Friday, November 8, 2013

My HSG Procedure

A hysterosalpingogram ("HSG") is a special kind of X-ray that looks at the inside of the uterus and fallopian tubes and the area around them. It often is done for women who are having a hard time becoming pregnant (infertile). It is pronounced he-ster-o-sal-ping-o-gram, but luckily, almost no one calls it by the full name. They just say HSG.

The HSG helps the doctor check out two important factors:

1. Whether or not the fallopian tubes are blocked or open. If the fallopian tubes are blocked, a woman will not be able to get pregnant, because the egg can't meet the sperm.

2. Whether or not the shape of the uterus is normal. In 10% to 15% of women with recurrent pregnancy loss, an abnormally shaped uterus is to blame.

A few days before my HSG procedure, I was googling on it and came upon some bloggers recounting their experience with HSG. One blogger's experience made we so worried that my stomach went tied up in knots. Basically, she felt so much pain during the procedure, and the pain lasted for several hours after. I immediately stopped reading, and tears fell down my face (gedik kan, belum pape lagi dah nangis). But yes, I cried, thinking of just how many challenges I will have to go through to get that beautiful baby, and this is just the first little challenge, and ini pun I dah nangis teresak-esak. Tak senonoh kan. Well, that was just a small breakdown moment I guess, I was also feeling kind of pressured kannn with all this not being able to get a baby business. However, when the day finally came, I was surprisingly 100% ready.

DA asked me to go through with the procedure with Dr Fatimah at Hospital Tawakkal. So hubs drove me there this time, yes I need his support, takoottt!!! It was Tuesday, 1st of October 2013, my CD11. I was really scared but remained calm. After registering at the X-ray department, I waited for my name to be called out. 
Trembling feet
When it was my turn, I was brought to a room with an examination table, some huge scanning equipments like the ones I always see in Grey's Anatomy, like a CT Scan equipment thingy. I changed into the hospital gown, and walked back outside to a chair waiting for the next instructions. Terkial2 tau my hands nak pegang the opening behind me, the velcros on the gown was not really working so when I walked, the whole world could see my behind, thank you very much. But luckily there wasn't anyone around, only nurses la.

Then my time came, I was asked to lie down on the examination table, with my knees raised and legs slightly parted as usual. Dr Fatimah ("DF") came in, she looks garang but rupanya when she started speaking, lembut sgt and very nice. She made small talk, asking me how many years have I been married, and other simple questions which actually helped to ease my ketakutan.

Me on the examination table
DF started by inserting a speculum (i call it mulut itik cos it looks like one) into my VJJ, this is similar to getting your annual pap smear. Then, my cervix was cleansed with an antiseptic solution, and a small flexible catheter (wow now I am sounding like the doctors in Grey's) which is much thinner than a coffee stirrer was inserted through the opening of my cervix and into my uterine cavity. Then DF removed the mulut itik, and then she injected a small amount of dye passing through the catheter, filling my uterine cavity and then filling my fallopian tubes. 

There was a "fluoroscopy" monitor screen next to me, which is a "live" x-ray that allows us to watch as the dye is travelling through the tubes. The tubes are considered open when the spillage of dye occures at the end of the tubes. This means that the dye has escaped the tube and thus your tube should be able to "pick up" your ovulated egg.  
Live view of the fluid flowing through
However, this was the step that I dreaded, as when the dye was gently infused into my cavity, some cramping occurred as my uterine cavity distends with the fluid. It is more or less like heavy menstrual cramping, but more to sengal2 sikit, sengal2 banyakla jugak kot when DF injected the fluid for the third time! 

But dont't worry, the doctor will always ask you if you can still bear the discomfort or not, and they will remove the catheter as soon as they've obtained a nice clear picture of your uterus and tubes. Some people still experience the cramps for several hours following this procedure, but for me alhamdulillah takde ape2 sangat. I was in the midst of my closing week, and I had to rush to office thereafter and worked till my 1 a.m. night shift ended. Oh and do use a pad or panty liner perhaps for 1 or two more days after your procedure, as there will be some bleeding.

Then you will just have to lie down for about 30 minutes just to make sure that the fluids are flowing through and take another X-ray. Cost of HSG at Hospital Tawakkal is RM180. Oh and they also need a referral letter from your doctor for this procedure.

My results: Both fallopian tubes are functioning normally, and uterus is looking okay.

YEAAAYYY!! Syukuralhamdulillahh!!! Can't wait to show Dr Adilah my beautiful X-ray!!

Tuesday, November 5, 2013

The Curtain is Raised


The day after my 30th birthday, was the day I realized that I have been moping around doing nothing for too long now. Well, actually it was on the eve of my birthday that I, out of nowhere, suddenly picked up the courage to call up Pantai Hospital for an appointment with the oh-so-famous Dr. Adilah Ahmat. My friend, Syafiq, recommended her, told me his aunt is now expecting a baby after going for treatment with Dr. Adilah.

So yes, I called them up and secured myself an appointment with Dr. Adilah on the 11th of September, 2013. That morning, I woke up at 6 a.m. and drove out to Pantai Hospital in Bangsar around 7 a.m. With my past experiences of appointments with a gynae (yes I did see a gynae once back in 2010 but it was just to fix my menstrual cycle), I know that I need to be there very very early if I don't want to get stuck for the whole day as gynaes tend to have a LOT of patients, and if you're like the 10th person in line, just call up your office and upgrade that half day leave to a full day cuti-cuti Malaysia.

Dub dab dub dab! My heart beats furiously. Well, actually the sound of the heartbeat is "lub dub lub dub", not sure if that is correct or not but I think learnt that in Biology class in high school. Ish merepek pulak kan.

