Thursday, October 30, 2008

Surgical Instructions

Pre-Op Instructions

1. Wear glasses (rather than contact lenses) the day of the surgery.
2. Remove nail polish from fingers and toes
3. Arrive at hosptial fasting, at least six hours before the surgery.
4. Cancel patients for Thursday, and plan on resting through Saturday.
5. When packing, plan on waiting around for a while ie bring a good book, and don't bring anything truly valuable in the suitcase.

The Day Of Surgery

1. Arrive at hospital at 7:30 in the morning, surgery itself will be anywhere between nine and noon.
2. Don't take any medications or vitamins that morning.
3. I am allowed to brush my teeth however.
4. I will be under for approximately 20 minutes, and once I wake up, I may eat and drink if I feel like it. The infusion will stay in place as long as I need it.
5. After resting for 4-5 hours, I may go home, unless I am feeling unwell and want to sleep at Hadassah overnight, for more supervision. (And all that yummy hosptial food...)


1. There should not be pain after the surgery, but certainly spotting or bleeding anywhere from three to ten days.
2. For the next month, no sex and no using tampons.
3. Starting Sunday after several days of rest, I may return to my usual routine, including exercise, except for avoiding swimming as exercise for three weeks.
4. Two weeks after surgery, report for an ultra-sound.

Notes to self:
1. Don't forget to pack: heavy socks or slippers, a robe from home, a sweater or sweatshirt.
2. Get someone to bring me sushi once I wake up, I am not eating hospital food.
3. The night before, I must also set up the house to keep the cats inside, in case I end up sleeping overnight.
4. Give several people contact information for my family in the US, and a copy of my will. (Just in case...)

Tuesday, October 28, 2008

Tapioca Pudding, Anyone?

Today, I attended my pre-surgical orientation at Hadassah Hospital. I had been under the impression that I would be in and out within two hours, and when I arrived, the nurse handed me my schedule for the day, which stated that I would be lucky if I left before 3:30 in the afternoon. Lunch - courtesy of the hospital - included.

8 am: Almost missed bus, after staying awake much of the night, listening to the rain.
8:45 am: Arrived Hadassah Hospital, told that the form I received yesterday from the HMO is incorrect and unusable.
9-9:45 am: Sat in Hadassah Admissions while they worked out the proper form and payment from the HMO. That is the wonderful element of this whole process, that the socialized medical system and my HMO in particular is picking up the costs for basically everything except sperm samples and hormones.

The first question they asked me in Admissions was "Next of Kin;" I did not understand initially what they needed from me, until I realized that I have lived in Israel alone for the last eleven years and more, that I have no direct family members living here, nor do I have a husband. It took me several minutes to think of a person (a distant cousin) whom I thought would want to know if I died on the table. That was perhaps the worst part of this whole day, realizing how alone I felt.

9:45 -11:45 am: Lots of waiting interspersed with brief interviews with the nurse, the doctor, and the lab tech. I managed to finish a great book for science geeks, "How the Mind Works" by Stephen Pinker, a wonderful combination of neurology, psychology and pop culture.
11:45 am-12:30 pm: Lunch, tapioca pudding and all. I resolved that the time that I needed to spend in the hospital next week would include sushi, snuck in with my overnight bag if I had to. I shared my meal with a lovely elderly couple, originally from Brooklyn; the wife was in hospital and her husband had come to visit her. Since they live near Hadassah as well, they said they would be thrilled to adopt me next week while I was in recovery.
12:30 pm: More sitting, and wishing I had not eaten the chicken.
1 pm: I am supposed to meet with the anesthesiologist, who is delayed by several hours. My doctor calls me into his office to explain the basic risks of being put under, I will sign the last of the consent forms the day of the surgery itself. I am released today earlier than expected, mostly because the Women's Floor, and the IVF Unit have a joint field trip day, what is called in Israel a "Yom Kef," and there is little likelihood that any more will get done.

What am I feeling? The IVF Unit at the same facility has lots of light, and an overall pleasant and welcoming atmosphere. Though (ironically) I work with un-well people as a profession, the Women's Floor felt like a hospital, with tired people hanging off their beds, others shuffling around in an inadequate hospital gown, the halls cramped and the bathrooms dirty.

I have until now, Thank G-d, lived a healthy life, and had no intention of being hospitalized until the birth of my child. I am uncomfortable with the idea of being partially incapacitated, and needing help for basic functions like standing up and using the bathroom, even if it is just for one day. And I also don't know what the surgeon will find as long as he is poking around, that unknown quantity scares me most of all.

