So Now What?

I had my doctor's appointment today.  It was SO hard being there while not being pregnant, especially since it was the first time since the follow up appointments after the surgery.  I was crying in the waiting room, although I was able to distract myself with my book and my silly Game of Thrones FB game.

It was better once my doctor came in.  He greeted me with a hug and immediately understood how hard it was for me to be there.  He said he had been rereading his notes from my case last year and that the hair on the back of his neck had risen again at how close a call it had been.  One thing that I have appreciated with him has been that he has been very human through this.  It would have been harder if he had been more of the "I'm always right, even when I'm not" type of doctor.

I told my doctor what has been going on, what symptoms I have been having that make me think the endo is back.  He confirmed that there was endo tissue that he hadn't gotten on the left because there hadn't been time while keeping me alive.  However, he also said that the symptoms I've been having may be more consistent with polyps than with endo.  He did say the pattern I have been having with my cycle falls into the realm of "normal" but could also make sense with the endo still being a problem.  I did forget to ask what stage the endo had been, so I'm going to call the nurse tomorrow and ask.

The key thing that he said, though, is that now that I have been diagnosed with endo, I can get things covered by insurance because it's testing and treating the adhesions from the endo, a diagnosed medical condition, rather than treating "unexplained infertility."  The first things he wants to check are the possibilities of polyps, a luteal phase defect, or another blocked tube.   He wants to do a kind of ultrasound to look for polyps, and he wants to do an HSG to see if adhesions are blocking my remaining tube.  I'll be calling around for prices on the HSG since that isn't in his office and even though insurance would cover it, I still have to be price-conscious because of having a deductible.  To check out the possibility of luteal phase defect, he wants me to start doing OPKs again so that he can then test my progesterone level a week after ovulation.  I wonder if I should start doing BBT again to go with it.

Depending on what we find out, we may be looking at anything from oral progesterone to Clomid to IUI.  Whether it falls into what insurance will cover or not, I can do anything short of IVF with him instead of with a fertility clinic.  I feel good about that, at least.  I know that, after what happened last year, he will pull and work anything he can to help us.  He thanked me for coming back to him after what happened, but it's what felt the most right, both because of how committed he is to us and because of the midwives there, who kept my son from being a c-section.

We will see what happens, but it's nice to be able to do something other than wonder and then despair every month.