IV Day 10 and Beyond, HSG questions, and news re Dr. Hilgers -updated

I don't think I mentioned this Monday, but I definitely did start my period yesterday, so actually Monday was probably CD1. Also Monday, I had called and left a message first thing with Dr. Hilgers office. I wanted them to hear from me exactly what we had done in NY, as well as the next steps layed out for us. Also, it occurred to me that though Dr Toth had said an HSG could be done anywhere in 30 days, I realized Dr. Hilgers may think differently. First of all, I know Dr Hilgers gets more info from his selective HSG. Secondly, I know Dr. Hilgers unblocked my tubes during the procedure where he was checking the tubes. I didn't want to turn this into two procedures when it only needed to be one. Third, I didn't know if I needed antibiotics on board just for checking. Finally, I wanted to talk to Dr. Hilgers about the need for me to do a cycle review this cycle and have all my meds back on board starting next cycle in case my tubes were unblocked.

On Tuesday morning, I took both my husband's and my IV out yesterday without incident. I just removed all the bandages, covered the spot with an alcohol pad and gauze and pulled out the tiny spaghetti string. It was maybe 10 inches or so. it didn't hurt, and it didn't really bleed at all. I packed up the pumps in bubble wrap and sent it insured to Dr. Toth's office right away. Yesterday was antibiotic free after that. My stomach is not hurting, I continue to have looser stools, but they haven't gotten worse at all.

Yesterday I also talked to Dr. Hilger's nurse, Teresa, and I am glad I did. First of all, she was very interested to hear about NY, as well as Dr. Toth's retirement plans. She had already received a copy of the D&C and HSG results. She listened to everything I said. If I understand right, she did think Dr. Hilgers would like to do an selective HSG, but potentially during a lap to get a better look. I don't know how I feel about that for a few reasons, mostly because I don't know if the risks outweigh the benefits. Once the procedure becomes surgery, I have great fear about spreading any potential remaining infection. Also, who knows when I can get in as we all know his surgery schedule is crazy and timing with this is key. And it just makes the logistics more difficult. I could be wrong, but I thought I could drive to Omaha, have the HSG and drive home. If it turns out I am under anesthesia, I might have to coordinate to bring my mom or someone else with. Just more hassle. If its worth it, fine. But the idea that we might undo $15k worth of treatment with something that may not be necessary...well I think I just stopped breathing for a second there. This is sort of our one chance at this full treatment per dh, you know? Teresa was going to check the surgery schedule and then talk to Dr. Hilgers either by writing it up and getting a written response or at their weekly meeting on Monday. She asked me which I preferred and we both just agreed that this is time sensitive. Obviously, I am going to wait and see what Dr. Hilgers recommends, but I do think he is new to this controlling infection during surgery. It seems there is a good chance it is inflammation and they will open without us even checking. I mean, Dr. Hilgers was able to open them last time with a wire during the selective HSG. That would indicate it probably wasn't scar tissue last time. If its the same, they may open on their own. We could potentially try without even checking them. However, there is risk in that. We are as clean as we will be. We are abstaining. Once we start ttc, we will start sharing any bugs we have that may have been left in either of us. We don't want to "waste" ttc and potentially spreading infection for three months with blocked tubes. So that makes me think we should check them as Dr. Toth suggested. He said anyone could do the procedure and I don't think he was worried about infection spreading for the typical checking of tubes. However, I could be wrong. I don't know much about the procedure and I thought a former patient said the Dr. Toth should be the one to unblock tubes because he can minimize infection. However, Dr. Toth told me he doesn't unblock tubes anymore. I don't know. So then, the question is do i have a local person do an HSG, Dr. Hilgers do an HSG or Dr. Hilgers do a lap HSG? Again, I am open to hearing people's thoughts because I don't know enough about the differences. It seems maybe if  Dr. Hilgers does the lap HSG, then he can unblock with a wire whereas he can't unblock them if he is just testing them? However, if you can only unblock the tubes that are closed due to inflammation, that seems to me they will already be opened if that is the case so that isn't a big threat? If they are really blocked due to scar tissue, could that be done during the same lap? I assume not, but I don't really know. If they are blocked and Dr. Hilgers finds out through HSG that doesn't include a lap, will he have teh full info he needs to determine if it is a minor versus major repair. If it's minor surgery repair, obviously I will be facing the surgery decision regardless if we avoided the HSG lap. So lots of unknowns about the procedure and risk. I will wait for Dr. Hilgers input, but in the meantime I would like to hear from those of you with experience.

Teresa also had some helpful recommendations for immune support.

  • D3 (start at 4000 iu a day for a month and then go to 2000ius)
  • The dose of Tumeric is 1000mg twice a day-turmeric is a powerful anti inflammatory-Dr. HIlgers later took me off this saying there is preliminary evidence of birth defects and he didn't want to chance it. 
  • a 12 strain probiotic -The probiotic is called thera biotic complete from a company called Prothera inc. You need a doctor's code to order it. 
  • a concentrated antioxidant drink you take 1 fl oz daily, contains acai, blueberry mango seed...I need to refer back to my notes but you can buy it at whole foods or through other places. I found this on amazon and it looks the exact same. Note, price is for 3 bottles, each with 32 servings.

This morning we started the oral antibiotics. We are on once a day 300 mg and 500 mg Zithromax. The is the one that can tint your sweat, tears, urine etc red so that would be crazy. It also might upset your stomach, but is best taken on an empty stomach. I took it at 7, felt nauseated around 8:45am despite breakfast by then, and then felt better around 10:30am. That makes me think it was the medicine, but we'll see. Charlie said he feels sick to his stomach after breakfast, so it could be a bug or a something we both ate.

The news I wanted to share about Dr. Hilgers that I am excited about is that both his son and daughter are ob/gyns and doing a fellowship with him. How cool is that?! I wish Dr. Toth would work more toward training others, but I am so grateful to Dr. Hilgers commitment to continue his life's work!


Anonymous said...

Hi, thanks for sharing this information. I have a few questions for you if you get a chance to address them. Do you know how prevalent this level of infection is? Are we all walking around with latent infection? Can two people who have only had sex with each other have this type of infection? If you have trouble conceiving but were able to carry the baby to term does that mean you do not have infection? Thanks!

E said...

I had the HSG about 2 months after full tx with DT. They were completely blocked, Dr. S unblocked them.

Then, 6 months later I had a full LAP and SHSG. Partial blockage and some possible endo-like spots removed from my cul-de-sac. Conceived the next cycle. But this was 9 months after the full tx with Dr. T, the average time he says for conceiving.

DH had also been on clomid for 6 months and had a variococele repair 2 months prior to conceiving our daughter. It was all just good timing for us. ;)

Rebecca said...

I have no advice, but wanted you to know I've been following your posts and praying for you. I will continue to do so!

Amy @ This Cross I Embrace said...

Dr Toth's sons should totally follow suit! I mean, sheesh, one's a Dartmouth and the other at Middlebury - no excuses! (We used to chat Midd stuff all the time when I was there. Commiserating about the cost of attending the nation's most expensive undergrad... awesome.)

Sounds like a good plan moving forward, keep us posted!

airing the chapel said...

Amy, you went to Middlebury. I did too! At least for one of the summer language programs in 1998, I think.

Wheelbarrow Rider: Forgive me. I'm having a hard time (maybe because I skim what I read) understanding what your ultimate goal is with these intensive antibiotic treatments. And I did not understand why you're husband got some shots in a very sensitive area. Just reading about the cries of pain hurt me tremendously but he's your husband! so discount my opinion if needed.