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.