Wednesday, November 28, 2007

Medical mysteries

Warning: possibly TMI.

I had a bit of a scare/shock last night. I was on my computer & having problems with my e-mail (despite numerous reboots), and getting frustrated and stressed out. (Two years' worth of e-mails have decided to play hide & seek with me.) (Andie, if you're reading, this is why I haven't returned your message!) Eventually, I decided to turn the d@mn PC off & try again tomorrow. (Still not working -- I'm calling my sister's techie boyfriend tomorrow night for advice.) Went to the bathroom, wiped myself & gazed, stunned, at the toilet paper. It was covered in blood -- bright orangey-red, sticky blood, the colour & consistency that I often get when my period is first starting.

Except -- I am nowhwere near the start of my period. In fact, I am right about midcycle -- it was day 17. Thanks to years of infertility treatment, "Taking Charge of Your Fertility" & charting, I am familiar enough with my cycles & the twinges of my body to know that I traditionally ovulate somewhere between day 19 & 23, & AF usually arrives somewhere between day 33 & 37.

So I am thinking it could have been ovulation related. (Stress-induced??) I have had plenty of good old CM the last few days, it's right about that time, & I did have some cramping last night after my discovery. I often do have some cramping or at least vaguely uncomfortable feelings at this time of my cycle. I put on a pad, popped a few Motrin & went to bed. This morning, there was still some faint staining, and more CM, but generally back to normal. So it seems to have been just that one brief gush.

I called my ob-gyn's office, at one of the top hospitals in the city. He is an extremely busy man, so I wasn't surprised when his receptionist told me that if it was just one day one time midcycle, it was nothing to worry about & nothing they would see me for. If it happens again or if I'm bleeding unexpectedly for more than one day, I'm to call again. Okey-dokey...

Has anyone else had mid-cycle bleeding/spotting of this sort? Particularly those you who, like me, are in those perimenopausal years. I'm 46, almost 47 years old, and although my period are still pretty regular, I know things are bound to get wonky sooner or later….

I remember when I was pregnant and we were going to see the genetic counsellor (as I was over 35)… I had to fill out a questionnaire in advance about my family's medical & reproductive history, and I had to call my mom for help with a few points. "Early menopause?" I said. "Good God, no, I thought it would never end!" said my mother (lol). Both my aunts on my dad's side of the family have had a lot of gynecological problems, etc. -- one of them had a hysterectomy when she was still in her 30s (although she'd had three children by then). I do tend to take after them in body type, so I am hoping this is not an omen of things to come.

Inconvenient and stressful as it was when I was in treatment, to have to get up at a godawful hour of the morning & slog my way to the clinic, stand in line for a brief encounter with the u/s wand, hotfoot it up to the RE's office & then slink into work late, etc. etc.… at least I had the feeling that I knew what was going on in there, and that someone was watching over me. I liked that. Right now, it's all a mystery, and while I'll admit I do tend to have some hypochondriac tendencies, I don't get the feeling that anyone in the medical field much cares or takes my concerns seriously. My dh frets over every little test our dr sends him to. Me, I like to know. I just had my annual mammogram, & while nobody likes the feeling of pancaked boobs, I like the extra reassurance that all is well. (And it was.) Even if, knock wood, it's not, then hopefully we'll catch whatever is wrong in time to do something about it.

I discovered when I was about 10 weeks pregnant (& spotting, & went to emergency, & had my very first ultrasound) that I have a bicornuate uterus. Most uteruses are shaped like a triangle, or an upside-down pear. Mine looks more like a slingshot (I saw it when I had an HSG test during my fertility workup). The radiologist asked if I knew I had one and had to ask him what it was. They assured me it was nothing to worry about (famous last words), and all through the rest of my pregnancy and subsequent infertility treatment, I got hazy and sometimes conflicting opinions about it. From my later research, I learned it most definitely can be a problem, depending on where the egg implants in the uterus, and women with uterine problems (the medical term is Mullerian anomalies) have a much greater incidence of pregnancy loss than those who don’t. I also got conflicting opinions on whether corrective surgery would help or be worth my while (I never did have it done). From what I understand, during my pregnancy, the baby was growing in one horn of my uterus, the placenta was in another, and umbilical cord ran between the two. There was a small calcified clot in the placenta and evidence of internal bleeding (brown amniotic fluid, plus I did spot all through my first trimester), so that makes sense to me. My baby had severe intrauterine growth retardation (IUGR). She was growing, right until the end, but not fast enough, & at each ultrasound, she fell further & further behind the "norm." When she was stillborn, six months into my pregnancy, she only weighed 125 grams, or about 4 ounces.

