A Second Opinion

Friday I met with an acupuncturist specializing in women's fertility--Jelena Stefanovic at Red Peony acupuncture. My friend Eileen had recently gone to see her and was so moved by what she had to say about the treatment plan she was on that she decided to stop seeing her old acupuncturist and switch to this new lady.

While my Fertile Soul treatment plan listed acupuncture points I should be getting, I had not yet found anyone to do the actual needling. I wasn't sure how to go about it since basically I felt like I didn't need another diagnosis--just someone to follow the treatment plan and make sure all of the points were being addressed. All the same, I still felt like I didn't want to see just anybody, and when Eileen told me she got the referral to Red Peony acupuncture from the staff at the Fertile Soul, it seemed like I had found my local provider.

I called on Wednesday and explained my situation to Jelena, who is not only an acupuncturist, but also the doctor of Chinese medicine who founded Red Peony. She said that even though I had already received a Chinese medicine evaluation and diagnosis, she would still like to go over my health history and basically conduct a new patient exam before doing any needling. And honestly, as a formerly practicing massage therapist, I can understand the value of conducting one's own review of a patient's condition and health before jumping into following someone else's treatment recommendations.

Happily, the acupuncture clinic is located just over a mile from where I work in northwest Portland, and I was even able to find a parking place nearby--no small miracle for that part of town. The clinic itself was small but clean and I was the only patient there. It was nice because Jelena was focused entirely on me and my session.

I found Jelena to be kind, professional and thorough--all qualities one would hope to find in any health care provider. She agreed with the Fertile Soul's diagnosis, but said if she were putting together an herbal formula for me, she would have me on three different formulas instead of two (right now I take one herbal tea formula before ovulation and a different formula after ovulation). She would have me taking a third formula during the first four days of my period, she said, and would add more herbs to combat the nausea I experience and also more herbs to move blood. She said that I am definitely getting some of those herbs with my formulas, but not as much as she thought I would be on, given my health history.

What really threw me for a loop was when she asked me if I have had a hysterosalpingogram--it's the test that shows whether or not the fallopian tubes are blocked. Blockage can occur from adhesions (where the tissue is stuck together as a result of inflammation and scarring), or from the tubes filling with fluid or pus and Jelena said that with my history of 20 years of endometriosis, she would recommend getting the test before I do anything else. She said that if my tubes were completely blocked, I would basically just be wasting my time with the herbs and acupuncture.

I could not believe what I was hearing--I told her that my understanding was that the herbs, acupuncture and abdominal / pelvic massage could reverse the effects of endometriosis (albeit over a period of several months to years) and that anyone, at any stage of the disease, still had a chance of conceiving on her own. This was not Jelena's opinion.

I left the clinic upset and cried on my way home. I really didn't (and still don't) know what to believe. Here I had just come from a retreat where Randine specifically said that a woman who had come to her with Stage 4 (the worst) endometriosis had conceived following her Fertile Soul treatment plan, and now I was hearing that it may not be possible for me given the likelihood that my case is fairly severe. Granted, I couldn't remember Randine saying anything about blocked fallopian tubes, but my impression was certainly that the abdominal massage we learned while at the retreat could help clear up any scarring and adhesions we might have.

I wondered if Jelena was more like a Western medical doctor who would be quick to say, "Oh, with your history, you'd better not waste your time trying to conceive naturally or even with an IUI. You'd better go straight to IVF." Or was she being realistic?

When I got home I looked up the chapter in The Infertility Cure about blocked fallopian tubes and Randine says that there are several Chinese medicine techniques that can be used to help clear blocked tubes--herbs can be taken orally to help alleviate inflammation (which I'm already doing) and in China, they are sometimes injected directly into the uterus where they flow out through the tubes to help heal them. That last practice is not allowed in the U.S., unfortunately. Randine says that women can use herbal enemas or suppositories and use specific acupoints to help clear blood stasis which is often associated with blocked fallopian tubes. And then there is a paragraph on massage that can be done deeply and as Randine says "can apply enough friction to the fallopian tubes to resolve the adhesions manually."

To me that doesn't sound like "you have no chance of conceiving naturally and would just be wasting your time and money to keep trying acupuncture and herbs." So you see the difficulty. Who to believe? What to do?

I think the test would be great to have done so I would at least know the condition of my fallopian tubes, but it is quite expensive and is something that our insurance will not cover at all.

