Things I needed to hear

We had our consultation with the fertility specialist, Dr. A, and we really liked him. I went in to the meeting feeling irritable and left feeling hopeful. So that's definitely something.

And that's despite the fact that he spent at least 20 minutes talking about how I need to lose weight. He said it in the nicest way possible, really. And it's not like it was surprising news. I'd been planning to ask Dr. A about how my weight might be affecting my fertility, in case he was one of these docs who's too embarrassed to discuss it. Turns out, he's not.

He pointed out that weighing too much can result in higher miscarriage rates and make it much more difficult to become pregnant in the first place. He said losing weight would double my chances of conception. So really, I have no excuse now. None.

Other highlights:

- I'll be having a number of tests run. They include: a physical, a heart check-up (I have an arrhythmia and enlarged heart valve), a bunch of blood tests to check hormone levels and for STDs, at least one ultrasound to check endometrial thickness, and probably a hysterosalpingogram and a hysterosonogram (which: yikes).

- My husband will donate more sperm to the cause even though we finally found out his motility and count are way above normal -- information my gynecologist mysteriously refused to tell us.

- Dr. A suspects PCOS. He says treatment would likely be metformin and clomiphene.

- Dr. A emphasizes eating of whole foods (not packaged), getting plenty of sleep, exercise, keeping caffeine and alcohol consumption fairly low, and limiting toxic exposure to stuff like pesticides, solvents, beauty salon crap, etc.

- Dr. A has freed me from lying around in bed, waiting for sperm to magically swim to the right place. For that matter, he's freed me from the missionary position. BAM!

-  Sex should be happening every 1.5 to 2.5 days mid-cycle. He says every day is fine, but he refrains from telling people that because he's worried they'll get divorced. Ha!

Finally, Dr. A says my "chances are excellent." I know we haven't run any tests yet, but I feel relieved and hopeful, nonetheless.

Ovulation ... ?

Because my life follows Murphy's Law, I became rather ill during what The Machine told me were my most fertile days. We managed to get some good "work" done before I turned into the walking dead, and then I waited for ovulation.

And waited. And waited.

And then my temperature spiked on a morning after I'd slept fitfully. This was three days after my last peak fertile day, according to the fertility monitor. The previous night I'd slept two hours. I can't be sure if the temperature spike can be attributed to illness, or actual ovulation.

The next day the temperature dropped back down to pre-ovulation numbers. In case you're not familiar with how tracking basal temps works: Your temperature is supposed to spike when you ovulate, and then basically stay high for the rest of that cycle. If the temperatures drop back down, that's usually an indication of low progesterone, according to Making Babies. That's something I've suspected for a while.

But I gotta say, I am suspicious of that temperature spike. I don't think it's genuine. Next cycle's temperature chart will be more telling, as long as I don't come down with The Crud again. But honestly, I don't think I ovulated.

MB says the most common anovulatory condition is PCOS, and that 10 percent of women have it. I've never been diagnosed. Post-miscarriage the ultrasound showed only one unruptured cyst, but that's been seven months now. Who knows what my ovaries have been up to since then.

Most women with PCOS have weight issues (yes), hair in unwanted places (hello mustache), and insulin resistance. I've been tested for insulin issues a number of times -- my sister has Type 1 diabetes and I'm overweight, so doctors probably assume I'm a ticking time bomb. But the results have always come back normal.

However, there are actually two faces of PCOS; one that involves insulin resistance, and another that involves hyperandrogenism -- elevated androgen levels result from unruptured cysts. I don't know if I've ever been tested for that, but you can bet I'll be asking for it. 

MB says the best at-home remedies for PCOS are eating well and exercising. Unfortunately, "eating well" for PCOS means something close to the Atkins diet. The disease responds well to it. And the book says, encouragingly, that the majority of women with PCOS can get pregnant naturally. 

So, as usual, I'm basically self-diagnosing. Something else entirely could be causing my temperatures to be off. In any case, I'm still planning to give it one more cycle, and then it's off to the doctor. I'll reluctantly give low-carb eating a shot for the next month and keep trying to knock off the pounds. Diet, exercise, and The Crud helped me lose another few pounds since last week, so I'm on the right track. 

