Peeking through a cracked door

November 27, 2009

On Monday Jeremy and I attended my appointment with Dr. G, my GI doc. Dr. G always makes me smile when he enters a room. He's a rather short man, which always surprises me because in my mind, he's larger than life. Back when I was first sick, when other hospitals were turning me down because they wouldn't/couldn't treat a pregnant woman in my condition, Dr. G said he would treat me as soon as a bed opened at his hospital.

He shakes our hands and smiles, then jumps up on the examining table and talks with us as his feet dangle. We sit in the chairs against the wall. "So how're you doing?" he asks. I tell him I'm doing well. "Yeah? Then why'd you bring him with you?" he asks, motioning with his head to Jeremy, a cocky smile on his face.

"We wanted to talk to you about pregnancy," I say. "What would you say about me getting pregnant?" I feel myself start to flush, the anxiety creeping up red around my neck. Here we go.

"I would recommend that you have the remainder of your rectum removed before you get pregnant." Well don't beat around the bush now Dr. G (sarcasm intended).

"Really?" I ask, pleading as if my disappointment can get him to change his mind.

"Granted, you only have a small portion of your rectum left, but even a small portion can cause a lot of problems. Sure, some women go into remission with the disease during pregnancy, but because of your history of the disease flaring and not responding to medications during pregnancy, we could expect that to happen again if you were to be pregnant again." He pauses. "Have you talked with anyone else about this?" he asks.

"Yeah, we talked with Dr. T and with my OB."

"And what did they say?" he asks.

"Dr. T said that if I wanted to get pregnant we should start trying right away because every surgery increases the chances of infertility because of scar tissue and whatnot. My OB said that I would be considered high risk and they would watch me closely. She talked about how she would want me to deliver and told me that I would have to be on a medication other than Cipro," I explain.

"Yeah, I didn't even think about that part," he says.

Jeremy chimes in, "She said especially during the first trimester the Cipro would not be good."

"None of the medications would be good during the first trimester," Dr. G agrees. "We could try you on probiotics. I can't remember, have we tried probiotics yet?" he asks. I tell him we haven't. "I wouldn't be as worried about the infertility piece. Yeah, scar tissue can cause problems, but maybe you have scar tissue, maybe you don't. There's really no way to know for sure until you get in there. And as far as being high risk is concerned, you definitely wouldn't be as high risk as you were last time. We know that. This is just my opinion. You could go to another doctor who would tell you to go for it and that there's no reason you shouldn't get pregnant."

He goes back to talking about having my remaining piece of rectum removed. "It's something that's on my list for you eventually anyway. Because of the severity of the disease in you, you're high risk for rectal cancer. I'd like to see it come out." And then the part that I'm dreading,"Of course, any time you go in and make changes after your j-pouch has been created, you risk ending up with a permanent ostomy. The j-pouch is pretty delicate and revisions aren't always possible, so you'd have to think about that too in deciding whether to have the surgery or not."

Any other information he gave us is lost on me. I've gotten as much as I can digest. He shakes our hands again and I say, "Thank you. You're one of the people we're thankful for this year," and I start to get choked up. "Well I'm glad you're my patient," he says with a smile and leaves.

Since then, I've started on one of the probiotics he recommended. After I've been on it for about three weeks I'll go off the Cipro and see how I feel. I have a follow-up appointment with Dr. G again January 25th. Till then, much to process. But please know that even though I'm asking questions about pregnancy, we are still proceeding with the adoption process. We're still waiting for the orientation and classes to be scheduled, which probably won't happen until the beginning of the year. It's just I haven't been able to close the door completely on pregnancy yet (smile).