Part 11

After surgery, my recovery was longer – it was harder.

It took 10 days before I even began to feel human again, but not without complications.  Multiple times throughout recovery my temperature spiked dramatically – which can be a sign of infection.  For multiple nights in a row, my husband was waking me up every hour to take my temperature and check to see if I was still alive (a little paranoid perhaps).

I also developed some complications from my IV site.  I developed this hard, painful lump about half an inch down from where my IV was inserted.  It would throb all day (even with pain meds) and it was painful to the touch.  Dr. Carnovale was concerned that I might have developed a blood clot, so he had me come in to look at it and check my incisions for infection given all of the problems I was having.

I walked into the office that day, still mostly drugged and still in a lot of pain.  Sarah opens the door to the waiting room, and with her big smiling face, as usual, she calls me in.  We walk back to an exam room – and I’m – again, instructed to strip from the waist down.  Ugh.  I’ll never get used to this.

Shortly after that, Dr. Carnovale comes in.  He starts asking a bunch of questions, looks at my incisions, and then focuses in on my hand.  As he’s inspecting it, he starts to push around the vein and feel for swelling.  Every poke, push, and prod is pure agony.  I sit grimacing in pain.  Dr. Carnovale finishes inspecting and says, “Well Jessica, it’s the most peculiar thing.  I don’t believe you have a clot – which is a good thing – but it appears that your vein has collapsed in the spot right after the lump.  This is what I would normally expect from an elderly patient but not for a healthy woman in her early 30’s.  The lump is likely swelling or a minor infection from the IV.  I’m going to put you on antibiotics – hopefully that will attack this and whatever is causing the fever.  Let’s just keep an eye on it.  If it doesn’t get better, let me know.”

I sit up from the table and he says, “Now, how is your recovery going, aside from all of this?”

“I’m doing pretty well.  My pain is more than last time and just different, but I’m fine.  I’m a lot more swollen, ” I say.

“That’s because of the amount of tissue work I had to do in surgery.  We can talk next week during your post-op appointment, but you were one of the worst cases I’ve even seen.  Easily in the top 5 worst.  I imagine that recovery will be slow – I had to remove a lot of endometriosis and free up a lot in your pelvic cavity.  The amount of that I had to do would explain all the swelling.  The good news is that you should be feeling a lot better soon,” Dr. Carnovale finishes.

I get dressed and we leave the office, picking up a new antibiotic prescription on the way home.  I pour myself back into bed and decide to worry later.

Day after day, without fail, I began to feel better.

A week later and it’s time for my post-op appointment with Dr. Carnovale.  At this point I feel like I live at his office.  For the first time in two weeks, I put on real pants, climb into the car and head to the office with minimal pain – just the sharp jab every time a piece of my waistline pulls at one of my incisions (there’s three, all right at my waist).

As we’re sitting in Dr. Carnovale’s waiting room, the door opens and we’re again greeted by Sarah’s smiling face.  She walks us back, this time to Dr. Carnovale’s office.  We take a seat a the small table in his office and Sarah says, “Dr. Carnovale will be in, in a minute.”

Dr. Carnovale’s office is small and the walls are covered with credentials and awards.  He’s got mountains of books on the shelves and a few select photos of a pair of children that resemble him.  His office overlooks this horrible apartment complex and a open field that’s likely slated for more hospital property.  I stare out the window and prepare myself for whatever is coming next.

A few moment’s later Dr. Carnovale is walking in, file in hand.  He sits down at the table, flips open my file and begins showing me pictures of my insides – they’re more gruesome than the ones from my first surgery.  They’re filled with blood.  He then starts showing and explaining to me what the pictures mean, “Here’s your ovary.  Here’s the mass.  Here’s me opening up the mass with the laser.  Here’s me peeling off the mass with the laser,” says Dr. Carnovale.

He then says, “This one (as he points to the worst picture of them all) is your right ovary and the mass on the ovary.  The mass was about 3 times the size of your actual ovary.  In order to remove all of it, I had to take some of your ovary as well.”

Dr. Carnovale looks up and says, “I would show you the video but for some reason the camera didn’t work that day so I didn’t get any footage (no, really I don’t need to see the footage).  Jessica you were one of the worst cases I’ve ever seen.  During your surgery I called a gastroenterologist into the surgery to consult because your colon was so badly fused to the backside of your uterus from all the endometriosis.  He recommended that we not attempt dislodge it, that the surgery would be too involved without consulting your first.  It’s mostly a quality of life issue.  It’s likely what’s causing most of your pain and trouble with bowel movements.  However, removing it puts you at serious risk for other complications like incontinence (hmmmm, have trouble pooping on occasion or not be able to control your pooping all the time – decisions, decisions).  So we left it (THANK GOODNESS).  I don’t think that it will effect your ability to get pregnant.  The good news is that we were able to remove all the masses and any endometriosis that was left lingering in your pelvic cavity.  ”

Okay, so what’s next?  What now?  What can we do?  I have a thousand questions in my mind and really all I’m thinking is – “get to the point dude.”

So I say, “So what’s next?”

Dr. Carnovale pulls out all of my fertility tests and starts to comb through them with me and Ben.  He says, “Well, your sonohysterography looked really good.  It seems that your uterus is in really good shape.  Ben’s tests all came back really good, so we’re in good shape there as well.  However, your Ovarian Reserve Score is of concern to me.  The Ovarian Reserve Score tells us the likely amount of eggs you would produce through a stimulation – thus telling us how many eggs we could retrieve and fertilize in an IVF cycle.  A woman your age and health, we’d expect a score between 8 and 11 – your score was 5 – and that was before we did the surgery.  This diminishes your odds significantly.  For a woman your age our success rate is about 70%.  I would say your chances are about 30-40% given your score and circumstances.  We’re going to be racing against the endometriosis and a number of other factors to try and get you pregnant.  IVF is your only option at this point.”

Well, it’s not the news we were hoping to hear, but it sure was what we were expecting to hear.  We were fully prepared for it.  So Ben asks, “So when can we start?”

Dr. Carnovale says, “Given your recovery Jessica, I’d say as early as May or June.”

“Great, we want to do the May cycle,” I say without hesitation.  Ben and I had already talked about it.  We were ready for April or May.  May is green light for us.  Ben nods along with me in agreement.  May’s our month.

Dr. Carnovale seems take aback by our quick decisiveness, but then says, “Ok, well let me get Sarah. We’ll put you on the schedule for May and get you rolling.  I’ll have you sit down with Jodi as well and make sure you understand the financial stuff.”

Thirty minutes later, we’re walking out of Dr. Carnovale’s office with a single sheet of paper and a whole lot of questions.  Our first step is to take the “IVF Class” which will be in three weeks.  Until then…we wait, and hope, and pray for May…