Me & G

As you may or may not remember, after my laparoscopy, John and I decided to hold off before trying Glumetza. We wanted to give my body a chance to recover, and we wanted to see if the surgery alone might do the trick.

Three months and three cycles later, we felt ready to give the Glumetza a try.

I was a little worried about the potential side effects. The super friendly Internet advised I might be in for "gastrointestinal upset."

I’ve been taking the Glumetza for about 2 ½ weeks, and I definitely feel weirder than usual. Nausea and stomach aches come and go. But it hasn’t been that bad, and I’m hoping it gets better.

Glumetza (Metformin) is actually a diabetes medication, and I’m wondering how I could better support its effectiveness through nutrition and exercise.

I know what I should be doing --- avoiding sugar, refined carbohydrates, caffeine and alcohol. I just have trouble doing what I know I should do.   

In the meantime, I’ve been walking about four times a week. I’ve been taking Vitamin B Complex and Chlorophyll pills every day. And I’m looking for a prenatal that doesn’t smell or taste disgusting.

Any suggestions?

Baby Steps to Babyville

It’s been three weeks since the surgery. I would say things are mostly back to normal other than the fact that a.) At times, I still feel more tired than usual, and b.) I’m not sure when I’ll get my period again. So, what’s next in this great adventure? Well, the day of the laparoscopy, John and the doc talked while I was still asleep. Even though everything went great, the doctor wanted to send us home with a prescription for Clomid.

Now, I don’t have anything against Clomid expect everyone I know who has ever taken it felt mildly to severely crazy while on it, and most of them didn’t end up pregnant. Life is hard enough, so I would prefer to avoid adding any unnecessary mood swings to the mix, if at all possible. I fully acknowledge I might change my mind about this at some point, but I’m not at that point. Knowing this, John turned down the good doctor, which probably doesn’t happen all too often because John said he seemed surprised.

I trust this doctor, so I wanted to discuss his recommendation for Clomid a bit more during my follow up. I expressed my concerns, and he sent me home with two prescriptions. One for Glumetza (Metformin) and one for Letrozole, in case the Glumetza alone doesn’t work.

It’s nice to know I have these options, but after a lot of thought, I’m not ready to take either right at this moment. For some reason I had it in my head that Glumetza (which is supposed to treat insulin resistance in women with PCOS) would be the equivalent of a baby aspirin.

Then I started googling the evil Internet. It’s possible I wouldn’t have any side effects, but if I did, it would most likely be in the form of nausea and/or diarrhea. Call me crazy, but if I’m going to take drugs, I would like them to make me feel better not worse.

I’m not even going to discuss Letrozole, which is supposed to be like Clomid but more mild. Wikipedia says it’s used to treat breast cancer, and after I saw that I really didn’t want to know anymore. Honestly, before I start pumping my body full of powerful drugs, I would like to know if the surgery alone does the trick.

So, it’s back to natural remedies for now.

I’m going to give my body a chance to fully recover and wait until my next cycle begins (the doctor warned the laparoscopy would likely throw things way off). Once I’m back on track, I might wait one more full cycle before starting the Glumetza. 

In the meantime, I’m focusing on significantly improving my diet. (That tiny bit of cancer has me drinking wheatgrass and green smoothies.) I’m going to keep the supplements simple and focus on just taking my prenatals and fish oil. The authors of Making Babies stressed those were the two most important. Well, most important other than the most natural remedy of all ~ the fun part. (Wink. Wink.)

Modern Medicine

I showered, shaved my legs, flat ironed my hair and dressed in the biggest, cutest sweats I own before John and I headed out the door at 5:30 a.m. last Thursday. We arrived before the surgery center even opened, so we snapped a few photos of ourselves outside. I was, shockingly, not nervous, not even a little bit.

My laparoscopy was scheduled for 7:30 a.m., and I was wheeled into the operating room at 7:45 a.m. The surgery lasted 2 hours. I was afraid I would wake up in pain, but I didn't. I woke up to the sound of John and the nurse talking. As I was coming to, I could feel John holding my hand and rubbing my shoulder. He told me later that every time he rubbed my shoulder my heart rate would increase on the monitor.
 

