for the analysis before he was allowed to leave. I was laughing out loud at this text exchange, much to the bafflement of the other women in the room, it felt really good to smile again.



Around forty-five minutes after that text conversation, he called to say he was on his way back to the hospital to collect me. The semen analysis showed that he had super duper swimmers, at least one one of us is working perfectly! The relief I felt at that moment was immense, after all the diagnoses and disappointments, everything had gone as well as we'd possibly hoped today and I couldn't wait to give my boy a massive cuddle. I know people talk about proverbial roller coasters but our experience of IVF so far has certainly been just that - a bloody high one. We've done all we can and we now have an agonising wait for a phone call from the embryologist in the morning to hear if our egg has made it through the night. Come on little one!

Friday, 1 December 2017

Scan Two

Friday 1st December 2017
Kingston ACU
Kingston Hospital, London

Today has been one of the toughest days I've had to get through since we said goodbye to my darling Dad exactly two years ago.

Alongside the sadness that comes with every anniversary, I was feeling calm but not too expectant as we once again got in the car to go to the hospital for another follicle monitoring scan. The initial bloating I had experienced 5-6 days ago had now pretty much subsided and I had expressed my concerns to Jon about the lack of discomfort a couple of days previously. Surely I should feel like my ovaries were ready to explode after seven days of stimulation injections? Luckily for Jon, I've had no manic outbursts, although part of me wished I had felt in the mood to throw a few pans around - at least I'd have some indication that the hormones were working.

I've always had a realistic outlook on life and today was no different, we can't change the situation and it's completely out of our hands. The inner control freak in me tried to remember this as I was laying on the bed with an ultrasound probe up my noo noo. I could feel my hopes slowly depleting the longer I laid there, the nurse was certainly having a good look around, I was starting to wonder if she could find anything at all. Eventually she said she was going to get the doctor to get a second opinion, as was always the case with a low follicle count. There, she had said it.

It seemed like an eternity before they both returned, but hardly any time for the doctor to confirm there was only one possible plan going forward. There was one lonely follicle which was considered 'ready' in my right ovary, the rest (maybe two or three) were non-runners, too small and extremely unlikely to grow to maturity, even if I kept up with the stim injections. I was devastated.

In the time it took me to re-robe reality had sunk in and I was fighting back tears. I was trying to keep it together so I could remember everything the nurse was telling me, Jon held my hand as he could see I was getting increasingly distressed and by the time we had sat down, I was inconsolable. The nurse was asking me questions but eventually offered to just talk so I could compose myself. We were told the plan was to bring egg collection forward to Monday, if we leave it any longer the one ripe follicle could become over-mature and we could lose it.

Back the waiting room I became more aware of all the couples who were a similar age to us, I was wondering if they'd had more promising news than we'd just been dealt. Regardless of their situations, everyone was there for the same reason, clutching their bags of medication and looking decidedly anxious. Thankfully, after a short wait we were called back in to see the doctor to go through the protocol for the weekend. The plan is to carry on today as we have been; three Suprecur nasal sprays and two Menopur injections. Tomorrow night, the stim injections will be replaced by a trigger injection (hCG) which has to be administered exactly 36 hours before egg collection. This induces the final maturation of the egg inside the follicle, if indeed there is one. I'm even starting to have doubts about that.

As we were leaving the hospital, we passed a lady pushing twins in a buggy, it was almost too much to bear. By the time we got to the car I was sobbing and I don't think anyone could've said anything to make me feel any better at that point. We drove to a car park in Richmond Park so we could have a chat (and another good cry). I wanted to go home and curl up in a ball on the sofa but I came to the conclusion that going into work and keeping busy would be the best option. I'm glad I made the call to be around people and not restrict myself to my own thoughts today, I'm definitely feeling a smidge more positive tonight.

So this is the hand we've been dealt. I'm completely heartbroken there will be no frozen embryos to have another shot if this one fails. This is it.

