Thursday, January 28, 2010

4 lbs

Apparently, changing my diet and exercising in addition to the Metformin has helped because I have already lost 4 lbs. Yay, me!! I haven't been following the low GI diet completely because I have been trying to eat up what food I do have in the house. In this economy and with finances the way they are, I just can't throw away food because I am starting a new diet. So, I have been doing the diet as best I can with the food I have and I still have lost weight. Yippee!!!

Today I went to the grocery store armed with my list of approved food and ingredients for various recipes. Since the diet relies so heavily on fruits, veggies and whole grain foods, it is a big change in how we have been eating. I was very worried about how much my grocery bill was going to be. I figured it was going to be higher than normal. It seems like all the food that is good for you is also more expensive. I was pleasantly surprised to find my bill was actually LOWER than normal. We must have been buying some expensive junk before. Granted, I didn't buy much meat this trip because I have plenty, but, still, it was about $20 lower than normal. Now we will just have to see if I bought enough to get through the week.

Poor T is not as excited as I am about changing the way we eat. The only junk food I bought this week was Oreos mainly because of B (that girl loves her Double Stuffed), but also because I don't want to completely deprive us of snackedly goodness. Total deprivation would probably back fire, quickly. T was a bit less than enthusiastic about what I bought and what will be available for him to eat. I strongly suspect he will be making a side trip to the store before the week is out. That or sneaking at work. That's OK with me. Right now it is more important for me to stick to the diet than him. I can work on him in the ensuing weeks :). B, on the other hand, so far doesn't seem phased by it. She was very happy with her salad today and really enjoyed trying a mango for the first time. I made sure to include some salami, which she really likes, so it wasn't completely different. Being so young, she will probably have less trouble adapting than T and I. I am really hopeful that we can stick with this. B will grow up eating healthy so it will be second nature to her to eat healthy when she is a teen and adult. If we get nothing else out of this than that, I will feel it has been worth it and productive.

The other good thing is that I have gotten 2 co workers looking into starting the low GI diet. One is interested for herself and her husband, and the other interested for her father who has recently been diagnosed with diabetes. Now I have at least one buddy for support as we work towards losing weight and getting healthier. T is doing this for me but I don't know that I would say he is all that interested or someone I will turn to when things get tough for moral support. He will be there in a pinch but day to day complaining, I think I would do better with a fellow woman and dieter.

I have read that losing just 5% of my weight can improve conception by 70% in a woman with PCOS. 70 % - WOW. I am already half way there. I know I have other issues involved with our infertility but at the very least, maybe I will start having regular periods again and possibly even start ovulating on my own again. If I can get my progesterone and estrogen back under control, I might even start sleeping better again because too low progesterone and too high estrogen can both cause insomnia. I have to admit, I have been sleeping better the last few nights since I started taking the Provera. Hormones are really funny things. I never realized what havoc they can cause when they are even just slightly out of whack.

Thursday, January 21, 2010

Provera, we meet again

I had blood work done yesterday because my period still hasn't started. Surprise, Surprise - my progesterone levels are low again so I get to start taking Provera again. The upside is that it will start my period and then I can get my Clomid Challenge Test. The downside, it will probably be about another month before that will be done. This waiting is so torturous. I can barely stand it.

I did take the opportunity to ask the nurse a few questions about some of the results from my previous blood work. My biggest concern was my AMH level (Anti-Mullerian Hormone). A very basic explanation is that AMH blood levels indicate the size of the remaining egg supply - the ovarian reserve. Normal AMH levels are over 1.0 ng/ml. My level was 0.2 ng/ml. This is very low, dismally low. It looks like I have an egg quantity issue. The nurse, however, said that they can still help me as long as my FSH levels (Follicle stimulating hormone) are low. FSH is the hormone that helps produce mature eggs by stimulating the ovaries to get follicles to develop. Immature eggs rest inside follicles, stimulate the follicle and you stimulate the immature egg to develop. Higher levels mean the body is having to work harder to get the follicle to develop. High levels are not good. So if I have low AMH and high FSH, it means I would have poor egg quantity and quality - premature ovarian failure. You normally see high FSH levels in menopausal women. The higher the FSH, the likelihood of responding to infertility treatments like IVF is poor. As long as my FSH levels are within an acceptable range, I could still respond to fertility drugs, though I would probably have to take inject able drugs as opposed to the oral kind. The inject able drugs (inject able gonadotropins) are the same hormones as FSH. So very scientific. Basically, I have an egg issue in addition to a hormone issue. How bad the egg issue is will determine if fertility treatments are even an option for me. The Clomid Challenge Test will determine my FSH and where we go from here.

