I'm so lucky because my cousin lives just 5 miles away from Dr. S's office. What are the chances? (Especially since we both grew up in California!) I drove up last night and spent the night with her and her family. We were able to catch up which was wonderful because I haven't seen her in awhile. Even though we're just 2 hours apart, we don't get to see each other as often as we'd like. Life gets busy for us both and the time just flies by.
My appointment was at 7:30am and I didn't leave the office until 10:00. I knew he would spend a good amount of time with me, but I wasn't really sure what we were going to do for all of that time.
At first we had a conversation about my medical and infertility history. Even though I had mailed my records to him in advance he hadn't looked at them yet. I got the feeling he operates this way on purpose - he wanted to hear my history first, and then look at my records.
After talking for awhile I had the exam. Ugh. It was quite an exam. Thankfully I've had a least a couple of months with no doctor's visits or exams. Last fall it felt like I was being examined every week. As the other ladies who met with Dr. S have done, I will spare you the details, but it was a VERY thorough exam. There were a few moments when I wasn't sure what was going on - what he was putting where - but let's just say there was a lot going on down there.
During the exam he wanted me to let him know if I was feeling pressure/discomfort (which is to be expected) or if it was painful. For the most part it was just discomfort, but at one point it was very painful where he was examining. He told me later that the painful area is the same location where my endo was removed during my first surgery. Interesting, huh? He said it could be simply scar tissue that is sensitive, or the endo could be back.
After the exam was over we had another conversation. At this point he had looked over my Creighton charts, medical records and he was able to process the information from our first conversation and the exam. We discussed a lot, but the big news from the appointment is that he recommends another surgery.
He thinks I should get a selective HSG done and another laparoscopy to check on the endometriosis. I am ok with having another surgery, but the major problem is that Dr. S is not covered by my insurance. It's one thing to pay out-of-pocket for today's appointment, but surgery is completely different story. My husband and I will have to discuss our options and see what is possible. Dr. S was thinking of scheduling me for this summer, but we might have to wait until 2011 if it involves changing insurance policies.
Here is what else we discussed:
-Get another seminal analysis done. It's been about 3 years since my husband was checked out.
-Full hormone panel: he's going to look at my hormones throughout my cycle. He's also going to have some other tests run to see if I have any auto-immune issues. This is one area that is really mysterious to me, so I'm glad he's looking into it.
-Cervical eversion: basically this means that I have some mucus-secreting tissue on the outside of my cervix - when it should be on the inside. He said this is not related to my infertility, but it could make it difficult when I'm trying to chart. (Dr. B noticed this back in '08 and cauterized it with silver nitrate, but Dr. S said it didn't help much. He will treat it using another method during a future appointment.)
-Nutrition/Vitamins: I have been reading "Fertility, Cycles and Nutrition" and it has a lot of advice on making nutritional changes to help increase fertility. But I have never been convinced that it would make a difference for me. Will I really conceive after giving up coffee or gluten? I guess it's possible but I haven't felt strongly enough to make any changes. Dr. S said that general health (eating well and exercising) is important for healthy fertility, but unless I have reason to believe I have food sensitivities he didn't think drastic changes were necessary. He recommended a website (Cambridge Nutritional Sciences) that helps diagnose food intolerances.
-Charting: Dr. S encouraged me to continue charting. As I've mentioned in the past, I had given up charting for awhile. (In looking back it was almost 6 months - yikes!) I tried to be good for the last two months since I knew I was seeing Dr. S, but it wasn't great. He even suggested a refresher course with my practitioner to get me back on track. He also added another element to the charting - he created a document to keep track of PMS. He wants me to write down any PMS symptoms that I have throughout my cycle.
Most of these tests will have to wait until we get back from our trip since I am mid-cycle now and will be mid-cycle while we're gone.
On my drive back I stopped at the Lourdes Grotto in Emmitsburg, MD. It's a beautiful place to pray and I'm glad I had a little time to stop. It was so quiet and peaceful - at 11:00am not many people were there. The weather has finally warmed up a bit and I was able to sit outside and pray. I kept thinking that soon I will be at the real grotto! I took a few pictures with my phone that I will try to upload and post.
More than anything I was filled with peace as I sat there and reflected. After all this time I am getting better at surrendering and trusting in the Lord. I prayed that God's will be done in our life, no matter what that means. Whether is more infertility treatment or adoption, all I want is to do His will.
**updated with pictures**
This huge statue of Mary is visible from the highway
The Grotto
Lovely statue of the Holy Family
Spring water at the Grotto... while it's not the miraculous water from Lourdes, I think it's supposed to remind us of it. I filled up my water bottle (at the spigot, not from the pond) and drank it while I was there!
Statue of St. Louis de Montfort
Dr. S sounds like a fantastic doctor! It seems like you had an incredibly thorough appointment and that he spent some quality time with you!
ReplyDeleteGosh, I'm so sorry that you were in pain. But, it sounds like a great start to a renewed look into your IF!
ReplyDeleteMy doctor never recommended food changes either (Dr. Hilgers) and I wonder how much difference that makes as well. It didn't seem to matter for us either.
And yes, do a refresher charting course! It'll give you renewed energy to chart, cuz let's face it, it can get old and forgettable!
So glad you're on the right track! I hope you and your DH find answers in prayer about the surgery. That's a tough one. But even if he's not covered, would it be "out of network" coverage? Sometimes it's only a difference of 10% or so. I'm hoping for the best for you :)
G-
ReplyDeleteThat sounds pretty painful! Eeek!