Aside from myself and Jon, the other person I'm really feeling for today is my Mum. Not only is she mourning her husband, I've just had to tell her our dreadful news. It has crossed my mind that we might not ever be able to make her a Nanna. For that, I feel awful.

Thursday, 29 June 2017

Outpatient Hysteroscopy

Wednesday 28th June 2017
Kingston Hospital
Roehampton Wing

Today was attempt two of my 'clear out' hysteroscopy. I won't go into the reasons why the first one that was booked at the beginning of the month was cancelled, let's just say it was an misjudgement on my part. This was my first outpatient hysteroscopy so I had no idea what to expect or how uncomfortable it would be. I assumed as there were no offers of any sort of anaesthetic, it would be similar to experiencing sharp period pain or an HSG. Oh how wrong I was.

On arrival, a trainee doctor named Lisa greeted me and showed me to the consultation room where Miss Al-Shabibi was waiting. I later learned she is the lead in Outpatient Hysteroscopy at Kingston, I really wish I'd been privy to that information pre-op as it might've helped relax me a little! She explained everything that would happen and I signed the papers. I stripped and changed into the gown and followed the two lady doctors into theatre. Here, two more nurses were waiting for me and I felt very comfortable surrounded by a gaggle of women. Girl Power, or so I thought. Soon I had my legs resting in the stirrups, and liquid was injected into my cervix to widen it ready for the hysteroscope. I was comfortably chatting away to Lisa about work, my crappy commute, blah, blah, blah and then... a sharp stabbing pain so bad it took my breath away. I'm not exaggerating when I say it felt like she was jabbing me with a red hot poker. My chatter was soon replaced with yelps, cries and short, sharp breathing in between whimpers. I suddenly knew how it felt to be a Looney Tunes character, eyes on stalks and steam coming out of my ears, I certainly must have looked crazy! I was already holding (squeezing) Lisa's hand, now one of the other nurses quickly came round and offered her hand on my other side as she could see and hear my distress. As the hysteroscope was being inserted the pain was getting progressively worse. I was struggling to picture anything else apart from that torture tool.

Mrs A-S: "Look at the camera images, you can see one of your tubes"
Me: (Not looking and the screen) "Aaaaaaaargh"
Mrs A-S: "And there's your other one"
Me: (Turning to the screen for 2 seconds) "Aaaaaaaaaargh, how much longer?"
Mrs A-S: "Not long now, I'm just tidying up"

After what seemed like an eternity but in reality was only a few minutes, it was thankfully over. As soon as she pulled the Devil Device© out, there was almost instant relief, although some of the pain was still there, the pressure was greatly reduced. She seemed surprised at this which baffled me at the time.

After changing back into my skivvies, now with standard-issue hospital nappy pad, I was back in the consultation room. I found myself suddenly feeling embarrassed and started apologising profusely for being a baby. Maybe I was having a low-pain threshold day, or maybe it's due to my suspected adenomyosis or because I'm due on my period any day now? Whatever the reason, I did not feel good. I pride myself on how well I cope with most situations and now I felt like a failure. After trying to reassure me, Miss Al-Shabibi explained that she was extremely happy with how everything was looking, but she had removed a little more of the septum tissue that was left. There were no adhesions and it looked very clear which was a huge relief - no clearing of the cobwebs required. She told me she would report back to Mr Kalu and he would be in touch about the next step. And that was that, I was on my merry way, albeit walking like a rustling John Wayne. Stupidly and naively I hadn't taken any pain relief pre-op and I certainly needed it now, so I popped into the pharmacy on the way out. By the time I'd driven home, the Nurofen was kicking in and I felt a little more comfortable. Inevitably, as soon as I removed the ridiculously over-sized nappy, the floodgates opened. Bloody marvellous.

After settling on the sofa in my PJs for the evening, I started reading forums about women's experiences of having a hysteroscopy without anaesthesia. There's even a Facebook page called Campaign Against Painful Hysteroscopy! I found a vast spectrum of stories ranging from people who said it was merely uncomfortable to women whose procedure had to be abandoned because it was so painful and carried out at a later date under a general. Some women even said it was worse than childbirth! I felt a bit better knowing I was somewhere in the middle with my experience, I was just relieved it was over, I do not want to go through that again.

