Sunday, January 30, 2011

my biggest regret

If any of you think you know who I am - please do not read on and rather don't read any of my posts - I am putting too much very personal information here.   But, if I am still just an unidentified blogger - this is the story of why I beat myself up.

Several years ago, I was having mild pain.  Nothing bad, but knowing what I know, I got an ultrasound.   I watched as they were doing it and knew enough to see that there was something odd - something that even to my eye did not look quite right. The reading was a small corpus luteum cyst versus solid mass but they recommended MRI to further evaluate.  Impossible for a corpus luteum I thought, I was on the pill.  You can't have a corpus luteum if you're ovulation is blocked by pills.  So I got worried - really worried.

Then came the MRI.  Definitive diagnosis was dermoid which is a solid ovarian tumor usually with skin tissues, fat, hair and sometimes teeth.  Pretty easy to diagnose, but I never asked to look at the images.  I trusted the radiologist and my surgeon.

So I had a full exploratory laparotomy at her suggestion.  No laparoscopy or mini-lap for me.  Nope - big old incision with great big healing time.  But I trusted her so went through with it.  I knew then that leaving a dermoid alone would probably not be good for future fertility, and if I did need ovulation induction that nobody would want to stimulate an ovary with a dermoid on it.

Problem was, they went in, and nothing was there.  Polycystic ovary, but no dermoid.  So my surgeon did what surgeons do - she went looking for it.  Split open the ovary, dug out some follicles, sent some tissue to path and closed me up.

The recovery was hard and a definite lesson in what I make my patients endure, but it was especially hard to think that it was unnecessary.  I slowly got better and made my peace with it.  Just moved forward with a stomach that doesn't quite look like it used to.

That was until the infertility.  For my baseline sono, my previously operated on ovary is less than half the size as the other and seems to be scarred way up out of its normal placement.  I was frustrated to see this, but didn't worry about it too much - after all, I still had a little stump there and there was a whole other side to get pregnant from!

That was until the HSG.  Only one tube open.  Other could have been spasmed or blocked by scar tissue - but here's the kicker - the open tube is on the side of my gimpy ovary.  I cried when I had the hsg, cried in the car, cried at home and just kept crying.  Days turned into weeks and I was just a little quivering puddle.  Why did I let myself have the surgery?  Why didn't I look at the scan knowing what I know? Why . . . why  . . . why?

My REI just kept telling me that you only need part of one ovary and one tube and that it can work, and maybe after all the other was just spasmed.  I have tried to believe but the reality is I am already working with the PCOS and to have anatomic issues on top is a lot more to overcome than just ovulation.

So of course through all of this it turns out that my normal ovary ovulates a lot better than the gimp, and of course the other day the new single follicle again was on the normal ovary/blocked tube side.  They have offered me another hsg, but I am not sure what it would change.  Its a lot of pain for no change in decision making and it doesn't make the cost of IVF any less prohibitive.

In retrospect I have run the scenario in my head a thousand times, and would have probably made the same decisions faced with the same information.  My biggest regret is that I went looking in the first place.  I should have just ignored it and moved forward but the paranoia got to me first.  Its also difficult to take that as a lesson for the future.  How do you not overanalyze the situation at hand?  Infertility is part medical, part emotional, part luck and is the single item that keeps me from having the life I have envisioned.  How do I not think about that?  How do I not read too much into each scan?  How am I ever supposed to relax about this and let go of the guilt?

I think the answer is that I won't relax and I won't forgive myself until infertility is just a part of my past and not my present.  As much as I want to make peace with this as a process, every ultrasound will always be a reflection of how I screwed up no matter logically that I know I didn't.

And with that - on to the next one tomorrow - go go gimp ovary.


  1. I am so sorry that you have so much lingering guilt about the surgery - the physical hurdles are enough to deal with without the guilt. Of course the guilt is unwarranted and of course you did what made sense at the time and was the most reasonable and rational choice at the time. Logically, I am pretty sure that you already know that, though. Sending many thoughts and prayers that great things happen for you soon and that your current misgivings about the previous surgery will soon become irrelevant!

  2. Guilt is a bitch. I find myself thinking "if I knew now..." quite a bit. But, you did the best with what you had at the time. I have a really hard time not beating myself up for the past. But, there really isn't much point in doing that.

    Have you ever read Vonnegut's Timequake? Everyone has to go back and relive their lives for several years and, knowing what they know now, they're not able to make ANY changes. I think that would be the ultimate torture.

  3. Ughhhh! How frustrating. I am sorry that you're having guilt and emotional pain over all of this. My thoughts are with you.

  4. It sucks you have the knowledge that is provoking the guilt. The average person - even the average IFer - wouldn't know that what that surgeon did and the surgery was going to be an issue in the future or that it possibly wasn't necessary. You're in a unique position and you shouldn't feel guilty - even though that's no solace. I'm sorry you're dealing with this.

  5. Hi there. I stumbled across your blog and just wanted to say hi. I am a nurse practitioner so I know how it is to go through this as a medical professional. I work in internal medicine, so I'm not surrounded by preggos like you are, but I know how hard it is to hand over the control. Good luck! I'll be starting IVF next month; it'll be our first.