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My first procedure

October 9, 2011

grayhairedmom.comThe checklist of procedures we received covered a wide variety of tests: bloodwork for communicable diseases including HIV and hep C; bloodwork for diabetes, cholesterol, and hormonal screenings; standard yearly tests such as mamogram and pap smear; and then for those recipients over 45 years of age, 3 additional tests–EKG, chest xray, and an echo treadmill stress test.

Since D had already tested fertile, the obvious starting point for me seemed to be the SHG, saline something or other, which examines the structure of the uterus and will pick up on obvious physical problems that would make carrying a baby to full-term improbable or impossible. Why undergo anything else before I knew that I at least had the potential to carry a baby.

Anyone who is as afraid of doctors, dentists, and tests as I am develops a sense about just how awful a procedure will be–the more soothingly a medical professional talks when he or she discusses the test, the more horrible it will be. I definitely picked up a vibe about this SHG. Just the description did not sound fun. You schedule it on day 10 of your cycle and it involves having your uterus filled with saline solution and then having a probe inserted so that the doctor can examine the walls and anatomy. Plus, you take antibiotics beforehand to prevent infection, and you are also advised to “take a tylenol” and hour or so before you go in for the test. Tylenol? Seriously, I was going for something a bit stronger than tylenol if someone was pumping my uterus full of saline. Minimum, prescription strength aleve or a vicodin, maybe.

To demostrate just how doctor-phobic I am (was?), it took me two months to actually schedule the exam. Because of the timing required, you call a special number on day 1 of your cycle. The receptionist is trained to understand the time-sensitivity, i.e., to get you an appointment with the next available doc for the appropriate day.

So, cue my period at the end of August, 2008. I got up the next morning, checklist in shaking hand, and called the number. I tell the receptionist that I’m supposed to schedule an SHG. She said, “Do you mean an HSG?” I read off the checklist, “saline hyster …..whatever.” She said, “we don’t do those here, call this number.” The woman who answered at the second number asked which test I wanted to schedule. I told her an SHG. She said, “we don’t do those here” and told me to dial the first number again. I took this as an omen and decided to wait until the next month.

End of September, first day of my period, and it just doesn’t seem right to me, again. I can’t really explain the foot-dragging, other than to say that I didn’t quite feel ready, yet. My insurance did cover the diagnostic pre-testing, so other than co-pays, no money was required to start the testing, which was good because we didn’t have any.

But probably the real reason was, at this point, D and I had been together for almost 3 years and although we were going to undergo IVF, we had never had a discussion about our long-term potential. I know, that sounds incredible, but 3 years for me is a very scary time in the relationship. I had had a few previous long-term relationships that ended at almost exactly at the 3-year mark, and always because I chose that time to push for a more solid commitment. Once (or twice or three times bitten) twice shy, right? We celebrated our actual 3-year anniversary in early September of 2008 with a romantic dinner on our roofdeck, but still no discussion at all about the future. I started  to have real doubts that D was not on the same page. Then again, I thought maybe he was waiting to see how serious I was about going through with the IVF before committing.

So, end of October, and now D has noticed that it’s been 3 full months since our initial consultation, he’s been tested, I’ve been tracking my ovulation since June to try to maximize any small chance that we might conceive naturally, but I haven’t started any testing. Dr. Nakhuda told us that the average time from initial consultation to embryo transfer was 4 months. Here we were in October already and I hadn’t scheduled test 1.

At the same time, another potential problem was beginning to show–the housing and financial crisis (brought to us all by that dope, GWB) was finally rearing its ugly head in the NYC real estate market. The estimated out-of-pocket cost for treatment was 31K. We had planned to refinance the apartment and take out equity to cover the costs. D took on the financial wheeling and dealing as his sole responsibility, especially since the apartment was his property. Remember–not married yet, so technically I’m D’s tenant. Also, technically, could I be considered D’s surrogate, which I pointed out one night in an effort to spark a discussion of long-term thinking, with no luck.

So, just as we start the refi ball rolling, the housing market collapse reaches NYC, changing the valuation on the apartment downward. Fortunately, we were still “above water” and actually in profit territory, but the equity we had planned to pull out wasn’t there anymore. In other words, we could refinance and take advantage of lower interest rates, but we could not pull 30K out of the equity. Dead in the water. For about 24 hours. Until our guy at the American Broadcast Employee’s ( credit union (yay credit unions and boooooo! banks) called and said he reworked some numbers, and we could get 30K after all.

