Follistim, Party of One

CD19, folks! It’s been a bit since I updated, and a lot has happened the last 19 days! Let me break it down for you.

 

1. Provera was hateful to me and Letrozole was kind. Had a baseline ultrasound done on CD3. My Cycle Coordinator, H, has been wonderful in working with me and having some labs and other stuff done here locally so I don’t have to take off work as much. I got to go to Dr. L’s office for the baseline ultrasound and the girls there were ecstatic to see me. The ultrasound tech even used me as a teaching device that day, since my ovaries have a perfect string of pearls. I’m pretty much textbook, folks.

2. I began my very first cycle of Follistim. We started out with 75 units on CD’s 8-10. On CD11 Hubby and I made the 2 hour drive to have my midcycle ultrasound and labs done. It was uneventful. No mature follicles to be seen. So I was instructed to continue the Follistim 75units a day for the next 5 days. Then on CD16 we would return for another ultrasound to check things out.

3. I’ve become a pro at jabbing myself with a needle! Hooray! At first it was a little tough. I mean, it didn’t hurt, and I knew it wouldn’t hurt. But it’s like my brain wouldn’t tell my hand to give myself the shot! Crazy. But eventually I got the hang of it and I’ve been shooting myself up like a mad man.

4. Back to the clinic 2 hours away for our 2nd ultrasound on CD16. We got some good news. Actually, great news! There it was, on the screen. The most beautiful big black blob I’d ever seen. One mature follicle measuring 19mm. Bigger than Dallas right there on the screen. When she told me I closed my eyes and asked which ovary it was on. Luckily, it was on the RIGHT ovary! The left had a few little ones that weren’t mature yet. And the right only had that one. But oh my gosh, it was amazing. And it only takes one, right? I was pretty much giddy the whole way home. It’s just an amazing feeling to finally get some good news! After the last several cycles of my follies only growing to 12mm and then stopping, this is fantastic. I love Follistim. LOVE IT.

5. So we triggered that night at 8:00. Sexy time like crazy the last 2 nights {and probably tonight, just to be sure!}. Yesterday I was having bad period-like cramps most of the day, with some twinging of my ovary. I’m not sure if that’s a good sign or a bad sign.

 

So there you have it. Starting out the TWW with pretty high spirits. I’m always very careful not to get my hopes up, but it’s just so hard this time around. I don’t want to jinx it…but I’ve just got this feeling…. Fingers crossed!!!

 

 

Once More, With Feeling!

fertilizedeggsplease

 

I’ve been a little MIA from the blogging world lately.  It’s just that with the holidays and work and doctor’s appointments, I tend to spend my free time doing absolutely nothing.  So here we go with an update.

My follow up appointment with Dr. P was on the 31st.  Dr. P was looking much healthier this go around and seemed to be excited to get going with our treatment plan now that we had my lab results back.  Hubby’s karyoptype came back normal, as did mine.  Most of my other results were normal, too, expcept for increased testosterone and things like that that we had expected.  Then the bad not so good news.  My insulin resistance test came back positive.  So it’s official.  I’m insulin resistant.  All of my blood sugar numbers were great…perfect, he said.  But, my body is resistant to the insulin that keeps those sugars great, so it’s making an abundance of it.  The excess insulin is triggering my ovaries to make more testosterone, which interferes with the growth of my follicles.  Which essentially makes me a sad/angry/infertile woman at the end of every cycle.

Now, none of this was news to me.  I had expected that I had a hint of IR, just because I’m pretty textbook for it.  But Dr. L had tried to put me on Metformin before, and the side effects were terrible.  {TMI time} I couldn’t control my bowel movements, people.   And in my line of work where I am running around and with patients all day long, you can’t just scadaddle off to the restroom at the drop of a hat.  Not to mention, in an office of 35 women, we have exactly TWO bathrooms.  Seriously.  And I swear to God people just camp out in there sometimes.  You can never go when you need to go.

