Friday, August 30, 2013


I just returned home from a memorial service for a friend's mother, who died too young, was lost too soon.

I never met her but she was remarkable, nine of her children were in attendance.  The room was filled with sisters, grandchildren, cousins, neighbors, loved ones.  Her DNA was in bloom in the room, along with music.  As was her spirit.  She was a poet, an activist, a mother.  The memories of this woman were tangible, the room was thick with love, warmth and humor.  Those memories, along with the many words she penned, ensured that she really is still with her family, her friends and the many people she touched.  There were many tears, but she was - she is - eternal.

The miscarriage of a baby - particularly one early in utero - is wrapped in complication.  Many friends and strangers, intending to be kind, tell you that this really wasn't a baby at all, but a cluster of cells.  And  a cluster with chromosomal problems at that, deeply flawed and never meant to breathe on this earthly realm.  This truly isn't helpful.

When you lose a pregnancy, at any stage, you lose a dream.  It could be a vision of yourself as a mother.  It could be a sibling for your living child.  It could be the dream of a family picture that you envisioned.  For some women, the dream is borne with two lines on stick.  For others, the dream begins at an ultrasound. 

I think I've mentioned before that I am an only child.  I was - am - a very happy one, with more love than I can express for my parents, and a rapport with them that I think is unique. But I always imagined niblet with a little sister or brother.  Not because I have any belief that she needs them to be a stable human being.  Not because I believe that siblings are always there for one another.  Not because I think that onlies are spoiled, or at risk of some social disease.  Just because, well, because this was my dream.  Some people dream of acquiring a boat.  Some people dream of a trip to Hawaii.  I dream of raising two children.

Every baby I have lost is a loss of that dream.  But to explain to people my miscarriages in those terms, in the parlance of dreams, well, that doesn't really do the trick either.  It's not quite right.  Some people dream of going to grad school, but they blow their MCATS/LSATS/GMATS.  They've lost something too, right?  Visions of their careers, or the futures they would have?  I was a dancer, a ballerina, and dreamed of being on stage as a full-time career.  It didn't happen for me.  I found fulfillment elsewhere, while I still mourned the loss of a vision of myself.  But just trust me when I say that the losses of my babies feels very different from the loss of my dance dreams.  Mourning them simply cannot be the same.

And please, just throw your rationality to the wind when I say, with the utmost determination, that they were my babies.  Not my clusters of cells, not my fertilized eggs, not my zygotes.  They were my babies.

So what are the words to describe the gaping hole that is felt for babies that could never live?  For babies that were mere clusters of cells for those who did not know them?  For babies that could never create poetry, or leave a room full of attendants with memories, and music and stories?  For babies that perhaps only live on in a medical record or a blurry ultrasound picture? 

Words hurt, words sting, words express, words heal.  But sometimes they're really difficult to find.

Tuesday, August 20, 2013

Seven words.

"Your husband has no abnormalities.  Keep trying."

The message sent to me by my RE, via the hospital's online lab report portal for patients. 

Saturday, August 17, 2013


The next few weeks following the news that my recent pregnancy was lost due to a rare Trisomy were a fog.  As you've figured by now, reproduction for me is like an old movie set, in Victorian-era London, with the copious use of a smoke machine.  We learned that there would be one of two outcomes: a) this is a random "de novo" event, and my recent loss is the result of some more unfortunate luck, or b)  There is an "explanation" to my problems:  my husband is a carrier of an inherited chromosomal abnormality called a Balanced Translocation and I will continue to lose babies because of it.

So what does a girl facing a potentially rare chromosomal defect that causes miscarriages do?  Join a support group of course!

The Balanced Translocation (BT) support group is one smart group of ladies (and a few rare gents who like to discuss their feelings with the virtual world).  Some are women who have survived as many as 8 miscarriages.  Others are women who have discovered -  after having one completely normal pregnancy -  that they can't conceive a healthy baby the second time around. All of the group's participants have been through a special ring of hell called Repeat Pregnancy Loss (RPL). 

BT is a game-changer.  Some couples turn to IVF with genetic screening to try and cull out only healthy eggs - this may or may not be covered by insurance (more than likely not). Others stick it out and brace themselves for multiple miscarriages - three, four, five, ten(!) -  in pursuit of a healthy baby.  Because BT turns out to be a game of reproductive roulette. 

