Summarize the following:
Your gynecologist will want to know how your tubes were "tied." Procedures that cause the least amount of damage and maintain tube length are easier to reverse. Your two fallopian tubes are a part of your uterus; they are like long, thin ears on the uterus. Your tube catches an egg released from your ovary and carries the sperm to that egg. After the egg and sperm join, this fertilized egg is carried it into the uterus where it implants and grows into a fetus. There are many ways to have your tubes "tied," but none of these procedures actually "tie" them like a knot. Your doctor may have used tubal rings or clips to clamp them shut. Another method is to scar and block your tubes using either a burning tool or special insert. The tubal reversal is performed in either a hospital or an outpatient center. The gynecologist will perform a laparoscopic procedure. This includes removing any foreign objects (clip, ring, insert), cutting away any scar tissue, and then reconnecting the tubes by sewing the healthy ends back together. Your gynecologist will be operating in your pelvis which is the lower portion of your abdomen. There is a risk of bleeding, infection, and injury to organs located near your tubes. Anesthesia is used to control your pain and to keep you asleep; you could develop a bad reaction these medications. Getting pregnant is the outcome you want. However, there is a 10% chance your pregnancy could be ectopic, in which the fertilized egg implants and grows outside your uterus. A majority of the time this happens in one of your tubes which is not large enough for a baby to grow. Your pregnancy would end early, your tube could be damaged, or you could have significant, even life-threatening, bleeding. Your OB/GYN will need to know about any health issues involving your uterus, ovaries, and vagina in order to figure out if you are a good candidate for a tubal reversal. The success of your tubal reversal is affected by how much scar tissue you have in and around your tubes. It is important to know if you had surgery in the past for endometriosis. This disease occurs when little pieces of the lining inside your uterus end up outside of your uterus stuck on organs like your ovaries or bladder. Your doctor will ask if you have a history of pelvic inflammatory disease (PID). PID occurs when a serious infection spreads from your vagina up into your uterus, fallopian tubes, and ovaries. Scar tissue from previous surgery, endometriosis, and/or PID could make the reversal harder to do. The doctor is looking for anything which may affect your ability to get pregnant. Being pregnant in the past is a good sign it can happen again. Let her know if you were ever pregnant and if it was a healthy pregnancy. You are likely to be a good candidate for reversal if your tubes were closed with rings or clips or if you only had a small part of your tube removed. Procedures like Essure and Adiana that use inserts and sometimes burning are harder to reverse because of the amount of scarring. If you are younger than 40 and had your tubes tied immediately after delivery, some surgeons consider you to be the best candidate for reversal. This exam and any studies your doctor orders are important to help keep you safe during the surgery. A safe procedure increases your chances of getting pregnant. An older woman, 40 years and up, usually has poorer egg quality and fewer healthy eggs remaining. You may find it harder to get pregnant. Your doctor may order a study where your follicles are counted to see how many eggs you have left. She also can order blood tests to check your follicle stimulating hormone (FSH) and estradiol (E2) levels. If these hormone levels are abnormal, it may be a sign that your ovaries are not working well enough to get you pregnant. Your doctor may find it harder to perform your tubal reversal if you are overweight. Your procedure will take longer. You will be under anesthesia longer, increasing your risk of having a bad reaction. Your doctor will determine your body mass index (BMI), an indicator of body fatness, by using your height and weight. Your extra weight should not affect your ability to get pregnant. Your doctor may order a hysterosalpingogram (HSG) to check the length of your fallopian tubes. This procedure can be performed in two ways. The first way is to inject a dye into your uterus then use fluoroscopy, a special X-ray, to see your tubes. The second way is to put sterile fluid filled with small bubble into your uterus and see your tubes with ultrasound which uses sound waves. Ultrasound also can be used to see if your ovaries appear normal and healthy. Knowing about your general state of health, such as the presence of heart disease, lung disease, bleeding disorders, or any previous bad reactions to anesthesia, helps your doctor take better care you during the surgery. It is best for your partner to undergo semen analysis, including a sperm count. You want him to be able to get you pregnant once your tubes are untied. This test is fairly inexpensive. The gynecologist will send your partner to an urologist. This type of doctor can treat your partner if any problems are found. This is another option for becoming pregnant if you are not a good candidate for tubal reversal or it fails. IVF involves combining eggs and sperm outside the body in a laboratory and then placing the fertilized eggs inside your uterus. There are good and bad things about IVF. Trying to decide between IVF and tubal reversal is hard. Your doctor will talk to you and your partner about things like age, cost, how much time it may take to get pregnant, and how you still may not get pregnant.

summary: Get copies of your operative reports. Ask your doctor about how a tubal reversal is performed. Talk to your gynecologist about any reproductive issues. Undergo a thorough physical examination by your doctor. Bring your partner with you to the doctor. Talk to your doctor about in vitro fertilization (IVF).

Summarize the following:
When you live with depression, it's important to know your own body and observe patterns in yourself. Keep track of these patterns by writing in a journal. This is beneficial for understanding how your environment has an effect on your mood, energy, health, sleep, etc. Writing in a journal can also help you understand how other people are affecting you. Journaling can also help you process your emotions and gain insight into why certain things make you feel the way you do. Journaling is a simple activity that only takes a few minutes a day. If you require more structure, search online for tips on journaling, or find a book about the journaling process. Make writing in your journal a daily habit. Even if you spend only a few minutes writing, it can help you process your emotions and gain insight into why certain things make you feel the way you do. Make it easy for yourself to jot down notes. Keep a pen and paper with you at all times, or consider using a simple note-taking application on a phone or tablet computer that you often have with you. Journaling is about getting your feelings and thoughts down on paper. Don't worry about spelling, grammar or style. This is the time to write whatever you want, rather than trying to craft the perfect message. Don't worry about what other people might think. Use your journal however you want; you can keep everything private, share some things with friends and family or your therapist, or start a public tell-all blog. It is up to you and your comfort level how you use your journal.
summary: Write in a journal. Try to write every day. Keep a pen and paper handy. Write whatever you want. Share only if you want to share.