A look at where we've been...and where we're going

Hi everyone. We wanted to let you know that I am scheduled to be having surgery on July 29th in Columbus, OH and we wanted to ask for your prayers. Over the past four years, I have been under the care of excellent NaPro physicians to help address my PCOS (Polycystic Ovarian Syndrome). NaPro Technology is short for “Natural Procreative Technology” and is a new women’s health science that working in conjunction with Creighton model of Natural Family Planning (NFP) to monitor and maintain a woman’s reproductive and gynecological health. It also provides medical and surgical treatments that cooperate completely with the reproductive system. Over thirty years of scientific research have yielded these treatments which are not only perfectly in line with Catholic and moral teaching, but also have been shown to be 30% MORE effective in resolving issues treated by non-NaPro methods such as the Pill and In-Vitro Fertilization.

Anyway, we have been working with excellent doctors in Indiana, then in Pennsylvania, and now in Ohio over the past four years, and although have seen some improvement in my condition through medication, diet, weight loss (32 pounds), and life-style adjustments, it is now time to surgically address the issues which we believe to be the main cause of our inability to, as of yet, conceive a child. Thus, I am scheduled for surgery with Dr. Parker on July 29th at noon. Dr. Parker is an amazing man. His biography and letter to patients are both well worth the read. He has been an incredible support to us not only physically, but emotionally and spiritually as well.

We had our “pre-op” appointment in Columbus, on Friday the 11th, and now have a better handle on how this is planned to go. The surgery will be a “major” surgery lasting approximately 4 hours. It will be an investigative surgery at first, but will most likely include an Ovarian Wedge Resection. Rather than try to explain it ourselves, we have included the text of the Pope Paul VI Institute pamphlet explaining it at the conclusion of this post. We will be leaving for Columbus on Tuesday, July 28th, surgery is Wednesday, July 29th, and we expect I will be kept overnight, released Thursday, July 30th, we will stay in Columbus in a hotel that evening just to be near Dr. Parker “just in case” and then we will have an appointment with him in his office Friday, July 31st, get cleared for me to ride in a car, and then we will be on our way back to Indiana. The expected recovery time is 2 weeks of intensive recovery and a further 4 weeks until I am completely recovered. We will certainly keep all of you posted as to how things progress.

We are aware that some of you may be hearing this for the first time and that it might seem strange to be hearing about all of this only now, and we ask for your understanding regarding why we have not shared any of this with you before now. As you can probably imagine, we are not only concerned about my overall health, but also mourn deeply for the children that we so long to have. This journey along the way of the cross of infertility is a difficult one and each person handles it on their own way. Until now, we have chosen to remain rather private about the whole experience, and to draw closer to each other and closer to Jesus by uniting our sufferings to His. We have also chosen not to let either my health, or our childlessness, to become the center of our lives any more so than necessary (the doctor’s appointments, blood tests, and ultrasounds, and other responsibilities pertaining to this have themselves have become a part-time job as it is). Instead, we have chosen to focus on our blessings, and to get involved in activities such as Abortion Clinic ministry, volunteering at the crisis pregnancy centers, assisting in Catholic Infertility support groups (Hannah’s Tears), and getting the message of authentic women’s health out especially to teenage women. This involvement allows us not to focus on ourselves and to work at transforming our own pain into something which can help others. Each day brings new experiences and new emotions as we learn to live with this cross that we have been given for this period of our lives. We continue to hope and pray and ask for your prayers as well, that either this cross would be lifted and that I would be healed and we would be given the gift of a child, and that we would continue to receive the graces necessary to carry this cross with humility and trust for as long as Our Lord requires it of us.

What about adoption or foster care you might ask? Again, this is a personal decision that each couple must face, and while we are open to both ideas, we always wait on the leading of the Holy Spirit before embarking down either fork in the road. At this point in time, we have felt distinctly led by God to make three different offers of adoption to women considering abortions. We have not known any of the women personally (one in Culver, one in New York, one in Texas), but have been made aware of their situations through mutual friends. In the first case, the pregnancy was ectopic and the woman lost the baby. The second two women, by the grace of God, cancelled their scheduled abortions, and have chosen to keep their babies and raise them themselves. We are so grateful to God for even the small part we have been allowed to play in saving these little lives and are thankful to even some type of good can come from our own personal suffering.

We understand that you will probably have questions about our situation about my health, surgery, recovery, etc and we are happy to talk about it as we are able to. But we also ask for your understanding when we ask that this not become a part of regular conversation. We know of your love and of your desire to support us, but ask that we be allowed to be the ones to bring these topics of conversation up. Your prayers, and not bringing these topics up in conversation are the best ways you can support us. For those times that we experience an increased mourning regarding our infertility, it is difficult to discuss the topic, as the pain only increases in doing so (it is like salt in a raw wound). For those times, when we have a small reprieve and by the grace of God, our suffering is lessened for awhile, it is difficult to discuss these topics, because it will once again bring to our mind, that which we have for a time been able NOT to think about. Therefore, we thank you in advance for your love and support and prayers and for allowing us to bring these topics into conversation as we are willing and able. This really is one of the best things you can do for us. We promise to keep you posted when there is something to report.

