Cervical Stenosis

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No new news.  I thought after I started spotting last night that would be the end.  I feared waking up this morning.  But since it has been all day and no spotting or cramping at all.  I did take a pregnancy test (like I mentioned before I have about 100 of them under my bathroom sink because they come with every OPK I order).  The line is now lighter than the control. :(  Meaning my hCG levels are dropping.  I think this baby is gone.  

I thought I would mention why I am all for D&C from my last post.  This is a TMI post, warning now.  I have Cervical Stenosis.  When I was 19 I developed Cervical Dysplasia, abnormal cell growth on my cervix.  It is what is between normal cell growth and cancer, sometimes called pre-cancer.  I had a LEEP to remove these cells.  A LEEP is great because it is the most effective treatment of all the ones out there for dysplasia.  Most people only need one to get rid of the cells, except if you are unlucky.  When I was 24 my dysplasia came back and I went for my second LEEP.  This one didn't go over so well.  

I noticed the few times I did get my period I was in extreme pain.  I'd bleed red for a day, then brown.  It was followed by extreme cramps.  Eventually I would start bleeding red again with tons of clots, but the pain would go away.  One time I remember the pain being so bad I could barely walk but my husband forced me to.  All of a sudden my pants felt so warm and wet.  I thought I peed only to go into the bathroom and find tons of blood.

I mentioned this to my past OBGYN and she passed me off like some other crazy women complaining about mild cramps.  Then in a pap smear she couldn't find my cervix.  When she finially did she mentioned it was very scarred.  

Over the next year I learned I have a condition called Cervical Stenosis.  This is a very rare risk to having a LEEP (or two) done.  My cervix is mainly scar tissue now.  Like most scar tissue it is much tougher than the original.  The opening in my cervix is very narrow.  

When I get my period and it starts to clot then my cervix "clogs" and doesn't allow anything to pass, so my flow up stops.  But my uterus is still going, it cramps more and more causing extreme presure.  Eventually the "flood gates" open and all is well again.

Also many procedures where tubes are inserted past my cervix are painful.  Last September my HSG got canceled after the RE could not insert the small tube into my uterus.

I'm assuming a 6 week old embryo and everything that goes with it is larger than the standard clot.  I'm worried my cervix will not know to dilate, or do anything to let this thing pass easily.  I'm worried about the pain.  I'd rather be knocked out and have a D&C.  I'm going to talk to the RE when I go in for Tuesday's u/s.

-Selbe

Ultrasound in the Morning

OBGYN - I never called them back.

RE - I go in tomorrow morning (7 weeks, 6 days) for another u/s (probably instead of the one that was scheduled for next Tuesday).  My RE has offices all over New England, including about a half hour from here right next down the road from my work.  Very convenient!  Except some days, like tomorrow, no one is in that office and I'm sent to the main office instead.  In a different state, a little over an hour from here.  I hate the drive, it's right outside of Boston.  But I suck it up.  And on the way back I pass one of the few Sonic restaurants in all of New England, you know the rest of the story.  

Best Case Scenario - They find a baby (or two) that actually looks 7 or 8 weeks and has heartbeat.  

Worst Case Scenario - They find the same thing they saw two weeks ago, just the 5 week sac.

Still no cramping though.  I figure I'd be in extreme pain if my body was trying to export a baby due to my cervical stenosis.  Even simple period clots are made extremely painful with this.  I don't see anything anymore when I wipe (brown or red), and nothing on the pantyliner.  Just when I check my cervix (which is still high and hard today).

-Selbe

Cervical Cancer Awareness

I'm pretty sure this is PMS rant week for me.

I HATE breast cancer awareness games on Facebook.  I really wish people would not send them to me.  I wrote a whole long post back in September about the last "game" since it caused more problems than good.  I read some of the posts about women who have or have had breast cancer and their thoughts on it.  Most were more hurt than anything since the cancer has robbed them of their own fertility. 

I understand the need for awareness, I don't mind the little pink ribbons everywhere.  But breast cancer is not the only type of cancer out there!  All of us have been affected by cancer, whether it be ourselves, family members, friends or pets.  Maybe it was breast cancer, maybe it was another type.  

Sometimes I wear a teal ribbon.  People ask me what it is for because they "have never seen that colour before."  My teal ribbon (or teal mixed with some other colour) is for cervical, ovarian,  and endometrial cancer, along with PCOS and infertility.  I was going to post about something completely different today but now this is going to be all about cervical cancer since that is what has affected me the most.  It never gets awareness, no one ever talks about it, and I hear so much information that is WRONG about it.