So what is our gameplan according to Dr. P?  Back on Metformin.  He told me it was not an option.  You want to have a baby?  Take the Metformin.  Period.  Well, ok, doc.  So he put me on 500mg twice a day, starting off the first week just taking it with my evening meal until my stomach can adjust.  He prescribed the Extended Release {ER} which seems to help a LOT with the stomach issues…I actually haven’t had any except I seem to be gassy all the time now.  Which could have something to do with the 2nd part of my IR treatment…

Diet.

Ugh.

We {hubby included, because I’ll be damned if I have to do this and he doesn’t!} were informed to start following a 1200 calorie diet and cut way back on sugar intake.  Sure.  Sounds fine.  Except for the fact that I can drink a gallon of sweet tea a day all by myself.  Seriously.  I’m addicted to the stuff.  Take away sodas.  Take away sweets.  I’ll be just fine.  But my sweet tea??  Oh, God, this is gonna be bad.

It’s not a bad thing.  We’re both overweight.  We’re both out of shape.  This is something we’ve needed to do for a long time.  I’ve known I needed to get myself healthier for a long time.  I could just never get myself motivated to do so.  Until the Fertility Specialist says if you want to have a baby, this is what you have to do.  That’s my motivation.  Why I didn’t look at it this way before?  I have no idea.  But that’s how I’m looking at it now.  I’m just doing what I have to do.  I was talking to a friend this week about my future fertility treatments, and she said to me, “I don’t think I could ever give myself a shot.”  Without any hesitation, I looked at her and said, “When you want something bad enough, you’ll do whatever you have to do.” 

So far its not going too bad.  We went through the cabinets and got rid of any and all food not on my approved list.  A brand new unopened package of Oreos thrown out. {Actually, I gave them away because I can’t bear the thought of throwing away perfectly good food}  My “snack” foods have been replaced with sugar free pudding, popcicles, and cool whip and fresh fruit.  The dinners I cook are pretty much the same, with a few changes like buying things with whole grains, etc.  I’m packing my lunch for work instead of going out to eat all the time and that saves calories and money.  I’m watching my portions and tracking my calories and so far I’ve done ok and lost 2.4lbs since the start of this week {which I’m attributing to cutting out the sweet tea lol!}.  I haven’t had anything to drink but water {except for 1 can of Diet Dr. Pepper} and with the help of Sweet Tea flavored Mio, it hasn’t been too bad at all.   It’s not easy, but easier than I thought it would be. {Making myself eat breakfast has been my biggest challenge, because I am NOT a breakfast eater at all!}  And I’m not there yet, but I’m eating world’s better than I was a week ago, so that’s something.

Next step: Incorporating exercise into my daily routine.  But, one step at a time.

Ok, where were we?  After explaining the diet/Metformin plan to me, Dr. P says he’d like to give me a month or two to get the IR under control before going on with any treatment.  Um, excuse me??  Did I hear you correctly, doc??  You want me to wait two months to start ANY kind of meds?  Nope.  Sorry.  Not gonna happen.  Two months, in the grand scheme of things, is not that long.  But two months for someone who has been TTC for two years is an eternitiy.  I haven’t had a period since November 8th and I’m going out of my frickin’ mind about it.  I’m gonna take your Metformin and I’m gonna cut my ties with my beloved sweet tea, so the least you can do is give me some mothertrucking Letrozole, guy.

The story, according to my husband, is that I whined and threw a fit and got my way.  But really, all I said was I didn’t want to wait that long to get started.  I’ve waited long enough, Dr. P, and you’ll soon realize that I’m going to be a pretty impatient patient.

So he gets out his prescription pad and writes me one more script….for Provera.  Ah, old friend, we meet again.  It’s gonna be a fun ten days.

He tells me to wait to start the Provera until I set up my Patient Education Class with Nurse M.  His plan for us right now is to do Letrozole with FSH injectables and timed intercourse {UGH}.  If it doesn’t work after a couple cycles we will move on to the IUI process.  I think this is just his way of tiding me over, since he wanted to wait until I was on the Metformin a couple of months before we did IUI anyway, but whatever, I’ll take it.  I can’t stand the thought of doing NOTHING.

So we signed up for the next available Patient Education Class with Nurse M on January 8th, this Tuesday.  I’m not exactly sure what she’s going to teach me in this class that I don’t already know, besides maybe how to give myself a shot.  But they won’t let me start my meds until its done, so we’ll be there Tuesday morning, bright and early.

