Aug 7, 2012

Pregnancy Complications: OHSS and SCH Continue

Yesterday was our graduation appointment from our Reproductive Endocrinologist.  We had such a great experience with this doctor and all of his staff and I know I will miss seeing them every week.  They have been so supportive and caring through this process!  It was bittersweet leaving. 
At this appointment I asked a lot of questions about my OHSS and SCH because I knew it was the last time I'd see them.


OHSS:
  • My ovaries are still swollen and large. I still have a gargantuan cyst (plus additional small ones) in my left ovary. I still have several small/medium cysts in my right ovary. The free fluid amounts are down and no longer a huge concern.
  •  I can probably pull back on the Gatorade consumption, but not on protein yet. Although I still don't particularly like Gatorade, I see its benefits and will probably continue drinking it, but I'll enjoy a few more glasses of refreshing water than I have had!
  •  I was told to expect my OB to know little to nothing about moderate/severe OHSS* and to call their office if I have any problems with my ovaries or issues my OB is unaware how to deal with. I love my OB and I'm not really concerned, but it was sweet of them to say anyway.
  • Their estimate for resolution is at least another 4 weeks and perhaps even longer before my ovaries return to normal size. I asked a follow up question about how we will know when I am okay and was told if I am still in pain much beyond that, it might be time to aspirate the cysts. Not a pleasant thought.
  • While on vacation, I experienced sharp shooting pain in my left ovary. It was bad enough to wake me up on several occasions. The pain went around my back and even shot up and down my leg. It was awful. One particularly bad night, I was up for 45 minutes crying. Apparently, I should have gone to the ER for this. Apparently, these are classic signs of an ovarian torsion associated with OHSS and I am lucky my ovary untwisted itself. If the ovary remains twisted, it is not receiving any blood flow and could completely die causing me to lose an ovary. Anything over 30 minutes or so of this level of severe pain is a problem. Next time I'll know. This time, I am fortunate that God was watching over me.
SCH:
  • My SCH is smaller!  Wahoo! Sadly, it isn't gone.
  • Since it is still there, they are keeping me on very modified bed rest.  It actually sounded more like the restricted activity I was on back in June, but they still called it bed rest.  I see lots of cheating in my future.  I got the impression they believe bed rest should continue until the SCH is completely resolved, but are more than happy to pass this off to my OB.  Apparently, OBs are typically much more experienced with SCH than REs are.  Many OBs don't subscribe to bed rest as a prescription for it, so I might get taken off bed rest at my OB appointment!



*This is because only patients who go through IVF will experience it (and only about 1% of births in the U.S. are from IVF) and even among IVF patients moderate/severe OHSS will only occur in 1-3% of patients. Even among those, less than 10% will still be expressing symptoms by the time they transition care to an OB. So, at most 0.003% of the patients a typical OB sees will have symptoms of OHSS while under their care.

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