I'm glad you had such a thorough appointment. I really am.
I can't believe you'll be in Lourdes soon!
Continued prayers of course...
He sounds like he's very knowledgeable! that's great, sorry the exam had to be so uncomfortable..........
ReplyDeleteIf all you want is to do His will, then you can't go wrong! :) I am glad it was a good appt (and thorough!) and it sounds like you have a good game plan. I am sorry he isn't covered by insurance, certainly adds another element to the whole thing.
ReplyDeleteOhmygosh, I LOVE that grotto. I used to go up to the shrine once a month when I lived in Baltimore. It is wonderful. Don't you just love the little chapel?
ReplyDeletePraying that he can help you both find new hope and restored fertility health! So glad you got to spend some time in prayer at the grotto later. I am sure there was so much to reflect on and bring to prayer.
ReplyDeleteThe exam sounds overwhelming, but I guess if it pinpoints the problem we all would put up with it. Making me wish I could make an appt with him.
What an excellent appointment!!
ReplyDeleteI love the PMS chart, almost all of my clients use it and shove it in my face as soon as they come in and sit down for their follow-ups... and I have to explain to them that while it's good to know what symptoms they're having, the PMS chart is really for the NaPro Dr, not me ;) But everyone just seems to LOVE it- it finally validates that they are not raging Bs but actually have legitimate hormonal issues.
As for the nutritional element, that Cambridge website is the one Dr Boyle uses (he was the one who presented the stuff about nutrition and fertility at last year's AAFCP meeting, which prompted my Dr to tell me to look into it. In the end, I used a US test, instead of paying for the UK one). I just went gluten free recently and have seen some positive changes already, so as far-fetched as it may sound, it probably can help with fertility. Worth a shot!
I wonder if he is planning on using a hyfrecator for your eversion? My Dr uses this for cervical issues like that, rather than the silver nitrate, which I've heard mixed reviews on. I know Dr Watson (NaPro NJ, now retired) used to do silver nitrate, but my Dr only does the hyfrecation.
I'm really intrigued about everything you learned today, and looking forward to seeing how it all unfolds! I also think I will contact his office for another visit, myself!! (Everyone seems to have had such awesome appts lately!)
Okay, someone is going to have to tell me what goes on in these exams. I am afraid my imagination is getting the worst of me!
ReplyDeleteIt does sound like a productive meeting with a game plan . . …and doesn’t a new game plan always make us feel better. I hate having to worry about the insurance issues. It is such a pain when the doctor you want is out of network.
Love the pictures! What a peaceful looking place.
totally understand the exam. i was really traumatized by it!!!
ReplyDeleteit sounds like it all went well. praying for you as you discern whether to pursue surgery with dr. S!
Wow! Another surgery! Oh my gosh! What is up with us IF girls and surgery! We just can't seem to get enough of it can we!
ReplyDeleteSounds promising! ;)
TCIE-I NEED THAT PMS CHART!!!!!
To tell you the truth, I was surprised to hear that so many people were surprised by that part of the exam! Although unpleasant, it is an extremely important part of a thorough exam - especially for endo. All of my exams with my dr's (3 or 4 different doctors at this point) have been extremely thorough, and before my last surgery, usually extremely painful as well. Is that a Tepeyac thing not to include that part of the exam?
ReplyDeleteI'm sorry to hear he wants to do another surgery, especially since he isn't covered under your insurance, but he's had so many successes in the past it really seems like he knows what he's talking about!
I'd like a copy of the PM.S chart too!!! Sounds like an informative appt...and the surgery sounds hopeful too eventhough us IF girls know what a "pain" it can be. Geez....I know our ins wouldn't cover dr h...so we had to go local. IF is expensive enough. Wishing you the best as you make decisions and praying you have a safe trip!!!
ReplyDeleteoh you are a million times the woman I am! I am so sorry I never finished my post about the appointment ... especially before yours! I feel like a bad friend. I love your sense of calm and peace and desire to follow God's will. You are an inspiration.
ReplyDeleteThe insurance thing is tricky! I HATE the stress over insurance and medical stuff most of all. OK, second most of all. The lack of a baby would be the thing I hate most. I switched to my husband's insurance Blue Cross Blue Shield (federal employee program), so Dr. Stegman would be covered. It is costing us more per month -- enough that if it were just the one appointment, it would not be worth it. But it's definitely worth it when a surgery comes into play. I wonder if the carefirst PPO program would cover him?
I would definitely want him to do the surgery!
You got the Dr. S specials! ha! I have had quite a few in my 4 years of being his patient. :) He is very thorough and his memory is quite good.
ReplyDeleteI am curious about the immune testing he is going to do. Please keep us posted.
He using the CrMS chart a lot in his diagnosis and treatment plan. It is actually vital for him. He also really values the FCP's role in NaPro, which when their jobs are done well, he can do his job well. It can all work quite nicely!
Glad you liked him and also got to the grotto. I love it there. After my sister had a m/c I went there to pray for her and light a candle for both of us. She conceived much more quickly than me, but it worked for both of us. :)
So glad you had a good appointment and a lot of things to look into. I'll pray that you guys make the right decision regarding surgery/insurance. At the least, it seems like you have some good things to look into right now and can get started on any treatment he recommends, then put off the surgery for a bit if necessary and see what happens. Glad you got to the grotto - such a peacful place.
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