I learned a lot about statistics the next few weeks.  The best explanation of BT, and the potential translocation my husband carried, was found here:

Another awesome attempt at genetics comes from this blogger, who helpfully uses playdough to illustrate her husband's BT.

The bottom line is that when you or your partner carry a genetic translocation, you have at least a 50% chance of conceiving a baby that is "unbalanced" - this means severe disability, often so severe that the baby won't survive the pregnancy, let alone the outside world.  This is what accounts for the high miscarriage rate in its carriers.  You then have something along the lines of a 25% chance of conceiving a baby who carries the chromosomal defect but is otherwise perfectly healthy (though prone to their own miscarriages when they later reproduce).  And then there's something like a 25% chance of having a baby that is "perfect" a non-carrier.  All of these numbers are rough estimates and the outcomes hinge on the specific kind of BT carried, along with too many other factors for me to wrap my humanities-driven brain around.

Carriers of BT have to face horrifying and calculating decisions on a daily basis.  Do I keep ttc naturally?    Do I turn to IVF to try to cull more healthy eggs?  Do I undergo CVS and amnio despite their miscarriage risks?  Do I terminate a baby who is unbalanced? What are my parameters for stress and grief?  At what physical and emotional price to I continue to push my body's limits?

These decisions consume me for the next few weeks as we wait for Husband's lab work to come in.  All I can do is hope that our baby's T-14 was "de novo" - a one-off defect that wasn't inherited.  I am no longer hoping for an explanation on my pregnancy loss because the explanation is terrifying.  Wow. I am actually hoping for more bad luck.

Waiting. Again.

Having had a miscarriage already once, complicated by, well, the specter of cancer, this new loss was actually more terrifying.  Was it another molar pregnancy?  Something even worse?

This go-around, I am registered on my fancy hospital's web-portal, and can access all of my lab results as soon as they're in.  I was at a work-related function when I made the mistake of checking the site.  Kids, put the phone down, or you'll learn the hard way that nearly bursting into tears in front of your colleagues isn't optimal.

Karyotyping results:  Trisomy 14, Trisomy 22.

Wait, what?  My poor baby had not just one chromosomal abnormality, but two????  Sweet jesus.

That night I get home and of course research the fuck out of these trisomies.  For starters, is it beyond bad to see a DOUBLE trisomy? 

T-22, turns out it pretty common, often associated with advanced maternal age. 

T-14, however, throws me for a loop.  The only hits I really get on it are related to something called a "Robertsonian Translocation" which appears to be an inherited genetic defect.  Good god, are we inherently flawed on top of old?

The next day, new RE calls.  "Your karyotype results are very interesting," she says, with the fascination in her voice that I am becoming accustomed to.  "I had to talk to a genetic counselor to understand them!" 

I love being a walking statistical anomaly. 

Let me guess, Doc, do you suspect we have a balanced translocation?  It turns out my withering old egg contributed the T-22, however, the T-14 came from Husband's DNA.  He would have to get karyotyped himself now to determine whether or not he was a carrier.  For once, I wasn't the one who would be donating vials of blood for the cause.

Friday, August 9, 2013

Dr. Feelgood

My new RE is something of an intimidating woman.  She's just not warm and fuzzy.  Her reviews on Healthgrades have many a complaint about her telling patients to lose weight.  I was actually nervous about this factoid, seeing as I was a bloated pregnant lady.

And when I brought Husband in with me that Monday to see her, she did in fact tell me to lay off the refined sugars should I attempt ttc again - and told my poor husband he could follow the same advice for good measure.  At least she was equitable about it.

We finally got to talk, and I got the distinct impression my case fascinated her, I could see the wheels spinning in her head as I described my history.  Partial Molar Pregnancy.  Asherman's.  Repeat Pregnancy Loss.  But for the first time in a while, a doctor managed to make me feel a little less shitty about my circumstances. 

"You didn't need chemo after the molar? Good."
"Your scar tissue was all localized in your cervix?  Removed in one procedure?  Great."
"You were getting regular cycles?  You had a healthy pregnancy?  You're clearly fertile."

When we got to the part about how I was going to remove my dead baby, she threw me for a loop:

"I don't like to prescribe cytotec to women like you.  If you'd popped out a bunch of kids, maybe.  But it's traumatizing.  And frankly, I want to test the fetus to see whether there were chromosomal issues.  I suspect this is a chromosomal problem, which is normal at your age.  Ideally, this is a situation where you dropped a bad egg.  We should really do a D&C."

