Decisions, Decisions

Today was my ovary check appointment with the Fertility Gurus. I only have two kids in care on Mondays, and one of those is on vacation this week.  The other one leaves at 12:45, so as of then I was off work! Brian worked last night from 3 AM until 1 PM today (!!!!), so he was able to go with me to Charlottesville.  I love when we can go together to these appointments; I dearly love spending time with Brian, and the two hour round trip is a good chance just to catch up and talk about our day.  And while I know that it helps the parents of children I provide day care for to have Brian watch the children when I have to leave for appointments, having him there for moral support is wonderful; it seems more like a "team effort" when we're both there.  So around 1:45 we headed off for Charlottesville.

One of the reasons we both wanted to go to this appointment was to discuss IUI further with the doctor.  We haven't committed to it before this because we were determined to continue to try for a few more months before turning to more invasive procedures. But we're numbers-people, and need to know a lot of facts before we commit to anything.  

So many things have stood in our way to getting pregnant, and it seems like as soon as we conquer one problem another one springs up.  We can't help but wonder if God isn't putting these obstacles there to force us back to his timeline.  No matter what we think, God knows when we'll have children, and how.  We can do everything we want to push things along, but until He's ready for us to be parents, we won't be.  That has become very, very obvious to us in the past few months, and we've discovered that banging your head against a wall gives you a headache.  

So, we've come to the realization lately that we have approached a crossroads in our fertility trials.  Basically, commit to IUI and put all our resources into that for now, or commit to adoption and be finished with all fertility treatments.  The two are not compatible, so we have a choice to make.  Unfortunately, there is so much to think about for both cases.  Today we wanted to get some numbers from the Gurus about success rates for IUI.  

We met with Dr. Bateman today (not our regular Guru, but he's growing on us).  We let him know what we're thinking, and that we're very interested in IUI.  From our research, we've learned that the national average success rate is between 4-23%, depending on the clinic. That's a huge span, isn't it?!  The Guru said their current success rate is 10%, and that there sometimes seems to be an unexplained cumulative effect; your success rate goes up after three or four consecutive inseminations.  With that cumulative tendency in affect, we'd be looking at maybe a 30% success rate.  Not guaranteed, of course, and there's no promise that I'll have that cumulative effect, but we're looking at somewhere between 10-30%.  

In addition, we figured up the cost.  Which, not including lost income, would be $504 per month.  We're figuring we'd need to commit to a minimum of 5 months to get that cumulative effect and let it work for us, which brings us to just over $2500.  Strangely, we don't have that lying around.  In order to afford that, we'll take the next few months "off" -- no Clomid, no inseminations, no appointments.  Just going back to being normal people with normal lives.  That'll save us about $130 monthly, but that won't touch our IUI Total.  So, we'd be scraping all the time -- don't look for us to go anywhere or do anything.  We'll be saving.  

Of course, in increasing our chances of getting pregnant (30%!) we also have to seriously look at my miscarriage risk.  Dr. Guru put it at about 20%, up 5% from the national average for "normal" people (you know, people without PCOS, infertility, or a big butt).  Currently, losing a baby in utero or from prematurity is my Absolute Biggest Fear That Keeps Me Awake At Night.

Down the other road (that diverges in a wood?) is adoption.  We're currently looking into domestic adoption of a non-white or mixed race child.  There is a huge surplus of non-white children to be adopted because white families are wanting to adopt lily-white children that will look just like them.  We do not have this need.  Not knocking you if you choose to adopt yourself some white babies.  But I don't mind if all my kids are of different races, if they look like me, or not.  Sure, knowing what our genetic make-up would look like would be cool.  Having a baby sleeping in the crib by the bed would be faaaaar cooler, thanks.  If that kid is not white, I'm not really going to be bothered.  Want a baby now, thanks.  IUI wouldn't mean that we don't adopt if it doesn't work, just that we'd be putting on the far-back burner until we were done with treatments.

The drawback for adoption?  It's E X P E N S I V E, ya'll.  Like new-car-expensive.  Like new-cars-for-both-of-us, fully-loaded-expensive.  See above about not going anywhere, doing anything, skrimping and saving.  Woot.  And the wait could be months or years.  Based on the need for people to adopt non-white kiddos, probably shorter.  But still, it's not immediate.   Much like making one yourself, you know?  And did I mention it costs a lot?  Yep.

So, we're taking a while to examine our options, regroup, huddle and discuss our next down, and decide which path to take.  We'll be praying for wisdom and guidance, as well as acceptance of God's will.  We'd be most appreciative if you'd do the same for us.  I'm not sure when we'll have a decision, but you'll know where we're going when we do.  

What's Goin' On, What's Goin' On

10 Baileys Points if you can identify the inspiration for the title for this post.

I know I said I'd try to update with what all has been going on around here lately, and then kept you all waiting. It's been a long couple of days, so bear with me. Nothing much terribly important has been going on in the grand scheme of things. Unless you are me, in which case it's been a seriously stressful two weeks. Here's the background....

