Not what I expected

So surgery is off the table right now. Or at least postponed for a couple months.

I was very surprised by this. Quite shocked, actually.

Yesterday, at my appointment, Dr. L looked at my pictures of my pelvic region taken during my first surgery (which was just diagnostic, so they were "before" pictures) and thought it didn't look all that bad. While my ovaries were enlarged due to big endometriomas, she thought the amount of endo everywhere else was small and mainly superficial and the cul de sac didn't have any endo on it, which was good (umm.. I was very surprised by all of this since I've been thinking for the last two years that my abdomen was ravaged by endometriosis. Dr. Hi.lgers definitely led me to believe it was pretty bad. Heck, I needed an open surgery!). Then she asked what dose of Tamoxifen I'd been taking and apparently it was a pretty low dose, so she wrote me a prescription for 40 mgs and said she wanted me to take that for two months and then if I wasn't pregnant, we'd look more into a surgery.

WHAT?! I was so surprised as she left the office to write the prescription that I didn't know what to say. Ryan asked more questions when she returned, but nothing she said helped me to understand any more. I just got the feeling that she wanted to take a conservative approach because surgery is always a risk.

I'm still not quite sure how I feel about this. I was all prepared for a surgery. Not that I wanted to have surgery, but I had accepted that it was a necessary evil, and even more, it might have been the answer I'd been searching for. I was expecting to leave her office with a surgery date and my parents were making plans to come down to visit as I recovered.

And let's not forget that I have pain on my left side, near where my ovary probably is, and right now there is no known reason for it. The pain is nothing like my endo pain prior to my surgery. And it happens at very different times than the endo pain did. I could possibly have an endometrioma again on the left ovary (that was the really bad ovary, which was five times the normal size due to an endometrioma), but Dr. L said that would have shown up in the ultrasound I had last month.

I just believe all of that points to one possibility - adhesions. And if they are there, then I'd like to attempt to have them removed.

I mean, clearly something is keeping me from conceiving.

Two more rounds of Tamoxifen, just basically to rule out the effectiveness of a higher dose, seems like a lot more waiting when all I've done is wait for the past five years. I guess two months isn't a long time though, in the whole scheme of things.

Honestly, I'd probably be more upset about this if it weren't for the fact that I have an appointment with Dr. B next Thursday to discuss my low adrenal levels. At least I will be able to discuss this with him and get his opinion on putting off surgery. After all, he was the one who suggested it.

Oh, and Dr. L also suggested having an HSG done in the meantime just to make sure my tubes are okay. I dread having that done outside of surgery again, but one thing about that procedure actually piqued my interest, and that was when she said it might also let her see if things were moving freely in there. I guess that would at least give us some idea of whether there are adhesions.

I also asked her about my low adrenal test results - just to get more information of course! - and she looked at the test results and said they were depressed all day. She didn't really have much to say about that and when I asked if that could be affecting my fertility she wasn't really sure. But at least I found out more details. And GIMH did me a favor yesterday and asked Dr. B about low adrenals (isn't she sweet?) and he told her that there isn't really anything you can do for it. Of course, I know from many of you that there are treatments, but I'm assuming he doesn't believe they are really effective. I am going to ask him about treating it next week, so any information any of you can give me on treatment plans ahead of time would be greatly appreciated.

In cycle news, I think I am on day 16. As far as I know at this point, yesterday was most likely my peak day. This has actually been my most normal cycle in basically forever, so I guess that is good. For the first time in years I didn't go straight from red stickers to white stickers. I actually had some green stickers in there! Not sure what that means, if anything, but all I know is it looks more textbook, that's for sure.

And although I'm on no Tamoxifen or B6, I still had normal mucus. The quality became increasingly more peak-like over a span of five or six days, and then on both days 14 and 15 I saw 10KL x2.

When I told Dr. L this she was not surprised. She said it happens sometimes that women have their best cycles after discontinuing medication or just taking a break, since the medication has built up in your system and is still having an effect on you.

Well I guess I'll just look forward to my appointment a week from tomorrow and hopefully I'll have more of a plan in place after that. It's just so frustrating - we've been trying for nearly five years, tackled multiple problems, and we're still no closer to a pregnancy than when we started. Such is the life of an infertile woman, I guess.