Our Lady of Guadalupe, pray for us.
St. Gianna Molla, pray for us.

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OVARIAN WEDGE RESECTION
Thomas W. Hilgers, M.D.

Years ago, in the 1950’s to early 1970’s, Polycystic Ovarian Disease was treated surgically with the use of a procedure called Ovarian Wedge Resection. When one goes back and reviews the medical literature on that procedure, it reveals that there was a 70 percent pregnancy rate and a 70 to 80 percent rate upon which menstrual cycles (which were often long and irregular) were now regular.
When the drug Clomid came out in the mid-1960’s, one of the conditions in which it was effective was Polycystic Ovarian Disease. AS a result, there was now a medical treatment for polycystic ovaries and it reduced the need for surgical intervention. In addition, the wedge resection, in those days, created scar tissue and sometimes was somewhat counterproductive.

Interestingly enough, in the switch form a surgical procedure to treat polycystic ovaries to a medical treatment (i.e. Clomid), a 60-70 percentage pregnancy rate was sacrificed for a 35 percent pregnancy rate with the latter treatment. In addition, the cycles remained long and irregular and while being treated with Clomid and one could not take Clomid permanently.

A few years ago, at the Pope Paul VI Institute, it was decided to take another look at this question of wedge resection of the ovaries. The reason that this was undertaken was because of the progress that had been made over the last 10 to 15 years in the prevention of scar tissue and adhesion formation. Thus it was thought, that this surgical procedure, with the use of lasers and additional techniques for the prevention of adhesions, would be very successful at doing so. If that could be done then the value of Ovarian Wedge Resection could be maintained while at the same time decreasing the surgical problems associated with it 25 years ago.

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Finally this is a procedure which, while improving a woman's health, also results in a regular menstrual cycle with regular ovulation and an improvement in fertility. The pregnancy rate following this procedure will be between 50 and 70 percent depending upon other circumstances.
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THE SURGERY

An Ovarian Wedge Resection requires making an incision into the abdomen. This incision is usually four to six inches long and is, thus, a major surgery. It requires being in the hospital and requires a general anesthesia. Typically it takes 2-3 hours to complete.

The hospital stay is usually 48 hours and the postoperative recovery is generally not too severe because the abdominal incision is fairly small. Two weeks following the surgery the patient is up and around doing most things although it still requires a full six weeks of recovery.

During the course of the surgery a wedge of tissue is removed from the middle portion of the ovary. The incision into the ovary is made with a carbon dioxide laser. This type of an incision is very precise and non-traumatic. That is to say, it is the type of incision which reduces significantly the changes of subsequent scar tissue formation.

In repairing the ovary following the removal of the wedge, the most important principle is to use a type of suture which reduces or eliminates the formation of adhesions and also to close the ovary with a technique which reduces adhesion formation as well. Thus, at the Pope Paul VI Institute, a suture called Prolene is used to repair the ovary and a particular technique is used to reduce the adhesion formation. In fact, this technique works extremely well at preventing adhesions and if the surgery is done one should anticipate that virtually no adhesions should develop (although that can’t be 100 percent guaranteed).

ANTICIPATED RESULTS

Following the wedge resection, the cycles tend to become more regular again in about 80 percent of cases. Ovulation becomes more effective and Clomid can still be used but, in this case, at much lower doses.

Because women who have polycystic ovaries often have very long cycles, their risk of cancer of uterus and breast in increased. Cancer of the uterus, in particular, may occur in as many as 25 percent of these women. This is due to the continuous, prolonged stimulation of estrogen in the absence of progesterone (which happens with these long and irregular cycles). Progesterone can be administered on a cyclic basis to prevent this from happening.

After a wedge resection and when the cycles become more regular (in 80 percent of the cases), there is a natural regulation of the cycle because ovulation is now occurring more regularly, there are no longer prolonged episodes of estrogen stimulation and progesterone is produced on a regular basis thus preventing cancer of the uterus and breast.

In addition, while the male hormones are often elevated in women with Polycystic Ovarian Disease, and it requires medication to keep them down, these hormone levels decrease with wedge resection.

Finally, this is a procedure which, while improving a woman’s health, also results in regular menstrual cycle with regular ovulation and an improvement in fertility. The pregnancy rate following this procedure is nearly 70 percent in the experience of the Pope Paul VI Institute.

©2004, Pope Paul VI Institute Press Omaha, Nebraska http://www.popepaulvi.com/