Now, T and I are practicing patience and playing the waiting game. I want to know my levels BUT, I don't want to know. T says hope is still alive right now and we need to hold on to that. Unfortunately, I am having trouble staying optimistic. T is a glass half full kind of guy and I am the glass is half empty fill the damn thing up kind of gal. Optimism has never been my strong point. I have all these scenarios going through my brain, none of them good. I am afraid to hope, I think. Because if I hope and we get bad news, it will crush me. As long as I believe it is going to be bad, if we get good news, I can be surprised and ecstatic. If it is bad, then I have already started preparing myself for it. See - glass half empty but with the expectation that it can be filled up.

I think I need to back off on my research for a bit and take a breather. Reading all this stuff that can happen or what things might mean is just stressing me out. I am filling my handy dandy note book up with so much stuff to ask the RE that he is going to freak when he sees me walk in with all these pages. I remember when I went to one of our early pediatrician appointments with B and I was full of questions I had gleaned from various parenting magazines and books. I was so worried about milestones and her development and kind of freaking out. I remember the doctor sat me down and said the first thing we need to do was throw away all those books. Charts and levels and standards do not make a child and each child is an individual and they don't develop on a time line. I think I need to adopt that philosophy to this situation and step back, take a breather and wait for all our results to come in. Easier said then done. I guess I need to work on my practicing patience.

Wednesday, January 20, 2010

My wonderful husband

My posts so far have been fairly depressing and negative so I wanted to be a bit more upbeat. I got home from work last night and was surprised at the door by T who bent me back romantic movie style and kissed me the same way. He had a hot bubble bath waiting for me, candles all over the bathroom and bedroom. He fixed me a drink and we shared a wonderful bath together. Then, yes there is more, he gave me a lovely massage after the bath. It was heavenly. We spent the next hour sipping our drinks and talking quietly before we went to bed. I asked him why he was doing all this, I have to admit I was a little bit suspicious :). His answer, just because... What a wonderful, fantastic way to end the day. I have my bad days and then, T does something like this that lifts me up and lets me know how loved I am. I guess I was wrong about Monday blues coloring the rest of the week.

Tuesday, January 19, 2010

The grass is always greener...

Have you ever watched the show Lost? I recently started watching the first season on DVD and was hooked. Too bad it is ending after this current season, huh? Typical. Anyway, probably the major theme underlying this first season is changing yourself/reinventing yourself, a clean slate. Basically, the old you is gone so its time for a new one who doesn't have to be held to the same constraints and screw ups as the old you. Wouldn't that be absolutely fantastic? To be able to reinvent yourself and start all over?

I started thinking about this and thought, OK, if I could change one thing in my life, what would it be? Definitely my job. I dislike shift work, working so many holidays, the mandatory overtime, the politics, working in the evenings away from my family, and the list goes on and on. I think a large part of my stress and unhappiness in life is a result of my job. Unfortunately, leaving my job is not something that is going to happen anytime soon, if ever. I have been thinking that if I could go back in time, I would not have taken this job and would have continued for my master's degree after I received my bachelors. If I could have gotten my master's back then, I think I would be in a job that I wanted and that would not stress me out so bad and bring me such unhappiness.

I have been daydreaming about never having taken my job, being more educated/better qualified, having a better for me job, for days now. What would it have been like? How much more money could I have made? What other kinds of people I might have met? What would my life be like now?? WHOA WHOA WHOA !!! That last one kind of grabbed my attention and made me realize something -- what would my life be like if I had never ended up where I am now? I would never have met my husband to begin with. If I had never met my husband, I never would have had my precious B. B is the one thing I can look at in my life and can say I helped make this spectacular, wonderful person happen. She is the best thing that has ever happened to me and the best thing I have ever done. And if I had never taken my current job, she would not exist.

I realized that by changing one aspect of my life, I would have completely altered the path my life has taken. Would I possibly be happier, wealthier and less stressed? Definitely. But I also wouldn't have the one thing in my life that makes up for all the rest, the one thing in my life that I would walk through fire - my family. I wouldn't have T or B and that is just not acceptable.

So I am in a crappy job, stressed out, financially not where I wanted to be at this point in life, but I have my family. I have my B who gives me the greatest joy in my life everyday by just being my daughter. Maybe reinventing myself, wiping the slate clean isn't as fantastic as I thought it might be.