EVER!


11.04.18 - Update from Campaign Against Painful Hysteroscopy Facebook page

It's good to see Patient website being truthful about the risk of severe pain during outpatient hysteroscopy. We need ALL NHS gynae clinics to provide honest patient information leaflets warning of % risk of severe pain and giving the option of sedation or GA...

https://patient.info/health/hysteroscopy

Me: If you're about to have an outpatient hysteroscopy, I would advise you head to the Will it hurt? section and make sure you go through these points with your gynaecologist before the procedure. I can't stress enough, knowing what I know now, that if I was given the option of a GA I would accept it every time. At the very least they should be offering you sedation, please bear this in mind. That said, I have since spoken to ladies who have had no problems so don't take my experience as gospel, just be prepared.

Sunday, 21 May 2017

Copper Coil

Yesterday, was another day of firsts. I ran my first ever Park Run and experienced my first ever coil removal sans anaesthetic - go me! The Park Run was a success, as in I completed the 3 mile course in less than half an hour, but unfortunately I was in pain the whole way round and suffered cramping for some time afterwards. Nevertheless, I felt a sense of achievement and the endorphins put me in a good mood for the day ahead, despite being overtaken by a man pushing a buggy (maybe more than one).

Later that day I had my final appointment with Mr Kalu before he was going to refer us for fertility treatment. We talked about our options and how he thinks referring us straight for IVF is our best chance given my age and the severity of the endometriosis. He said he would refer us as soon as I've had another hysteroscopy to have one final look inside my uterus to check for adhesions and a final clearing of any cobwebs. There is currently a three month waiting list at Kingston Hospital for IVF so all being well, I'll be able to start treatment at the end of the summer. Whilst, I'm not relishing the prospect of having yet another procedure, I'm looking forward to getting our fertility journey underway. After a few months of setbacks, things seem to be finally heading in the right direction.

Mr Kalu then informed me he was going to remove the dreaded coil. Gulp. Although this was my second IUD, I'd never been awake for insertion or extraction before so as I lay on the bed with my legs akimbo, I was a little tense to say the least. I could feel it scraping every millimetre of my cervix as he was pulling the wretched thing out, I can now see why women only have them every 5 years!


After a few minutes of chat while I was fumbling around for my underwear, which were of course tucked neatly under my leggings on the chair (I have no problem with a doctor studying my floodlit private parts but there's no way he's going to see my knickers), I asked to see the coil that he'd just removed. This is what he removed from the waste bin...


I'll just leave that there with you.


Saturday, 1 April 2017

Hysteroscopy

Saturday 25th March 2017
BMI Coombe Wing
Kingston Hospital, London


Seven weeks on from my first procedure I was back on the same private ward ready for my second general anaesthetic and my second hysteroscopy. I felt so much more relaxed this time round, knowing there was no incision surgery and what to expect with the anaesthetic - I was almost looking forward to it! The only thing in the back of my mind was the trauma of the catheter after my last surgery - I was really hoping I wouldn't have to go through that experience EVER again.

Diverting from the subject momentarily as March is an important month for ladies worldwide. International Women's Day occurs annually on the 8th and what you probably don't know is that March is also Endometriosis Awareness Month. On the day of my second surgery there were marches happening in 47 countries globally to raise attention to this crippling condition. From Argentina to Kuwait to Zimbabwe - women (and men) were out in force! In London, along with the march, a few ladies met with MPs at Downing Street to discuss the issues surrounding misdiagnosis and unacceptable diagnosis times - hopefully this will lead to more awareness and guidelines for GPs. This would definitely be a few steps in the right direction.


Mr Kalu did his circulation of the ward early and informed me I was first on the theatre list once more. He explained that he was going to remove the coil and 'tidy up' any remaining tissue with the aid of a hysteroscope.