I use the Clearblue Easy Fertility Monitor to keep track of my cycle and find the two most fertile days to get pregnant. I highly recommend this little gadget to anyone trying to get pregnant, infertile or not. In fact, when the YaYa Princess decides to have herself a little tax deduction, I'll be happy to loan her my monitor, provided it's not in use at the time. And at something like $200, begging/borrowing/stealing is highly recommended. I bought mine secondhand and will gladly pass it along when we're done with our family. You know, in like 10 years when it's probably obsolete. But I digress. Every morning at 7:30 I push the button on this handy little computer. It records the time and cycle day, and if necessary prompts me to pee on a stick (POAS, if you're part of the infertile community). Then I put the stick in the monitor, it does some manner of magical divination (or scientific reading, whatever) and tells me my Fertility Status. Low days are like any other day, high fertility days may be a good day for ...um...yeah. And The Peak Day is the most awaited day in all of Infertilityland. That day and the next day are the best days to get all knocked up, or inseminated if you're going the full medical route. A fortuitous day, no doubt. The science of this works like so:

Your body uses hormones to control your cycle and fertility. You know that, I'm sure. I start out the month (we call it a "cycle", you know...) with Clomid on cycle days 5-9. Somewhere around CD 11 I start P'ingOAS. The level of estrogen in your body (and consequently in your bloodstream) begins to increase as you near ovulation. A follicle or two begins to form on your ovary, which contains the egg. At this point, viola: "High Fertility" is indicated on the monitor. This is a good day for extracurricular activities, but not mandated. Ha! Man-dated. ;) 24-36 hours before you actually ovulate, your body releases lutenizing hormone, called LH. This is the handy little chemical that makes your follicle rupture, releasing the egg. The follicle goes on to do other cool things, but they are not part of this story. So, this LH surge is picked up by the fertility monitor in your urine (actually, my urine, thanks) and the monitor goes to Peak Fertility. This means: Get Busy. Ovulation will be in the next 24-36 hours, so the following day is good, too. Since an egg has a lifespan of 12-24 hours, you need to have the other ingredient there prior to the egg. Cart before the horse sort of situation. After your Peak Day, the monitor stops asking for test sticks and you go back to waiting. This is called the Two Week Wait (TWW) in the happy infertility community. Basically the length of time between ovulation and either your period or a pregnancy test.

Sounds easy enough, right? Except for this month, when my life went like this:

CD 5-9 Clomid

CD 11 commence peeing on technology

CD 18 high fertility reading -- right on track for me to ovulate at day 20 like usual. That day 14 thing is bull, by the way

CD 19-26 still high fertility. No peak, no change, just ...................................high.

At this point, I worried. Actually, I commenced worrying around CD 22, but that's neither here nor there. By CD 26, I called Jan The Very Cool Nurse at my fertility clinic. She was equally puzzled, and concerned, and scheduled me for an emergency appointment Tuesday morning. This meant Brian had to change his schedule really quickly and we had to pay for an ultrasound....again. This is a monthly occurrence, so not too big a deal. But worrisome when you don't have a little window in your abdomen to see what's goin' on. The likely scenario was that I had not ovulated, and was going to need a little further chemical encouragement to pop that follicle. Or that I had ovulated and the monitor had missed it somehow. You know, because $200 technology isn't foolproof. But if Jan was worried, that worried me. That's where I was when I posted the other day, letting you all know that I was off to the doc's.

The ultrasound showed at least one, and possibly two follicles on my ovaries. It was impossible to tell if they were ready to pop, or if they already had ruptured and were now corpus luteum-s. Corpi lutei? Only a blood test would tell, checking for that ever-useful hormone, progesterone. I've posted about that before, so I'll spare you the link. An elevated progesterone level would indicate that I had ovulated, and a low level would indicate that I needed help to do so. Help in the form of a "trigger shot" of hCG. Since I was unable to stay in Charlottesville to get the shot if my blood work came back low, I got to learn how to give myself a shot, and was sent home with syringes and hCG to shoot myself up later that night. I was told to call back in an hour for my results.

This is where it gets a bit anti-climactic. My progesterone level was an 11, which indicates that I ovulated. The doctor estimated that it was around CD 20, based on my progesterone level. My monitor missed it. Two weeks of wondering and worrying, 2 hours of driving across the mountain, $130 of doctor's bills and hCG costs, and a 20 minute lesson in how to stab myself effectively in the stomach because of a minor technological malfunction. Fun, and totally typical in the infertility journey that tons of people travel. The good news is that I ovulated, and that our timing may have been good, and I'll know in a week or so if I'm in the family way. Praying, you know.

Here's what just popped into my mind: no one knew about this but the people in this house. That day was stressful and a bit scary (read this link to understand why: Ovarian Hyperstimulation), and no one knew. Because infertility isn't something you talk about, or put on your church's prayer list, or mention to your grandmother or cousin, or sometimes even your best friend. I've been amazed lately to find out the people that we know that struggled or still do struggle with infertility. All by ourselves, usually. I once mentioned to the YaYa Princess that no one makes eye contact in the fertility clinic waiting room. It's kind of weird, actually. So I would encourage you to make yourself open to your friends and family so that if they need to talk they feel comfortable. It can be a cold, lonely journey, and I really wish that everyone had as many outlets as we do. We're blessed with family and friends who are open to hearing about our weird experiences, too much information, and blogs about cervices. Not everyone is this lucky, so please be understanding and gentle to them. Maybe there's someone at work who is grouchy, or seems tired or irritable. They may be dealing with infertility quietly, and need someone to care. You may be able to help someone who is going through such a situation as we faced this cycle. Uncertainty, failure, and anxiety are not fun -- be a help to someone you know!

Now, I'm off to bed. Having spent an entire day dealing with vertigo for some reason, I'm exhausted. Smooches to you all, thanks for listening, and goodnight. Oh, and a shout out to The Bum - we heard about Cooper's little journey away from home, and we'll be keeping you in our thoughts and prayers. I hope he's home soon!! Night, ya'll.

New a-Comin'

Hey, ya'll.  Big things are a-foot and I'm headed to the doctor tomorrow.  I am NOT pregnant, so come down off the ceiling.  I was hoping to post about it tonight to keep you all in the loop, but have run out of time.  So I'll put it up tomorrow sometime.  In the meantime, we'd appreciate prayers and thoughts tomorrow.  My appointment is at 10:30.  Thanks!