But Doctor, what about scarring?  "I won't use force," she says.  "It will be a gentle suction D&C.  There's some curettage, but it shouldn't cause harm."

I look at Husband.  I think about my worst case scenario, another flight to Boston.  I imagine no longer enduring labor pains in my tiny bathroom while Husband tries to hide Niblet away. Take a breath.  OK, a D&C it will be. 

She performs an exam, we chit chat in that awkward way you do when someone will be inserting objects up your vagina, I focus on her teal green toes.  They match her mani. She's really put together.  I, on the other hand, in my current mental state, look like someone who wandered in off the set of a disaster movie.  We talk progesterone.  "You're taking the pills orally?!?!  Oh, I never prescribe them that way.  They act like a sedativeNext time you will take them as suppositories."  I like both the confirmation that my fog and exhaustion was over the top, and of course, I like the words, "next time."

She performs another ultrasound ("hard to get a really good picture with that tilted uterus") confirms that my baby has no discernible movement or heartbeat and we schedule my D&C for the following morning.

Scenes from a miscarriage. Week 3.

Wednesday June 5.  Pregnancy Week 6, Day 4.  Whoa.  I am exhausted. And queasy.  And last night I polished off a jar of pickle juice.  Yes, I said juice.  With a straw.

Thursday June 6, 10am.  Arrive at Maternal Fetal Medicine for ultrasound.

Thursday, 10:30am.  Lying on table squinting at ultrasound monitor.  Tech leaves room to bring in doctor.  The gestational sac is not measuring properly.  A kind doctor comes in.  We talk about my partial molar pregnancy.  I am likely miscarrying again.

Thursday, 11am.  Drive home crying.

Thursday 3pm.  My OB calls, she orders more lab-work.  She repeats what I am still processing, that there is a likely possibility I am miscarrying.  I do not remember the details of this conversation. 

Thursday 4pm.  Arrive at lab for blood-work that will confirm I am once again carrying another dead or dying baby.  Sitting in the chair, choosing which arm to lay forth for more blood, I cry. The phlebotomist asks if I would like to go behind a privacy curtain.

Friday, June 7, 10am.  I emailed Dr. Isaacson the night before asking his advice on miscarriage management.  He advises I either take drugs to induce the miscarriage, or opt for a "gentle suction D&C."  He warns that the drugs don't always work, and in some cases an AS patient ends up in the ER, under the case of a doctor who isn't careful to avoid scarring. He assures me that if my period doesn't return 8 weeks after a D&C, I can revisit him in Boston and he will perform another hysteroscopy.

Friday, 3pm. My doctor calls, she is going on vacation (again).  She suggests that I should see a new Reproductive Endocrinologist to manage my miscarriage because my case history is so complicated.  I am somewhat happy to learn it is a doctor familiar from the Asherman's forum.  She is reportedly competent.  We discuss whether I should take misoprostol (cytotec) to induce miscarriage.  I am given a promise that her office will call new RE, and this RE will fit me in her schedule next week on Monday.

Saturday June 8.  Cancel my zumba class.  Cry.

Sunday June 9, 2pm.  Seven weeks pregnant.  How did I get here?  Accompanied Husband and Niblet to her daycare classmate's birthday party at an enormous bowling alley.  Wonder in a haze, is anyone else here losing a baby, amongst the sound of clanging balls, falling (duck)pins, the sticky floors, the children screaming and skittering around, hopped up on sugar, breathlessly anticipating pizza and fruit punch. 

Sunday, 9pm.  I read every story I can find about cytotec, specifically the intense pain involved.  "I can do this.  I can do this. I can do this," I repeat to myself like a demented little engine that could.  I don't want another D&C.  I don't want my Asherman's to return.  I will gird myself for laboring this tiny sac at home. 

Scenes from a miscarriage. Week 2.

Wednesday May 29.  Week 5 Day 4 of pregnancy.  I'm really fucking tired.  Arrive at hospital Advanced Radiology lab for first ultrasound.  Warned by doctor that the most I will see is a gestational sac, perhaps a fetal pole.

