That (Long and Gruesome) Six-Month Wait

It was around April last year (2011) after almost a year of unsuccessful TTC attempts when we finally decided to seek professional medical help.

Enlisting the help of a doctor friend who holds clinic at the UPMC-FMAB in PGH , she gave us recommendations of specialists in my case, which is an OB-Reproductive Endocrinologist, as endometriosis is believed to be caused by hormonal problems and disruptions in the woman's reproductive system.

Endometriosis

Adenomyosis

Aside from her recommendations, I also did my share of research and inquiry through friends, social networking sites and the Internet.  I found this forum particularly helpful as I became acquainted with the BEST and MOST TRUSTED OBs in the country. I was able to ask questions and learn from the experiences of other women, their successes and failures, giving me an idea what will it be like should I decide to undergo treatments or surgery.

My doctor friend gave us several names of specialists on reproductive endocrinology and infertility. I trust her inkling since a doctor most probably knows better than an ordinary individual without a medical background, not to mention doctors pretty much know WHO'S WHO in their profession.

Finally, we decided to see Dr. Gladys G. Tanangonan.

We scheduled our first consultation with her.  But firstly before that, I made a list of my symptoms (I ticked/checked which among these things I have). It helps to have your questions listed to make most out of the consultation.

TIP: Going to the doctor can be intimidating. One might feel rushed and forget to ask questions that are important. It's always a good idea to know what to ask beforehand and to take notes during the visit. Some of the questions here may be worth asking. Print out this page and take it with you to your next appointment. You may also want to look at this for more idea on finding a specialist for your case and several other things to consider when you make a consultation.

Our first meeting with Dr. Tanangonan was promising. Unlike my previous consultations with other OBs, we found much more hope and reassurance in her words.  She seems to know better about what I'm having and she answers questions straightforwardly but with compassion. She explained thoroughly without the feeling that she's in a hurry. Ours was an interactive conversation where me and my husband felt engaged and participative partners rather than mere recipients and followers of whatever treatment the doctor prescribes.

Obviously, we want to have a baby. So she thought of giving us a contact schedule: when and how often should we do the baby dance :D She said that sometimes, it's all about the proper timing and awareness of a woman's menstrual cycle and ovulation that determines her fertility and when she is most likely to conceive. So there goes the schedule which to me seemed mechanical.  Nevertheless, we should follow :-)

That first cycle was a failure, we didn't conceive despite strictly abiding by the schedule. Probably because me and my husband were just not so solved with the idea of having contact on schedule plus the pressure that goes with it: "This has to be!"

We were amenable to the idea of combination treatment, meaning not resorting to surgery immediately without trying other conservative options. First, our goal is to stop the menses so that the cyst won't grow to cause more problems. First she had me on Diane pills.  (My previous OB prescribed Althea which is relatively cheaper than Diane.  I think I was able to finish a few blister packs of Althea and just one pack of Diane because I didn't like it's effect on me.)

Diane 35

Althea 

After that, Dr. Tanangonan said she plans to give me GnRH agonist (Luprolex) once for 6 months.  A shot costs PhP9,000.00.

Luprolex Vial 1.88 mg. 

Our next option would be a laparoscopic procedure where she will probe inside my uterus using small incisions to make a proper diagnosis of my condition (to determine the stage of my endo) in addition to fulgurating the cyst/s and removing adhesions.

It was May of 2011 when I had my first shot of Luprolex. It was quite a good thing that I'm less than 50kg that a half dose will be just fine for me, so it saved us a lot. The doctor told me I shouldn't go over 50 or the drug might not be as effective.  Oh sure, with all the expenses I am compelled to defer my food trips and curb my cravings instantly.

I shouldn't be having my period the following month and that is June but to my surprise it came as usual though not as painful, with less blood clots and not heavier as it used to be. I was a bit alarmed coz after 2 weeks I still have spotting. I told my OB about it and she was quick to note that some experience flare ups with the initial dose and will subsequently subside after the next doses were given. She reminded me to take 2 caps of calcium everyday (1,000 mg) as the drug has an effect on bones (it can cause osteoporosis because it mimics menopause).

For couple of months, my moods were unpredictable. I had hot flushes then there were times I felt really cold. My joints were painful and I had numbing lower back pains. I felt my bones were getting weaker and brittle :( I lost weight unintentionally: from 50kg., I was 43kg after just a few months . I looked haggard and frail. My clothes didn't seem to fit my tiny physique I need an immediate wardrobe makeover.

My last shot was in October.  My period should resume by November (shivers...not again!) After that, I'm scheduled to have my trans-vaginal ultrasound on the 3rd-5th day of my menstruation to check the progress of my treatment. My doctor said that we can also have the HSG done to check if there are blockages in my fallopian tubes. She quoted me around PhP15K for the procedure. Geesh.

November came and still no signs of Aunt Flo visiting.  To me this is partly good.  No painful abdominal cramps, no sleepless nights, practically no limits to what I can do...at least for now.  But heck! This is also alarming.  What happened? Did the treatment ruin my cycle? Were my hormones disrupted and thwarted by my attempt to go into pseudo-menopause? Will I ever get my period back? Oh noes.

November flew just as fast and in came December (shivers....again and again).  I knew it was coming. I was preparing with the thought of reintroducing myself to the kind of pain and agony I once had (but never ever missed!). Six months seemed long but I'm prepared for this. I know its just around the corner so I said to myself, "Let's get it on!"