Now, I've looked online at what this involves and quite frankly the instrument scares the bejesus out of me. It's a thin(ish) metal rod with a camera on the end which relays images of ones uterus back to a monitor so the doctor or nurse can have a good ganders. I know it's not the first time I've had the pleasure of meeting this device, but for some reason the hysteroscope horrifies me, I was glad I was going to be knocked out for this procedure.

I find the experience of having a general anaesthetic an enjoyable but also a strange one. I don't remember the feeling of 'going under' for a few seconds beforehand - no countdown from 10 - just awake and then gone. I can only compare it to having a light in my brain that only flicks off, rather than a gradual dimmer switch.

I am relieved to say the the whole procedure, from going down for the general, to the operation felt a lot less traumatic and more straightforward. I'm assuming the anaesthetist gave me a much lower dose this time round as I was more keen to return to the land of living post-op. As soon as I was back in my room I was alert, sitting up chatting and I felt pretty good. My mouth was less dry and I had an appetite. An hour later I crashed.

Just before Mr Kalu did his afternoon rounds, I managed to pee. A lot. I was so happy I could've cried. Unfortunately my elation was short-lived.

Mr Kalu explained that he'd managed to remove more of the fibrous tissue but it was difficult to remove everything. He went on to explain that this would be the last time he'd carry out the procedure as he was concerned about creating scarring and adhesions which could add to my endo/adeno problems. He'd put in another copper coil to once again help with endometrial lining growth over the site. Wait, what? That wasn't part of the plan. I assumed this was all because the tissue had grown back and that this was always going to be a recurring problem. It definitely felt like one step forward, two steps back, this left me feeling extremely dejected and I struggled to fight back the tears in the car on the way home.

Saturday, 4 March 2017

Diagnosis Letter

I realise this isn't very interesting or would even make much sense to many of you (I had to google every other word), but I thought I would post as it may be useful for fellow endometriosis sufferers.

Laparoscopic ablation of endometriosis, dye test, Hysteroscopy division of uterine septum and insertion of copper coil.

Findings:
1) Uterine Septum
2) Severe Endometriosis/Adenomyosis

Hysteroscopy: Her cervix and cervical canal were normal. The uterus is anteverted and bulky. There was a midline septum bisecting the cavity and extending to the midcavity. The utero-cervical length measured 8cm after division of the septum. Both tubal ostia were seen and are normal. Endometrial biopsy was sent for histology. The midline septum was divided using hysteroscopic scissors until both tubal ostia were visible and the cavity was more regular at the end of the procedure. The uterocervical length of 8cm. Procedure was uncomplicated.

Laparoscopy: There was severe endometriosis involving the rectum which was hitched up to the back of the cervix. There were significant wet endometriosis lesions on the serosal surface  of the uterus and on the right pelvic side wall peritoneum. The uterus was soft and adenomyotic in appearance. The right ovary was bulky and contains a haemorrhagic corpus luteum. The left was normal. Both fallopian tubes were freely mobile. There was prompt fill and spill of methylene blue dye from both tubes, confirming bilateral tubal patency. Her peritoneal endometriosis was ablated. The procedure was uncomplicated.

She was discharged home on analgesics and a stat dose of 1g AzithromycinI have prescribed a course of oestrogen (Progynova 2mg bd) for 28 days to help endometrial regeneration over the area where the septum was divided and Provera 5mg tds from day 18 and for 10 days to induce a withdrawal bleed. The coil will be retrieved in 6 weeks during a second-look hysteroscopy to ensure there are no residual endometrial adhesions. A follow-up appointment has been arranged for post-op review.

Yours sincerely
Mr E Kalu
Consultant Gynaecologist 

Thursday, 23 February 2017

My Hospital Debut

Saturday 4th February 2017
BMI Coombe Wing
Kingston Hospital, London

Today was a day of firsts. At the age of 36 and a half (+14 days) it was my first hospital admission, my first general anaesthetic and my first operation. Despite all the biopsies, scans and other tests I've had previously, I've been pretty fortunate so far.