Or Maybe Not....

Okay, scratch that bit about the IUI being scheduled for this month.  We decided to put it off for at least one more cycle.  Not only is it horridly expensive, and out-of-pocket since our insurance bites (and will no longer pay one penny toward our IF treatments!), but Brian wants to see what his neurologist has to say before we do this.  Neurologist,you say? Yep...

Some of you may know that Brian has degenerative disk disease in his cervical spine.  It's pretty bad, to the point that his chiropractor will no longer touch him and the last neurologist to see him said that any good blow to the head or fall from any height at all would either paralyze or kill him.  Such fun things to have hang over your head, really.  This seems to be a family issue -- one of his sisters has some back issues, I believe, and his mother had major surgery (two years ago?) on her spine.  MAJOR surgery.  So, we're not surprised.  When you add in the fact that Brian played football until he was about 19 (offense and defense, woo hoo!), you have one seriously injured back.  Unfortunately, that degenerative disk disease leads to pinched nerves and muscle spasms, shoulder pain, migraines, and numbness in his hands and feet.  Or occasionally arms and legs.  His migraines are nearly constant, and are atypical in presentation.  So he may not have the blinding pain that I deal with when I get a migraine, but he has horrible dizziness (he's been treated for vertigo for years), nausea, numbness, inability to see clearly, and something extra-fun called "brain fog", which is exactly what it sounds like.  

A lot of his symptoms seem to stem from his vestibular function; if you turn off the lights, Brian will fall over.  He has absolutely no balance when the lights are off or his eyes are closed, and it's not just a clumsy issue (that's me). Finally, all the symptoms that he's experiencing have just gotten out of control.  Yesterday at work he was unable to read.  This is a literate man, folks.  Who was completely unable to make sense of any words on a page.  Or numbers.  Have I mentioned he manages a retail store?  A few numbers are involved.  Apparently at night, the numbers on our clock jump, too.  Tons of fun, I'm sure.  He perpetually just feels off, and it's gotten old.

So, about a month ago, he went to see our family doctor(s).  He was given a referral to one of the best neurologists around, and finally had his appointment at the beginning of March.  Dr. Perdue said that he thinks the migraines are the first thing to address.  He gave Brian a beta blocker.  Brian then proceded to not sleep for four days.  Instead, he'd sit bolt-upright in bed and talk nonsense, scaring the crap out of me.  Just as fun as it sounds, really.  So, after four days of no sleep, Brian went off that particular pill, thank God.  And immediately got a migraine.  He had an MRI this week, and we're waiting for the results of that.  Unfortunately, his next neuro appointment is in early April.  At this point, the questions are these:

• Is his degenerative disk disease to blame for everything, or totally unrelated?
  
• Are his migraines atypical and causing all this, or is there something else?
  
• Is this an injury-related/disk issue, or is it a congenital problem?
  
• Is this a one-time thing, or can he pass these issues on to our children?
  
• Will this get worse, and is there any treatment that won't make him feel even worse?
  

Of course, we're both terrified of things like brain tumors and such, and we've definitely thought about MS.  Dr. Perdue doubts both of these things, though, so we're looking at either he has a really bad neck and is headed for surgery, or he has some manner of disorder/syndrome that is getting progressively worse.  And, being such tech-savvy people, we've of course turned to Google for all our answers.  Brian's best defense in such trying times is to be totally informed. This led to being tested extensively for Meniere's Disease earlier in 2008, which was ruled out. Which is strange, since several doctors thought that this was the exact answer we were looking for; he has all the symptoms, but not the necessary inner ear structure to diagnose Meniere's.  And the doctor he saw is considered an expert in Meniere's, so we're pretty confident in that lack of diagnosis. 

Unfortunately, if you rule out Meniere's, what we're looking at may be Vestibular Ataxia. He has failed his Romberg's Test, most recently last night while demonstrating it for Cousin Mike and myself.....and again just now when I asked him to do it again.  When you couple his symptoms with the fact that his mom has a few inherited things that can be scary (Alpha-1 Anti-Trypsin Deficiency and heterochromia being our main concerns), we afraid that a "sydrome" of some sort may be to blame.  If you follow the heterochromia links out, you'll find that there are a host of sydromes that can be indicated by this simple sign.  A simple sign that Brian's mom, his sister, my father, and my grandfather have.  We're not playing with this.  At this point, degenerative disk disease caused by a healthy highschool football career will be most preferable.  

Now we have to decide what to do about having children.  If it's not genetic, woo hoo and we go on with IUI as soon as we can.  If Brian has something genetic, we will have to decide if we want to risk taking a chance to pass this on to our kids.  We most likely will not, since we feel it's just irresponsible to pass on things that you know full well will comprise a child's quality of life or will shorten it drastically.  Please do not flame me if you have, will have, or have had a child that inherited a genetic condition that you knew you had. It's our personal choice, and it's been prayerfully made. That said, we're continuing with Clomid and The Old-Fashioned Way for this cycle.  If God wants us to conceive this month, we will, and we'll deal with the consequences.  If Dr. Perdue feels that Brian's issues are genetically linked, we'll both seek genetic testing.  We'll go from there.  We're both completely open to adoption, even though we so deeply want biological children.   

We're not worrying about much of anything at this point, and just praying that this week's MRI shows nothing life-threatening.  Chronic, degenerative, or genetic things we can deal with.  A brain tumor or such would be devastating.  We'll deal with it, but of course would prefer not to.  So a lot of time is being spent on our knees these days.  Brian is still dealing with all his symptoms and never knows what a day is going to bring.  If you see him and he looks positively exhausted, distracted, or downright foggy, you'll know what's going on.  He's been in chronic pain for a long, long time and things are progressing from bad to worse at a pretty fast clip.  Please pray as you feel led for knowledge, strength, guidance, and God's will.  Oh, yeah -- and a clean MRI and football-induced neck injury!!! :)

Progesterone Level Update

Guess whose progesterone level was up to 16 by Thursday?  

