A Little Bit of Closure

I'm spending this rainy Monday making homemade soup and catching up on bills and wading through my 2-inch stack of "explanation of benefits" forms from HealthNet. One bill just crossed my desk that gives cause to write.

Back on the 9th of last month I went in for a chlamydia titre test. Not that I think I might have chlamydia, but my new OB/GYN (Dr. T) thought a prior infection might have been responsible for the massive amounts of scar tissue and adhesions that cover my Fallopian tubes. A chlamydia titre test can tell if you have EVER had chlamydia in your life. The infection leaves trace antibodies in your blood that can be picked up with a simple blood test many years later. Dr. T said that he wanted me to do the test so that I would have "closure" as to whether a prior chlamydia infection was what left me in this state.

Hunter Labs has a lab in Dr. T's office...so they did the blood draw right there. Apparently the people running the office that day didn't know what number to code a chlamydia test. The found something that looked like chlamydia and ran that. Unfortunately it was for a chlamydia pneumonia test...essentially, pneumonia. Which I clearly don't have.

When I went back to see Dr. T on the 22nd for my post IVF failure antral count, they let on that the lab had screwed up, and "While you're waiting for Dr. T, why don't you run down the hall and let them draw some more blood on you so they can rerun the test today? We'll make sure you don't get billed for the first one." And, of course, I did just that, and I didn't think much about said test until today, when the bill for the erroneous pneumonia bill crossed my path.

So I telephoned Dr. T's office about the bill. Of course they promised to take care of it. "And did you get your test results ever?" No. Never saw them. Not a clue. The nurse paused for a second or two and then, "Well it's negative".

Great. Huge sigh of relief.

I thanked the gods that my "baby kitty" was never tainted with the chlamydia bug. Then what caused the scar tissue that, today, leaves me with blocked tubes. This test result gives me a smidgen of closure on my sexually active teenage years. Those were the days just before AIDS was on our horizon so we weren't too afraid of what we might get from not using condoms. Everything was curable back then, as far as we knew. I didn't think, however, that I would get pregnant. But we knew that, it too, was curable.

But this first pregnancy, at 15, ended in me having an ectopic that ruptured and hemorrhaged. I didn't even know I was pregnant before or after my surgery. We knew I had hemorrhaged, nearly died, but we didn't know why. This was in the days before "beta HCG" tests, which leaves me wondering how the hell they diagnosed pregnancy back then. Also, there didn't seem to be reliable methods of ascertaining if a pregnancy was ectopic. So, it wasn't until the pathology report came in, many weeks later, when I was fully healed, that fetal tissue had been found in the baseball-sized clot of tissue and blood that the Kaiser Doc had pulled out of me. I remember that day clearly. That phone call. I remember being a bit stupified, yes, that's the word, that I had been pregnant at all, and that it had nearly done me in. It didn't sink it, that is for sure.

The Kaiser Doc mentioned, during this call, that she noticed that my tubes seemed longer than normal and that the ends of the tubes seemed to have had extra fimbria. A congenital defect or deformity. Very easy for an egg to get lost or caught up in the wrong place. Because of this phone conversation with the Kaiser Doc, I had always believed that my ectopic was something beyond my control.

So I took the BCPs that the Kaiser Doc gave me. I was pretty good about taking them each day. But I must have missed a pill, or maybe I was just too fertile at this young age, because I wound up pregnant again the next year about the same time. This time I was panicked because I didn't want to go through the pain of another ectopic. It was a normal pregnancy, and lodged directly in my uterus, but I didn't know this until the doctor who had performed my abortion answered, "Yes, it was in the uterus."

Fast forward to today...my last OB, Dr. G, who did my lap and ovarian surgery in October 2005, was pretty convinced that my first ectopic was likely because I had contracted chlamydia prior to even my first pregnancy. When? At 13? At 14? Did I contract this the first time I had sex? My god. She seemed pretty sure about this and said that she didn't see anything abnormal about my tube lengths or fimbria. I was shocked. I wondered if the Kaiser Doc, whom I had always admired, was a closet quack. I felt sullied, dirtied in a way: I had become damaged goods even before I was 18 years old, before I left High School. Right then, I hated myself for having been sexually active at such a young age. I cried as quietly as I could in my post surgery gurney...feeling, knowing, that I had caused my own infertility. Hating myself, hating the boy I slept with. Wondering why J, who sat next to me, consoling me, bothered to be with me since I couldn't give him children. (Oh yes, I was worked up, rolling shamelessly in self pity).

So today, when Dr. T's nurse told me my chlamydia titre test was negative, that I had NEVER EVER in my entire life contracted chlamydia, it was like a gust of fresh wind blew into my heart. It suddenly felt a bit lighter. Maybe the Kaiser Doc was right. Maybe it was a congenital defect that caused the ectopic. Surely it is possible that the deformity caused the ectopic, then the ectopic caused the scaring and adhesions and that a doctor, today, can't tell much about the state of my tubes due to the scar tissue. But back in 1980-something, the Kaiser Doc saw my tubes before they have become covered with adhesions, maybe she got the best glimpse anyone would ever see of them.

Dr. T's nurse continued on. Maybe I had the scarring from endometriosis? "Nope: I've had two laps that confirm this". She said, "Then maybe another type of bacteria?" I thought, "Maybe but what sort? Bring on the test!" I really do hope that the Kaiser Doc was right, that this was all due to a congenital deformity, because if is the case, maybe, just maybe, I will be able to stop blaming myself for being sexually active at 15 and all of the infertility shit that J and I are enduring right now.

And that would be a relief.

And as an aside...my period is a day late. Probably pretty normal for coming off of an IVF cycle, and, as you know, my tubes are clogged to high hell.

But I can't help but be hopeful.