You know how on house they have a group of doctors who look over your medical history or specialize in particular areas? Today was my day to go see a "Reproductive Endocrinology Infertility Specialist" but not for the reason you may think...

This REI Specialist specializes in not only infertility, but also specializes in Endometriosis.

Today, I went to go see her. Her name is Dr. Julie Tan, and she was in Avon, Ohio. 

She seemed very nice and seemed like she knew her stuff, but I just didn't really like the fact that she pushed birth control on me knowing my medical history and the fact that I have had a DVT/PE in the past and the fact that I underwent Chemotherapy in the past, meant that Lupron was a no. Not only was Lupron a no for me, but she kept pushing it telling me to give it one month. Ultimately, I told her that my insurance would not cover it, and I would prefer instead of masking the issue, that they try to officially diagnose my condition and treat it, rather than mask it (If you think PCOS, think birth control only masks PCOS, sort of the same concept with Endometriosis, Lupron masks the Endo instead of helping it)

So basically, here is my after visit summary from today's encounter:

Consult from: Dr. Raymond

April M Driesse is a 24 year old. Caucasian female  Patient has a history of PCOS and severe dysmenorrhea.  Dysmenorrhea happened since childhood.  PCOS diagnosed in 2012.
Addison's disease diagnosed at age 11 on Cortef and floricef.
H/o DVT/PE - Hypercoagulable.
Chronic back pain see pain management.
For the past year, pt c/o constant pelvic pain.  Much worse during period.
H/o RPL x 6.

Obstetric History
 G8  P2  T0  P2  A6  TAB0  SAB6  E0  M0  L1

(This means Gestation: 8 (I have 1 living child, 1 stillborn, and 6 miscarriages, they do not count chemical pregnancies during this. P: This means Para, The Birth of Viable Babies, that is 20 weeks onward so I have Gabriella and I have my stillborn. T: This means Term. Gabriella was born 36 weeks, so she was not term, and my stillborn was at 20 weeks, so Term is 0 for me. P: This P signifies Pre-Term Births. This number is 2 for me, because my stillborn was at 20 weeks and Gabriella was 36 weeks. TAB means Theraputic Abortion, which is 0 for me, because I've never had any abortions. SAB is Spontaneous Abortions, or in my case, miscarriage. This is a fancy/offensive way of saying a woman has had a miscarriage. For me, I have had 6, and I've had 2 chemical pregnancies which were miscarriages but for whatever reason they do not count those. E means Ectopic, which for me is 0. M stands for Molar Pregnancy which for me is 0, and L stands for Living, which for me is 1)

Menstrual Hx:
Menarche: 7 years old
Cycle length: 32-35 days
Duration: 6 days
Flow: heavy to light

Tonsillectomy Hx - 1999
D and C Diagnostic (x2)

History of present illness:
Characteristics of the pain are as

Chronicity: Onset: since she was 7 years old. 
Location: suprapubic and low back pain without radiation
Quality: dull and sharp
Quantity: 10/10 in intensity during mense.  7/10 during intercourse
Aggravating factors: none
Alleviating factors: heating pad
Associated symptoms: no

Menarche? 7
Are you still having menstrual periods? Yes
If yes: PERIOD REGULARITY: regular q 28-30 days, FLOW CHARACTERISTICS: heavy, bleed through protection and length of flow 6 days, DYSMENORRHEA: throughout menses, CYCLIC SYMPTOMS:  pelvic pain, HORMONE REPLACEMENT: Has tried Micronor, Lo-Orval and Other OCP in past.
Do you pass clots? Yes

April M Driesse is a 25 year old female with severe dysmenorrhea.
We went over several options both surgical and medical.
Patient at first interested in medical treatment with lupron but later decide to have surgery.
She will contact her endocrinologist and hematologist for recommendation for treatment prior to her surgery.
Since she has quite significant pelvic muscle tenderness, I recommend she starts pelvic floor PT.
Order placed.
R/b/a of the procedure discussed. Patient would like to proceed with surgery.
I discuss with her that due to her medical problems, I think it is appropriate to try medical management first.  However, patient declines medical treatment and only interested in having surgery.
Julie Tan, MD

So basically, now we wait for a surgery date and for pre-op and all that fun stuff, I'll update when I have more... but I am really getting sick and tired of popping pain pills and living my life in pain... I just want to get rid of this Endometriosis, if that is even what I have, and then be able to improve my fertility and have a little bit less pain each month...


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