I can’t tell you how relieved I am right now.
Today was my consultation with a gynecological surgical doctor at Kai.ser. I had had some anxiety and fears about the cost of the surgery, thinking that it could be a fertility-related procedure hence not covered by my insurance. I was also fearful that my constant bleeding in the last month and the tugging and pulling feeling in my abdominal area were more serious than just hormonal changes in my body. I know those were irrational thoughts, but I just couldn’t help myself. My fear was manifested in my dream one day: I was rushed to the emergency room because of the discovery of a lump in my pelvic area. You can imagine how I felt when I woke up from that dream.
I arrived at 10:45am for my 11am appointment. To my surprise, I was called to the back immediately for my blood pressure and weight. I knew I was anxious, and my blood pressure reflected it. The nurse asked if I was a little nervous. She said that I didn’t have to worry because I was in good hands with the doctor that I would see. She said she would remeasure my blood pressure at the end of the visit. I was already situated in the exam room at 10:55am. The surgical doctor entered at 11:02am. I’ll call her Dr. Gentle. She was really really nice. I’d say she is one of the nicest doctors I have ever met. I had to tell her a brief history about my infertility journey as well as my surgical history since none of it was done at Kai.ser so she had no records of any sort. I explained to her that my abdominal myomectomy was done to remove about 50+ tiny submucosal and intramural fibroids. I told her that I did not understand how scar tissue could be formed inside the cavity, since a saline sonogram two years after the surgery did not show any scar tissue. Dr. Gentle said that scar tissue is usually formed following a uterine surgery that might have penetrated through the uterine cavity. There should not be any scar tissue if there was none two years after the surgery. She suggested that I may not have any scar tissue after all. Of course during the procedure she’d take a look and determine if anything has to be cut.
I explained to her what happened at the saline sonogram and the attempt at the hysteroscopy at UC.SF. After hearing that my cervix was too wide, Dr. Gentle asked if Dr. No Nonsense tried to clip the cervix close. Uh… I don’t think so. She said that the cervix is supposed to be wide to allow the equipment to go in. At Kai.ser, medication is given to the patients to soften and widen the cervix. In that moment, I started to think that Dr. Gentle might be the better professional to remove whatever I have inside me than Dr. NN. She really seemed more knowledgeable about these procedures than Dr. NN. I said that Dr. NN suggested doing an operation under general anesthesia. Dr. Gentle said that it is not necessary. She suggested doing a clinical procedure rather than one at the hospital in the operating room. Basically similar to what Dr. NN did. Maybe even simpler. She explained to me that a procedure done in the OR under general anesthesia is basically the same as one done in the clinic. So there is no need to subject me to anything more than a localized sedation. She is going to use a technology called MyoSure, which is a technology that removes tissue in the uterus without cutting into the uterine lining. She gave me a brochure and told me to watch a video online about the surgery. Because I am a fertility patient, she feels strongly that this is the best way to preserve my lining. This procedure can be done within 10 minutes. I can go back to work the next day. And we can try to get pregnant again the following menstrual cycle.
I was feeling more and more relieved as she explained things to me. I asked her how soon I could be scheduled with a procedure. She immediately got on the computer system to look for a time. Initially she gave me July 28th. I told her that we would like to pursue an egg donor who could start a cycle in August. It would really help us if I could be seen sooner. She is such a nice and compassionate doctor. She looked in the system again, looked at the calendar, and mumbled things to herself for about five minutes. Then she happily announced that July 15th would work. The timing can’t be more perfect. We will return from our train trip to Chicago on July 11th. July 15th is the earliest, best possible time for this procedure.
Dr. No Nonsense requested to email whoever is going to do my surgery. Dr. Gentle said that she could schedule a time to discuss the case with him on the phone. However, since Dr. NN is traveling outside of the country for a conference now, it’s tough for him to have a phone call. Dr. Gentle said that the best way to communicate is for me to obtain my saline sonogram notes and my surgical notes, scan them, and email them to her. I will get that done in the next week or so.
Dr. Gentle told me that my bleeding (three to four weeks worth before I started the birth control pill) is most likely caused by the hormones that I was taking before. Scar tissue does not cause extra bleeding. I was relieved to hear that.
Because of the cervix problem at my last hysteroscopy, Dr. Gentle performed a manual exam on me. She said that my cervix looked and felt normal. Then she put her fingers in to feel my uterus. She commented on how well my previous OB/GYN performed the abdominal myomectomy. She said that my uterus felt very normal after the removals of so many fibroids. “Normal” is such a nice word to hear when all I usually get during doctor visits is bad news. She told me that she does almost all of Kai.ser’s abdominal myomectomy in San Francisco. I asked her if a full abdominal myomectomy is what she would do in my case, vs. a laparoscopic surgery. She said that with 50+ fibroids, it was probably going to be really hard to do a lap surgery. The trade-off is that a full abdominal myomectomy weakens the uterine wall so a Caesarean-section is needed. This is going to be true in my case when I get pregnant in the future.
Dr. Gentle ordered all the medications that are required for the surgery for me. She explained everything to me and gave me a printout. I asked her about the codes of the procedure because I was still afraid that it would count as a fertility treatment rather than a medical necessity. She wrote down that it was going to be clinic visit procedure and most likely a co-payment like the one that I paid today. My diagnosis is Intrauterine Synechiae, which has nothing to do with infertility codes. To find out the cost, I was told by her to go down to Members Services to find out, since the phone call that I placed to Kai.ser last Friday had not be returned yet. After that, I could go down to the pharmacy to pick up the meds that she had just ordered. (Later on, member services told me that I would have to call the business office to find out the cost.)
Dr. Gentle saw me for a total of 40 minutes. She could not be more thorough. She put me at so much ease that I literally felt the weight lifted off my shoulder. The nurse was right. I feel that I am in very good hands as she is someone who does surgeries every single day. Although I just met her, I feel confident in her ability to fix my problems. The way she talked about it, it seems to be a very simple procedure. Since I was so relieved, my post visit blood pressure went back down to close to normal. Interestingly, I looked up Dr. Gentle online after my visit with her and found all these 5-star reviews on Ye.lp. A surgeon. Doesn’t it feel like looking up a restaurant??? But it is a great relief to know that she is so well liked and is such a great surgeon.
God is answering my prayers in a way that is unexpected. Given the information and the timing when we scheduled the hysteroscopy with my own RE, I felt that it was the best choice at that moment. Little did I know that God has other plans for us. Maybe Dr. Gentle is supposed to be the doctor who should do the procedure. I don’t know how God works. But I know that I have been praying and asking God to steer us to the right path, and to give me peace and strength along the way. I asked him to take away my worries and fear. Today, I finally feel the relief that I haven’t felt in a long time. It feels like there is an end to my wait in the pit. I am slowly climbing out. I am very thankful for that.
So here we are. Finally some positive news. Phew!