The appointment went great and I got all the answers I wanted!
First off, Dr. T was disappointed that he didn't find any endo to remove or many reasons for my pain...except that my bowel was glued to my abdominal wall by scar tissue and that may very well have been causing a majority of my pain. He also said that just because he didn't find endo, doesn't mean there isn't any. In fact, he said that the less endo you have can mean more pain. By having more endo, that may have damaged nerve endings to send pain signals to your brain. But small amounts of it that haven't yet damaged those nerves can still send this "WTF OUCH!" signals to the brain. Good to know I'm not crazy!
So, his next train of thought was how to stop more endo from coming back. He mentioned Lupron, then I realized that I had to remind him that I've been on Lupron before and that the plan this time is to get pregnant. He went back at this point and reviewed the notes on my chart in more detail. I realize he has a lot of patients and there's no way he can remember everything about everyone. Once I said that, he went straight into saying that pregnancy is a great way to keep endo away!
I tell him that my cycles are super irregular, sometimes I O...sometimes I don't. He suggests Femara. So he starts explaining how it works...and that it makes sure that a signal gets sent to the brain so I can ovulate. And that it's primarily a drug for early treatment of breast cancer but that it's been used also for helping women ovulate...and that it's completely safe. Mostly stuff I've already researched. And some other stuff about estrogen...
I asked if that plan is to take it CD 3-7 (typical protocol from what I've read)...but he says he prefers and has had better luck with CD 5-9. I ask if it's a good idea to still use OPKs...which, in hindsight was a silly question. I was going to use them anyway. But he says it's a good idea because then I'll know when my LH surges.
I ask about progerstone...hoping for a blood draw because I was 7dpo yesterday. But he says that's not necessary and he's going to put me on progesterone regardless, just to be safe. He gave me some samples of Crinone (vaginal suppositories)...but told me not to fill the script for Crinone yet because insurance might not cover it and it's super expensive. So, hoping he can give me a ton more samples when the time comes or that he has some sort of backup plan. If it comes down to spending hundreds of dollars for it, we will find a way, but I'm hoping it doesn't come to that. I'm also not super excited about using them every day until I'm 12 weeks...but I will if that's what it takes. I'll need to start it the moment I get a BFP!
Let's see...what else? Oh...he wants DH to have a sperm analysis done. Dr. T mentioned it to DH after my surgery...and that was one of the first things DH told me about when I woke up. He's not happy about it...but we live close enough to the drop-off that he can do his business at home and we can drive the sample up there. I told him I will let him wait until the end of next week in case I am pregnant this time...but if AF arrives, he's doing it! Doc says there's no point in me going through all this if there is an issue with DH's little guys.
So, I got my script for Femara 2.5mg to be taken CD5-9.
Six sample doses of Crinone and a script for 20 more doses.
Instruction paperwork for DH's SA.
Follow-up appointment 9/28 at 3:30pm.( By that time I should be almost through my first Femara cycle)
Return to work note.
Also, I told him about my concerns once I do get pregnant. He told me to call him ASAP once I get a + hpt and he'll order bloodwork right away, then a follow-up beta 2-3 days later to make sure levels are rising. And I will be asking (begging) about a 6-7 week early ultrasound :)
8dpo today and will start testing this weekend. Fingers crossed it worked this time and we won't need meds. Either way I'm happy with the progress we're making...I have sooo much hope!