Thursday, January 3, 2013

The Story: What happens next ~ Tests

One would think that at this point I have been through enough and that I was going to get a break. But no, there was more to come and I am yet to get a break! The stopping of the bleeding during the D&C turned out to be temporary and once home and active again, signs of it crept back. A red, no pun intended, flag was raised. Something was still not a 100% right. The OB had his suspicions but I needed more tests to confirm his thoughts. Those tests turned out to be hardcore, invasive, intrusive, painful procedures, not the likes of taking blood sample and running them to the lab, but rather tests where I myself was the specimen and laid there on the examination table while doctors poked and prodded, jabbed and looked at. At the conclusion of these tests my medical terms repertoire expanded way more than I would have cared for.

The first of these tests was a sonohysterogram. A sonohysterogram, is a special ultrasound technique, that utilizes a saline to provide images of the inside of the uterus. It is a very specific procedure that can only be performed within a certain time framework. I needed to keep close watch on my cycle and as soon as I hit the designated day, I was to call the scheduling department who was then required to fit me into the first available timeslot. The trick was balancing Jeff’s schedule with my cycle with the time slots available for that particular doctor that my OB had recommended. If you think that was easy, think again! What it all meant was that Jeff’s schedule had to be the least important factor and the doctor’s the most. And since then, the pattern has not changed. Since that first dent in the totem pole, Jeff has had to modify his schedule every time I needed to see a doctor, get monitored by a specialist, take a test, or refill a prescription. It has not exactly been a smooth ride, and doctors’ offices are notorious for having little respect for people’s times and lives other than what coincides with their own schedules.
Once we had the test scheduled, we had to get to the office. It was on the opposite side of town, in rush hour traffic, with a toddler and an extra pair of hands. We opted to take my dad with us to the visit because we needed someone to watch JR during the procedure. Once at the office, JR was entertained with all the newness and we waited. When it was our turn, we got ushered into the sonogram room and waited again. Then, when the nurse became available, I got prepped and we waited some more. Finally, the doctor came in and from there it was a 10-minute look at what was causing the havoc in my uterus. I had some “open” wounds, unhealed tissue and blood residue from the last D&C. The placenta from the previous surgery had implanted on the scar from the C-section I had with Jannah-Rae and it was all madness in there. Something needed to be done to “fix” all that. I could not be walking around with a uterus that looked like a bomb had exploded in it.
And yet, the OB was not satisfied with these findings. Although they did confirm his suspicions, he needed more proof, especially since the doctor at the radiology lab had recommended more testing. It being my body, I think the decision for them was easy: get me to undergo more procedures to confirm the same findings. And as we knew very little at the time about what was medically necessary and what was not, Jeff and I were willing to do whatever they recommended to get answers.
Hysteroscopy was next.
A hysteroscopy is the inspection of the uterine cavity by endoscopy with access through the cervix. It allows for the diagnosis of intrauterine pathology. Hysteroscopy is usually done in the hospital under general anesthesia but my OB recommended we do it in a clinic under local anesthesia. Considering how much general anesthesia I had been under in the last two years, Jeff and I agreed to go the local route and get it done at a clinic. Little did we know that this decision would come back to haunt us in the future.
We scheduled the procedure for a Friday afternoon. Jeff and my mom both took the afternoon off and escorted JR and me to the location. Having my mom with us later proved to be the best decision we had made around that procedure. We had directions to the office, and were told it was a “modest” office in the hope of preparing us for what we were about to encounter. But nothing could have really prepared us for what we stumbled upon. The building was old, the elevator was creaky and we, and the doctors and nurses, were the only English speakers in the vicinity. Even the television spoke Spanish. The clinic was sparsely furnished and even less sparsely decorated. Other than the expensive piece of equipment that was later used on me during the procedure, the place looked run down, clean but run down. The image that comes to mind when I now think about it is a back-alley abortion clinic. The doctor could have been really talented and experienced but I was not the type of clientele he served.
Our appointment was at 3 in the afternoon. We got there promptly, signed in and sat down. Two hours later, we were still sitting down. I was ready to leave. Apparently, we did not have an “official” appointment but were at the mercy of the existing schedule and were only seen when all the other patients had been taken care of and there was no one but us left in the waiting area. Remember when I said having my mom there was the best decision we had made that day? Well, as it turned out, there was a bookstore nearby and we decided that it was best for JR and Teta to wait there than in the clinic. It was close to 6 before we were out of the office and by then we were drained both physically and emotionally.
The procedure turned out to be painful, impersonal and invasive. I laid back on the examination table while the doctor inserted needles of anesthesia into my cervix and poked to make sure the medication took. No, it had not taken yet. I needed more. So I got more. My heart rate started racing so I could not have any more anesthesia and had to toughen it through. Then the hysteroscope went in and it was show time! A little to the left, a little to the right, further up, a little more. And the images started appearing on the screen. Yes, I had had a placenta accreta and yes, it has caused damage. My uterine lining was thin, there wounds from the D&C had still not healed, and there was unhealthy tissue residing there. My OB’s suspicions were now even more grounded in facts. He took the pictures, had a video made and escorted us out. Our work here was done and now his work was about to start. But not until we jumped through one more hoop would we be on our way to salvation. That afternoon, my OB tried to calm us down and talk us through the situation but no amount of “talking” was going to get us through what was yet to come. 
And what came next was just as dreadful as what had come before it and just as time consuming. You would think that by now I would have guessed that an appointment at a doctor’s office was merely a space saver and not a guarantee of service. Yet every time I make an appointment, and specifically ask for the first available of the day, I convince myself that my experience will be different.
The road now lead us to a third “specialist.” This time a surgeon, or rather a pelvic surgeon. Although we came to him prepared with a thick file of documentation, reports, results, medical history, he, however, had his own idea of how to diagnose my condition. To us this meant another excruciating test: an MRI.
If you have not had an MRI before, I highly recommend you try and maintain that condition; MRI’s are not exactly a walk in the woods.  Magnetic resonance imaging (MRI), is a medical imaging technique used in radiology to visualize internal structures of the body in detail. You lie within a large, powerful magnet where the magnetic field is used to align the magnetization of some atomic nuclei in the body, and radio frequency magnetic fields are applied to systematically alter the alignment of this magnetization.