Wednesday, 2:30pm.  Youngish ultrasound tech is baffled by request for ultrasound this early in pregnancy.  Engenders no confidence.  Loudly exclaims "I don't see anything in there.....maybe... yeah, I don't know.... I can't say I am seeing a sac..... I don't know."  I am told my doctor will get an official report the next day.

Wednesday, 2:50pm.  Drive home crying.

Wednesday 6pm.  Start feeling mysterious cramp around right ovary.  Between the pain and the words of ultrasound tech I am now convinced my pregnancy is ectopic.

Wednesday 6:15pm.  Join "ectopic pregnancy" support group on  Pose symptoms and questions to group.  Read horror stories about ruptured fallopian tubes and near-death experiences.

Wednesday, 9pm.  Warn husband of potential trip to ER.

Thursday May 30, 1am.  Is my cramping getting worse.  Is my baby trapped in my right tube?  Am I going to survive an ectopic pregnancy?

Thursday May 30, 10am.  Call doctor for Advanced Radiology ultrasound report.  Speak to kind assistant who says report isn't in yet, the doctor will call me as soon as she gets the result. 

Thursday 10:15am.  Imagine senior ultrasound technician staring at the images of my uterus in confusion.  I know from years of this shit, it's very tilted.

Friday May 31, 8am.  Call doctor back for lab report, kind assistant is pissed off at Advanced Radiology, my ultrasound report still isn't in yet.

Friday, 9am.  Fuck it.  Call in sick from work.  I'm exhausted.  Take niblet to pool in act of desperation to give her the attentive, loving, non-panicked mother who won't scar her for life, the mother that she deserves. 

Friday, 3pm.  Doctor calls me while I am buying Niblet a grilled cheese at the pool snack bar.  Her report says there is a gestational sac in my uterus.  IN MY UTERUS.  And I have a benign corpeus luteum cyst on my right ovary.  I should return to a lab next week for another ultrasound. 

Friday, 3:10pm.  Who is that crazy grinning lady with the kid in the pool snack bar?

Friday, 3:15pm.  Schedule radiology appointment for the following week with the hospital's department of Maternal Fetal Medicine.  In other words I will see a doctor who can actually read ultrasounds. 

Scenes from a miscarriage. Week 1.

Tuesday May 21. First blood-work, 4 weeks 3 days pregnant. 

Wednesday May 22.  Learn HCG = 668, Progesterone = 18.8.  Remain calm.

Thursday May 23. Second blood-work, 4 weeks 5 days.

Friday May 24, 2pm. Learn HCG rose to 1254.  This is an almost but not quite a 50% increase. Call doctor in panic.  She has left the office at 2.

Friday, 6pm.  New doctor returns my call, this is our first conversation, the first time she hears my voice.  I explain my Asherman's connection to one of her former patients.  She immediately warns that my age is a risk factor.  But my Hcg is fine, she just wants one more HCG and progesterone check. I then take the opportunity to summarize my reproductive history for her, as she does not have the benefit of my chart.  Healthy vaginal birth in 2009.  Partial Molar Pregnancy in 2012.  Asherman's Syndrome.  Concerns about incompetent cervix post-AS treatment in Boston.  She literally says "Oy," when I ask if I can teach my zumba class. (As long as I am not bleeding).  And then warns that she will be away for the holiday weekend.

Saturday May 25.  4 weeks 7 days, head to lab for betas.

Sunday May 26.  5 weeks pregnant.  Anxiously await call for doctor, who said she would receive my betas electronically and inform me of my progress.

Monday May 27, 8pm.  Finally receive call from Doctor.  HCG = 2439, which is good, but progesterone is low, only 10.9, which is bad.  Panic ensues. Dr. Google says it should be at least 15 - 20 is better - for a baby to survive.  Doctor will email in a prescription for oral progesterone to my local pharmacy, tells me not to worry, "I put more stake in rising HCG numbers than progesterone, yours are good," she says, clearly hearing my panic.

Monday, 9pm.  Scouring the internet for literature about the role of progesterone in a healthy pregnancy, imagine my body as a giant hormonally deficient vise crushing my baby to death.

Monday, 2 am.  Up awake imagining my baby fighting for its very survival because, have I mentioned I am hormonally deficient?

Tuesday May 28, 9am.  Arrive at Pharmacy and beg kind woman who looks at me like I am demented to rush my order, which has come through their email.