Monday, January 18, 2010

Blue Monday

I hate Mondays. Today sucked. I was doing OK until I got a call from my mom and it went downhill from there. Now don't get me wrong, I love my mom dearly but sometimes we don't communicate well. She called at a bad time and I went ahead and tried to talk to her even though I knew it was a bad time, but I hadn't talked with her for awhile so...Any way, she was actually trying to tell me that she approved of my blog and all but, following an argument this past weekend with T about our infertility issues, I was very sensitive. I won't got into details, but, sometimes you just need support and not someone to try and "fix" things or give you platitudes. Sometimes I just need someone to vent to, cry on their shoulder, just listen and hear me, not tell me what I need to do or that it will all work out or to stop worrying so much.
T is much more laid back than I am (thank God otherwise our household would be completely manic) and he seems to be taking this in stride. Sometimes he is so easy going that I wonder if he is really affected or all that worried. I take the proactive, what are all the possibilities angle and he takes the wait and see, don't borrow trouble angle. They don't always mesh as we found out this past weekend. And this waiting is KILLING me. I want to get the Challenge test done so we know where we go from here but I still haven't gotten my period. I will have to call the RE tomorrow which probably means more blood work and Provera. That means it won't be until sometime next month before we can schedule the test. UUURRGGG!!
On the good side of things, I have decided to go on the low GI diet (glycemic index). I have heard good things about this diet and am hopeful it will help with the insulin resistance AND weight loss. Poor T is not so excited but he is a trooper. He doesn't really get much of a choice since I do most of the grocery shopping :). I have been keeping up with getting more exercise - I have been doing yoga/pilates, we went to the zoo on Saturday and walked around for hours, and we went bowling yesterday. Not high impact exercise but still exercise and I will build on it.
I am just kind of blue today. Its the waiting and not knowing. Also, sometimes I feel like I am the only one who is taking this situation that seriously. I am trying to be proactive and do things to try and help with the PCOS like the GI diet, exercise, cutting my sugar intake plus researching infertility, IVF, IUI and PCOS. I found a nice board - - on PCOS with the help of a friend. It has a lot of good info. I just want a plan of action and hate being in this holding pattern. It is driving me absolutely crazy. I know there is nothing I can do right now but I really dislike being told that and being told to just be patient. So I am having a blue Monday and a crappy outlook right now. It will pass, I hope :). I think T hopes it will pass, too. Hopefully having a crappy start to the week won't color the rest of the week. Mondays suck.

Tuesday, January 12, 2010

Trying to retake control

I was thinking last night that one of the reasons I feel so lost and stressed out right now is that I feel like I have lost control. I am a bit (OK a whole lot) of a control freak. I had a plan for our future and now that plan is null and void as of right now. So much of me - my thoughts, my energies - revolve around our fertility issues now. It almost consumes me. Very unhealthy. SOOOOOO...I decided this morning to try and get a measure of control back in my life.

How am I going to try to achieve this, you ask? First by trying to tackle the problems that have evolved from PCOS. A friend sent me this link last night and it kind of kick started my decision - It is about how diet, exercise and weight control affect fertility. I think if I can start to feel better - my overall health, my self esteem - then I won't feel so overwhelmed. This involves a diet change and exercise, what we all know we need to do and have heard so often. The PCOS helped in my weight gain - probably 50 pounds over the last 1.5- 2 years- but I can't blame it solely on that. I know once the Metformin starts working, I may start dropping some of the weight because my body will be metabolizing what I eat better. But I can help that along. This article from Newsweek talks about how "good" carbs are beneficial for not only weight loss but helping out with my insulin resistance which in turn effects fertility. I am now on a mission to educate myself about what "good" carbs are and how to incorporate them into my diet. I also know that smaller portions are integral in weight loss but I also think that smaller portions and more frequent meals may help with my stomach rebellion against the Metformin. Last night I ate a much smaller meal than I normally do and I didn't have nearly the stomach problems I have been having with the Metformin. I don't know if it was related but it was a relief.

This morning I decided it was time to quit making excuses and get on a regular exercise regiment. I pulled out some DVDs I had bought once and never used on Pilates/Yoga and used them. Now I have never done Yoga so I know my form was horrible, but it got me sweating and my heart rate going. And it gave me a good laugh to see my 3 year old daughter, B, also trying to master downward facing dog. And the big plus, it made me feel good about myself..something I haven't felt in awhile. I am also hoping it will help with my insomnia. I am a bit sore right now but it is a good sore.

Overall, I felt pretty productive and like I was moving forward, not stagnant, today. I hope that I can keep it up and even get T in on it with me. If we do this together, we can encourage each other. I feel more empowered today than I have in a long time and I have such powerful motivation this time. Maybe we can find some good in all of this.

