Monday, September 23, 2013

Hydrosalpinx? Paraovarian Cyst? The Mystery Continues

It's been awhile since I've written.  Here is what has happened in September so far...

       Pre Appointment with my RE:
  • I spent Labor Day worried sick awaiting an appointment with my Reproductive Endocrinologist.
  • I was relieved to hear that my RE didn't think I had a hydrosalpinx.  Especially after convincing myself that the removal of my tubes was imminent.  He called it an 'artifact'.
  • Results of End-of-August ultrasound: 
    • " Complex cyst on the right ovary measuring 12x11mm probable residual follicle.  11x14mm left paraovarian cyst and 12x13x7mm tubular filled area in left adnexa which may represent a hydrosalpinx.  No ovarian cyst in the left ovary. "
  • I wasn't too worried that he wasn't too worried about the paraovarian cyst because my focus had been on the possibility of a hydrosalpinx.
  • I was expecting to have an HSG to rule out a hydrosalpinx... didn't happen.
  • I wasn't expecting my RE to say "Let's get aggressive and put you back on Clomid"
  • I was a little shell shocked in the appointment.  I was SOOO relieved to hear he didn't think I had a hydrosalpinx that I was much more willing to go along with his new clomid plan.  I would have fought tooth and nail if I had been in my right mind.
  • I later became VERY worried about the paraovarian cyst because of a little internet research (basically ovarian cysts can resolve themselves during pregnancy while paraovarian cysts do not.  Paraovarian cysts continue to grow during pregnany often requiring surgery DURING PREGNANCY).  Freaked out yet?  I was.
       Post Appointment:
  • My husband was at the appointment.  Thank goodness.  He was able to help me process and provide a couple good points to consider moving ahead. 
       Moving ahead?
  • After the end-of-August ultrasound and after convincing myself that my tubes were toast I decided that it was probably time to switch RE's.  I always knew that if we were to get to the point of doing IVF I would have to switch.  My clinic is great but not the greatest in my area.  I live in Boston and have MANY options for clinics.  I need to be at a better one for something like IVF for many reasons.  
  • Something else is nagging at me too.  This hydrosalpinx may have established itself as a result of my polyp removal surgery.  My RE was in that area for the surgery and could have injured my tube(s) in the process if locating my polyp.  It was a difficult surgery for the Doctor due to my retroverted uterus and the location of the polyp at the top of my uterus.  For the record I place no blame on my RE nor do I have any hard feelings about this unfortunate situation. Every procedure has its risks.  There is no need to dwell on the why/how this happened.  It certainly isn't going to fix my fluid filled tube(s).  Instead I need to focus on next steps. But if I stuck with this office I would probably but be able to fully trust the doctor anymore because if these fleeting thoughts.
        New Reproductive Endocrinologist:
  • I have already putting the wheels in motion for a new RE.  As much as I will miss this office and as much as I appreciate them helping me through many hurdles I know that if I stay with them and things don't work out I will blame myself for sticking with the same RE.  
  • Part of my decision to switch also is because I need to also consider the opinions of my family.  My in-laws are in the medical field and aren't too happy that I am not at one of the top offices right now (although they haven't said so they were thrilled to hear that I will be switching).  Not being at a top office really didn't bother me after the experience with my first RE who was at a top office.  That was NOT the right place for me at the time.
  • I need to take this potential diagnosis as a sign that I need to move on.  I feel like I am about to break up with my boyfriend or something.  I am dreading it because I do like him so much.
      CD 2 Ultrasound - September 22:
  • The ultrasound technician told me that she could see the "area of interest" from last month and that it is still there but small and that it is hard to tell if it is a paraovarian cyst or a hydrosalpinx.
  • Nurse phone call...
    • She said: I have a small cyst on the right, probably a corpus luteum cyst.  Nothing to be concerned about.  Start the clomid tomorrow.
    • I said: What about the paraovarian cyst?
    • She said: You will have to talk to your Doctor about it.
Rainshower: This is no artifact.  It is something.  Yet they want me to go forward with the cycle and medication?
Rainbow:     I am so grateful I have an appointment with another RE soon to make sense of all of this.  I just don't know who to trust anymore.