Pantry Soup October 13, 2008

   I guess I haven’t written lately.  I think I just needed time to process everything.  I kept thinking about writing, but could never muster up a coherent post while on a computer (which is to say, about 13 hours a day).

 

   The appointment with my RE went well, I think.  She upped my dosage of metformin to 2000mg a day, so I’m crossing my fingers that does something.  She also gave me provera (after I asked) to induce a period, which started yesterday.  I’m not sure why I miss them so much when I don’t have them; they suck.  And if we weren’t trying to get me pregnant, I’d be happy with, oh, about 2 a year, just for safety’s sake.  Also, she told me that I can move to the next step (Clomid) whenever I want, but would like me to give the upped dosage at least 3-6 months to see how it works, if at all.  At this point I’m planning to wait about 3 months, until the first of the year.

 

   My grandmother’s appointment with the team of doctors went okay, all things considering.  She’s been officially diagnosed with Stage IV lung cancer that’s metastasized to the mediastic lymph nodes and brain.  It’s incurable, and they said that she’s got 9-12 months to live, maybe up to 24 months with treatment.  Treatment includes surgery to remove the brain tumor (where all of her symptoms are coming from), radiation to the brain, and chemo/radiation combo for the lung and lymph nodes.  The brain surgery is today.  In fact, I’m thinking they’re probably cutting into her skull right about now.  It gives me the heebie-jeebies and makes me nauseous to think about it.

 

   Work’s been okay.  I alternate between being super-productive, or a big lump of worthlessness.  It all depends on my mood.

 

   My Mom’s birthday is Sunday, and Paul and I are hosting lunch Sunday for my parents, my grandparents, and maybe my brother.  I’m greatly looking forward to having everyone over.  My grandparents haven’t seen our new apartment, and now that we have a dining room, it should be much better than Mom’s birthday last year, when we were all (9 of us) crammed in our small living room eating tacos off our laps.  This year we’re making lemon roast chicken and gravy, browned butter mashed potatoes, green bean casserole (from scratch!), and corn (for Dad).  I’m also making my “famous” Loaded Carrot Cake with cream cheese icing (also from scratch), and some sort of chcocolatey thing (maybe pots de chocolate?) for Dad and Paul, who don’t like carrot cake.  I was also thinking I would make a couple raspberry pies, one for Paul and me (it’s my favorite) and one to send home with Grammy (her favorite, too).  Hey, maybe I’ll post my recipes!

 

   I’ve been on a soup-making bend lately.  Vats of home-made chicken stock.  Chicken noodle made from leftovers.  Creamy tomato soup from scratch.  Pantry Mexican soup.  Next is chili.  They all get packaged into individual servings and stuck in the freezer for lunches.  Maybe I’ll post those recipes too.  Can you tell I tend to cook when stressed?

all-you-can-eat buffet September 30, 2008

   There’s a certain art form in the all you can eat buffet.  Whether it’s Chinese or all-American, the objective is the same: load as much as you can on one plate the first trip through; pot stickers on top of rice on top of General Tso’s, next to teriyaki chicken and chicken fingers and spicy broccoli.  Forget the fact that you can go back up as many times as you want; that first plate is the most important, a source of pride.

   I’m used to carrying around a relatively small plate.  Chicken fingers and pot stickers, max.  However, recently I’ve been expected to also pile some fried rice on to that plate.  Luckily, rice is small and can filter down into all the nooks and crannies between the chicken.  But when I was asked to include some sushi, it went rolling all over and on to the floor, a huge mess.  Luckily someone also then handed me a bigger plate.  This one’s the size of a turkey platter and it can hold a lot, but it gets awful heavy.  And I know that someday, it will be too full and someone will break out the pizza pan-sized plate and expect me to be able to handle it.  I just have to hope that someone else will be there to help me carry it.

 

   Okay, so I’ve probably taken that metaphor as far as it will go.  My point is this: I have a lot on my mental/emotional plate right now.  The everyday, not-so-stressful stresses like marriage, family, and work have been expanded upon.  Marriage now includes not just trying to get pregnant, but infertility.  Family includes a grandmother with advanced metastatic cancer.  And work includes a handful of people who think I don’t know how to do my job.  Luckily I have a husband who is supportive and willing to do what he can to help carry the load.  Sometimes I just wish he (or anyone!) would carry all of it, which I realize is completely unfair, because he has is own load to carry.

