Acceptance

OK, so I have come to the conclusion that the impending operation could actually be a good thing. As much as I am loath to admit this, I have to accept it. for me, the biggest thing, is no longer about clearing out my blocked Fallopian Tube, it has become about learning the extent of the condition I have in order to understand the pain I feel.

I am "simple folk" really.It is a fact that endometriosis causes pain, which I often experience at the most inappropriate times - like after intercourse (poor Hubby feels absolutely awful when he notices the silent tears which force themselves down my cheeks uninvited!). But in my body, there isn't a real understanding in my head about why I can often be in so much pain, I have to drive with a hot water bottle hidden under my top, or be at work, and excuse myself to the toilet to hide, because the pain has been that intense, that sudden it brings tears to my eyes.

In this regard, I welcome the laparoscopic salpingostomy for the answers it will bring. And in this respect - I think I do need to have this procedure. As the pain intensifies, I have reached that place of needing to fully grasp why. I know what I know about endometriosis from the internet and great sites like, The Infertility Network or Endometriosis UK and I praise God for women who have walked this read before me who have recognised the need for answers and understanding.

But I need to know what is happening in my own body. As much as I am loathe to admit that this procedure is necessary in my Journey for Bubba.

Can Acne Really Be a Friend For The Journey?

I have recently come across something called "face mapping", which was developed by the International Dermal Institute for Dermalogica. It is a system of looking at what the spots on our faces COULD be telling us about our internal state of being.

Although there are as many ideas about what a break-out of spots in each of the zones on our faces mean, the thing which struck me, as someone who has one tube blocked,  is that according to the Face Mapping image which popped up on my Facebook page, the acne which arrives on my chin, on-schedule, every month, may actually be an indication of which side I am ovulating on.

The theory goes that if the spots on my chin (The chin being the place where we get the hormonal acne each month and so is the outward sign we are ovulating, as if most of us hadn't gasped that monthly annoyance ourselves!!!) seem to alternate which side they pop-up on, then this may be an indication of which side I am ovulating on.

Unfortunately, I don't know how true this is, so I don't know how valuable the information to those of us who are on a Journey for Bubba, but it could be that God has created it within our bodies, the ability for our inner-self to inform us physically of what is happening below the surface! How great that would be if it is true - and how I wish I had known sooner.

So, I can only remember the last couple of cycles, and the spots did seem to pop-up on different sides of my chin each month. This month, we have the right side with the delightful outbreak, last month the left side had the unsightly blemishes, and the month before that, I was trying to hide the right side, when having photos taken!

Now, I am no scientist. But at this stage, I am prepared to look for as much help as I can find in having success on this Journey for Bubba, and one of things I would find most helpful, is knowing which month I have ovulated from the "good", unblocked, fully functioning Fallopian tube, as opposed to the blocked, nonfunctional one. So, I am going to test this theory out for a while, it may help, it may not. But I feel a little "happier" at thinking that maybe my body is not against me after all, and is actually trying to help me on this path, rather than completely hindering me.

Results Day

This week has been a really difficult week on this journey. I had an appointment with the consultant on Monday, and found out - finally - the results of all the tests I have had. It was a difficult moment.

Hubby was with me as we made our way to the hospital. Other than what I had been told in part, we didn't know what to expect. I registered and we sat together in the waiting room, waiting for my name to be called. I have to be honest, as each minute ticked by, I was becoming more and more fidgety and more anxious at what he would tell me. What future prospects did I have, following all the investigations into my sub-fertility.

Finally, fifteen minutes later than my appointed time, my name was called. Hubby and I followed the voice into the consultation room and were greeted by a grinning consultant. Not the same one I had seen before, all those months previously, a different guy. But still a guy.

He advised me first of all what I already knew - that I had a blocked tube - but he didn't know what had blocked it. Then he told me something which totally broke my heart. "We know one tube is definitely blocked, this is usually an indication that there are problems with your other tube also. It looks clear on the x-ray, with the dye spillage looking normal, but there could be problems in your tube meaning it is not as clear as it should be.This also means you are at high risk of an ectopic pregnancy and we would need to scan you at six weeks - so as soon as you found out you were pregnant, we would need to book you in for a scan."