August 2004 - I was 19 when I went to PPH for my first pap smear.  I really only wanted birth control pills, they made me get the stupid pap.  It came up abnormal and I was told to come back for another in six months.

December 2004 - Second pap also abnormal, I'm told I carry HPV (Human Papillomavirus).  Everyone that gets two abnormal paps is labeled as HPV.  I was heartbroken to know I had an incurable STD.  (That was also the least of my worries.)  After that I was sent to a real OBGYN where I "hung out" for the next several years.

January 2005 - Colposcopy.  I went alone since my mum was gone years ago and my ex dumped me the month before.  FYI a Colposcopy or Colpo is a biopsy of the cervix.  You are in stirrups, cervix is giving a shot to numb it, vinegar is placed on the cervix (which turns the abnormal cells white), and a biopsy is done at different locations on the cervix.  It's done by a long stick that kind of sounds like nail clippers to do the biopsy.  Then the little chunks of your cervix is stuck in jars (labeled with whatever o'clock they are) and sent to a lab.  A solution is put on your cervix to stop the bleeding.  You are awake the whole time and are sent home right after.

February 2005 - LEEP.  My biopsy came back as CIN III severe dysplasia high risk.  FYI a LEEP or LLETZ is removal of the cells from the cervix.  Stirrups, numbed cervix, sticky pad put on your butt to "ground" you and an electric wire loop is used to cut away the bad cells.  More solution to stop the bleeding at the end.  Same as a Colpo, awake for the whole thing and sent home same day.  Although some doctors put women out for it, I've always been awake.  A LEEP is bad because it takes away the most amount of cervix out of other treatments used, a LEEP is good because it has the highest success rate.  

And then I had many more pap smears and Colpos over the years, some of often as every three months since they kept coming back abnormal.  I really don't remember how many I've had since I lost count.  But I'm pretty sure at times my OBGYN saw more of me than his pregnant patients.

I was 20 with CIN III.  This is all I ever knew at the time and it was all normal to me.  I was OK with it.

June 2005 - HPV test came back negative.  Dr. M said 1. I still carrying the virus but it was in the dominate state; or 2. I never actually had it in the first place.  He also said it didn't matter ether way since 80% of the population has the virus.  FYI HPV is an STD that causes warts, cancer, warts AND cancer, or nether.  Most of the time it is undetected, especially in men.  There is no cure.  And I have never had genital warts, incase you were wondering.

LEEP usually has the highest sucess rate.  After a couple years I was finally cleared to have paps every six months.  And then it came back.  I cried at work one day and no one knew why.  I wasn't crying because of my abnormal pap, the Dr telling me I need a Colpo or the physical pain.  I cried because after years I needed to go through all this shit all over again.  I was 23 at the time.

August 2008 - Another Colpo, only CIN II this time.  I've "improved", but I still need another LEEP.  PPH told me I was their most calmest patient ever for a Colpo and even let me play Tetris on my iPhone during the procedure.  

February 2008 - My second LEEP.  The Dr. told me with my overall health and age that this was very rare and I was just really unlucky.  Great.

Since then all my paps have been normal.  I'm still in shock to this day and tell them I don't mind coming back for another in a couple months.

With cervical cells there are three different groups.

• Normal
• Dysplasia AKA pre-cancer (CIN I, II, & III)
• Cancer

A lot of times it is slow moving and it would be able ten years before I actually died from it.  With Dysplasia CIN I and II it can even go away on its own in some cases.  But with CIN III if you wait long enough it will most likely turn into cancer.

What about the cervical cancer vaccine?  People ask me about this.  Sometimes they even replace cervical with ovarian or another type of cancer.  First off I have never been given the vaccine.  I'm old and when it was being developed I had already had my first LEEP.  So it was too late for me and I've never had an OBGYN bother to push it.  Second it is labeled wrong.  It is not the cervical cancer vaccine, it is the HPV vaccine!  The vaccine makes it so you do not get the six most common types of HPV.  But there are over 100 different strains of the virus.  Just because you are vaccinated doesn't mean you won't get HPV.  Just because you don't have HPV doesn't mean you won't get cervical cancer.  Often times when people think of a vaccine they believe that having it means there is a 100% chance they won't get whatever they are vaccinated for.  People even think that with the common flu vaccine, then don't understand why they do end up with the flu later on.  I worry about the HPV vaccine being marketed as the cervical cancer vaccine.  Will women now believe they won't get such cancer?  Will women skip out or wait longer between pap smears because they don't think they will get it?  What if they wait and it's too late by the time it is caught?  I fear the cervical cancer vaccine will cause more problems down the road.