I still have a hysterosalpingogram referral from my last OBGYN visit in March, so maybe I will call next week and see if I can get an estimate of the cost. I need to talk to Michael too and see what he thinks, but I am leaning more toward having the test done.

I'm just afraid of what I might find out.

Surfacing--Again

My period started Saturday while we were camping at the beach with our friends. It's the first one I've had since beginning the herbs and while I wasn't expecting a miracle, I think I was hoping for a dramatic decrease in pain, as well as a return to a 28 day cycle. I did experience some changes, but unfortunately, neither of those two things was among them.

Some months I have what I call a "bad" period, by which I mean an hour or two of extremely intense symptoms that make me feel like I am going to die--literally die. The first time I had one of these episodes was when I was 16 and since it was so bad (and none of us had any idea what was wrong), my mom ended up taking me to the emergency room. Since being off of birth control, I have the episodes sporadically. Sometimes there are 4 or 5 months when I just have regular menstrual cramping without most of the other symptoms of my episodes. But I had a "bad" period in June and now again in July.

I find that if I start taking advil or ibuprofen early on during my period, I can usually avoid the really horrible symptoms (nausea with and without vomiting, diarrhea, sweating, feeling faint and of course severe cramping that feels like someone's hand is gripping my uterus and squeezing mercilessly). I have to really stay on top of the pain and keep popping the pills or the symptoms can get the better of me. I even set my alarm during the night so I can take more advil and make sure I stay ahead of everything.

Something I noticed that was different about this period was that I had little or no warning before I was running for the bathroom, doubled over in pain. It hit fast and hard and I spent a good hour just trying to breathe and get through it. I was shocked by the intensity of what I was feeling--the cramps felt like little knives running me through over and over. And, honestly, I felt more than a little betrayed.

I felt like my period should be improved because of the herbs and the other things I am doing and taking to help with the endometriosis. So I felt betrayed, disappointed and angry--very, very angry. (As a side note, anger is something that I have noticed feeling a whole lot lately--especially the week leading up to my period. This really is not like me, and I am chalking it up to hormonal changes from the herbs, but who knows?). I felt angry even though the quiet voice in my head kept telling me that it has only been 1 month and the Fertile Soul folks said I had to give it at least 3 months before deciding that it wasn't working. And it wasn't like I didn't see changes; the biggest change I have noticed during this period is the decrease in the amount of clots, which is a very, very good thing.

When I got home from the beach yesterday, I talked with my friend Eileen, who is also taking herbs and doing other "natural" things to conceive. She also has endometriosis, so she understands everything I am feeling. We talked and she encouraged me gently, in just the way I needed, not to expect too much too soon. I think that a big part of my disappointment stems from the expectations I have every month--I always feel like maybe this is the month that it will happen and I will get pregnant; then when my period begins I am devastated. So I think I may focus on not getting pregnant for a few months . . . what I think I will do instead is just focus on healing my body and preparing it. Maybe if I really have no expectations of conceiving, my emotions will be on more of an even keel and I'll be happier, and therefore healthier than if I were riding the PMS roller coaster.

Eileen's suggestion last night was that I take extra good care of myself during my period and that I do a castor oil pack to help with the endometriosis. I did castor oil packs a couple of years ago for awhile, but stopped when I gave up on all of the things I was doing to conceive naturally. Randine recommends using them in The Infertility Cure, and before I went on the retreat I bought a new bottle of castor oil as well as a fresh piece of muslin in preparation of resuming the practice.

The packs are simple to make and use, but are messy and require some time being still. You saturate the muslin (flannel works too) with oil and place it across the area you want to heal. Plastic wrap goes on top of that, followed by a heating pad. Then you leave it on for 30-60 minutes. The muslin can be stored in a plastic bag and reused over and over for several months, adding more oil as needed to keep the muslin saturated.

I don't think it's known exactly how the packs work, but it's thought that the heat in combination with some property of the castor oil helps decrease inflammation in the body. Castor oil packs boost the immune system and aid in tissue repair. I read an article about them and was surprised to learn that they are used to help with arthritis, gallstones, stomach cramps, constipation, and even things like carpal tunnel syndrome & joint sprains--crazy!

So I did a castor oil pack before bed last night and felt oddly comforted--maybe it was from the heating pad, but maybe it was because I was nurturing myself. Either way, I'll take it. :)

I'm off now to do another pack before bed tonight. Thanks for listening.