Monday, October 27, 2008

When is a Polyp Not a Polyp?

Answer: When it is the tip of the iceberg.

During my hysteroscopy today, the doctor discovered that the small polyp removed earlier this month was only the little bit sticking out from the neck of the cervix, and that in fact the much larger section is sitting inside, and blocking the neck. And probably stopping me from keeping my pregnancies, either by preventing the sperm from entering, or by excreting hormones which send mixed messages to my body and prevent implantation. (Kind of like the effect of an IUD.)

I wonder if the outcome of all these attempts at IUI would have been different, if the smaller polyp had been removed two years ago, when it was discovered by my gynecologist on a routine annual check-up.

So next Wednesday I have surgery, real surgery with anesthesia and recovery time, to remove this non-malignant growth and generally explore my innards. I asked the surgeon to break my hymen, as long as he was visiting anyway and I would be unconscious. He agreed, and I will then no longer be a technical virgin.

Polyps are certainly a better diagnosis than fibroids (with which my mother had suffered for many years) and yet I cannot get excited about surgery, no matter how beneficial it will be to my quest.

It's good that I will be asleep, as evidenced from my hysteria today, doctors make the worst patients.

Monday, October 20, 2008

Mom's Yom Kippur Epiphany

Through therapy but mostly life experience, I had long given up on changing my family, but especially my parents; parents and children tend to get locked in patterns that rarely evolve. My mother and father have known about my attempts to become pregnant, and the subject was stuffed away in the Denial Box. I figured that when the baby was a fact on the ground, they would accept their role as grandparents, or not.

Perhaps it is the season of introspection and forgiveness, or perhaps it was the ultimatum that I gave my mother; mainly, I told her (and I meant it) recently that I was a 40 year old grown up who did not have to ask her for permission to get pregnant, and that if she chose to sit in the corner and stew, it was her loss, not mine. But right before Yom Kippur, my mother and I experienced a break-through in our relationship, and specifically as regards the potential that I will become a mother myself before I become a wife.

We talked, she cried and apologized for her actions and words not reflecting her intentions. I told her that I was angry at G-d, the Universe and Everything for the loss of this last pregnancy, and that I felt that I could not sit and pray when "G-d and I have nothing to talk about." Mom may have been thinking that my lack of traditional participation in Yom Kippur prayers would send me straight to Hell, but what she said was, "I guess that is between you and G-d." ( I did fast for the occasion of the Day of Attonement.)

As much as I can feel the support of my parents from 6,000 miles away, it is a far better and more secure place than I have ever been.

Sunday, October 12, 2008

One More Chance

Despite the nurse's optimism this morning, I knew that I was not pregnant, and took the blood tests to check the beta hCG levels, which were as expected, negative. After a long consultation with the doctor, here is the current plan:

1. October: break time, due to Jewish holidays. I get to use this opportunity to take all sorts of lovely and invasive tests in preparation for switching from IUI to IVF.
2. November: last chance for an IUI cycle, aided by hormones, after which we switch over to the IVF plan.

Upside? Less lines for blood tests.
Downside? Many more hormones and a procedure of egg collection that will need to put me under anesthesia, and will put me out of commission for two to three days afterward.

I am very much hoping it does not come to that.

Monday, October 6, 2008

Return of an Old Enemy

On Sunday I literally vomited from the morning and through the night, and while a small part of me hoped that this was hell's version of morning sickness, it felt too much like the PMS I used to have as a teenager.

On Monday I was doubled over with pain, like a knife sticking into my stomach, a pain so bad I could not work.

This morning I got my period, and instead of being kind and loving to myself, I find myself being sad and quite angry at my body. And angry at the Universe for deciding that I do not deserve to have love in my life from a husband, nor do I deserve a child.

In this same morning, I was so distracted with my anger that I neglected to notice an open door on the porch, and walked into a pane of glass. Better than any soft break I ever did in karate. And the washing machine broke, and the hot water boiler needs to be replaced.

Hell of a way to go into Yom Kippur.

Thursday, October 2, 2008

The Not Quite Pregnant Test

I was supposed to go to the Hospital early this morning to take a blood test, to check my levels of Progesterone. Why? Because the level might say that you might be pregnant. Why? Because that is the procedure (arms folded in stubborn indignation).

I looked at the time, felt exhausted and asked myself why there was any reason to possibly boost my hopes when I could wait one more week, take the official betaHcG pregnancy test, and know for certain. I agreed with myself and turned over and slept for two more hours, and then went to the pool.

A morning well spent.