Monday, January 11, 2010

Test results so far

I have had so much blood work done I feel like a vampire's victim. For some reason my progesterone levels have dropped since September. They aren't getting high enough to trigger a period let alone ovulation. Last month I took progesterone (Provera)to trigger a period so I could get some blood work tests done. The RE (reproductive endocrinologist - fertility specialist)was checking for Polycystic Ovarian Syndrome (PCOS). This is a condition where there is weight gain, acne, coarse/dark hair that develops where previously there wasn't an issue - there are other symptoms but these are the ones that I have. Basically, your hormones are all out of whack. And, surprise surprise, I have it. We found that my testosterone is high and I am insulin resistant. Hence, I have not been ovulating correctly for some time now. The kicker, the one that socked me right in the gut and has led to this blog, my eggs are aging prematurely and there is a question about whether I have any viable eggs left. I don't know the particulars on this because I was so upset when the nurse called that I didn't think to ask any real questions. I do know that I know have to take a Clomid Challenge test. They load me up on clomid (fertility drug to stimulate ovulation) and test my blood and do an ultrasound to see how and if my eggs react. Of course, I have to wait until my period starts before they can start the test but it has yet to make an appearance. I suspect I will be making further acquaintance with the Provera pills. I don't think I have ever wanted my periods to start as badly as I have since we started seeing the RE.

Now, my husband (T) has also been tested. We figured there really was no need because he already had a child from a previous marriage and then there was our daughter. But the RE wanted it so we did it. Another shock, T also has some fertility issues now - sperm morphology issues. His little guys are not formed correctly so they can't break through the egg to fertilize it. The fun never stops around here. His issue is caused by LOW testosterone. If only I had his blood and he had mine. The treatment, he also gets to take Clomid. The urologist is pretty confident that this can be corrected so we aren't too worried right now.

As to my PCOS, the treatment is an antidiabetic drug called Metformin. I am beginning to hate Metformin. Some of its side effects include upset stomach and nausea. Boy, does it ever cause those. I start out one 1 pill and work my way up to 3 a day. I am on 1 pill right now and it is making me so sick that I am dreading what it is going to be like as I up the levels. I am really hoping my body becomes accustomed to it because this sucks so much right now.

T and I knew from the get go that the probable treatment for our infertility was going to be fertility drugs and insemination ( IUI - intrauterine insemination). But now, after researching what my test results are showing, I am really afraid that it is going to be invitro ( IVF - invitro fertilization). IVF scares the hell out of me. The cost is prohibitive to begin with and I don't know if we can afford it. Our insurance only covers diagnostic care, not the infertility treatments. We had put money away for the IUI treatments ( there would be 3 of them as long as they weren't successful) but now....I just don't know. The drugs alone are in the thousands. And what if I am not a candidate for IVF, are we looking at egg donor, embryo adoption or, what I fear the most, adoption? There are so many questions and fears going through my head that sometimes I feel like I am going to explode. And none of these questions, like what kind of treatment are we looking at now, can even be answered until after the Clomid Challenge Test and the RE followup visit.

So, as of right now, all we can do is wait. Wait for my period to start so we can move on with the test. And of course, it isn't cooperating so that is something else for me to worry and agonize over. Sometimes I wonder if all this is even worth it. I already have a daughter. A lot of couples in our position don't even have one child. Maybe I should count my blessings and accept what I have been given. But then I see a baby or a pregnant friend or play with/hold a baby and wonder, why has this happened to ME and, damn it, I want more kids!!!

How did this happen to us??

I have never blogged before so bear with me as I try to organize everything that is going through my thoughts. To begin with, I am 34 years old and have already had one child. My husband and I had planned on having at least one more child, maybe more after our daughter. I conceived with our first soooo easy, in fact, we weren't even trying -- surprise!! But it was a wonderful surprise. So, 2.5 years later, we decided to try for Baby #2. Imagine my surprise when month after month we weren't pregnant. A year after trying, we were referred onto a reproductive specialist. Here we are, 3 months after that and I am scared, stressed, and completely incredulous that this could happen to ME. I thought this only happened to people who never had a live birth, who were OLD, who had some sort of surgery/illness/trauma that didn't enable them to have children. Not to 34 year old women who already have a child, a husband who has another child from a previous marriage and the intense desire and ability to provide a good, loving home to many children.
I feel very alone and isolated right now. It seems everywhere I look, people I know are pregnant or have babies. No one I know personally has ever had to deal with this themselves, at least to my knowledge. Who can I talk to? Well meaning friends and family ( those that know our problems with this) tell me that it will happen, just keep trying, and, the one I personally despise the most, there is always adoption. Who do I talk to about our test results, our treatment options, my burgeoning depression, the stress level, how sex is now a mission not a pleasure, and my absolute fear that I will never be able to provide my daughter with a younger brother or sister. I feel like I have failed as a woman. Hence, I have decided to start this blog. If no one but me ever reads it, I don't care. It is a place for me to write down all my thoughts, feelings and secret fears that I can't really voice otherwise. Maybe it will help save my sanity.