This is my story.  Although I am safe now I am never out of the blue.  I am left with cervical stenosis.  I've never had full blown cancer, I've never had any parts removed due to it.  However, I'll never bitch about how "painful" or uncomfortable a pap smear is ever again.  Those who do are all fucking babies.  (Except the OBGYN that tried dilated my cervix with her fingernails since she couldn't find it during a pap smear last year.  Yes that was painful.  Bitch!)

It shouldn't be all about breast cancer, breast cancer and breast cancer.  So many other types need awareness too.  

-Selbe

CD2, yeah AF arrived!

Post-Op & Planning Appointment 11/3

The Surgery:

It went well.  I recovered quickly and he didn't even look at my stomach at the appointment.  I guess the stitches (?) is suposed to fall off or go away on it own.  I've never actually had stitches before.

RE talked about the same things from the pictures before.  

Right Fallopian Tube:  Eh but he's not too concerned the risk of an ectopic pregnancy.

Uterus:  I have an hyperplastic endometrium.  Not too much of a concern though.  The biopsy of it came back normal.

"a condition of excessive proliferation (cell growth) of the cells of the endometrium (inner lining of the uterus.)...

...result from high levels of estrogens, combined with insufficient levels of the progesterone-like hormones which ordinarily counteract estrogen's proliferative effects on this tissue. This may occur in a number of settings, including obesity, polycystic ovary syndrome, estrogen producing tumours and certain formulations of estrogen replacement therapy." - Wikipedia

Cervix:  I also have cervical stenosis as "very little normal cervix was remaining" and it was a bitch to dilate.  This was already assumed for awhile.  My cervix is scarring over and the opening is very narrow.  This is why cramps are so painful to me and my HSG was a trip from hell.  It's complements of my LEEP in 2005 and 2009, but mainly the second one.  It's a rare risk of having a LEEP done but of course my body loves to be "rare".  I forgot to ask Dr. H about the possibility of having an cervical cerclage put in if I do get PG.  The actual thought of having my cervix stitched closed terrifies me so we will put that thought off for awhile.  FYI a cervical cerclage is used in women that have a incompetence.  The cervix begin to dilate way before it should, maybe times due to the weight of the growing baby.  It results in miscarriage or early labor.  The cervix is stitched closed around 14 weeks and the stitches are removed around 37 weeks.

Ovaries, left fallopian tube and vagina are all good.  Fuck something semi works.  

What's Next?:

I have CD21 Progesterone BW next Monday.  I need to have at least a 3.3 to have ovulated, even if it's a crappy ovulation.  No 1.7!  A 10 is ideal for a non-medicated cycle.  (It was 15 when I was Clomid or if I'm on any other drugs.)

And then I need to decide, ovulation or not.  No ovulation then Provera will be my buddy again.  

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Dr. H began talking about doing an IUI (intrauterine insemination).  It's a couple types of shots and then Bean's sperm is poured into my uterus once I've ovulated.  My cervix hates me and I fear having another tube stuck up it, even though the RE assures me it is much smaller than the one for the HSG.  The cost is between $2000-2500 which will not include my meds, an additional $500.  But spending $3000 does not 100% get me a baby, only about a 17% of one.  So odds are I'll need multiple which is $3000 each cycle/month.  

And then there is IVF.  We are not even going to get into that because each cycle costs $12,000.  Again no 100% guarantee.  But if I buy two (results in BFN) then the third if free.  How nice of them!  If I spend $24k I'd better get a lot for free, along with a free crib, stroller and all the other stuff.  We can just pretend like this doesn't exist for now, like the cerclage I'll probably need.

My insurance will NOT cover any of my meds used for an IUI or IVF.  In fact they will even refuse to pay for basic U/S and BW.  They want no part of it.  (Then again my infertile ass is expensive, I don't want to pay for me ether.)  But they will cover my meds for timed intercourse (TI).