 

   Tomorrow I have an appointment with my RE, a follow-up to see how I’m responding to the Metformin.  I have a list of questions as long as my arm about what the next steps will be, and I’m actually pretty anxious about the whole thing.  It doesn’t seem that I’m ovulating on Met, and I’m afraid she’ll want to wait another 3 months or so before taking the next step (Clomid).  I’m hoping she’ll at least give me some Provera so I can start a fresh cycle, as I’m currently on day 49.

   Tomorrow is also my grandmother’s appointment with her team of doctors.  The oncologists and brain surgeons will tell her exactly what she has and give her treatment options, if there are any.  I’d say 80% of my current stress is about that.  I just don’t know what we’ll do if there are no treatment options.

   So today when my coworker decided to have an attitude with me, I lost my shit.  Now we’re both just plugging away, trying to avoid confrontation as much as possible.  Sometimes you just need to have some time to yourself (even if it’s only so you don’t kill someone).

Wait…wait…wait…okay GO! Nah, I don’t feel like it. September 17, 2008

   Sometimes I have no patience.  Other times, what appears to be patience is actually indifference.  I’ve spent years of my life pining away for a child.  When I was 11, I started making lists of baby names that I liked.  When I was 17 and my period was late, I took not one, but 3 pregnancy tests, and when my period came (only) 4 days late, I was a little sad.  What I now know to be PCOS has caused my period to be late or non-existent many, many times over.  I couldn’t tell you how many sticks I’ve peed on over the years, anxious and unsure whether I wanted it to be positive or negative.

   However, now that we’re actually trying and I’m on day 36 of my cycle, I haven’t so much as glanced at the drawer full of tests.  I’m thinking maybe I’ll take one tomorrow, but I highly doubt it will be positive and don’t really want to waste a test or my energy hoping.  I’m still not even sure I ovulated, either 18 days ago like originally thought, or any time after that.  I feel the changes in my body from the metformin, but I’m not sure if it’s enough.  I’m thinking I might need to add some therapies, such as cinnamon or Vitex.  My next appointment with my RE is the 1^st of October, so I’m hoping either my body does something by then, or she’ll up my dose of the Met to 2000mg.  And maybe give me some Clomid.

   About the clomid, actually.  I’m so hesitant on it.  My mom tried it for awhile when I was a kid, and apparently it turned her into a complete nutcase, so she quit trying.  I’m also pretty afraid of multiples.  Not that I don’t secretly want twins, I think a lot of women do.  But we could not afford to have twins (or more!) right now, among other reasons.  On the other hand, I want to be pregnant, like, months ago.  At this point I’m willing to do (almost) anything to get pregnant.  So I just don’t know!

   Also, I’m worried that she won’t give me anything extra until I get my weight down some more.  I just can’t do it!  It’s like, impossible for me to lose weight.

   Oh, and another fear!  What if it doesn’t work?  What if she ups my metformin, and gives me clomid, and I lose weight, and I still can’t get pregnant (or even ovulate!)?  I’m so afraid of moving on to that next level of infertility, and I just don’t want to do it.  I’ve seen people go through it, and it’s not pretty.  Never mind the emotional effects; we couldn’t afford to move on to other options.  Our healthcare doesn’t cover anything (not even fertility testing!), and our savings are meager.  We would be stuck in this void of not really trying, but not-not trying, working overtime and second jobs to scrimp pennies so that some day, when we’re, like, 40, we could afford a one-shot go at either IVF or adoption.

   I now find myself a bit ambivalent about the whole thing.  I haven’t been great about temping lately, or checking my crotch every time I pee.  I guess I know that I can’t get myself worked up about it too much, for fear that I will only be let down.  I guess I’ve been NOT trying for so long, it seems really bizarre to me to actually be trying.  I feel like I’m in an alternate universe.

   And yet, I have little thoughts out of nowhere sometimes.  Like this morning, I was letting my coworker know that I’d be taking a day in November off for my little brother’s college graduation, and in the back of my head I thought, I could be pregnant by then.  Then I was like, what the hell was that?  Why does my brain play tricks on me like that?

All-Day Good-Time Pityfest, 1st annual August 20, 2008

   I’m feeling very sad today.  I cried on the way to work, and feel like crying now, although I’m at work so it’s not exactly practical.  I’m feeling frustrated and alone.  I don’t know where to go next.  What I thought was my period the other day was really just spotting for a couple days, and my temps are still up, and I get to stare at a fresh BFN every morning.  I don’t know if I ovulated two weeks ago or not.  Probably not.  We’re officially starting to try in a couple weeks, and I really wish I could just take some Provera and start a fresh cycle.  But I don’t have an another appointment with my RE for 6 weeks, and I don’t think my PCP will give me anything now that she’s passed me on to the RE.