I had promised myself I wouldn't cry, but at that point, my world, my woman-hood, my future suddenly became unclear.

He went on, "Because your husband already has a son, I am afraid - according to the NHS rules, not my rules - you would not be eligible for help with IVF treatments. If money isn't an object, I would recommend referring you immediately for IVF treatment."

Hubby asked him, "How much would this cost?"

"£5,000"

"IVF is not an option for us" I whispered, as I wiped tears from my eyes. Hubby and I had spoken about this in the past - not because of the cost, but for ethical reasons which I will go into another time, I had already made the decision IVF was not an option I could take."

"That's not fair my wife has to suffer because of my previous relationship" Hubby responded.

We sat in silence for a while, tears rolling down my face. Hubby took my hand and squeezed it.

The consultant broke the silence, "This is the hardest part of what I do. For whatever reason you two have met each other later in life, and now it feels as though you are being punished because of the rules of the NHS."

I don't believe for one moment God is punishing me. I don't know why this is the journey He has chosen for Hubby and I to walk on, but I believe He is with me every step of the way. God isn't a cruel God who will punish me. He forgives our sins, removing them as far as the east is from the west. We have all sinned, we all fall short of God's standards, but through Jesus, we find true forgiveness and a hope for our future. I silently disregarded what the consultant had said about this feeling like a punishment. It doesn't. It feels like a difficult season in my - our - life. 

"So what other options are open to us?" I asked the consultant.

"Well, I can add you to the waiting list, and I can perform an operation to go in and physically unblock your tubes. There will be four keyhole incisions made in your abdomen," he pointed to the four areas on my belly,"I would cut you here and then see exactly what your tubes look like and clear them as best I can. The success rate for my operations is that about 80% of the women who's tubes I operate on go on to conceive."

"What's the success rate then for a successful pregnancy?" I asked.

"About half that amount."

Again there was a heavy silence in the room as I processed this information.

"If you did want to avoid the surgery, if you were to say I really can't handle having an operation, then I would give you a course of fertility drugs, but could only prescribe them to you for six months."

"And what's the success rate of that?"

"That's really difficult to ascertain because we don't know the condition of your tubes, and because of your age, but again about 40% success for a full-term pregnancy."

We eventually left the room with this information heavy on our shoulders, and the decision weighing on my mind. As soon as I got home, I broke down and sobbed. There was no other reaction I could manage. I couldn't speak to anyone, I didn't reply to any of the texts I had received asking how it had gone. I just sobbed, with God. It isn't fair. It's not supposed to be like this. 

I've not yet made a decision - I don't know what I'm going to do. I just need to hear a Word from God to hold onto at this time. He is, after all, the Creator of life.

What Causes a Blocked Fallopian Tube

After receiving the news a few weeks ago that one of my tubes is blocked, and having not yet received a follow-up consultation where I can find out more about the condition (a follow-up ultra-sound appointment though), I decided to find out more myself.

I'm so not medically minded, and sometimes looking for this kind of information can leave more questions than answers, but nevertheless, I need to know what is happening, and whether it can be "fixed".

One of the first things I discover is that a blocked tube is one of the biggest and most major causes of fertility problems in women. Lucky me! And it seems that there are a variety of types and causes! Again, lucky me! I obviously don't know what "type" of blockage I have, nor of the cause of it. The most likely, coupled with the other symptoms I have experienced (including excruciating pain at inappropriate times), is endometriosis, which is an inflammation of the inner lining of the uterus, where it forms outside of the uterus, eg on the tubes. Endometriosis accounts for around 30% of the infertility problems women suffer. But not every woman who has endometriosis will struggle to conceive (the figures I have found fluctuate between 30% and 50%).