Tuesday 10am.  Take first dose of Progesterone.  Attempt to "will" myself to a zen-like calm through visualization exercises.  Imagine the cluster of cells in my uterus cheering at the added hormones now coursing through my veins.

Tuesday, 6pm.  Wow.  I am really freaking tired.

Wednesday, August 7, 2013

The Indignities of Advanced Maternal Age

"Supervision of high-risk pregnancy of elderly multigravida."  This is the shit you have to put up with when you're pregnant over 35.

('Pregnancy with other poor reproductive history" is sadly, a test code that doesn't discriminate).

Pregnancy after a miscarriage feels like....

Dumbfounded silence.  The sound of air. 

And then it feels like "Wheeeeeeee!"

Until then it doesn't.

Let me backtrack.  I knew I was pregnant in May, before I even took a test. BAM.  When I finally peed on a stick and saw matching lines I was strangely calm.  I am pretty sure I was quite blasé with my husband like, "Well, I'm pregnant.  O.K.  Cool.  Let's see if it sticks."  This is not the stuff that Clear Blue Easy Ads are made of.

First, I needed a new OB because, well, hell, I couldn't go back to the irritating lady who cracked jokes with a nurse in front of me before she scraped my uterus up and rendered me infertile, let alone the practice that instructed me to arrive for my D&C at the wrong time.

Luckily a member of my AS group saved the day, she told me of a great local obstetrician who delivered her first daughter after AS treatment, a doctor who took her concerns seriously. I would need to change hospitals, and become a patient at the hospital I had previously shunned as it was known in my town as C-Section central.  Of course, the more educated me now understood that this was because the women seeking obstetrics at this hospital were more high-risk.  Like it or not, I was now high-risk too --between my age and my sad little over-dilated cervix, I needed all the extra monitoring I could get. 

(I would like to slap the "old me" now, the one who self-righteously viewed the hospital's publically available C-Section statistics as indicative of servicing well-heeled ladies who lunch, ladies who wouldn't want those lunches upset by something so common as labor.  PLEASE CAN I SMACK ME?) 

So I called this nice OB's office at 4 weeks 2 days pregnant. They set me up with blood tests to monitor my HCG and progesterone, even though the doctor wasn't actually available to see me.  Not an ideal situation, but I took it.

Tuesday, August 6, 2013

Have I mentioned that I really hated my first RE?

I returned to Dr. X for my follow-up as prescribed by Dr. Isaacson, and wouldn't you know it, the guy managed to eff that up too.  No, seriously.  Remember that pipelle he was supposed to use to clear my cervix of scar tissue?  Yeah, well, he went ahead and painfully dilated my cervix instead.  And me, being in a sort of vulnerable position (seeing as I was lying prone and stirrups were involved), I was just like, "were you supposed to do that?"  Dr. X responded, "Oh, well, this is taking your doctor's suggestion one step further."  Are you trying to SHOW OFF Dr. X?  Because that is UNBELIEVABLY wrong.  AS patients are already at risk of incompetent cervix should they fall pregnant, you just made me even more vulnerable.  Jesus. Thanks doc.

THEN  - after he has already performed the completely unnecessary procedure - Dr. X gets all anxious and asks me if I could be pregnant, because dilating one's cervix could you know, cause a pregnancy to fail.  NOW YOU ASK ME?  No, I am still being monitored for my partial molar pregnancy, and I have to wait another month to pull the goalie.  No, I'm not on the pill, we use condoms and I am not about to get on the pill at my age, I am cranky enough. 

The next month my HCG remains negative.  Finally, we're back in business.

Sunday, August 4, 2013

You know your doctor is great when....

You've flown a few hundred miles and they manage to see you on time. 

When you are called from the waiting room you are escorted into a nice private room with good magazines and soon after a student/resident with a friendly smile comes in.  She explains she is here to listen to your story and take you case history.  And she listens.  REALLY listens.  For like, at least a half hour.

When about 10 minutes after the resident leaves, your new RE walks in the room, looks you straight in the eye and says, "It's a pleasure to meet you.  I am pretty confident about what is going on here."  And it becomes clear that this doctor listened to the description from his student.

When your new RE proceeds to whip out a handy plastic model uterus, placing it before you.  And says, "I believe that the majority of your scar tissue is here (pointing to cervical canal).  I am also pretty sure that your cramps are actually a good sign, there is healthy endometrium in your uterus that is shedding each month.  Your upper uterus could well be scar-free"

When you note aloud that no one has believed you up to this point, he says, "I believe a patient knows best about what's going on in her body."  And for a moment you would bear this guy's children you're so happy.