I'm usually calm in most circumstances, but in the week leading up to the procedure I found myself thinking not so much about the operation itself, but the anaesthesia - loss of sensation. I had spoken to a few people about my worries and I had mixed reviews. Some hate the thought of being in an induced sleep, while others seem to enjoy the heady sensation of coming round. Thinking about being knocked out then waking up in an entirely different place with no recollection of the bit in between did scare me, but intrigued me at the same time.

We woke early to be at the hospital for 7am. Kingston Hospital is only a 15 minute drive so I was grateful I didn't have long to dwell on the impending procedure. We arrived early and were shown to my room, it seemed comfortable enough but I hoped I wouldn't have to spend too long there. The nurse explained that I would be first into theatre that day and I would need to change into the cotton gown, dark green compression socks and extremely fetching paper knickers. Both Mr Kalu and the anaesthetist came round to discuss what would happen before and during the operation and to answer any questions I might have. We talked about the gas that would be pumped into my abdomen so he could see my organs more clearly and how this might be uncomfortable for a few days after the operation. Soon afterwards, nurse Izabela (who was an absolute angel) came to collect me and we walked down to the anaesthesia room which was adjoined to the operating theatre. Even though we were talking about anything but the procedure, I started to feel quite anxious and I suddenly wished Jon was still with me. She made sure I was comfortable on the trolley, gave my arm a quick reassuring squeeze and left me in the capable hands of the anaesthetists. I was hooked up to the monitor and they started asking me about my home, my job and anything else to take my mind off the cannula that was being inserted into my left hand. A mask was placed over my nose and mouth and...

I woke up in a recovery room with a few other patients, all of whom were looking decidedly perkier than myself. Nurse Izabela was again squeezing and rubbing my arm, but this time it was to encourage me to wake up, something I was very reluctant to do at the time. I enjoyed the hazy feeling of slowly regaining consciousness but I just wanted to sleep, I couldn't understand why they wouldn't allow me to doze. I think I was in the recovery room for around half an hour before they wheeled me back up to my room, still feeling inebriated and grinning like a loon at my husband.


As much as I wanted to sleep, I was urged to stay awake as the nurses needed to check my readings every 15 minutes - heart rate, blood pressure and oxygen levels. My blood pressure was really low so they gave me intravenous fluids and oxygen. I remember feeling extremely dehydrated and was chugging water like it was going out of fashion. The nurses stressed how important it was for me to try to wee as it's quite common to have a sleepy bladder after having a general anaesthetic. Patience is something I haven't been blessed with.

I wasn't hungry but I'd been in theatre for two hours so I was brought lunch not long after being deposited back on my bed. As lovely as it was, I struggled to eat the cod and mash as my dry mouth made it extremely difficult to swallow anything without having a sip of water after each mouthful. Jon was again the lucky recipient of the rest of my meal.

Being a Saturday, I was glad I'd decided to bring our iPad so we could watch Chelsea convincingly beat the Gooners. I just wished that I'd had full control of my bobbing head to fully appreciate the win at the time. I can only compare it to fighting tiredness on a long haul flight, although I'm glad I didn't have the embarrassment of falling asleep on someone's shoulder this time.


I still had no idea of my diagnosis or what surgery had been carried out whilst I was anaesthetised. I was aware that as well as the naval incision, there were two other dressings, one over each ovary. I assumed that some kind of surgery had taken place as I was sure a diagnostic laparoscopy wouldn't have taken two hours. While I was waiting for Mr Kalu to do his rounds, I was still being monitored regularly. The nurses were worried about my low blood pressure and my lack of pee - I didn't understand how I could possibly be dehydrated with the insane amount of water and herbal tea I was getting through. I was attempting to walk (shuffle) up and down the corridor by this point to try and spark my lazy bladder back to life and to release some of the gas pressure in my abdomen which was becoming more uncomfortable. I was trying everything, sitting on the toilet for a few minutes, running a tap, thinking of waterfalls... nada. I think it was around 8 hours before my bladder gave in under the strain and I managed to leak what I thought was, a fair amount into the pan. My joy was unfortunately short-lived. The nurse measured the pee from the cardboard pot then carried out a scan to see how much was left in my bladder. There was still 500ml of liquid remaining, this is a dangerous level which could lead to all kinds of urinary complications if not drained. The same process happened a couple of hours later - elation at being able to pee followed by despondency that it wasn't enough. The nurses were now suggesting that I would have to stay in overnight and have a catheter inserted if my situation didn't improve by early evening. Fan-bloody-tastic.

