a gray cloud

The last week has been tough. I have been feeling very frustrated and angry since my appointment with the surgeon on Thursday. I have so much I want to say not about me, but about my babies, and I have been having a very hard time concentrating and getting it out, which in of itself is very frustrating - it makes me feel like I am not honoring them properly. Disappointingly, this post is probably going to be mostly about me and my appointment last week.

When I left off last time, we were beginning to consider the advantages and disadvantages of the myomectomy, the fibroid surgery (which, for reasons I will not get into right now, does seem like something we will likely pursue before returning to IVF).

On Thursday we had the diagnostic hysteroscopy with one of the two doctors who does endoscopic gynecological surgery to see what the fibroids look like now and in order to make a decision about the surgery and to hypothetically schedule it. Instead, we found out that my uterus is full of retained placenta and it was impossible to visualize the fibroids.

This was really surprising to us since it was a potential complication that no one discussed with us and because I had actually already had a D&C for retained placenta immediately following delivery. Apparently, vaginal birth between ~20-26 weeks is a risk factor for retained placenta and the risk with multiples is even greater. Add in the fibroid, the placental abruption, and my failure to deliver Aminadav's placenta, and in retrospect, this complication is not terribly shocking, but it still really really sucks.

The plan now is to do an operative hysteroscopy to remove the retained placenta on April 22. Unfortunately, they can't also do the myomectomy at the same time, so we will need to wait for my uterus to heal from this first procedure and then do the fibroid surgery later on. And then heal from that. Remember that crazy idea my RE had about starting a new IVF after Passover? I am wondering if the joke is on me - perhaps we're talking about Passover 2013.

There is a small possibility that the retained placenta will come out with my next period. The doctor seems to think this is not terribly likely, or at least not terribly likely that it will all come out (this is actually really disgusting to be writing about, and probably pretty disgusting to be reading about, so I apologize). What is more likely it seems is that I will get a period and the tissue will become more "organized" as they say and as a result, take up less surface area of my uterus, which will hypothetically make it an easier procedure with lower risk of causing significant scarring or adhesions. This is apparently why we are waiting until April 22 (that and socialized medicine, which I actually have few complaints about).

Unfortunately, for as long as I am walking around with retained placenta there is the risk of hemorrhage. I have been reassured this risk isn't terribly high since I am not actively bleeding at the moment, but high enough that air travel, specifically transatlantic air travel of the variety we had planned for most of the month of April, is not particularly wise. There is also the secondary issue that no travel health insurance plan will cover us abroad (i.e in the United States) because of my current condition. (It is worth mentioning that one doctor said air travel would be fine, one doctor said not a good risk to take, and a third implicated it's a bad idea but said it's up to us.)

The one immediate thing I was looking forward to was traveling with Y to the states to spend Passover with his family in Miami and then our trip out to California and up the Pacific Coast Highway. We were both really looking forward to the change of scenery and alone time together. The plane tickets were purchased, the arrangements made, and we thought this trip was a done deal. We literally planned the trip in the recovery room after my D&C, which was just a couple hours after I delivered the babies.

This was supposed to be our escape from all of this horribleness and I am so sad that now it seems we can't even take this trip, or at least the California component is in great jeopardy - no consensus on Miami yet. It is really hard to keep my chin up - stuff just keeps going wrong and it is increasingly hard to believe anything will change. When the doctor mentioned the risk of hemorrhage all I could think was "Hemorrhage? Why not? Sounds like something that would happen to me." I hate being this downtrodden and negative about everything. Still waiting for this big gray cloud to lift.