Good-bye, my (not so secret) love… July 22, 2008

   I had my appointment with the Reproductive Endocrinologist yesterday.  My mom went with me, because she’s been through this all before, and Paul can’t take a lot of time off work right now (and he wouldn’t have been much help anyways).  The RE was great; she was very nice and listened to my questions.  Her big thing was that I need to lose weight, at least 10%, but she was sure to say how she knew it was difficult because of the insulin resistance.  She asked if I was interested in metformin despite the side effects (diarrhea, loss of appetite, indigestion), and I said yes.  So she prescribed that, which I started this morning.  I am to start with one pill in the morning for 5 days, then add a second pill in the evenings for another 5-7 days, then a 3^rd pill if I can tolerate it.  I’ll let you know how it goes.  She also wants me to get bloodwork done in about 6 weeks to check my liver and kidney function, because a serious side effect is lactic acidosis.

   Step 2 is that she referred me to a nutritionist who specializes in diabetes, PCOS, and insulin resistance.  I need to find out tonight if my insurance will cover it, but I think I’ll go at least once to see what she has to say, even if I have to pay for it myself.  I’m sure she’ll tell me to cut out refined carbs, and eat a lot more whole grains, fruits, and veggies.  I love refined carbs.  I mean, if my husband hadn’t come along when he had, I might have MARRIED refined carbs.  I’m eating chocolate covered pretzels as I write this.  It will be sad, so very sad.

   Another suggestion she had was gastric bypass surgery.  She encouraged me to do some research on it and think about it.  My first instinct is no.  I mean, I’ve thought about it before.  I’m sure anyone who’s even slightly overweight has thought about it.  But I know that it’s no easier (probably even harder) than “traditional” weight loss, and there are the risks, plus I’d be so afraid that I’d lose all the weight only to gain it all back again in a couple years.  Also, she told me that it’s about a 6 month process before the surgery (counseling, dieting, etc), and then they recommend people wait at least a year, preferably two, before trying to conceive.  That would mean I would be 30 before we could even TTC, which is heartbreaking to me, to not even have a chance until then.

   So my plan is to take the metformin unless it kills me, and try desperately to eat better and exercise some more.  Wish me luck.

And the winner is… July 8, 2008

   Last Tuesday I had an appointment with my doctor to go over my bloodwork results.  The progesterone levels indicated that I hadn’t ovulated, and were actually a little low even for that.  She said I might need to supplement with progesterone when I do get pregnant.

   Almost everything else was okay, including my cholesterol, prolactin, and thyroid levels.  What wasn’t okay was my insulin.  I was showing as slightly insulin-resistant, which is a big marker for PCOS.  And while she never used the term PCOS herself, she didn’t disagree with me when I brought it up, and said she wanted to start me on metformin because most women get pregnant within a couple months of starting it, and refer me to a RE.  When I told her that we weren’t technically TTC until September, she changed her mind.  Instead, she referred me straight to a RE at the big hospital.  That appointment is now scheduled for 2 weeks from today.

   The receptionist at the RE’s office was confused as to why I was coming in, so I had to explain everything to her, even though I was at work.  I thought my doctor’s office was supposed to include that information in the referral paperwork?

   So now I have the appointment to look forward to, and don’t have much idea what to expect.  Maybe an ultrasound?  Probably a metformin prescription?

   The reason it took me so long to post was that I was trying to process this information.  I’ve suspected PCOS for about a year now (which was why I went off the Pill so early before TCC), but it’s different to pretty much know that’s what’s wrong with me.  I’ve been pretty touchy this whole week, falling to tears with barely a nudge.  My mom has been too.  She said she just wishes that I didn’t have to go through this.  She did, and it sucked, and even though it’s come a long way since then, it’s still not good.

   I sat down with Paul and explained the situation.  His first comment was “how can the ovaries cause all that damage?”  I explained that the ovaries were really just a side-effect, and gave him definitions on insulin-resistance, diabetes, etc, and told him about metformin and Clomid and such.  He seemed to understand, but I know he doesn’t understand the seriousness of it, although he did ask about long-term effects (diabetes, heart disease, high cholesterol, cancer), so that was nice of him.  I’m pretty sure he still thinks getting pregnant will be as easy as unprotected sex at the right moment.  And it could be.  The problem is getting that right moment, because I’m not ovulating.