I’m so ready for a baby, so ready to be pregnant, so ready to just try.  But how do I know when to try when I keep looking like I’m about to ovulate, then my temp goes up for a couple days so it looks like I did ovulate, but then my temps go back down?  Over and over again this happens.  Maybe we’ll set up a plan of sex every other or every third day, and not beat ourselves up if we skip a day here or there.  I figure if we can get into a groove like that, we’re covering the bases.  Assuming I will ever ovulate.

   And of course assuming we have no other problems.  I’m considering asking the RE when I go back in October if we should go ahead and have the other basic tests done (sperm analysis, HSG, etc) so we can get them out of the way, but she probably won’t yet because “we’re so young and have so much time.”  She’ll probably want me to be ovulating and us trying for at least 6 months before she requests those tests.

   And how long before she wants us to try Clomid?  Will she order the tests before prescribing Clomid?  When I saw her before, she made it sound like she’d start me on it as soon as I lost 5-10% of my weight.  But I’m not sure I want Clomid, mostly because of the risk of multiples.  I’d love it if we could do this on our own, with only the metformin.  It seems like Clomid is just thrown around all willy-nilly to anyone who’s having the slightest problem conceiving, like it’s an easy fix.  But I know how crazy my Mom got on Clomid, and I’m not sure my husband could handle me like that.

   The other issue is the weight.  I’ve always struggled with losing weight, but I thought that as soon as something was seriously threatened, such as my health or my fertility, I’d be able to get my ass in gear and lose the weight.  But I’m finding that’s not the case.  I’ve lost about 7 pounds since starting the metformin about a month ago, and I’m not really putting any effort into it.  I know that if I tried, even a little, I could lose more.  I’d love to lose at least 5% (17 pounds) by the time I go back to my RE, but I just can’t seem to get off the couch in the evenings to walk, or to give up the ice cream.

   So I’m sad, and frustrated, and confused.  I’m also lazy and impatient, but that’s nothing new.  I can’t wait until I can go home and get a big hug from Paul, and from the kittens.

Now the cart goes where? August 13, 2008

   I’m pretty sure I’ve never been this excited about starting my period.  Not even my first period was this fraught with grins.  I celebrated by eating a very illegal Butterfinger.

   This time it was spontaneous, and I’m pretty sure it’s the first time I’ve started my period all by myself since I was about 16.  Since then, I’ve either been on birth control, or pregnant, or miscarrying, or being ravaged by the joys of PCOS.  So maybe this means the metformin is actually working?  Ask me again how I feel in about 2 weeks as I’m waiting to ovulate.  I’m not expecting to be so giddy around that time.  Unless of course I actually do ovulate, to which I just might have to jump on my desk and do a happy dance for my whole department.  But they can just hold their horses, because I’m not selling tickets for that show quite yet.

Weekend Update August 4, 2008

   It was a good, but busy, weekend.  Friday night I made 4 dozen cupcakes, complete with red, white, and blue sprinkles baked right in.  Saturday morning I free-formed letters (Bon Voyage Theresa) and anchors out of red and blue melted white chocolate, then made butter cream icing from scratch.  When the cupcakes were done, it was quite cute, and fit in with the patriotic/nautical theme of the party.

   The party started at noon at my in-laws, and we spent a couple of nice hours there before we had to hit the road.  I’ll confess that I was grateful for an excuse to leave, because otherwise we would have been there until, like, 7 o’clock, and that is just too much time for me to spend with some of my in-laws.

   Around 2:30 we hit the road for MA for a concert (Sarah Barelles, Counting Crows, Maroon 5), and I’m not sure what our TomTom was smoking, but it took us to Timbuktu and back before we finally got there.  Factor in Saturday afternoon Boston traffic, Red Sox game traffic, and traffic for the Springsteen concert at Foxboro, and it took us FOREVER to get there!  But we were right on time, and had decent seats.  The show was great (I heart Adam Levine), and the people-watching is always fun at concerts.  Paul was not overly thrilled, but this one was all about me, and he didn’t hate it.  He basically just focuses on the guitars.  The drive home was a little better, although we didn’t get home until about 3 in the morning.  I haven’t done that since college.

   Yesterday we just bummed around and got a lot done around the house.  We divided and conquered, with Paul grocery shopping and washing dishes, while I did 5 loads of laundry.  Now it’s back to (slow, slow) work.

