I think I spoke too soon about the infection's being cleared up. I started hurting more again on Sunday, and the low-grade fever came back. I gave it yesterday to clear up, then when it didn't, called the doctor back this morning. She wants to do another round of the same antibiotic, about which I have mixed feelings. I felt much better while I was on it, but obviously, as soon as I stopped it, I started getting sicker again. Did I just not take it for long enough, or is it inadequate to the task at hand? I'll give it one more go, but if it doesn't clear everything up for good this time, we'll revisit the question of the D&C.
Speaking of questions to revisit, this whole infection business has pushed me to revisit the postpartum birth control question. We knew all along we were probably done after this one, but I couldn't quite bring myself to get a tubal done with the CS. I hated to rule out even the outside chance we might want another in a few more years, when the girls will be in school and I could better handle another awful pregnancy. Also, this may sound silly, but I wanted to make sure that Andrew was born and that everything would be okay with him. After all the drama of this pregnancy, some part of me didn't believe that we'd really have a live, healthy baby, and I knew that if something awful went wrong, I'd eventually want to try again. So, I said no to the tubal, and had planned on getting a copper IUD (not the Mirena, don't care for hormonal birth control after the events of the last several years).
However, this infection has officially been the straw that broke the camel's back. I can't handle the thought of ever doing this again. I held up through the hyperemesis, the T18 scare, and the months of bedrest for preterm labor. The asthma exacerbation was almost funny, in that "now what!" way where you have to choose whether to laugh or cry. But there's nothing funny about the fact that, four weeks after my son's birth, I'm still spending most of my days in bed because my pelvis feels like it's full of rusty nails and barbed wire. I was feeling so cheery last week when I was feeling well, but now I'm right back to wondering what it's going to take to cure this, and what kind of permanent damage I'm going to be left with before it's all said and done. For all I know, it may not even be possible or prudent for me to conceive again -- endometritis is a type of pelvic inflammatory disease, after all.
In any case, I never want to have another pregnancy, even an accidental one, unlikely as the idea of that seems to someone whose bathroom cabinet still holds a sharps container. I don't want my husband to get a vasectomy, since that is even less reversible in the event of future circumstances than a tubal ligation. If I get myself sterilized, I'd have the option of doing IVF if I wanted another pregnancy badly enough; but if he gets sterilized and anything happens to me, any future wife would be like my sister, permanently infertile as a result of a choice made in another marriage.
I haven't decided whether I will do the Essure procedure or a traditional tubal ligation, but this is mostly a question of logistics. I have to see what is covered by my insurance, and will cost me less. I have to see whether I'm going to wind up being anesthetized for another gyn procedure like a D&C or a lap, where it would be convenient to tie my tubes while I'm already out. Heck, for all I know, this still could end with a hysterectomy, which would render the whole question moot.
In any case, we've got to get the infection cleared up before I can make any decisions. I hope this round of antibiotics does the trick, though I'm less confident than I was.