Mr Kalu arrived later that afternoon and went through everything that he did during the procedure. He firstly confirmed that he had found a uterine septum (option C from the previous post) and that he'd removed as much as the fibrous tissue as he could. He had fitted a copper coil and prescribed me a course of oestrogen (HRT) to aid endometrial regeneration over the area of surgery. He went on to explain that he had found significant deep infiltrating endometriosis (DIE) and adenomyosis and would grade it as severe (stage 4) as it was so widespread. He had found deep lesions on the outer surface of my uterus, peritoneum, Pouch of Douglas and bowel. This is where it got a little bit hazy - too much to take in when you're struggling with concentration - but he said it was all recorded in a letter which he then handed to me. My GP would also receive a copy. I tried to understand what was written in the letter, but it was full of medical terms which would need going over with a fine-tooth comb (Dr Google) when I was more alert, right now I needed to focus on getting out of hospital.

It got to 8pm and there was no improvement in my vesical function, the decision was made that I would have to stay overnight and have a catheter inserted to drain my bladder. I started to worry that it might never function properly ever again. Now, I've never had a problem with exposing my nethers to doctors and nurses, I've had enough tests over the years not to be overly self-conscious, but this next bit took undignified to a completely new level. I was quite distressed as I lay on the bed trying to mentally prepare myself for what was going to happen. I knew I had to relax to help the nurse with the insertion but it was difficult when you see the size of the tube and have no idea how that is going to fit in there. I wouldn't say it hurt, but it did sting and it was certainly very uncomfortable. The nurse seemed to be stretching and poking around down there for a long time which was only adding to my anguish, but eventually, she seemed happy enough and left me and my bag to it. A couple of minutes later she popped her head round the door to have a look at my pee progress but looked baffled because the pouch was completely empty. With the amount of liquid in my bladder, it should have been flowing straight away. After a few more bewildered glances she came back, this time with another nurse to attempt another insertion. After much head scratching, peering, prodding and leaking, between them they were successful with attempt number three and in just a few minutes I had filled the bag with a litre of fluid. What a traumatising ordeal.

Jon left around 10pm to let me try and sleep, it had been a long day and we were both exhausted. Although I had drained well over a litre and a half by this point, I was still feeling extremely bloated. I put this down to the gas in my abdomen rather than my bladder being stretched. I was lucky I didn't experience any shoulder pain that is a common occurrence after a laparoscopy. I managed to get a little sleep propped up in my hospital bed in between the nurse calls and the corridor chatter. I was grateful to have my own room, despite the private bathroom being wasted on me.

The next day Jon arrived around 8am, I'd been awake for a couple of hours and felt much better than the previous day. I wasn't in too much pain but the catheter was starting to agitate me. I'd been grateful for it through the night as it meant I hadn't had to get up on my own to go to the loo, now it was just getting in the way. After breakfast, Mr Kalu came in to see how I was doing. He informed me that it might take a while for me to urinate after they take the catheter out, but I had to be patient - patience is definitely not something I've been blessed with! My readings were back to normal and the nurses decided it would be a good time to say goodbye and good riddance to the tube. Remarkably, I managed to go for a completely normal pee within an hour so I could finally start to look forward to going home.