 ~ ~ ~ ~ ~

   In other news, I’m now up to 1500 mg of Metformin.  Most of my symptoms have dissipated, with the exception of the dreaded diarrhea.  Hopefully that eventually goes away too.  Now we’ll wait to see if I ever ovulate.

update July 29, 2008

   On Sunday I upped my dosage for metformin from 500mg to 1000mg.  So far the diarrhea has calmed down to a once a day incidence that seems to be moving a little later everyday.  The symptom that’s taken its place is nausea.  It’s like constant morning sickness, but no pregnancy to show for it.  So I’m expecting this symptom to start winding down come Friday, when I have to up my dose again to 1500mg.  Oh, the anticipation to see what side effects that will bring!  The metallic/chemical taste in my mouth has gone away except when I eat chicken.  No more chicken for me for awhile, I think, which sucks because Paul and I love it and have it a few times a week.  Maybe I’ll try turkey and see how I like that.

   In other news, I’m dreading an in-law family party this weekend.  It’s at my FIL and step-MIL’s house, and it’s a combination 4^th of July/birthday/graduation/going-away party.  My step-MIL has a 4^th of July party every summer, on various weekends that never seem to fall on the actual 4^th.  The birthday/graduation/going-away part is for my step-SIL, who recently turned 18 and graduated from high school.  Next week she leaves for Navy boot camp.  So this party will probably not be as bad as I’m thinking, but you never know.  I’m expecting to have to explain why I’m not drinking (can’t have alcohol with metformin), and I don’t want to give away all my health issues, and everyone (especially step-MIL) will suspect that I’m pregnant if I’m not drinking.  Then of course we’ll get the questions about when we’re going to have kids.  (Mental note: talk to Paul about this to make sure we’re on the same page with our answers.)  Now that we’ve been married almost a year, this question is starting to come up.  There’s never a right answer to that question, unless it’s your mother or your best friend asking.  No one else needs to know the details, in my opinion.

   My relationship with my in-laws is weird, and my husband’s relationship with his own family is for another post altogether.  Let’s just say for now that Paul doesn’t really get along with his step-mom, or his real mom.  I get along with everyone just fine, but am constantly annoyed by my step-MIL, and am very close to hating my real MIL.  I’m annoyed greatly by both my step-SIL and half-SIL, but I absolutely ADORE my BIL and FIL.  Those are the two people that my husband grew up with and they mean the most to him, so I guess that’s the important part.  I guess I just have to cross my fingers and hope for the best.

Icky. July 24, 2008

Today’s day 3 of metformin (500 mg/day).  I guess it’s going okay.  I feel, constantly, a general sense of unease in the digestive area.  I’m bloated, gassy, crampy, and uncomfortable.  Everyday, two and a half hours (exactly) after I take the pill, I have diarrhea.  I’ve gone from being (almost) constantly hungry before I started metformin, to never, ever being hungry.  I’m forcing myself to eat at the appropriate times, even if it’s just a little.  I also have a chemical/metallic taste in my mouth in the evenings, which on the first night caused me to throw out the chicken my husband had made for dinner because I thought it had spoiled.  Another interesting side effect is that I seem to have lost 4 pounds between Monday and today, which is very nice, although it could just be a fluke or water-weight.  But water-weight would seem odd, given how ridiculously bloated I am.

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.

What next? June 10, 2008

In late December, I told my husband I was going off birth control pills, in an attempt to regulate my body before we starting trying.  I started charting my temps in an effort to learn my body.  In that time, I’ve ovulated once, maybe twice.  Or maybe not at all.  My first “cycle” was over 80 days, finally ended by Provera.  My second “cycle,” where I’m pretty sure I ovulated (on day 13), was finally ended with Provera after 55 days.  I’m on cycle 3, and might have ovulated over the weekend, but I’m not sure.  I’m having blood work done on Monday to check my progesterone and other hormone levels, and I have no idea what to expect.

My Mom was told at 19 that she was infertile, because of what has now been determined to be Polycystic Ovarian Syndrome (PCOS).  I was a fluke pregnancy, and after I was born my Mom tried Clomid and other drugs to have another baby, to no avail.  My brother was another fluke pregnancy, 7 years after me.

I worry that I have PCOS, because it can be hereditary, and because I have a few symptoms, such as being overweight.  But I feel a little better knowing that I could take Metformin and might have some hope.  I guess if the blood work finds that I’m not ovulating, the next step might be Provera again and then day 3 blood work?  I have no idea.  We’re not even trying to get pregnant quite yet, but I’m glad that we’re at least getting a head start on what might be a long process.