Hysteroscopy Post-op

I went in for my post-op yesterday. My appointment was scheduled for 2:50 pm and they ask that you arrive 15 min early to check in. I had already confirmed my information online so I didn't think I need to be there that early but I was hoping if I got there early maybe I'd get seen sooner.

On my way there, my gas light turned on and I debated whether I had enough time to get gas before the appointment. My gas light rarely goes on, it's not something I procrastinate because I have no interest in getting stuck anywhere. But recently I drove my husband's car and that needed gas so in my mind I had already gotten gas recently and kept forgetting to fill mine. I decided I didn't want to risk getting stuck without gas so went to the pumps near the office and ended up getting to the appointment by 2:40 pm. Plenty of time. Checking in took about 30 seconds because I had done everything online. Then I sat and waited. And waited. They were clearly running behind.

At 3:15 I got called back by the assistant to get vitals. She took bp, pulse, and temp. She asked me to get on the scale and I asked if I have to since I was just there. She retracted quickly saying, no no we don't have to it's just part of the protocol. Well eff protocol. I'm really quite done doing stuff "just because." I'm pretty much game to do anything that will be helpful but I'm not a puppet and if something isn't necessary then what's the point? I had also weighed myself earlier that morning and I know how much I weigh and just gave her that number which was good enough. I know when we start actual IVF or something then I'll have less of a choice and I'm ok with that. Honestly, I was wearing complicated sandals and didn't want to deal with taking them off if it wasn't necessary.

Nurse left and I waited some more. A medical student comes in and said she will get some information to tell the doctor and then the doctor will come in. At this point I was feeling annoyed. The wait didn't bother me until that very moment. When the medical student tried to explain why she's there instead of the doctor she said something like, "Well, because we can give you more time and get the information to the doctor." I'm paraphrasing but that's the gist. This upset me because I'm paying to see the doctor, I'm not paying for a med student's time nor did I schedule on the med student's calendar. Surely they will bill me with the doctor's fees. I'm not a case study or a charity case - I'm a paying customer and I didn't come here for a med student. This was all going through my mind as I tried to not get angry because when I get angry I cry. So I switched gears in my mind and said, fine let's do it. This is, after all, a "teaching hospital" and something else to get used to in a new clinic. Awesome.

So she started asking questions about my recovery - fever, chills, nausea. I told her that recovery took a while, in my opinion because of the general anesthesia. I told her about my cramping and spotting. She asked a few more questions and then went to the doc. The walls are pretty thin and I could hear the discussion in the doc's office. What I think happened was that the doc was running so behind schedule that she never had time to eat lunch and so instead of making me wait she sent in a med student to do the grunt paperwork before coming in. I'm on board with that. I would have been even more on board if the student had introduced herself by saying, "Hi I'm a med student and I know you've been waiting for the doc so in order to maximize your time here and get your appointment moving, I'll get some notes before the doctor comes in." That would have made me feel like even though they're running behind they're still respectful of my time and that my appointment isn't truncated with the doctor just because the schedule is messed up.

ANYWAY. Doctor comes in, says hi, and says she doesn't like that I'm still spotting. She asked if she could do an exam to check for infection. They left and I got undressed... the sandals had to come off afterall. She didn't see signs of infection. She took samples to look under the microscope and didn't see anything alarming there either. She recommended I stop the bc pills to get a period even though I'm not due to do that for another week. The thinking being that the procedure may have irritated the lining and it's off balance or something. If spotting and cramping continues after my period then she wants to put me on antibiotics. Ironically, in the quest of searching for inflammation, it's possible that the procedure triggered some inflammation.

Originally, the next step would have been the ERA. But since she wants to make sure there's no inflammation before testing the lining, her recommendation was to do IVF next. Moving up the timeline on the IVF is fine and this schedule lines up with when my husband's mandatory wait is over. It actually works out well to move up this period because then we're doing a retrieval as soon as he's ready. We're waiting for pathology results regarding the stain that the RPL specialist wanted to see. That's taking a little longer than expected and coupled with this newest unexplained spotting, she wanted to change the timeline a little bit.

In summary, here are the next steps:
- Initiate period asap
- Break cycle in July waiting for spotting to resolve and pathology results
- IVF cycle in August
- ERA cycle in September
- FET in October

There are a lot of ifs in that timeline and I know it's not set in stone. For example, depending on the timing after the retrieval we may push off the ERA/FET by a month due to the holidays. Also there will only be an FET if there are embryos from the IVF cycle, obviously.

The ERA is supposed to be a natural cycle, which means multiple days of monitoring, possibly on a daily basis. She asked if Saturdays are out completely and I said not necessarily. I'll come in for a procedure if I have to, especially for something like a retrieval or a very specifically timed FET because there's so much at stake. But for something like the elective ERA where I know there will be lots of days I have to go in, it's just not worth the hassle and stress to try to do it over the holiday season where there will be so many days that it will be a challenge to go in.

While I don't like the delay of the ERA, I'm happy with this switch. It means having the retrieval in the summer before things get hectic for me at work in the fall. It also means getting the heavy recovery procedure out of the way. I like the idea of possibly taking a break for the holidays before getting back into it for the ERA/FET. I know it's all going to work out how it's supposed to and I have no say over things I can't control, but for right now I'm content with this schedule and I'm trying not to worry about the spotting.