Mine, that's who.  

That's good news, if you're following along. The doctor said he wanted to see a progesterone level of at least 10, preferably 15...  I'll go ya one better, Doc.  So, we're possibly all set for IUI this coming cycle.  Which should arrive any day now.....  Start praying --- or donate via PayPal, cause it ain't cheap.

Also, Brian just returned from his contrast MRI.  He's having some neurological issues possibly tied to the degenerative disk disease he has.  Lots of pain, numbness, migraines, etc.  So we're hoping to get this all straightened out as soon as possible.  Of course we're praying that the MRI is clear, but we're also needing some answers!

Meanwhile, I have a little migraine action of my own.  Ugh.  Happy Hump Day, people!

Doctor Update

Hey, everybody! I know it's been awhile since I updated.  I've been trying to promote Baileys Basics like crazy, so I've been over at that blog, trying to get a post up every day or two.  So, if you miss me here please check over there!  In addition, I'm thinking about selling cards, bookplates, etc. online through Etsy, too.   It's something I've done for ages for myself and family, so I might as well start turning a profit, no?  We're big on alternate streams of income around here, and that's one more to add to the river.  I'll keep you posted on how that turns out.

Friday I went to RMSCVA to see Dr. Williams for my ovary check.  This month we used a higher dosage of Clomid (four pills to equal 200 mg daily, if you're a numbers kinda person) because I'm not ovualting "robustly" enough.  I'm not 100% sure how "robustly" I'm supposed to be ovualting. Basically, when they do my ovary check (via internal ultrasound) they can tell me that I ovulated.  The nurse then does a blood draw to check how well I ovulated.  Last month my progesterone levels were too low.  This could result in losing a pregnancy, if I conceived.  Not something I want to deal with, so we need to address the situation.  A higher level of Clomid might do the trick, so they upped it for this past cycle.  

While I was there, I asked Dr. Williams about the possibility that our schedule is just off for testing my progesterone.  The average cycle is 28 days long.  You take Clomid on cycle days (CD) 5-9 and should ovulate around CD 14.  Then you go for an ovary check sometime on CD 21-25.  I'm a consistent CD 20 ovualter, with a 35 day cycle.  Consequently, the appointments on CD 22 or 23 like I've been having just aren't going to cut it.  Since progesterone rises after you ovulate to a peak around a week later and then slack off to induce menses, testing so soon after ovualtion could lead to a deceptively low level.  Usually progesterone defiencies are indicative of a luteal phase defect, but since I'm having a solid 15 day luteal phase before my period, I doubt it.  I think we're just testing too early.  So, this month they tested my progesterone on CD 22, and it was low.  I have a lab order to test again on Thursday of this week (conveniently here in Harrisonburg instead of driving to Charlottesville!) to see if it peaks any higher.  Keep your fingers crossed and keep praying!

Once we get my progesterone levels figured out and I'm Ovulating Robustly, we're going to try Intrauterine Insemination, or IUI.  This should increase our chances of conception dramatically.  We hope. It's expensive, but it beats more months of trial and error.  We'll let you know when that happens!  

After my appointment, I met Little Bro and Sweet Lizzy for a trip to the cutest store in the world and dinner at the best dumpling shop ever.  We had pork dumplings and spicy noodles so good they'd make your tongue beat your brains out.  If you're in Charlottesville, go to the walking mall and hit the tiny little dumpling shop.  Go now, I'm serious.  Then go over to O Suzannah! and buy something awesome. As always, it was great to see the brother and sis in law, and they make a trip to Charlottesville more fun than imaginable.  

Well, egg rolls are ready to be heated and a salad is calling my name.  The Bum and Cousin Mike are moving to the Great White North (you know, Parkersburg, WV) today, so wish them luck and decent weather for the drive.  We'll visit them in April and have a new camera, so expect pictures!  Happy Tuesdsay, Happy March, and where the heck is Spring?!

Doctor Visit Update

Hello, all. I saw Dr. Williams yesterday, and he told me.....that I ovulated!!! I was stunned. I may have made a fool out of myself in the office when he told me, actually. I grinned like an idiot all the way home, and couldn't resist calling people to tell them. Which had to be a weird phone call. Yaya Princess was in a limo with clients, and there's a good chance Little Bro was in his carpool. Sorry, ya'll. But I ovulated! I'm surprised it wasn't on CNN....

What does this mean? Well, if our timing was good, I could be pregnant. Wow. We'll know in about seven to ten days. I'm about five days into the famed "Two Week Wait". Which I have to say sucks just as bad as I thought it would. If my period is late, I'll test. And test. And test some more. If it shows up, that's okay, too. At least we know that 150 mg of Clomid is the right place to start. I'm cool either way. But did I mention that I ovulated?!?!

I'm taking it easy today. We were out super-late with Mama, Bro, and Lizzy last night, and slept in. Brian went to work, and I went to the couch. I'm supposed to be accomplishing a lot. So far, I've accomplished a nap and a blueberry muffin. Such hard work... But hey, I may be growing a human. Leave me alone! I am having a few weird things going on (I'll spare you the details) that make me wonder, but I know how the Two Week Wait messes with your head; this isn't my first time at the rodeo, after all. So I'm not obsessing. Nope. Not a bit.... Okay, I'm totally obsessing. In fact, I'm now off to watch as many baby-delivery-huge family shows as possible. And maybe take a nap. Have a great Saturday!