The doctor told John the surgery went great and our chances of conception are excellent. He removed endometriosis, drilled on my ovaries, checked my fallopian tubes (which are clear) and removed my appendix. I knew prior to the surgery my appendix might be removed if it had endometriosis on it, but I was still surprised to find out I had undergone an appendectomy. When I asked the nurse if my appendix had endometriosis, she said it was sent to pathology, which I thought was slightly odd.

I expected to be sent home 2 hours or so after surgery, but I had to wait more than 7 hours because they won’t let you leave until you pee the required 100 ccs. Not that I minded. I alternated between sleep and conversation and wasn't at all aware of the time. I was barely in any discomfort at all.

By the time we left the surgery center, it was after 5 p.m., and we had to stop at the pharmacy on our way home. We hit rush hour traffic, and I kept my head in a barf bag (which I had packed just in case). I never threw up, but I felt nauseated the whole drive.

When we arrived at my parents' home (where I have been recovering), the real fun began --- horrifying pain shooting through my right shoulder and neck. Big thanks to those who warned me about this crazy kind of gas pain. It hurt so bad I bit my other arm. The pain lessened significantly every day and it wasn’t constant, but it lasted about 5 days. It really was the absolute worst part. 

The good news is the percocet not only helps with the pain, it helps you forget the pain even happened. Of course, it gave me a huge headache so I switched to ibuprofen Saturday night. I also had to remain on a liquid diet until Saturday morning because you can’t eat until you pass gas. (Anyone else see a trend regarding my bodily functions? I am still waiting to poop.)

Other than that, the recovery has been extremely smooth.

I saw my doctor on Tuesday. He confirmed a diagnosis of stage 3 endometriosis and PCOS. I asked him if he found endometriosis on my appendix, if that is why it was removed.

“No. What I found on your appendix was much worse,” my doctor said.

“OK,” I replied.

“Your appendix had cancer on it.”

Do not be alarmed. What was found was a teensy, tinsy, 4 mm smidge of cancer. Had this spot of C been 2 cm or bigger, it would be a different story. Still, hearing a doctor say the word cancer makes you want to run out and eat something healthy.

I’m also in awe of the perfect timing of it all and thankful to God for modern medicine.

Doctor, Doctor, Mr. MD

I took your advice. I shaved my legs. I painted my nails. I gathered up all the information I have regarding my own medical history.


I arrived at my doctor’s appointment 30 minutes early with extra glossy lips and a clip board in hand. I typed up a 3-year account of my menstrual cycle and a list of all my recent supplements. I filled out the medical history form the office had sent me prior to the appointment. I even brought in all my supplements (except the royal jelly, which requires refrigeration) and my copy of the Making Babies book, neither of which were necessary.

I felt as prepared as I would ever be. And I figured I knew exactly how this would go down. By the end of the appointment, I would have doctor’s orders for six weeks worth of blood tests, and in two months, I would be back in his office for the results. I was wrong.

John and I met with the doctor in his office. He looked through my medical history and asked me questions. He is soft spoken and kind, and we liked him right away. It helped that we were referred to him by dear friends, so we already felt a level of trust and confidence in him that we wouldn’t normally feel toward a stranger.

After our initial discussion, we went to an exam room. Let’s just say it wasn’t the most fun I’ve ever had. By the end, I felt nauseous and faint. But the worst of it didn’t last long, and it was worth it. I now know some important things I didn’t know before. First, there are multiple cysts on both my ovaries. Second, the doctor believes I have endometriosis and PCOS.

The PCOS part wasn’t a surprise, and because I suspected PCOS, I never really thought about endometriosis. It didn’t occur to me that both might be at play. So, after peeling myself off the exam table and getting dressed, John and I met back up with the doctor in his office. This is where he gave us his professional recommendation, which is to have a laparoscopy as soon as possible.

One thing he said, which I really appreciated, was the importance of having this surgery for my overall health (not just to improve the likelihood of pregnancy). Not getting pregnant is what got my attention, but it is a symptom of something else.

My surgery is scheduled for Wednesday morning. I'd appreciate prayers and good thoughts, and any pre-surgery advice.


UPDATE: Laparoscopy was moved to Thursday. 

Desperate Measures

I'm making an appointment with my OB/GYN.

Yep, that's right, my old fashioned, medication loving, likes to tell me to just "relax," has no diet tips except Weight Watchers, has never stuck a needle in me except to draw blood, and who wouldn't know what to do with herbs unless they were on a salad OB/GYN.

