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Sunday, January 25, 2009

My fears.....

I am seeing my new doctor tomorrow. She is supposed to be this really great RE (reproductive endocrinologist) who has helped hundreds of women in my situation. I am scared to death.

First off.....if she says that there is a chance I can get pregnant...what will the cost be? Never mind the financial strain that we are already under just trying to keep me comfortable because of the PCOS and endo....but more fertility treatments than I have already tried cost literally hundreds and thousands of dollars. How could we ever afford it? No insurance and only one income does not rich people make. And thats not the only cost. How much longer can I be in pain and "just deal" with it because I so desperately want to be a mother? How much longer can I put this strain on my marriage because we want a child to share our love with? How fair is it to try like hell to being a child into my life when I am still so sick and in so much pain that I may not be able to care for them the way they deserve? There are so many more costs to consider other than money. In fact, money is the least of it. I would find a way to get the money if that was my only concern.

Then there is the fear that I will hear what I am sitting here tonight trying to prepare myself for. That the chances are so low that it would not even be worth it to try. I have always thought that there might be something wrong with me in the reproductive department, but when I was with my ex-husband I just thought that God was looking out for me and not letting me get pregnant because he knew that he would have been a bad father. But what about now? Now I have a man who would be a fantastic father....who loves me and would love any child that we would be blessed with. I always thought that it was Daniel....I thought, "thank God he couldn't have kids cause then I would still be tied to him" I guess it was me that whole time. Long story short I have been thinking about this for years and here I am about to be faced with the possibility that it will never happen for me and my heart is breaking. I am crying every other hour because I hear the doctor telling me what I am so scared will be true. I am infertile. And the thing is I might get awesome news tomorrow but what if I don't? Even though I am trying like hell to prepare for the worst I know there is no way I will be able to hold it together if I get the news that somehow I already know is coming.

And then there is what to do next? What to do if the news is bad and then we have to deal with the next steps....the steps to get me out of pain and on with my life? I talk all the time about how if it comes down to it I would be ok with having my ovaries removed or even having a total hysterectomy....but really thats just talk. It sounds all well and good to act strong when you are sitting there having coffee with your mother...its a whole other thing when you are sitting here in the middle of the night not able to sleep going over and over it in your head. On the one hand....I would KILL to never have another period again...but then again what women wouldn't? On the other hand how would I ever deal with that inevitable feeling of not feeling whole? Two very good friends of mine recently underwent hysterctomies due to adenomyosis. (I will place a brief description at the end of this blog for those of you who are interested.) These are two of the strongest bravest women I have ever had the pleasure of calling friends....and even though I know it is never as easy as it sounds...they are dealing better than I ever could. You read stories about how women without breasts because of cancer or things like that come to the realization that they are still whole women even though they are missing the most outward feminine part of them. These women are stronger than me I think. I still have all my girlie bits and yet I feel broken and not whole would I feel if I didn't have my uterus anymore? Or even if I didn't have my ovaries? Even right now, sitting here, I feel as though what defines me as a woman is somhow inferior to others. The logical side of me tells me that this just isn't true....but my poor broken heart sees it differently.

This damn depression scares me too. I have always gone through bouts of depression even when I was a child...and I can tell when its just a passing thing or if I am in for months or even a year or more of serious battling with my own head. This one is getting bad. Before you all freak out and say I should see someone I fully intend on asking the new doc tomorrow for a referral. But seriously...who wouldn't be depressed with all of this stuff going on? Every minute of every day of my life I am thinking about all of these things. It has gotten to the point that I have to have the TV or radio or SOME kind of noise going on at all times just so that I am not overloaded with the screaming thoughts in my head. I put the TV on sleep for three hours and then somehow sometimes I am able to get to sleep. I ask dan to turn the TV back on when he leaves to work so when I wake up I will have something to focus on that isn't my own thoughts. Even while reading I have to have the radio on in the backround because if I don't I somehow see myself and relate everthing in the book to what is going on in this crazy head of mine. I fear seeing someone for this. I was on so many pills for so long when I was a child that when I turned 18 and could take myself off of them that is exactly what I did....because I really thought that I didn't need them, and for the most part I was right. I have been without anti-dperessants since then and I am afraid if I talk to someone they are just going to want to fill me up on prozac and send me on my way. I know all to well the side effects of these kinds of medications. I believe that they can so some people some good....but I also believe that most doctors use them as a fix-all and they are only using that particular pill that particular day because someone from that company bought them lunch the week before. I should stop talking about this now before I go off on the problems and my opinions on drug companies!

So that is today. All these things running around in my head and not a damn thing to do about them but write. It does help though...getting all these things out there into the world. I can say things when I write that were I talking I would search for hours for the right words. For those of you reading this, thank you for listening. And for those of you who are battling the same things I am and know where I am coming from, I hope that you get everything you desire and my prayer is that one day there will be a cure for our ills and these thoughts will be but a memory. God Bless you all.


Adenomyosis is a medical condition characterized by the presence of ectopic endometrial tissue (the inner lining of the uterus) within the myometrium (the thick, muscular layer of the uterus).

The condition is typically found in women between the ages of 35 and 50. Patients with adenomyosis can have painful and/or profuse menses (dysmenorrhea & menorrhagia, respectively).

Adenomyosis may involve the uterus focally, creating an adenomyoma, or diffusely. With diffuse involvement, the uterus becomes bulky and heavier.


The cause of adenomyosis is unknown, although it has been associated with any sort of uterine trauma that may break the barrier between the endometrium and myometrium, such as a caesarean section, tubal ligation, pregnancy termination, and any pregnancy.

Some say that the reason adenomyosis is common in women between the ages of 35 and 50 is because it is between these ages that women have an excess of estrogen. Near the age of 35, women typically cease to create as much natural progesterone, which counters the effects of estrogen. After the age of 50, due to menopause, women do not create as much estrogen.


The uterus may be imaged using ultrasound (US) or magnetic resonance imaging (MRI). Transvaginal ultrasound is the most cost effective and most available. Either modality will show an enlarged uterus. On ultrasound, the uterus will have a heterogeneous texture, without the focal well-defined masses that characterize uterine fibroids.

MRI provides better diagnostic capability due to the increased spatial and contrast resolution, and to not being limited by the presence of bowel gas or calcified uterine fibroids (as is ultrasound). In particular, MR is better able to differentiate adenomyosis from multiple small uterine fibroids. The uterus will have a thickened junctional zone with diminished signal on both T1 and T2 weighted sequences due to susceptibility effects of iron deposition due to chronic microhemorrhage. A thickness of the junctional zone greater than 10 to 12 mm (depending on who you read) is diagnostic of adenomyosis (<8>

MR can be used to classify adenomyosis based on the depth of penetration of the ectopic endometrium into the myometrium.


Treatment options range from use of NSAIDS & hormonal suppression for symptomatic relief, with hysterectomy the only permanent cure option. Women with Adenomyosis fail endometrial ablation because the ablation only affects the surface endometrial tissue, not the tissue that has grown into the muscle lining. This remaining tissue is still viable and will continue to cause pain. The result of failed ablation due to Adenomyosis is hysterectomy.

Those that believe an excess of estrogen is the cause or adenomyosis, or that it aggravates the symptoms, recommend avoiding products with xenoestrogens and/or recommend taking natural progesterone supplements.


There is no increased risk for cancer development. As the condition is estrogen-dependent, menopause presents a natural cure. Patients with adenomyosis often also have leiomyomata and/or endometriosis.



allisyn said...

thanks so much for your comment sara! the same goes for you hunny :) hope you have a great day today!