October 7, 2008: Our Second Anniversary

Um, where have two years gone?! Somehow, Brian and I have been married two full years now, and it feels like our wedding was last week. Does anyone have an explaination about this? We talked about it last night, and he feels the same, thankfully. It's hard to believe that in two years, we've both changed jobs, we bought a house, started trying to start a family, and watched two of our siblings get married (which makes us very, very old). And that's just the huge things; it's been a busy two years!

Tonight we both get off work early, so we'll be enjoying dinner out somewhere (any suggestions?). Saturday we have weather-permitting plans to go to Skyline Drive for our newly-annual picnic-for-our-anniversary. Last year was a wonderful time, and I hope we can repeat it. So, for my readers: how long have you been married, and what's the best part?

Meanwhile, I visited Dr. Williams again for bloodwork results. Yep, it's PCOS. Good deal. Better the devil I know then the devil(S!) I don't. He gave me this month's Clomid (doubled the dose; I see a trend!) and asked me to exercise four times a week, minimum. So my fat butt walked 3/4 mile last night (fast!). It was very nice to get back out and get moving, I have to say. I had the shocking realization that even though I used to go for a 30 minute walk nearly daily, that was...Four. Years. Ago. Holy cats; forget two years - where have the last four gone?!?!

Other than all that, we had a trip to West Virginia and a few thousand family gatherings in the past few weeks. I didn't take a single picture, so you'll have to take my word on it that it was fun! In addition, I have lots of great new things going on in the ol' shops, so check em out. Here are linkies:

Baileys Basics Etsy Shop

Baileys Basics Shop Handmade Shop

Baileys Basics Blog

Okay, off to accomplish something! Have a great day!

Clean Teeth, Unhappy Belly

Howdy, peeps. I have clean teeth. Before you think "Andi, that's random and has no relevance here!", trust me. I went to the dentist today. Now, join me in running your tongue over your teeth. Ah, I love that feeling! On to other things....

Like side-effects. My mother likes to point out to me (repeatedly and every time we talk) that in seven years of fertility treatments, she never had a single side effect to any of the drugs she took. Isn't that nice for her? Bless her heart. I, meanwhile, am officially on Side Effect Day. My personal name for the day that all the drugs finally kick in (Tuesday night....Wednesday...and BAM! Side Effect Day commences) and I feel like death. Last night, I took my mega-dose (apparently horribly dangerous for me, according to the pharmacist) of Provera. Here's a great thing about progesterone: it can make you sleep like a log. Or a stone. Or a baby (not really - I hear they wake up a lot). Anyhoo, you sleeeeeeep. Unfortunately, that was awesome with 5 little milligrams of progesterone. Quad-flippin'-druple that, and I had serious, serious trouble waking up today. And staying awake. It finally wore off somewhere around noon. When the doubled dose of Metformin kicked in, making me want to hurl.

Some of you my remember 2004, when I began taking Met. My appendages would go numb and tingly (Brian still finds this hilarious), my blood sugar would plummet to around 60 (much less hilarious), and I would get sick from any and all sugar, Chinese food, and lettuce. That lettuce part never went away, and every salad I eat is a bittersweet blessing. I miss them, but they hate me. Well, I'm on double that dosage now. Ah, my stomach is so very happy. Only JustMe can fully understand, I think. She has an unhappy belly, too. Ugh.

So, tonight I took my drugs early, hoping that lovely Provera-induced sleep would wear off a bit earlier tomorrow, making work less of a chore. Now, I'm trying so very, very hard to stay awake through the West Virginia game. Brian is edgy and mentally pacing the room (almost worse than physically pacing), and it's 14-7 with 5:19 to go in the 3rd quarter. WVU is not winning, sadly. Luckily, however, there is no blood on the field so far. OOOOOOOOH! Literally as I was typing that, my darling Pat White scored. I have to go watch now. Let's Goooooo, Mountaineers!!!!

The Fertility Guru said....

Hi, all. Forgive me for not calling everyone; my cell battery is dead as a doornail.

We had our appointment with the almighty Fertility Gurus today at 2 PM. In case you're not sure, it's an hour and ten minutes to RMSCVA from here, so we had to leave (ideally) by 12:30. We left around 12:50, of course. We arrived at 1:55 to a gorgeous facility (click that link -- I'm serious, it's gorgeous). I've stayed in many an uglier hotel. We had filled our paperwork out ahead of time, so we had a long wait in the nicely appointed waiting room. Here, there were some clues that this is not your average doctor's office, but one that expects you to arrive as a couple, and may be serving either partner. There are Sports Illustrateds and hunting magazines on the tables. There is a copy of Dr. Williams' book, The Fastest Way to Get Pregnant Naturally on the table, too. There were several couples there today, and the men kept disappearing to other rooms.... And returning with "samples". Ever seen a man return with a packet of his own swimmers, hand it to his wife and watch her put it someplace warm? All this happened like it was completely a normal occurrence. I realized we were going to love it here :)

We were called back by Dr. Williams himself, not a nurse. He is apparently a PCOS genius/specialist/certified guru, and we are officially in couple-y love with him. He was kind, funny, and informative. He did not yell at me for being fat, humiliating me in front of my husband. He didn't make us feel bad about our shortcomings as breeding humans. He managed to do a pelvic exam (and visual! yikes!) and ultrasound without making me cringe in embarrassment. He managed not to tickle me while finding my ovaries externally, either, which is a Feat.

