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Thread: Ttc 2013

  1. #696
    Join Date
    Sep 2012
    Location
    Los Angeles
    Posts
    4,588
    Poppy, I am very sorry. The condition as you know is called a hydrosalpinx (hydro = water, fluid; salpinx = tube) and that is exactly what intraabdominal or intrapelvic adhesions causes. They are cobwebby bands which choke off the tube, and the fluid builds up in side.

    Here is a normal HSG. You can see the Fallopian tubes are open, but very long and thin. Some people aren't aware that the tubes and ovaries are *not* connected. When you ovulate, the egg is released into the pelvis, and is swept up by the fimbriae (finger-like projections) at the very end of the tube. If sperm are swimming upwards, they meet in the tube and fertilization occurs there. If fertilization were to occur freely in the pelvis, the rare but very serious condition of abdominal pregnancy can develop. Anyway, in an HSG the dye spills out freely into the pelvis since the tubes are just open at the end:

    http://www.dallasivf.com/_media/imag...al-anatomy.jpg

    If the tube is blocked, from scarring from a prior ectopic/pelvic inflammatory disease, thick mucus, etc, it looks like this. Here you can see the massively dilated tubes which are blind pouches; no dye is exiting.

    http://www.tubal-reversal.net/blog/w...drosalpinx.jpg

    INtraabdominal/pelvic adhesions look like this. It might be difficult to appreciate if you've not trained your eye, but all of the pearly thin-looking bands connecting the different structures should not be there:

    http://www.operatingroomsystems.com/...7665177-12.jpg
    Last edited by blade; April 18th, 2013 at 04:43 PM.
    Blade, MD

    XY: Antoine Raphael
    XX: Cassia Viviane Noor

    Aurea * Emmanuelle * Endellion * Fleur * Jacinda * Lysandra * Melisande * Myrrine * Rosamond * Seraphine * Sylvana * Thea * Verity / Blaise * Cyprian * Evander * Jules * Laurence * Lionel * Malcolm * Marius * Quentin * Rainier

    كنوز الصحراء الشرقية Hayat _ Qamar _ Sahar _ Maysan _ Farah / Altair _ Fahd _ Faraj _ Khalil _ Tariq

  2. #698
    Join Date
    Dec 2012
    Location
    Texas
    Posts
    986
    Blade, that is really fascinating and interesting, even for the rest of us. Thank you.

    Alzora, your post was incredible. Thank you so much for sharing that. Your hard-earned wisdom is an excellent reminder of how blessed we all truly are, BFP or not.

    Sitting here, 7 DPO, wondering, obsessing... It's so easy to let life pass me by while I turn one thought over and over in my mind like a pebble in a stream. It's wasted energy, though, it truly is. My symptoms, this early, mean next to nothing, and I won't know anything for days, so why fret?

    You've inspired me to stop googling my ass off. This is stupid. I'm gonna go somewhere. :-)

    Have a lovely day, ladies.

  3. #700
    Join Date
    Sep 2012
    Location
    Los Angeles
    Posts
    4,588
    Quote Originally Posted by alzora View Post
    I've said so much about my accident that I thought a visual might be nice. The photo was taken only four months post-accident, and my stripe is now a pearly shade of pale pink. It is eight inches long and was never sewn or stapled. Doctors used something else to close it up--vac something? Blade would know...I think they somehow sucked it shut. They supposedly left it open for three days before even closing it up, according to my family. I don't know if that's true or why they would do that.
    @alzora I thought your post was very touching and inspiring too. In answer to your question (which is actually within my specialty, hooray), that is the standard management of a traumatic wound, especially if it's touch and go and the chance of needing to go back to the operating room is very high. In short, the ICU is a much safer place to be than an operating room. If things are getting hairy, patient's blood pressure is dropping, cardiac rhythm looking questionable, etc then the abdomen is left open. It is packed with sterile towels and a tent/silo is put in place (often times this is improvised with sterile IV bags) and a thin, sterile layer of plastic is put on top. It takes a long time to close an abdomen properly and even if it's only 24h, some healing will start to occur. If you need to watch the patient closely for further bleeding, further dead bowel, further infection, further increasing intraabdominal pressures, many things, then it's routine to have a "second look" in 24h. A wound vac is placed on top of this contraption to maintain a seal, as the abdominal cavity is supposed to be a sterile place, and to suck out the accumulating peritoneal fluid. Minimizing edema maximizes the chance of successfully closing the abdomen.