When he continues on, saying, "After I review you via ultrasound, I will take you in an operating room and cut away the scar tissue.  I am going to use scissors.  If you're in pain I will stop.  In a case like yours I will not be using any kind of estrogen treatment because it doesn't make an impact on cervical scarring."  Guys, he's explaining what he's going to do.  He's treating me like an adult!  And he's respecting my potential pain!

When he makes no promises.  "Cervical scarring is often prone to returning and requires some follow-up, a few visits every two weeks to your local doctor will be fine, all he or she needs to do is probe your cervical canal with a pipelle to clear the cavity of any filmy tissue that could return.  And if it returns after that you will come back to me and I will remove it again."

When he sees the aghast look on your face because you believe quite strongly your local doctor is an incompetent asshole.  "Any doctor, even your gynecologist can do this," he says kindly.  "Here, let me show you a pipelle, so you can see what I'm talking about." (proceeds to grab what looks like a really long q-tip).

When he takes you in for a plain old ultrasound and points to the screen and says, "Yes, see here?  Those are some adhesions."  And you're really fucking impressed because you have learned that most doctors will never be able to identify Asherman's on an ultrasound, yours sure didn't.

When you're lying on an operating table, staring up at a helpfully calming picture of a beach, and squeezing your eyes shut after about maybe, 5 minutes, because you know that he's applied betadine to your ladyparts, and then you can feel something really fucking uncomfortable (that would be the scope going in and up, and probably the micro-scissors), but then he says, "Open your eyes, do you want to see?  I've just cleared your cavity.  Here, look at this monitor."

When you look at the monitor, as instructed by a doctor who wants you informed and understanding of your surgery, in real-time, you are amazed because he is moving the camera around inside of you and showing you the cervical canal he's just cleared, as well as your fallopian tubes, which he sees are beautifully clear (his words).  You realize, he really does want you to take ownership of your body and your health.

When he finishes up, he asks how much ibuprofen you took and then jokes, "your stomach will feel worse than my surgery did from 800mg."

When after you've finished changing your clothes he prints out beautiful color pictures of your clear and healthy uterus, a lovely keepsake from Boston, along with a full description of diagnosis, treatment and follow-up instructions about that pipelle.

When you rush back to the waiting room to greet your husband, with tears in your eyes and you say, "I'm fixed."  And he looks confused, and you say, "He did it. It's done. He cleared all of the scarring.  I'm not infertile anymore." 

When you and your husband can sit in Doyle's Pub in Jamaica Plain about an hour after your surgery, eating clam chowder, drinking a beer, marveling at your color picture-vajayay-keepsake, and truly know with every fiber of your being that you just spent the best $500 dollars of your life on flights and a hotel room.* 

When you state that Keith would make a lovely first name for a baby boy.

*Dr. Isaacson is in your PPO network, so you're crossing your fingers that you don't wind up with out-of-pocket costs on your surgery.

Saturday, August 3, 2013

Pilgrimage to Boston.

By the time December 2012 rolled around, I was tired.  I was tired of this infertility that was so rudely foisted on me, tired of cramps that felt like monthly labor pains, I was tired of blood draws to monitor my HCG, and frankly, I was tired of mourning the loss of a future sibling for my niblet.  Because yes, let me say that a top of all else, I was sad.  The complications of my miscarriage forced me to go into overdrive to heal myself and find answers, see lots of doctors and get lots of tests, work-out like a crazy woman to lose the baby weight (THIS is a whole other post) and try to mother the child I already had in a way that wouldn't send her into therapy.  And through all of this, I didn't realize how sad I was.  Earlier that summer I was carrying a baby.  Until I wasn't.

