The Crazy is Creeping In November 11, 2008

   For 10 months now I’ve been taking my temperature every morning upon waking.  It doesn’t get old.  In fact, it helps me wake up in the morning.  In talking to a coworker about it earlier today, she told me that when she was TTC, she only got through about a month and a half before giving up out of annoyance and boredom.  I can’t help but wonder if that’s what contributed to it taking her 3+ years to conceive despite everything being in seemingly perfect health.

   I keep my thermometer in a mug on my nightstand.  Also in this mug is loose change, nail clippers, a few gum wrappers, and some earplugs.  My alarm goes off and instead of reaching for the snooze button I reach for the thermometer.  I never have a problem remembering it so I can later (once at work) enter it into the myriad of different programs and websites I use to keep track of all things cycle-related.

   I’m currently on cycle day 31, and a full 22 days past what looks like ovulation.  However, despite whatever “symptoms” I might be having, every single stick I pee on is negative.  All seven of them, of differing varieties.  I guess my current plan is to wait a few more days, and if there’s still nothing in the way of a positive test or a period or even a temp-drop, I’ll call my doctor and ask for a blood test.

   I’m having a difficult time even believing that my body has done something “normal.”  But it definitely looks like a clear thermal shift, and I have to hope my doctor (ob/gyn or RE, either one) would see the same thing.

   You know, I could keep taking my temp every day for the rest of my life and not be too bothered by it.  It’s the waiting between each temp-taking that’s annoying.  I obsess and over-analyze every little thing, then do myself no favors by looking stuff up online to fit my circumstances for exactly what I want to see.  Paul sees the tests piling up in the garbage and just says “nothing yet?” and gives me a hug.  He ignores my hours online pouring over pregnancy test photos and temp charts, and the stack of books on my side of the bed (“Taking Charge of Your Fertility,” “What to Expect When You’re Expecting,” among others).  And although he’s a little worried he might get laid off, and the economy sucks, and it will be at least another year before we can buy a house, he hasn’t even started to say that maybe we should hold off trying right now.  And god do I love him for that.

   I’m starting to get antsy for results.  If it turns out that I haven’t actually ovulated, I want another provera prescription so I can start again.  And I’m thinking about making an appointment with my RE, not for PCOS maintenance like I’ve been going to her for, but for actual fertility treatment, if she’ll have me.  I’m worried that she’ll not want to treat me yet because we’ve technically only been trying for a couple months.  However, how can we even “try” when I’m not ovulating?  Part of me wants to march in there and demand Clomid or Femara so we can actually start trying.

   I need to lose weight.  I know that.  I know that it will help with so many things, not the least of which is my cycles.  But I just can’t seem to get off my ass and do it.  If there were any motivator that would actually work, I always thought this would be it.  Part of me has always thought that one of the reasons I hold on to my weight is because it protects me.  Maybe I’m holding on to my weight now because I’m scared to be a mother, and subconsciously not ready.  But that’s just crazy, because I know beyond a doubt that I’m ready.  So why won’t I put down the effing ice cream and get my ass off the couch?

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).

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.

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.