Basically, we're waiting on test results, but we have come to some conclusions. I have a lot of symptoms of PCOS, and a probable diagnosis, especially considering our family history of it. However, I have a lot of symptoms that are definitely not PCOS-related, and in fact are contrary to it. So, I gave up 5 vials of blood to have a complete panel worked up to see what it might be that's ravaging my body so. It may just be non-typical PCOS. Or there may be an underlying cause that is either in addition to or mimics PCOS. We'll know in about a week or two, depending on when results come back.

For those of you who are medical-minded:
My ovaries were normal sized, which is unusual in PCOS, and my uterine lining (up to 5 mm this month!! woot!) is thin, of course, which is directly contrary to most PCO women. I was referred for a hysterosalpingogram after ten days of Provera. Provera is progesterone, but about 4 times the amount that I had before. With 5 mm of lining (woot!) and stronger meds, we're expecting company. Good ole Aunt Flo!

Basically, what it comes down to is this: Barring any negative results from Brian's semen analysis, which we don't expect, Dr. Williams', certified Fertility Guru, thinks we should have no big trouble getting pregnant. He said to stop temping in the morning, as he is now in charge of manipulating my cycle. He said to stop using the fertility monitor, take my meds, and just let them handle my treatment. He doubled my Metformin (I'll be nauseous for the next year or so) and doubled my Clomid. We are officially medicated out the wazoo and ready to go, folks. And, here ya go....he said he fully expects drugs to work, and isn't even seeing IVF as a possibility or necessity. Which, since we had drawn the line on this side of that procedure, is reassuring. We won't need what we don't want and can't afford!

Needless to say, this is all a bunch of huge blessings and we are amazingly pleased. We are definitely giving praise tonight, and feel that lots of prayers are already being answered. Thank you to everyone who's been on their knees for us; we really appreciate it, and know it helped. I'm realizing just how stressed I've been about this appointment, and what we might hear. I have no big problem trusting the Lord in all this, but waiting to see His will is stressful! I slept like a baby the whole way home, and Brian passed out on the couch as soon as we were in the door. I think we've both been a little keyed up!

So, in closing, here is our prayer list for the next two weeks:
For concrete results from Andrea's bloodwork
For a clear analysis for Brian (poor boy, what he goes through for babies....)
For a decent menses (that's a period, ya'll) for Andrea
For a clear hyterosalpingogram for Andrea
For as few side effects from Metformin and Clomid as possible for Andrea
For patience for Brian with a nauseated, less-than-pleasant wifey laying around, trying not to puke.
For a baby, of course!

Smooches to you all, praise to God for good answers so far, and goodnight!

Update from the doctor

Yesterday was my follow up appointment with Slush. Here's a little background in case you need it: PCOS sucks, I don't ovulate, I have literally no uterine lining. After a month of estrogen replacement therapy and progesterone to simulate a normal cycle, I started Clomid this cycle, about 24 days ago. At that point, I planned for blood work to check my natural progesterone level and made an appointment with Slush. It's all timed out to coincide with particular cycle days, and the blood work is to make sure that I ovulated, based on progesterone level.

So, I went to Slush's office to follow up and plan our next attack. I already knew that I hadn't ovulated, based on my daily temperature chart. Slush was nothing if not honest and blunt. She said that my progesterone level was an "abysmal" 1.4. It should be around 20. Based on my lack of uterine lining coupled with my abysmal progesterone level, we had a few options...
1. Increase the level of Clomid
2. Skip straight to Femera, the 2nd line of fertility drugs
3. Go to the reproductive gurus at Martha Washington

Slush said that she doesn't think that a higher dose of Clomid is going to do a thing. And that skipping to Femera leaves us nowhere to go. And, given my numbers, it most likely won't work. We can try Steps 1 and 2 and then refer me, but that's wasting time, energy, and emotional toil. Because she doesn't think it's going to work anyway. So, Slush said she pretty much had nothing more to offer me, except a referral across the mountain. Check out their website, if you'd like. If you've heard good things, please leave me a comment. I'll be seeing Dr. Williams, who it seems is knowledgeable in PCOS issues.

As always, losing weight is key in PCOS management. As though we all want to be fat, right? Whatever. Low carb diets have been reported to work well with PCOS, and I have followed a low carb diet in the past. We now focus on a natural, un-processed diet with little refined white sugar or other fake food. We like to use whole grains and honey or other natural sweeteners. Not eating grains, fruit, or vegetables is alien to our way of eating now. It's not like we've always eaten this way, but it's been keeping us healthy and boosted our immune systems. Now, I'll be eating meat. Lots of protein, little to no carbs. I'm not thrilled about it, but I'm willing to give it a shot. Please, have a piece of bread in honor of me.

Okay, laundry calls. My appointment is September 16, at 2 PM, if you're the praying type person. We'd appreciate it.

Ultrasound Fun

Today I was scheduled to have an ultrasound at Slush's office. This is as a result of my not having had a period in nearly six months, even with three rounds of drugs to make such a thing occur. For a while now, I've had a pretty good idea of what was going on, just based on how my body was acting. It turns out I was right.

I drank my required 40 ounces of water an hour before my appointment, and then was dumb enough to show up 25 minutes early. So, by the time I saw the ultrasound technician, I needed to pee as though I'd swallowed the Nile. The tech did a great job, and the ultrasound was a lot less painful then the last time, when a tech kept hitting my lowest rib (is that even near one's ovary?) She was very nice, and told me a lot of what she was seeing, too. Or rather, not seeing. After an external and an internal ultrasound, we had an idea of what was going on.