There is a great Yahoo group devoted to this subject, Mullerian Anomalies. (A link is in my sidebar.) I learned there that a large number of women with Mullerian anomalies also have kidney problems and disorders. This absolutely stunned me when I first found this out, as I was on antibiotics for years and was in and out of the hospital umpteen times as a child to monitor a bladder/ureter problem. As an adult, my mother told me that my one kidney was slightly smaller than the other and that I should tell the doctors this if I was ever to get pregnant, as it might create some difficulties. (Naïve little me, I assumed difficulties for ME, as in having to go to the bathroom more often. Little did I know…!!)

I keep wondering -- did the doctors know about this co-relation back then? (Perhaps not. So little seems to be known about it, even now.) But even if they didn’t, I certainly had enough X-rays and ultrasounds and other such tests in the same general vicinity over the years. Did they not see that my uterus was abnormally shaped? Or would that not have been evident in a pre-teen?

I was never screened for endometriosis either, despite the fact that I have, occasionally, had extremely debilitating cramps. Also, while in treatment, the nurses often coplained about not being able to see my left ovary, that it was "in hiding." I keep thinking that perhaps it's adhered to one of my other organs in some strange way. One u/s tech whom I saw a few times while in treatment told me I had a small fibroid, which nobody else ever mentioned.I mentioned it to my RE & he didn't seem to think it was important.

I always (especially when I was younger) felt that I was a pretty healthy person. And while I know some people would give their eyeteeth to be as healthy as I am right now, there have been so many little things the doctors have discovered about me over the years that have chipped away at that piece of my identity & self-esteen -- my bladder problems as a child (which I eventually outgrew, or so I thought), the extra wisdom tooth that they weren't able to extract when they took the other four out (!), the minor mitral valve prolapse that sent me to a number of heart specialists when I was first married (apparently on a scale of 1 to 6, I'm a 0.5), optic nerve head drusen (little crystals in the back of my eyes which, thankfully, have never gone anywhere or threatened my vision), hypothyroidism, gallstones (not yet removed). I guess it's all part of growing old, but man, sometimes it can really suck…

3 comments:

  1. Hate to use the "P" word -- but I think the spotting may have been perimenopausal mid-cycle/ovulatory spotting. Fluctuating hormone levels and all that. Gah.

    I know what you mean about the security of being under an RE's watch. At my annual exam in Sept. I told my N-P that I felt some cramping or pain around my right ovary. She didn't palpate anything different. But am I glad I went back to the RE at that time, just for the ultrasound that showed calcifications on my right ovary. My mom had an ovariectomy, and most of her sisters have had hysterectomies, so I want to stay on top of this.

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  2. The first few times I ovulated after coming off of depo, I had brown spotting like the beginning of my period. My GYN told me it was due to the drop in hormone levels, kind of like break-through bleeding on BC.

    Re: the bicornuate uterus, you might want to go check out Becky at http://worldofwinks.wordpress.com. She was originally diagnosed with a bicorunuate uterus and did a lap to fix whatever there was to fix. She ended up having a severe septum removed, but she knows a fair amount about Muellerian anomolies.

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  3. Hi Loribeth,

    I just came back to this post to say that it may be perimenopausal bleeding or it may be something else but with your history it is a good idea too check it out.

    I've always said that infertility and loss issues aren't just about having children but about having our health in general taken seriously. The doctors should have offered you surgery for your bicornate uterus and maybe you do need to get some more of these things checked out. If for nothing else, than some peace of mind.

    Take care, and email me if you want to chat more about it.

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