Having learned my lesson about waiting in medical offices, I opted to schedule the test for the first available morning appointment. On the designated day, we showed up with JR confident that it will be an in and out visit. We were wrong – again! We spent an hour in the waiting room and another 30 minutes in the back room, me in a hospital robe, waiting for our turn. The hold up this time: a scheduling conflict! The technician experienced to undertake the kind of imaging the surgeon required was not due to arrive till 9am; our appointment was at 8 and we were asked to arrive by 7:45. At 9:30, neither the technician had arrived nor was the MRI machine available to take me. I was beyond outraged at this lack of communication, lack of respect, and irresponsibility. We actually had to call for the office manager to find out the cause of our delay and although he apologized profusely, covered the cost of parking and gave us meal vouchers in an attempt to appease us, that did not correct the wrong we had been dealt.
When my name was finally called out, I breathed a sigh of relief knowing the end was near and that Jeff and JR could now hang out somewhere other than this  box of a waiting room. I was ready for it to be over but I was not ready for what came next. I had never seen an MRI machine before, let alone be slid inside one. It was huge, and metal, and cold. The room was almost taken over by this monstrosity and once I was prepped it was only the machine and I in that room. I was scared. I almost cried. I tried to be strong but it was hard. The only company I had in that dark cave was the voice through the speakers and the voice in my head. The one on the outside was guiding me through the process, asking how I was doing and updating me on the time left. The voice within was reminding me that this was my journey, my life, my practice. It kept repeating to me words I had read in a book, “Your life is your practice,” and reminding me to accept it and live it.
And I did. I went through another tunnel in the road and came out the other side. Once there, I hugged Jeff and Jannah-Rae tight. After all they are as much part of this journey as I am and they are part of my practice. I have never taken either one of them for granted but on that day I renewed my intention to be hold them closer and dearer.

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