    Some patients with chronically infected abdomens heal entirely by the vaccum. It's left in place for months and the resulting scar is very wide, very broad, and very ugly. Your scar is clearly surgical and mimics an incision, therefore your abdomen was officially closed. It might have been closed by a technique called delayed primary closure, where large retention sutures were left in place and the abdomen was formally closed after a few days, but it was definitely sutured closed. Which makes sense given your case and the type of injuries you sustained. If you had perforated your bowel, had massive intestinal injuries and resultant peritoneal infection, with abscesses and fistulae, then you would have been closed secondarily by a wound vac, and you would not like the results aesthetically.
    Blade, MD

    XY: Antoine Raphael
    XX: Cassia Viviane Noor

    Aurea * Emmanuelle * Endellion * Fleur * Jacinda * Lysandra * Melisande * Myrrine * Rosamond * Seraphine * Sylvana * Thea * Verity / Blaise * Cyprian * Evander * Jules * Laurence * Lionel * Malcolm * Marius * Quentin * Rainier

    كنوز الصحراء الشرقية Hayat _ Qamar _ Sahar _ Maysan _ Farah / Altair _ Fahd _ Faraj _ Khalil _ Tariq

  4. #702
    Join Date
    May 2012
    Posts
    1,810
    Wooow, I'm starting to understand this now! Okay I am definitely one of those people who thought that the ovaries were connected to the Fallopian tubes. I had quite a different idea of how things went on in there. So when blocked Fallopian tubes get pumped full of dye, does the dye just sit in them forever since it can't run out? And apart from obstructing the Fallopian tubes, are such adhesions a danger in other ways? They could be anywhere inside of me! My final tally:

    Brain injury
    Broken nose
    Fractured vertebrae in the neck
    Ten broken ribs
    Two collapsed lungs ("traumatic pneumothorax without open wound into thorax")
    Spleen went to be with Jesus ("Spleen laceration extending into parenchyma without mention of open wound into cavity")
    Pelvis was shattered to smithereens (paraphrased)
    Urethra and vagina were each sliced in half
    Bladder...I don't know what happened to it exactly but the urologist later told me that it was beyond recognition
    And lastly, blood blood blood. Blood everywhere.

    Any number of things could be stuck together inside of me now! I am a walking mess of tangled guts.

    So are you a trauma surgeon, Blade? Is that your specialty? God bless you. To face such injuries and not run out the back door...that takes guts, if you'll excuse the pun.

    Your description of a wound vac, particularly the bit about the wound being packed with towels, sounds amusingly like taxidermy. So I was stitched up at some point, then? I mean I have no idea what went on. I was so busy...I was hallucinating on methadone...as soon as my tubes were out and I could talk again, I thought that one of the male nurses and I were providing voices for characters on the old '90s TV show Dinosaurs...and then I thought I gave myself an abortion but I was a virgin at the time...and yes, I did break the news of the abortion to my parents and fiance quite dramatically there in the hospital. I did not have time, with all that going on, to check for stitches, though I've had this idea that there were none. When I was discharged and sent off to rehab, two guys came in and put all these little pieces of tape across my scar--Steri tape?--and I looked like a Halloween cartoon until the tapes fell off weeks later one by one. But if you say that scar was stitched earlier, then I don't doubt it. It's possible that it happened during one of my Dinosaurs performances with Craig the Nurse and I was too engaged to notice. It's even more likely that it happened earlier, during the stage of which I have no memory. Anything can happen when you're in Methadone Land.

    Sorry, guys...I get regaling you all with my war stories here and take up all of our TTC space. Speaking of space, we're on like page 70 of TTC 2013 and it's only April! We are a chatty bunch.
    Last edited by alzora; April 18th, 2013 at 07:30 PM.

  5. #704
    Join Date
    Oct 2011
    Location
    Emerald City
    Posts
    517
    Quote Originally Posted by alzora View Post
    So when blocked Fallopian tubes get pumped full of dye, does the dye just sit in them forever since it can't run out? And apart from obstructing the Fallopian tubes, are such adhesions a danger in other ways?
    The dye trickles out just how it went in. Alzora, your posts have been very inspiring today so I wanted to thank you for sharing it with us. I've never broken a bone in my body so I can't even imagine the magnitude of trauma you've been through. We all have a lot to be grateful for whether we know it or not.
    Last edited by poppy528; December 31st, 2013 at 04:00 PM. Reason: post redaction
    “And remember, my sentimental friend, that a heart is not judged by how much you love, but by how much you are loved by others.” L. Frank Baum, The Wizard of Oz

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