If this is the cause of the blocked tube, then it is a relief to know only one is blocked. But will the second tube become blocked also??? The only way to "fix" the problem seems to be through surgery, or through IVF treatments (which isn't really an option for me, for reasons I will go into another time). Should I just rely on the other tube functioning properly or should I be considering surgery?? Does it really make a difference? Again there are conflicting views where some say the surgery makes a woman more fertile for a while after it, while others say it may not necessarily fix the problem. Mild cases of endometriosis can be treated for a year or so of fertility drug treatment.

Symptoms of endometriosis include: extremely painful period cramps, heavy periods, pain during intercourse,  pelvic pain outside of the monthly cycle, constipation and/or diarrhea, blood in urine, pain when going to the toilet and a family history of it (please excuse me if I don't go into any detail about my own symptoms!!).

The future certainly looks bright, doesn't it! At least, at the moment, I have one tube which is unblocked. Until I have been through the ultra-sound scan, I won't know what the blockage is, how badly it is blocked, or whether it can be fixed. I am just waiting in limbo, with the knowledge that for whatever reason, my body isn't working properly at the moment.

As I researched blocked Fallopian Tubes, I found there are other causes which may help to explain other women's difficulties (I say other women, because many of the symptoms I have been experiencing line up more with the above than what I am about to outline below).

The most common is Pelvic Inflammatory Disease (PID). This is a bacterial infection of the reproduction system, sometimes, though not always, caused by STD's. Other causes of PID include childbirth, miscarriage, abortion, IUD (an internal contraception) insertion, or even the HSG x-ray, such as the one I described on 25th October. The symptoms of a PID include: irregular periods, unusual discharge from the vagina, problems when going to the toilet, flu-like symptoms such as fatigue, lack of appetite etc...

The most common STDs which can cause blocked tubes, if left untreated are Chlamydia and Gonorrhea - information about these conditions is widely available on the net, but when not "caught and treated" in time, these "silent diseases" can cause infertility. I say silent because, as a recent NHS campaign to highlight these two STD's have been trying to encourage girls and young women to get checked out on a regular basis,symptoms are often non-existent. Saying that, some women have experienced some of the following symptoms of Chlamydia include: a yellowish discharge, painful or frequently going to the toilet, a burning or itchiness around the vagina area and abnormal bleeding. Some of the symptoms of Gonorrhea include: discharge burning sensation when going to the toilet, pelvic pain and bleeding in between periods.

Other causes of a blocked tube include a history of a uterine infection as a result of abortion or miscarriage, a history of a ruptures appendix, previous abdominal surgery, an ectopic pregnancy in the past, or other surgery involving the Fallopian tubes.

Now depending on the cause, will depend on the treatment, including fertility drugs, surgery or the flushing of liquid through the tubes. But the most important thing is, if you suffer anything which is abnormal, painful or unusual, it is so important you get it checked out, as with many of these things, the earlier they are caught, the easier it is to treat them and the less long-term damage they causes.

Hysterosalpingography - AKA: HSG

It has taken me a while to come to terms with this particular aspect of the journey.

The X-Ray, known as Hysterosalpingography or HSG for short!

So it all started on the first day of the "new" cycle, when I had to call a number linking me directly to the radiology department at my local hospital in order to book an appointment between days 10 and 14 of my cycle.I actually couldn't get through, as it was late afternoon by the time I tried to call them, so I called the next day - day two of my cycle... time was ticking!! The lady I spoke with said she would need to check with the nurses to find out if there were any clear spaces in the appointments diary, and would get back to me after taking my details. She also told me... sorry advised me... that intercourse from now until I'd had the HSG. I had some important meetings that day, so nervously explained to my manager the situation and asked if I could be excused when the call came through... It's funny how often I checked my phone throughout those important discussions!

No call came through.

Day three arrived and again I waited anxiously to find out when I would be expected to attend. By lunch time I wondered if they'd forgotten and what the protocol was for calling back! And then I noticed a voicemail had been left on my phone. It was the hospital. They had an opening next week and would call me again to arrange the time for me to attend.

I did think it was a bit strange they had an opening but not the time - surely the opening included the time of the proposed appointment...?? I guess that's why I don't work in healthcare!