But first things first, we didn’t need to hand over any cash until we had passed all the tests and we were matched with a donor. That could be months down the road, so no reason to put off testing any longer.

The next month, I was determined not to chicken out or let any obstuctionist receptionist stop me. I called early one morning before leaving for work and got an appointment for my very first test on October 31, 2008.

That morning I woke up, took an aleve, an antibiotic, and had a cup of coffee before I remembered that the procedure is considered minor surgery, and I wasn’t supposed to eat beforehand. Would I have to wait another month?

Here’s where I have to admit to something that Ive never admitted to anyone before, not even really myself. I might have been looking for an out sign from D. I had had about six years to come to terms with never having a baby. After 2001-2002, when my back went out and I didn’t walk or work for months, I came to the conclusion that it was too late and that I couldn’t afford to have a baby alone. Most days I was OK with it most of the time. But D wasn’t there yet. Even at 45, after his divorce, he expected to meet someone with whom having children was a possibility, I guess. Even though we never had a flat-out discussion about it, I thought I had been pretty clear when on our second or third date, I told him I was having hot flashes and was in perimenopause. He didn’t run, so I assumed he was OK with knowing that I was past it. I’m not sure even now if I can speak for D and explain why he stayed with me if he still wanted children. I’d like to think that it’s because we are so good together and that he loved me and us enough to give up on having children. I think that’s it, but I’ve never asked him. (Have I told you I’m of Irish ancestry–not big on the talking….)

Deep, deep down, I wasn’t sure that either of us would be able to handle the changes in our lives or keep up with a baby. I was terrified, really, of all the tests I had to take. What would show up in all this testing after the kind of fucked-up stuff I’ve done for most of my life? I was especially horrified about having to have a chest xray. I’ve never had one, I’m a former smoker, and a recovering Catholic (stopped going to church except at gunpoint at about 13 or 14). Even though I’m an atheist, I can’t help but think that I’ve sinned by smoking and some day that all-knowing, vengeful, invisible, make-believe Sky Daddy will punish me. Not to mention the HIV tests. I’ve had one before, I’m not crazy, after all. But again, surely I must be punished for the grave sins of premarital sex and smoking. You can take the girl out of the church, right?

I arrived at CWRC and immediately told the receptionist that I had slipped and had a coffee. She asked what I was there for, and when I said “SHG,” her tone went from chipper and cheery to somber. I was really fucking in for it. She said “Oh, coffee is fine,” and I had two immediate and completely opposite feelings at once. Yay, I can have the test, and fuck it, I can have the test.

I was brought into a very technology-packed exam room, but not before signing a pre-op release. That did nothing to allay my fears. You know, if it hurts so bad, why don’t they put you under? Why is it that woman are expected to endure hellacious amounts of pain relieved only by a “tylenol?”

I got changed and sat on the exam table, and in walked Dr. Park, an adorable, young Asian-American woman. She had on a white lab coat with what appeared to be black-and-white striped tights and flat, black shoes that came to a long, turned-up point around mid-calf. Interesting fashion sense…I was more than a little scared now.

Dr. Park explained the procedure again, and we began: speculum inserted, ok, now the saline is pushed, ok, now the probe, ok, here’s your uterus, live on screen, still ok. Hmmmmmm, I see a tiny little spot, here, do you see it? Ummmmm, if you say so, sort of, and we’re DONE. That’s it? It was NOTHING. It was not even as uncomfortable as some of the PAP smears I’ve had. Dr. Park told me that some women “holler” during the test. Maybe I just have an insensitive uterus, because that was nothing.

But about that little spot. I’m told I need to have a follow-up test, a hysteroscopy, to determine what that little spot is. This is considered actual surgery complete with anesthesia, because this time, the doctor puts a camera up there to get a better look. Fun. Again, this must be done on day 7 of your cycle, so now I have to wait another month to schedule it. There is no sense going for any of the other bloodwork until this test is done, so I’m stalled again, for at least 30 days.

Dr. Park assured me that it is fairly common for women my age to need this additional test, but I was finding it difficult to take comfort from a doctor in striped tights. I was out of the sidewalk heading to work before I realized it was Halloween! Dr. Park was dressed up as a witch, only her lab coat hid everything except the tights and shoes. At least, I hope that was it.

Next installment–you have a lovely uterus and other things you never expect to hear in your lifetime.

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From → Pretesting

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