We ended up staying until after lunch as they thought my medication from the pharmacy downstairs would soon be ready for me to collect. After not eating much the previous day, my appetite had returned and I wasn't going to miss out on the roast beef I had ordered earlier! Another hour passed and I was getting restless, I just wanted to get home to the comfort of my own sofa. I signed the discharge forms and we carefully drove home, holding the seat belt and the elastic in my leggings away from my abdomen the whole way. Of course we had a call from the hospital within minutes of us being back saying my medication was ready.


Monday, 20 February 2017

Progress

After visiting my GP two years ago, I was referred for a pelvic ultrasound at St. Helier Hospital. I'd stopped taking the contraceptive pill 18 months previous with no success so we were keen to find out if there were any complications. The results of the ultrasound were fairly inconclusive, but I appeared to be ovulating which was encouraging.

Because nothing significant showed up on the ultrasound, I didn't return to my doctor for another 12 months. We'd moved house shortly after the last hospital appointment and it took time to settle into the new neighbourhood and change doctors, I guess we again just assumed we would conceive naturally during this time. What happened next changed all our lives forever - my father suddenly and unexpectedly passed away on 1st December 2015 from a massive heart attack. My world was completely turned upside down, I adored my daddy. For a few months, whilst I was going through the various horrific stages of grief, I couldn't even bear to think about children. It was too painful to comprehend that my Papa would now never meet his grandchild or that our son or daughter would grow up never knowing my lovely dad. On the other side of the coin, mum's deep sadness turned into longing for a little person to fill a small part of the colossal hole dad had left in our lives.


After a few very sad and challenging months, I booked an appointment at the new practice and went through my history with my new GP. She was really supportive and referred me to the gynaecology unit at Queen Mary's Hospital in Roehampton. I had my first appointment at the clinic in June of last year.

Two months later I had been booked in for a transvaginal pelvic scan and hysterosalpingogram - thankfully abbreviated to HSG. The first is an ultrasound which involves the insertion of a probe, enabling detailed images of the uterus and the ovaries to be obtained. The second is an x-ray using dye to determine if the fallopian tubes are open and to see if the uterus is a normal size and shape. I can only compare this to a lengthy smear test, it didn't hurt but it was assuredly uncomfortable. After these procedures I was given a mixed bag of good and bad news. The dye had travelled freely through my tubes which meant there were no blockages but my uterus appeared to be an abnormal shape. I had no idea what this meant and I wasn't given anymore information at the time.

During the follow-up appointment in October 2016 - my first meeting with Consultant Obstetrician & Gynaecologist, Mr Emmanuel Kalu - we talked about the results of the scan, the irregular shape of my uterus and the possibility that I could be suffering with endometriosis. And that was my first introduction to the condition. En-doh-mee-tree-oh-sis.

After studying the ultrasound and HSG results he tried to illustrate the possible semblance of my womb with a series of drawings. Doctor's scribbles are as bad as their handwriting so I've redrawn them for the purpose of my blog - I do like a good doodle. He suggested that he would be very surprised if the outcome wasn't option B or C.


Bog standard uterus



Arcurate uterus -  looks like a normal uterus, except it has a dip or a slight indentation at the top.



Septate uterus - the inside of the uterus is divided by a muscular or fibrous wall called the septum.



Mr Kalu advised I would need a further procedure called a laparoscopy to determine if I was suffering from endometriosis. It would also reveal which of the three illustrations resembled the shape of my uterus, which would be critical if we wanted to have children. He explained about the small incisions he would make in my belly button (wince) and abdomen and the possible surgery he would carry out if endometriosis was found. I felt confident and happy being under his wing. We discussed private health care as this is something I could claim through my insurance at work, he agreed this would be the most favourable option.

Of course I went home and googled endometriosis straight away. I read pages and pages about the condition. I was astounded to discover that 1 in 10 women suffer with it in varying degrees. If it's so common, why has it not been mentioned before by my GPs, considering my previous history?

My first laparoscopy was booked in for 10th December, six weeks after my appointment with Mr Kalu. Unfortunately I had to postpone the operation due to suffering with a chest infection the previous week, I was devastated. I had to wait eight weeks for another date - Saturday 4th February 2017.