So... more waiting... more checking of my phone, into the weekend... If I hadn't heard after the weekend, I determined I would call them to find out what time I would be required. I'm uber-organised and like to plan ahead. I like to know what I am doing and what is expected of me well in time. Finally, on day seven, a letter arrived in the post from the Radiology department. My appointment had been arranged for 10:30am on what became known as day 11.

A couple of days before the appointment I had to pick up the prescription given to me by the consultant for some antibiotics. The antibiotics are to prevent infection from the x-ray procedure and needed to be taken two hours before I arrived for my appointment! The chemist had to order them, as they didn't have any stock, and for the sake of two tablets, I was hit with a huge NHS bill! There goes the Chinese take-away I had been planning for after the x-ray!! Lol! When they arrived, it turned out that the two different types of tablets ended up being a total of nine tablets to make up the prescribed  amount of 1000g each.

Then on day nine, I received a call from one of the radiology team, asking if I would mind changing my appointment time from 10:30am to 9am. Wahhh!! My day-off lie-in... disrupted!!! "Sure," I replied, "I may as well get it over with sooner rather than later." Oh man! Because I had to take the tablets two hours before  I was due at the hospital, that actually meant a 7am start! Lovely!

I don't think I slept much the night before. I don't like the unknown and tomorrow's procedure was a total unknown. All I had been able to do is read the information pages I had been given and do a Google-search to find out more about what a HSG was for, what they do etc....

So, when the alarm went off in the morning, I yawned my way down to the kitchen to have breakfast and the antibiotics. I don't normally have breakfast as soon as I wake up, so this with the combination of all the water made me feel really uncomfortable and nauseous. According to the paperwork, they needed me to arrive with a full bladder. This was so they could test to make sure I wasn't pregnant. No chance of that if we've not been able to... you know... before the x-ray. Have you ever needed the toilet so much you might be sick??? Yeah?? That was me!

Hubby had agreed to come with em, so we arrived at the hospital at around ten to nine - and realised there were two radiology departments on the map I had been sent. Neither of which was highlighted to be the one I needed to head for. One was the "Out-Patients Radiology Department" the other was the "Main Radiology Department". As I was an outpatient, I headed for there. There was no one in the reception area, but a little dinky bell with a sign saying "Ring for attention". So I did. A girl came out and I showed her my papers and asked if I was in the right area. She said she was new, and would need to check, so she disappeared, coming back about two minutes later to tell me I was in the wrong Department. She directed me to the Main Radiology Department and hubby and I made our way. I was now two minutes late for the appointment! I hate being late! So not cool!

I arrived at the second reception, and the lady who was there was on a call. When she finished, she took my details and invited Hubby and I to sit in the waiting area opposite her. Which we did. And waited.

A nurse came out and called my name. Hubby asked if I wanted him to come in or wait where he was. I asked him to come through, but the nurse told him he couldn't as there were other patients around. It wouldn't matter though as I was just going to have my sample checked. So I gave a last look to Hubby before walking through the double doors.

The nurse asked me to give her a sample, handed me the bottle and a wider dish to pee into, then showed me to the toilets. I duly did as I was told in private, and then emerged from the toilet to hand her my sample. She tested it to makes sure I wasn't pregnant. I wasn't (what a surprise!!).

The nurse then asked me to follow her to a cubicle where she explained what was to happen. I needed to take off my own clothes and dress in the attractive hospital gowns, complete with unattractive slit at the back. You get the picture! Yeuch!!! It was cold in there too!! Before I undressed, I went out to where Hubby was waiting to give him my rings and necklace. I told him I was about to go in and asked him to pray for me as I was quite anxious. He reassured me I would be OK but he would pray. Love that man!

After undressing, my clothes were placed in a plastic basket with a handle. It really resembled a supermarket shopping basket!! So the nurse made a joke with me about it when we were going into the x-ray room. I followed behind her like a lost puppy, silently praying Jesus would come now so I wouldn't have to go through with this. When we reached the x-ray room, I was introduced to the Radiologist and her female assistant. Phew! I was dreading a male being involved and relaxed a little. Not a lot though.