But yes, it was the truth, I was really really scared. Honestly, I didn't have the courage to hear any bad news about my uterus, or my ovaries, and I certainly didn't want to ever find out that I can never have a baby. I text-ed Nadia telling her that I am at the hospital waiting for my turn and I told her that I am freaking out and I wanted to just go home and cancel everything. Well, Nadia babbled like a nenek and encouraged me to stay and at least hear what the doctor has to say.

Ok lah enough drama, let's get back to business. I stepped into Pantai Hospital and went straight to Block D, which is to your right if you are coming out of the carpark lift lobby. Walk right to the end past Baskin Robbins and Starbucks and the cafeteria and you will find another lift lobby. To your left is a huge directory of doctors, and you can find Dr Adilah's name there.

Then, take the lift to the 4th floor, that's where her office is, and you will need to register yourself and take your number at the registration desk. After registering myself, I went on and sat at one of the sofas outside the doctor's room and waited. I think I was number 5 that day, and around 1 hour later Dr Adilah's nurse, Ida, called my name.

Me: Good morning, Doctor! *smiling bravely*
DA: Morning! Eh ni ape citer ni kenape datang sorang jer ni...
Me: Ohh...husband keje, doctor. Die ade urgent meeting hari ni.
DA: Oklah takpe, bile last period?
Me: Tak ingat dah doctor. Maybe 4 to 5 months ago kot.
DA: Okay come let's do a scan. 

DA showed me to a bed behind a rail of curtains, and asked me to take off my pants and whatever I have under it (don't worry, she won't be there goggling at you taking ur pants off, she will come when u're done). Once done, I had to climb up the bed and lie down, with both of my legs raised and slightly parted. Then I covered myself with the blanket that was on the bed, and waited for her to come and examine me.

DA came and she started handling this kind of stick device, strapping a condom on it (not sure la what that was but looks like a condom to me) and applied lubricant to it. Then without even looking at my VJJ (see how professional she is) she smoothly and gently put it in me, can't feel a thing yeay! But I did feel a bit senak2 (ahh what's the English word for senak? Sorry Cha, I know u're reading this, ermm try google translate okay?) when she started probing inside me trying to get closer to my ovaries. 

So the procedure she was doing to me is called ultrasound pelvic scan. This is to detect any abnormalities in my uterus and ovaries, and yes she did find a lot of small follicles or cysts in my ovaries and showed them to me. The moment she told me that I might be having this condition called Polycystic Ovary Syndrome (PCOS), my heart skipped a beat. I have been doing some online reading on infertility, and PCOS is the main cause of it. 

to be continued....

The Curtain Is Raised Part II

This is the ultrasound scan of my ovaries. See those collection of little cysts that look like beads around the ovaries' edge? That shows that I have polycystic ovaries ("PCO"). But please pay extra attention at the information I typed out below, as many women are confused with the terms PCO and PCOS.

Women who have polycystic ovaries MAY NOT have Polycystic Ovary Syndrome ("PCOS"). In other words, PCO is not necessary for diagnosing PCOS, but is a common sign. As many as 30% or more of women with PCOS do not have PCO as a sign. 

So I still have a glimmer of hope! Maybe I don't have the dreaded PCOS! Why am I so worried about having it? Here's why;

Polycystic (pah-lee-SIS-tik) ovary syndrome (PCOS) is a health problem that can affect a woman's:
  • Menstrual cycle
  • Ability to have children
  • Hormones
  • Heart
  • Blood vessels
  • Appearance

I have highlighted in yellow the most important thing in a woman's life, in my opinion, the ability to have children. Who would want to feel less than a woman? Not me. I am a woman, therefore I should be able to bear children. But with this PCOS thingy invading my life, it is affecting my ability to do that (note that it is only affecting, and it is not impossible for me to have children - tetibe that glimmer of hope datang balik). 

So DA wanted to conduct blood tests on me to see if I have other symptoms of PCOS (danggg!!) and she also told me that my right ovary is a bit high up attached to the uterus wall and this worries her. Her concern was that if my right Fallopian tube is blocked because of the abnormal position of my ovary. So she asked me to go through the Hysterosalpingogram ("HSG") procedure just to make sure that my tubes are working. 

Some of my friends who have just started to be on TTC have asked me the details of my bills, as they would want to prepare themselves and decide on whichever alternative they want to try. So, this was my very first visit to see the beautiful Dr Adilah (she is very cantik and lemah lembut), and below are my costs;

Admin Fee RM4
Consultation and Assessment RM180
Procedure Ultrasound Pelvis Scan RM90
Laboratory investigation (Various blood tests) RM506
Medication (Norcolut, Clomid, Vibramycin) RM58.40
Total RM838.40

What I had to do;

1. Take Norcolut for 5 days in a row.
2. Then wait for Aunty Flow to come visit.
3. Take Clomid on the 3rd day of Aunty Flow's visit (Cycle Day 3/CD3), for 5 days in a row.
4. On CD11, go for HSG procedure. Take Vibramycin the day before procedure, on the day of procedure and the day after.
5. Next appointment with DA on CD12.

A little bit of info on the medications below;

Norcolut - Drug for delaying menstruation. However, it is also used to induce menstruation, not sure how it works, though. But yeah it worked for me, my Aunt Flow came 5 days after I finished the meds.
Clomid - A drug used for ovulation induction, to help me get lots of eggs!
Vibramycin - Just an antibiotic to prevent myself from getting any infections from the HSG procedure.

That's all for my first visit to the doctor. In my next post, I will be writing on the HSG procedure that I had and also the results of my follow up checkup with DA on CD12.

Thank you all for reading! Xoxo!