Monday, August 8, 2011

What would you do?

I really want to know because I think there may be some angles I haven't thought of so I'd like some outside input.

I went to my gyn doc today because I decided if I can't get pregnant then I want to do something about this damn endometriosis. Most of the treatment options I knew of also actively prevent pregnancy so they haven't been an option until now. Here's the thing, though. In my head I have given up all hope of ever having another baby. My heart still hangs on to that last ridiculous thread of hope, not helped by the aunt who "adopted and then got pregnant" story I keep hearing OVER AND OVER (please don't do that. ever.). So while I am theoretically on board with preventing pregnancy in the name of reduced pain, I am not so sold that I want to make it semi-permanent.

My doctor gave me several options to think about, listed below with some pros and cons I have thought of. Please tell me which option would appeal most to you and why, I'm hoping there is some factor I haven't considered because I am really, really torn.

Option 1: Take cyclic progesterone (2 weeks on and 2 weeks off)
Pros: It should regulate my period and won't prevent pregnancy
Cons: It will probably only help a little with the endo pain, progesterone makes me very sensitive to heat and I work outside in a heat index of 110-120 degrees.

Option 2: continous birth control for 3 months, then a period, then another 3 months OR cyclic progesterone.
Pros: possibly no period for 3 months (it didn't work last time but this is a higher dose), could 'reset' my ovaries and allow me to get pregnant after stopping
Cons: high dose is a higher risk of dangerous side effects, effectively sterile for at least 3 months and I'm not getting any younger, not really likely to work

Option 3: Lupron, which will cause artificial menopause for six months
Pros: no period for six months, likely to reduce endometriosis for awhile after stopping (worked for me before, for awhile)
Cons: might be very expensive, hot flashes are a side effect (work outside), might not work and will definitely prevent pregnancy for six months

Option 4: do nothing and save up for accupunture
pros: a little less stressful not having to remember pills, more natural, could get pregnant (insert laughter)
cons: VERY likely to go back to highly irregular periods and near constant bleeding, no relief from the endo pain, it will take a long time to afford treatments (a year or more)

Option 5: Get the mirena IUD for a year or two and reassess
pros: Might have no period at all, has been shown to reduce endo symptoms
cons: won't do anything for fertility, prevents pregnancy, might have constant periods, expensive (This is the option I wanted until a few days ago)

So, I am leaning towards the birth control for three months but I'm feeling very negative about the chances of it working. There are several things I have to consider. I can't take meds that will make me get heat exhaustion out in the field, which could kill me. The endo pain has gotten so bad that I spend the first two days of my period drunk and holding on to a heating pad. I'm running out of excuses for work. I am 35 and I've already had one baby with severe defects. I think that really jumps up the chances of having another poor outcome at my age. I really want to just say 'screw it, I'm not going to get pregnant' and go with the option most likely to reduce the pain. Problem is, I don't really know which option that is, and if it's lupron and IF my insurance will cover it, I still can't take it until winter so the hot flashes don't make me sick. But I can't convince my heart that there really is no hope. That non-logical part of me really wants to leave a window open for miracles. GAH! NOTHING IS EVER EASY!! I think I may get that tattooed on my forehead.

There is one thing I keep forgetting because I can't afford it right now. My main purpose for going today was to ask for another laparoscopy. I had one when I was 21 but nothing was removed because there was a lot of blood vessels nearby and my surgery was in a small hospital. There wasn't a surgeon on call that could fix massive internal bleeding so my doctor wasn't comfortable trying to cut off the growths she found. Now that I know this it can be planned for and I have a better chance of getting some real relief from surgery. My doctor was fine with doing the surgery but warned me that it is not feasible if I can't take significant time off of work (which I can't - no sick leave). She said there is a chance the small instruments won't be enough and they would have to make a larger incision and perform a laparotomy instead. That would be similar to a c-section and I would have to be out of work for six weeks. It will be 2 years, at least, before we can afford that. So, again, the &^%)& money is an issue. If only I had never gone to college and become a plumber instead.

Well, anyway - what do you think you would do if these were your options? Keep in mind I have a living child and we are pursuing foster adoption, so even though I really, really want another baby, it won't kill me if I can't have one (or so I tell myself).


  1. I say go with option #2. They make lower dosage pills but even if youre' not on those if you change your mind about the option, you can quit that same day. Your period may be messed up that month but it's better than getting shots/IUD, etc. and changing your mind midway. I used to take the generic and it's $9 a month.

    You could also take the pill for 3 months then switch to Lupron when it gets cooler.

  2. I'd probably pick option 2 as well because you can more easily just stop taking the bcp. The bcp will have side effects but at least they are pretty well known so you know what to look for.

    I'm sorry that the surgery is not an option right now. It seems so wrong that you have no sick leave benefits.