By mid-November, even before what might have been the pokiest failed HSG test in history, I had concluded that I was not going to find treatment for my AS locally.  I didn't trust Dr. X at all.  Now, there are currently three doctors in the UNITED STATES who are considered "A-list" experts in surgically treating AS.  Dr. March, in California, Dr. Olive in Wisconsin (who isn't as well known as he should be, based on the number of Midwestern AS sufferers on the boards who never heard of him), and Dr. Isaacson in Boston.   All three have treated thousands of women like me, women who were told their uterus was obliterated, women who were told to give up ever thinking of carrying a baby on their own. *

Dr. Isaacson, besides being the closest to me geographically (though still a plane ride away), performed most of his surgeries in-office, using a device called a flexible hysteroscope.  No HSG bullshit for him, he would insert a scope into my uterus (while I was awake and on copious amounts of ibuprofen) and he would start cutting away - then and there - any scarring he saw using micro-scissors.  Yes, I said micro-scissors (because as I learned from the AS group ladies, lasers or use of heat in the wrong hands could make scarring worse).  So like hundreds of women before me, I called the offices of Dr. Keith Isaacson at Newtown-Wellesley Hospital in Boston.  Doesn't he look nice? 

You guys, my conversation with the Bahston-accented receptionist at the front desk was more productive than four months of conversations I had been having with my own doctors.  When would I like an appointment?  No, I wouldn't need films of an HSG, Dr. Isaacson will just evaluate your uterus in-office and treat you that day.  Yes, it's ideal for him to see you during certain days of your cycle, but you haven't had a period in months?  No problem.  You need to catch a flight back home that day?  No problem.  It was like the goddamn Brigadoon of doctor's offices.  I felt so comfortable that by the end of our conversation I slipped into a yicky habit I am often accused of by friends, I started talking like her.  Thank god a coworker let me use her private office to make the phone call, so no one around me would be wondering "Why is she talking like that?  What happened to her vowels?"

My hysteroscopy was scheduled for December 12th and I received so many emails of encouragement in my inbox.  Every single woman who assured me that I would love this man and he would absolutely "fix me."  I procured cheap flights, a hotel room and a rental car for myself and dear husband.  He lived in Boston for a while, so he was gonna drive.  My ability to deal with stress has a limit after all.

 *Post-script:  I neglected to mention other A-list doctors in NY:  Dr. Palter, in Long Island who is reportedly amazing, and Dr. Copperman in NYC.  Dr. Copperman is a controversial doctor on the Asherman's site, because he actually uses laser surgery to remove adhesions.  Nevertheless, he has many glowing reviews and a track record that shows his abilities.


When you're experiencing medical problems - particularly ones that bring pain along with anxiety - often, just getting an official diagnosis is a step forward.

By the time I began regularly seeing a Reproductive Endocrinologist at "BABIES GUARANTEED FERTILITY CLINIC" I had already started a new relationship with the amazing women on the Asherman's Syndrome (AS) Support Group.  The more I read about the diagnosis and treatment of AS, the more I felt in my gut two problems:  1) He wasn't experienced in treating Asherman's yet he seemed to brush the surgery off as if it was easy-peasy, a 2) He was dicking me around in even coming up with a diagnostic plan quickly.  "You're not one of our usual kinds of patients," said a nice nurse at the clinic, meaning that I didn't need their assistance to start a normal ovulation cycle, to join an egg with sperm, or to implant an embryo.  Dr. X, to his credit, did realize after some blood work that even more blood work would probably get us nowhere, but couldn't decide whether to schedule me for an HSG at the hospital or a sonohysterogram (same thing basically, but in office and using saline solution). 

Finally, an HSG was scheduled.  Despite the fact that this test is reportedly painful as all fuck, I was excited.  I messaged women in my new AS support group with lame but important, anxiety-easing questions, like "Will I be able to teach a zumba class the same day?" Because after being told that it was my Svengali-like anxiety and neuroses keeping my period away, maybe I would get a more "medical" kind of answer.

Around Thanksgiving, about 4 months after the D&C that caused me so much pain, I show up at the hospital, take 800 mg of ibuprofen to steel myself to the prospect of a giant catheter filling my uterus up with fluid, and eventually lie on a cold table. And a nice woman tries to ram a tube up my cervix.  And I mean RAM.  I mean, the painful part of the procedure hasn't even begun yet!  And after a few more pushes, the kind woman stops and looks at me:  "I can't get the catheter in at all," she says, "it's like a brick wall is completely blocking me."  And she couldn't believe it when instead of bursting into tears, I actually managed a slight smile at her words.

And THAT, friends, is what I call the glory of vindication.  Because for FOUR MONTHS I have been saying I am getting a period, really, only it's trapped inside of me, building up each month and my body is literally contracting with LABOR PAINS to eliminate it.  And now a doctor will FINALLY believe me.