Friday, March 30, 2012

NaPro Appt Update & Possible Surgery

I had a followup with my local NaPro Ob/Gyn. As usual, I had my list of questions ready & DH & I were all set to tell her that we would be looking into PPVI as the next step. Well, things took an unexpected turn.

  1. After reviewing my history, she told us that endometriosis was possibly the only remaining cause for my miscarriages. She started reviewing my charts for the last few cycles. I explained to her the brown bleeding/mucus I had during the last cycle & she said it was expected of a miscarriage cycle. I pointed to my chart & tried convincing her that I have TEBB for 2 days most cycles and asked if I could be on antibiotics in case there is inflammation.
  2. And guess what, she surprised us by telling that she would do a Laprascopy at the beginning of my next cycle for possible endo and if so, she would laser it out. She will also do a hysteroscopic D&C to get samples for endometrial culture. If the culture shows any kind of infection, she will put me on antibiotics. If the endo is extensive and on places such as the bowel, she will recommend me to PPVI. Until last year, she was recommending her patients to a NaPro surgeon 3 hours away. Unfortunately, that NaPro surgeon moved to St. Louis. I don't know if that's the reason why she herself is doing the laparoscopy.
  3. She also told me that my mucus scores were not indicative of endo but we will never know until we do a lap. Since I had a laparoscopy for my ectopic & not laparotomy, she said the possibility of scarring/adhesions was less & that it was more common after a laparotomy. I also asked her what would be done if they find Poly Cystic Ovaries during the lap. She recommends diet & medication for PCOS & ovarian wedge resection is only for severe cases of PCOS.
  4. I asked her for Metformin since it can improve ovulation. She wanted me to get a Fasting Insulin test before she will consider Metformin. I have been tested for this before and it was normal but I will get it done again because it's been a while. She doesn't want me to try a new medication unless there is a real problem though I would have preferred being on Metformin & antibiotics for TEBB. :(
  5. I asked her about Thyroid antibodies and she had ordered the blood work for it. She said if I test positive for Thyroid Antibodies/Hashimoto's, there is nothing much that can be done other than continuing the Thyroid medication which I am already on. How does treat Thyroid antibodies?
  6. I asked her about HCG and she said it was reasonable to try HCG at this point since I have already been on Progesterone for many cycles. She prescribed me 10,000 IU of HCG post peak P+3,5,7,9 & said I could get it at any regular or compounding pharmacy. How much does HCG cost & where do you all get it from? 
  7. I forgot to ask about the selective HSG which Dr. H does during lap. Are there any other things which I need to ask?

So ladies, this is where I am now. If I am interested in going ahead with the laparoscopy, it can be done during my next cycle. I have the convenience that it can be done at a local hospital and so my insurance will likely cover everything. I will also get to know if I have endo sooner than later.

This is what is worrying me. I don't know how good my local NaPro doctor is with Endo/Adhesions. And we all know that PPVI is the best. However, it will be a few months until I can get into PPVI for a surgery & it is going to be out of network. So, we are wondering what needs to be done. It is not an easy decision! We are praying for clarity & guidance.

Any suggestions would be appreciated.


  1. Prayers for complete peace in your decisions

  2. Praying for you! These are tough decisions, I know. For my thyroid Dr. H put me on T3 which I had to get from a compounding pharmacy and it was about $35-$40/month. The HCG I think you can get from anywhere (Novarel was the brand I was using) and I don't remember how much it cost but I don't remember thinking it was too terribly expensive. DH thinks it was around $40-$60 for a month.

  3. Wow lots of stuff going on.
    I think a lap and hysteroscopy is a great idea. I found endo and poylps and I really did not have any signs of them. I had TEBB every cycle my entire life and thought it was normal until napro. Now I take antibiotics and it goes away.

    I don't know where you live, but I think the Dr you mentioned who moved was in PA. If so you might live near NJ. Dr. Beiter is a napro trained surgeon and he is really good. He did my surgeries and I highly recommend him. Everyone who I have rec him to has said great things about him.

    1. I live in NC and there was a endo surgeon Dr.Y at D.u.k.e who moved to St Louis.
      Thank you for recommending Dr. Beiter. Probably it should be a good option.

  4. When Dr. H did my lap and took cultures, the cultures all came back negative, but he still put me on antibiotics because his experience is that there still could be an infection even if the cultures don't come back positive. He said they rarely come back positive.

    I was getting my HCG mailed to me from Kubat's in Omaha, and it was around $50 a month. I once got it from a local pharmacy, and those jerks charge me around $300 for one month dose, saying the price had gone up because people were using it as a weight loss drug.

    1. I get HCG from Kubat's as well. They mail it to me in Indiana. It's about $60 with the syringes. They are easy to work with and quick to mail it out.

  5. Make sure you talk to people who have had surgery performed by your dr. It's best to have surgery by a napro trained dr if possible. My first surgery was with a local RE and I had a lot of scar tissue when I went for my second surgery.

  6. I'm assuming since she is a NaPro ob/gyn that she did the fellowship with Dr H... and so you will be in good hands :)

    I had surgery(ies) with a NaPro trained surgeon outside of PPVI, and I have never EVER regretted it.

    I'm so excited for you moving forward!! And I actually think all of her suggestions sounds awesome. I love that she's not just prescribing stuff that *may* work without knowing exactly what she's dealing with. It may make you frustrated a little, but a good, thorough healthcare plan requires some time and exploration.
    She sounds awesome :)

    1. TCIE, my NaPro oby/gyn is a medical consultant. I don't think she is a NaPro surgeon. So that's why I have been hesitant.

    2. TCIE, she's right. Her MC is not a NaPro surgeon.

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  8. It will be interesting to see what your thyroid results come back as....I had hashimotos.

    Stop the Thyroid Madness is a great reference....

    For endo surgery, I had surgery done at Center of Endometriosis in Atlanta, GA.

    I would go to a surgeon who does endo all day long. Just my two cents. :)

  9. I would go to a NaPro trained surgeon. Just so you wouldn't have to go back for another lap later.
    The TEBB sounds like inflammation, which surely could be endo.
    I get the HCG (Novarel) at Kubats and they ship timely and with no problems.
    It sounds like you are on a great path. I'll be praying for opportunities for surgery and treatment to open up for you!

  10. I also see Dr B in NJ and have had a few surgeries with him (4 over 12 months to be exact.) I have nothing but good things to say about him. He is EXCELLENT! He did the fellowship with Dr H.

    I get my HCG from a local compounding pharmacy I can't remember exactly how much it is because I fill other Rxs at the same time-but the bill is over $100 for all the meds together. I think I need to look into getting mine at Kubat's. It sounds cheaper.

    I'll say some prayers for you... this is not an easy decision.