So for TI it is the same meds and monitoring as an IUI.  Except when I ovulate I have sex like a normal person, you know penis in the vagina, no tube of sperm in the uterus.  I'd like it to be as normal as possible.  This has a lower success rate but then again it's a lot cheaper.  

The meds I'd use for the TI (or IUI) are:

Gonal-f RFF Pen 450 IU @ 75iu/day - Daily injection used for ovulation induction (OI) with FSH hormone from CD4 for a week or two.  This makes my ovaries produce lot 'o eggs.  This is much like Clomid but for those who don't do so well on it.  I can't wait to stab myself in my stomach!

Ovidrel - Once injection of HCG hormone for my ovaries to drop all the eggs.  I'll be monitored with several U/S to see when my eggs have fully matured with Gonal, then this shot is used.  

I might be on Progesterone also to reduce the risk of MC since my body doesn't produce enough of it on its own.

The injectables come with a higher risk of multiples.  I'm pretty sure it made Bean worry a bit when the nurse said that.  But it's a 10% chance of twin, and much lower for triples and so on.  She let him know there wouldn't be six which I'm sure he was picturing in his head.  To be honest we are both pretty excited for twinkies!

Decision:

I'm going to see what the Progesterone comes back as.  If it's good then I'll hang out on Vitex and hope to be normal for awhile longer.  Or I'll move to TI with the injectables.  If it's too low then I'll definitely be moving to TI.

I'm not ready for IUI.  We have the money but I feel I haven't had enough time having natural sex to have given it a good shot.  I've been having unprotected sex for over a year but very rarely have my ovaries actually released eggs.  And a couple my age only has 20% change each time with perfect timing.  

I'm also waiting to move since our new home (hopefully) has an Army base that does IVF at a discounted rate and includes the drugs.  

Bean is most likely going to be sent back out to sea in the spring.  I can do IUI and IVF while he is gone with his frozen sperm.  I'm going to use the "fresh" stuff now.

If TI works:

I'll have BW for check my betas (PG test) 14dpo after each TI cycle.

I will stay at my RE until 8-14 weeks before being sent to an OBGYN.  My first fetal U/S will be at 6 weeks, then one or two more at a later date before going to the OBGYN.

-Selbe 

CD19, 4dpo

Oh Menstrual Cramps!

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I have two types of menstrual cramps.  The standard cramps and the give-me-the-knife-I'll-cut-my-uterus-out-myself cramps.  There really is no in between for me.

The standard ones are not that awful.  They come to visit almost every cycle and with some meds I forget they are even there for a few hours.  I can still function normally.

I've only had two cases are really bad cramps in my life, both within the last couple years.  For the longest time I would make fun of women that would call out of work and other events for cramps.  What a bunch of wimps.  Take some fucking Midol and quit complaining.

(This is the part of this post that becomes TMI.)

My AF starts out brown and then turns red (like everyone else).  But then CD2 or 3 it turns back to brown and stops completely.  (Super short?)  Then the pain comes.  I'm ether laying on the bed in the fetal position, pacing in circles or somewhere in the middle.  Ether way I can't lay/sit/stand in one position for more than five minutes.  I've tried all the meds, heating pads, walking, orgasms, etc.  Nothing works.  I can't function and all I do is cry.

This goes on for several hours and I'm a mess.  And then my pants begin to feel really wet and warm.  I second guess the thought I might have peed myself.  But it's not that, it's blood and it's everywhere.  The pain starts to go away immediately.

I've mentioned this to two OBGYNs for far.  During my last pap smear my doctor said she couldn't find my cervix.  Kind of weird but said it was very scarred over and the opening was very small now.  Something called Cervical Stenosis that came from my second LEEP not healing correctly.  Possibly my cervix is closing and opening over and over again.  Or the clots are clogging it and stopping my AF.  I'm not sure.

I've never gone to the ER for ether of these cases.  It's come across my mind over and over again.  But I think that are just cramps, everyone gets cramps.  I'll just be wasting their time and they most likely won't be able to do anything for me anyways.  However, sometimes I think if I go maybe they'll give me an u/s or look at my cervix and can figure out why I'm in so much pain.  I'm torn.

I thought I'd write about this today since I had a feeling the Provera would give me stronger cramps than normal.  And it has but nothing too bad.  I have my Midol and warm laptop on my abdomen.  

Hidden Text: Dr., Portsmouth Naval, Lisa Tabenken