As the radiologist prepared the equipment, her assistant went through a checklist of stuff with me, including checking Hubby and I had refrained form intercourse, what date I'd started my last period, that I was between day 10 and 14 of this cycle. She explained the procedure, then asked me to sign the card to say I was happy to go ahead with the x-ray.

I then was invited to climb onto the bed in the middle of the room, complete with a pillow in the centre. "I need you to pop up on here, and we'll arrange you so your bottom is on the pillow." I tried to get settled into position as elegantly as I could muster. the gown was removed from under my bottom and the two ladies continued to prepare for the procedure.

Now... if you don't want to know all the graphic gory details, click away now!!

When they were ready, the gown was moved to my stomach area, and as with a smear test, ankles were brought together and knees maneuvered flat toward the bed... as far as I could - I'm not as flexible as I like to think I am!! Some large, white, disposable sheets were placed around my lower body to preserve my dignity as much as possible in that situation. The Radiologist explained she was about to insert a speculum, which will allow her to see where she is inserting the catheter. Before she did that she used an antiseptic cleaning wipe, apparently this helps to minimize the discomfort of the procedure  When she inserted the speculum, it was ice cold. Being the first patient of the day, clearly the thing had not been brought up to room temperature. This was really uncomfortable and added to the discomfort of tube being inside anyway! If you've ever had a cervical smear test, all of this so far will be akin to what you have experienced.

The catheter followed and was positioned, although the Radiologist did struggle a bit to insert this thin tube into the uterus. When she removed the speculum, the catheter popped out. I don't think it was supposed to do that! So the whole procedure was repeated. Painfully. But this time the Radiologist decided she would leave the speculum in place so as to ease the pain of removing it, and in case it caused the catheter came out again.

She then inserted the dye through the catheter into my uterus and took x-rays of the images being produced. When the dye went in, the cramps added to the pain of the speculum really wasn't pleasant. Then the speculum fell out, bringing the catheter with it. OH no!!! I hope they don't have to do it all again.

The Radiologist checked with her assistant that they had enough images, and upon checking affirmed they wouldn't need to try again. What a relief!

The white disposable sheets were removed so my legs could stretch out and the gown replaced to cover me again. Together they checked the images, while they blocked my view and encouraged me to relax.

Then the images were shown to me. The results of the HSG were given to me. Alone. While Hubby was sat in another room. I wished he'd been with me. To hold my hand. To wipe my tear at the bad news. One blocked fallopian tube and I am at high risk of ectopic pregnancy. She said she would be recommending that I be sent for an ultrasound to see in more detail the cause of the blockage.

I was helped up from the bed, offered a hot drink and led to the bathroom with a towel, a disposable sponge which became soapy when held under water and a sanitary towel to catch the dye when it fell out again.

In a daze, I went into the bathroom, cleaned myself up and changed into my own clothes. In a daze I sat down and obediently drank the hot water they had left for me. In a daze I wished Hubby was with me. In a daze I wondered what this meant. What had caused the tube to be blocked. Had it always been blocked? Had it become blocked? Can it be unblocked? In a daze I smiled back at the nurse when she smiled at me. In a daze I returned the cup to the nurse and asked if I could leave. In a daze I walked back through those double doors to where Hubby was waiting. In a daze I observed the row of men who were also waiting for their wives and girlfriends, and located Hubby. In a daze I took his hand as we left the hospital. When we sat in the car I told him what I had been told. He had questions, but we had no one to answer them. So in a daze we drove away.

For the rest of the day, and the following day, the pain from the procedure was quite intense. I curled up on the sofa with my hot water bottle till we had to go out. I think at one point the pain was so bad I just burst into tears and Hubby prayed for me.





It took four days before the news actually hit me.

It's taken longer for me to come to terms with it, as I wait for the consultant to send me details of my next appointment so we could have our questions answered. Until then I don't know why or what can be done.