I need to know what the hell is going on.

I mean, in some sense, I know what's going on. My naturopath OB has been treating me for PCOS with hormones, and was the one who diagnosed the cyst. However, I am now starting to feel like it is getting worse, or that something is going on in my body that shouldn't be. For the past three months I have cramped and heavily spotted on the days I am ovulating, or immediately after. My stomach is always upset. I am having hot flashes and nausea.

Not only do I feel crappy, but its making it hard to stay on the program. When my stomach is upset? All I want to do is eat carbs. I definitely don't want to swallow herbs or supplements. The spotting is doing to my mental state what the stomach woes are doing to my physical one. Every time it happens I think "what's the use, I obviously can't make babies" and go pour some wine.

I am not going to my traditional OB/GYN because I don't trust my naturopath or my acupuncturist. I think I have paid them both enough money to show my faith. It's just that I already know how both of them want to address this problem, and it isn't working. I need a perspective from someone who has been with me from the beginning of all of this, and who isn't afraid to throw a little western medicine at it. I mean, if this cyst needs to be removed, I want to know it now -- not when it bursts.

Maybe a third perspective is just what the doctor ordered.

I really hope so.

Same Old, Same Old

In the past eight weeks I have had three and a half periods.

For those of you without access to a uterus, that is a lot.

In March I had periods exactly two weeks apart. Then, I had 24 blissful days of non-period, and then what can only be described as a "whopper." I would say more, but you really don't want me to. Last week I had spotting EVERY. SINGLE. DAY. It was nothing to write home about (if anyone actually writes those kids of letters), but just there.

I figured that my body was maybe resetting itself. After all, I've changed my diet, thought about exercising more, am taking more pills than Charlie Sheen, and paying a woman to stick needles into my face. Wouldn't all that be enough to make my cycle go a little screwy? I figured it would soon right itself and help me on my way to reproductive bliss.

How wrong I was.

Today I went to see my gynecologist, just to check in since I am making all these changes, and to talk about the weird periods. She decided to do a quick pelvic (again, not saying more), and discovered that my lady bits weren't making changes, but instead were making an ovarian cyst.

Yep, an ovarian cyst, just like all the previous ovarian cysts that led me to buying this book and making all these changes in the first place.

So, what do I do now?

I don't know.

I just don't know.

Part of me says try harder. Part of me says this is over.

Most of me wishes this was just wasn't so complicated.

Oh, and that I would stop having so many damn periods.

Angry

I am having to work through a lot of feelings while reading this book and starting on this program. Most of those feelings have to do with the fact I feel every fertility expert I have ever dealt with flat out lied to me, and just did what they wanted, not taking what could actually be wrong with me into account.

In "Making Babies" there are more than six pages of questions your doctor should know the answers to before they start treating you. My initial interview with my doctor lasted about 10 minutes, and only a handful of questions, only about my menstrual history, not my lifestyle or overall health were asked. He didn't ask any questions of my husband once he looked as his lab results and saw his sperm count was good. I told myself it was because he had been doing this for so long he probably could just look at us and know what to do. However, reading this book, I feel he just saw us as two more items on an assembly line. If what had worked for others didn't work for us, it didn't matter, because he got paid anyway.

Every month I would ask my doctor if I could have PCOS. Every month he would tell me that was likely with my history, but that he really couldn't tell since I was on medication to stimulate my ovaries. I asked him about putting me on Metformin, which is recommended for women with PCOS. He said no. I asked about progesterone during my luteal phase. He said my luteal phase was long enough that I shouldn't need it. When I asked about acupuncture he just shrugged and said it was "my money."

A year and a half after I stopped the fertility treatments I went to see a naturopath, feeling like my hormones still weren't back to normal. With two blood tests she diagnosed my PCOS and put me on Metformin. Now, I read in this book that despite the fact I have a "normal" luteal phase that doesn't mean a lot, and that tests should be done to make sure my uterine lining is not just there, but good enough to support an embryo. Oh, and if it isn't? I should go on progesterone. I won't even go into the benefits of acupuncture pointed out in this book, since I am sure all three of us will go into the prickly details later.

I am sure that the fertility doctor I saw is beloved by some. Me? I am ready to show him just how crappy he is. Maybe then I won't feel so angry.