At the beginning of a woman's cycle, directly after her period, the endometrial lining should be around 2-3 mm thick. Mid-cycle, around the time that a woman ovulates, her endometrial lining should be around 12-14 mm thick. I am currently on cycle day 163, so mine should be around 42 feet, one would think. Instead, it's around 3 mm thick. I have basically no lining. Consequently, I cannot ovulate, and even if I did, I would have no place to put the embryo, barring my pocket. Hence, no pregnancy for me. Apparently it's a sign of an estrogen deficiency, which can be related to the almighty PCOS. Raise your hand if you saw that one coming. You can read a great link on thin endometrial lining here. Check out the last line in that article, if you want to know how I'm feeling. Did I mention there are new cysts on my ovaries, too? They were clear two years ago.

After the ultrasounds, I waited to see Slush. For about 45 minutes. Which means I peed about 6 times, to the amusement of the nurse. Finally Slush came in, told me what I already knew, and gave me some options. We'll start with estrogen replacement, add more progesterone, and then Clomid. We'll give that three months, then move on to Femara, which is more powerful than Clomid. We'll give that three months, as well. If that doesn't work, then Slush will refer me to the reproductive gurus in Charlottesville, as she called them. For high-powered ovarian stimulating drugs and intensive fertility treatments. She said to think positive, and hope that we don't get there. I was hoping we wouldn't even get to here.

I asked Slush for my actual chances of getting pregnant. She didn't directly answer me, and she also wasn't optimistic. However, she wasn't directly pessimistic, either. She knows me too well to give me a percentage or a number to hang my hopes on, or to focus obsessively on in a negative light. I am completely numb at some points, and completely raw at others. I barely remember getting to Mom's house after my appointment, and I don't remember most of the afternoon. However, I can't think too much, or I am easily overwhelmed with a crushing sadness that is very truly only understood by two people in my whole world right now. For Brian and Momma I am unbelievably thankful.

Tonight I went to the closing picnic for Bible school at church, and then for a very, very long drive. I needed to sing, drive fast, and smell the air in the valley. I watched the sunset, and then watched the ladybugs. I saw a few deer, but I did not count them. Okay, I did: four.

It's amazing how I am totally destroyed inside, and yet have a kind of peace about this. I have totally expected this for years. I have suspected the root of the problem for about two months now. We're not surprised by this finding, and we've discussed our options. We'll not be going as far down the infertility road as some people do. Adoption is already on our short list, and we have accepted that we may never produce a child biologically. I don't have to be pregnant. But I do want a child. And, for the record, I am married to an amazing man, in case you were wondering. I've cried a lot in the past 24 hours, and he's been totally okay with that, and has done exactly what I've needed him to. It seems no matter how prepared you think you are, hearing some of these words is still awfully hard.

Saturday has to be better than today, right?!?!

Ready to Roll

I know it's been a while since I posted here. Nothing much has been going on, though. We've been working a lot, getting through the holidays and such, and slowly getting our house in order. We finally decided that we would start trying to get pregnant in April. If you do the math, that would be a due date beginning in January 2009 and heading forward from there. Before anyone even says anything, that is so that we can avoid football season. I know that may sound silly, but I always feel bad when people have babies right in the middle of their husbands' favorite things. For instance, I have a cousin who has to come out of the mountains twice in November for his kids' birthday parties. That's just not fair to a guy who loves to hunt, and if it's his only outlet. For us, it's football. I would hate for Brian to have to choose between the Pitt game and a kid's birthday party. He would put the party first, of course, but I don't want him to have to even have to think about it. Now, that said, I don't know that we'll plan all of our kids around Moun.taineer football, but I can do that much this time out. So, April.
Unfortunately, I had a feeling that Slush would have a different idea. She is determined that I should be all skinny and fit before we have kids. You know, since I've always been so darn skinny, it should be easy to get that way again, right? Sure. I was supposed to have a repeat TSH (thyroid T4) test and go see her in December. I conveniently put it off, especially since I knew I could lose some more weight before going to see her. I think I'm up to 15 pounds gone now (I gained a bit at the beginning of January), so I finally went to get the bloodwork done. I also scheduled a visit with Slush for yesterday.
I didn't realize just how nervous I was going to be. I needed all my bloodwork to be in good shape, my weight to be down, and Slush to be in a good mood. I was pretty sure that Slush was going to insist on all sorts of things, prolong our wait, and tell me that fat chicks shouldn't have babies anyway. I'd like to point out that that is total bunk, by the way. So, I started looking into midwives in the area who are fat friendly. Just in case. Because I refuse to give up before I've begun.
On to my appointment.... My TSH was 3.2, not great. She's not going to medicate me, though. It's all good, because I feel wonderful anyway. I think a lot of my issues were from mold. We lived in a pretty old, moldy house, and I feel so much better now that we've moved away from there. My weight was down, my BP was good. So, I asked her if I could try to have a baby.
And she said yes! We get to start trying to have a baby! I have nine more birth control pills before I can be off of it for good. Then I need to spend a month (Feb.) getting acclimated to being off meds, a month (Mar.) just to figure out my cycle, and then we go for it. I cannot believe it. I have been on those pills since I was 17 and I finally get to be free of them. No more chemicals, estrogen headaches, and weird periods. No more worrying about the ethics of the pills, and no more worrying about what they're doing to my body. And we get to have a baby. I can't really think of it as "trying", because I'm determined that we will. Come hell or high water, we're going to get pregnant. Holy crap, I could be someone's mother by this time next year.....

Doctor Visit Today

Originally posted to Livejournal on May 1, 2007.

Warning: The following post will deal with matters of a physical nature and is brought to you by the words "gynecological", "thyroid", and a few numbers. Please feel free to skip it. Heck, I would. It's of no interst to anyone but me, but I need to get it out or else I'll sit around and rehash it with anyone willing to sit still long enough. And even those who don't want to, but have the misfortune of being related (or married!) to me. :) So, feel free to skip it. Unless you're particularly interested in thyroid function. Woo hoo, what a topic.
My ob-gyn has had me on a 1500 calorie, diabetic diet. Which I have to say, can work wonders. IF you want to eat that much food. Which I don't. At all. So, you'd think I'd be losing weight like a mad woman, right? Wrong. I've stayed the same some months, gained others, lost about 4 pounds right before the wedding. Which means that going in there every 1 1/2 to 3 months has been horrible and has allowed me to feel like an abject failure on a regular basis. Cause I need help with that?
Last time I was in was around January. We've switched to every six months to avoid killing the bank account with co-pays. Forget the fact that our new insurance isn't local and no one here takes it, so after June it's a crap-shoot. But, I digress. I went in sometime in January. Slush (my cool doc) informed me that she would be referring me to an endochronologist in May....the link can let you know what that is, if you don't have the extreme privilege of needing one of these in your collection of doctors. Basically to me, that's admitting failure. That's saying that my body is so messed up, and is so mis-constructed, that I need to go to UVA to get someone to figure it out. Now, don't get me wrong. The minute I need an endo in order to get preggo, I'm THERE. With bells on and my clothes off. No prob Bob. But not yet. I'm not ready to be that broken. But, something is just not working. Let's run down the list of things we do right around here:
1. everything is low fat, fat free, low sugar, or sugar free. We use sucanot instead of any other sugar or substitute so as to avoid the nasty side effects of those
2. we limit soy, as it is evil to your thyroid.
3. we use home-milled grain for the health benefits (and it's far yummier than dead wheat)
4. we use as much organic stuff as possible to avoid additives and high fructose corn syrup
5. we use only the leanest beef I can find, like Laura's Lean Beef, which is 96% fat free
6. we follow the ADA 1500 calorie diabetic diet
7. occasionally, my fat self moves a little
8. sodas are a no-no, and most caffiene is, too. I drink copious amounts of green tea.

Um, what am I doing wrong? No endo, please. I don't want to be that broken.

SOOOOO, today I return to Slush. So she can do the pap shhhmear dance with my cervix. Love that, really. I informed her that Yasmin is evil and I refuse to continue taking it on the basis that it is ruining my already pretty messed up body. No problem, back to my favorite BCP, Desogen. And the angels sang Hallelujah..... Then, I told her that I wanted my TSH panel retested to find out if my thyroid had moved out and gotten it's own apartment or what. And I asked if it was possible to aggressively treat hypothyroidism even if I'm "borderline", which I was last time. Since I have like 90% of the symptoms and all.... She said sure, and that she actually prescribes synthroid to anyone whose TSH is above a 3.

Apparently .3 - 3.0 is considered fine, and anything above 3 is hypothyroidism. But that number is also up for debate, as they think maybe the standards (up to 6, not 3) were too high and people were missing the synthroid boat. So, if I'm at 3, we'll add yet another drug to my body so that I can get knocked up without taking Clomid, a drug.....Does this make sense? Nah, but let's do it. I'm game.

Well, she checked my chart, and whaddaya know. I was 2.9 last time. Um, THAT'S THREE, isn't it??? How have I been a year without retest or treatment if I was practically AT treatable levels before?!!?! This is a great doc, don't get me wrong. I love this woman for what she has done and will do for me. She ROCKS. But, 2.9?!?! Eesh. No wonder I feel so swell. Seriously, read the symptoms. Welcome to my life. FUN stuff, man.

So, I promptly went to the lab, gave them a vial of Andrea's finest, and off I went, feeling justified. Had a rockin' day, actually. Sad to be hoping for a high TSH because I think I'll feel better with this fixed. Hm. Keep ya posted.

Now, off to Verizon to find out why a phone I spent $250 on exactly a month ago won't boot up. Fun stuff. Thank you for reading, and we know return you to your regularly scheduled surfing......

Official Outcome

Originally posted to Livejournal on March 4, 2007 at 6:31 PM

Well, it's official. I have a diagnosis for this nastiness. Side effects. No baby. One early period ensues. Which does answer some questions. Poses a few more, though. I have a lot to think about. No big decisions will be made before our previous TTC-deadline of June. If I get pregnant before that, so be it; God's will. If not, then we jump on the TTC bandwagon. Until then, I'll keep monitoring my body and trying to figure out what the hell it's doing.

Meanwhile, in addition to the Evil Red Witch, I get to have a cold. Fabulous. I sneezed all evening last evening, felt all nasty before bed and then couldn't possibly sleep last night. Woke up this morning feeling like death warmed up. Theoretically this evening I need to get my house cleaned and the laundry finished. I deeply want a nap. So, peppermint tea spiked with honey will have to do for incentive to stay awake, while providing a bit of space to breathe :)

In addition to my general lack of sleep last night, my darling hubby got called back to work at 5:00 AM. What!? I mean, seriously. Apparently the motion sensor had gone off, and as second on the call list hubby had to go in. The girl who lives closer didn't answer her phone. Probably asleep. Go figure. So at 5:30 he dashes off to the store to reactivate the alarm and then crawls back into bed to put his cold feet on me. I had been asleep for roughly an hour when the call came, and slept the 25 minutes he was gone. If I got any more sleep than that is anyone's guess. Luckily hubby could sleep until around 11 this AM before working a 12 hour shift. I hate the Unnamed Moderate-Sized Electronics Retail Empire. Sucks.

But you have to love kitty snuggles!!! Belle is all curled up on me. I'm going to go enjoy this! In response to Sealgair's post with adorable pictures of her cats, I'll eventually put some here of ours. Tiny has doubled in size lately, so I need some recent ones. She's almost caught up to both her ears, and to Merle. :) Off to drink copious amounts of peppermint and snuggle my kitties.