So there we have it.  I feel like I’m starting over, almost.  Like the last two years are being disregarded and I’m being treated as if all of this is new to me.  I’m sure that’s how they treat all new patients, but its a little frustrating, to say the least.  I’m ready.  For the big stuff.  If I had it my way we’d skip all this preliminary stuff and drop 20 grand on IVF tomorrow {might have to rob a bank or something first, but I can improvise}.

I’ll update soon about my first exam with Dr. P….it was interesting to say the least!

Hope everyone is having a happy new year!

 

Our First Consultation

This past Monday was our first consultation with the RE!  So exciting/scary/promising!  It’s been a crazy week with the holidays coming up, so I’m little behind on updating on how everything went.  But here we go…

First of all, everyone at the clinic {so far} has been so incredibly nice.  I get it, it’s their job and they work in a very delicate specialty.  But when you feel like you’re carrying around as much baggage as I do, it’s nice for people to not make you feel like you’re a burden.  Even if it is their job.

Hubby and I woke up way too early and left our house at 5:30am to make the 2 hour drive to the clinic.  $3.00 in toll fees and 2 detours later, we arrived at the clinic at around 7:50.  They don’t open until 8:00, and our appointment wasn’t until 8:30.  So we took a little joyride and found a place to take a bathroom break.  By the time we got back they were just opening the doors.  Hubs opened the truck door and asked if I was ready.  I wasn’t.  And I was.  All at the same time.

We were met with chaotic smiles behind the front desk.  There was clearly a new person being trained, quite possibly her very first day, and then they explained to us that the credit card machine wouldn’t settle, so they were on the phone trying to sort that out, and Dr. P {who happened to be the doctor I was seeing} was terribly ill this morning.  The girl assured me that things weren’t usually like this as she handed me and the hubs some papers to fill out {and thanked me a million times for filling out our medical history on the patient portal…which by the way is pretty awesome}.  I work in a medical office.  I can totally understand walking into a crazy Monday that you didn’t expect.

After handing in our papers we waited less than 10 minutes before being called back.  The girl who called us back {whose name I didn’t catch…I’ll have to pay more attention next time!} was all smiles as she asked me to step up on the scale.  I’m glad she was smiling because I was not!  Then Smiley took us into an exam room and asked the basic questions.  I had already filled everything out on the Patient Portal ahead of time, so she was basically just verifying the information.  She took my blood pressure then Smiley asked me to smile as she snapped my photo with a digital camera.  Then Hubs had to smile at Smiley for his photo.  At my office we just scan your driver’s license, but hey, whatever works.

Smiley then began to explain that Dr. P was very sick today, but since we were new patients and came from out of state, he was going to go ahead and see us before he went home.  Then she lead the way into his office.  Right off the bat I liked Dr. P.  He’s very personable, straight forward, and has just the right amount of a sense of humor.  The poor guy looked about half dead, though!  When they said he was sick they weren’t kidding!  I felt horrible for him, but so grateful that he chose to stay and see us.

First things first, we went over my history, discussed all the avenues we’ve already taken.  We came to the conclusion that I’ve got a lot of things working against me and that I’m pretty textbook for PCOS, but he wanted to do a few tests to rule out anything that could be disguising itself as PCOS.  Dr. P said we were going to be very aggressive with the meds to get me ovulating, probably keeping with the letrozole for now and adding FSH injectables.  Getting me ovualting wasn’t his biggest concern though.

Recently I had some blood work done.  A lot of bloodwork.  Bloodwork that required so much blood that I passed out in the lab.  Dr. P was studying my results and then informed me that I am a carrier of a single copy of both Factor V Leiden mutation and the C677T MTHFR mutation.  If you’re unfamiliar with this, I suggest you consult The Google, because it will explain it much better than me.  The basics of it is, I have a clotting disorder.  And the fact that I carry both mutations and not just one is just icing on the cake.  After explaining this to me, Dr. P then began to ask me questions about my miscarriage.

How far along were you?  8 weeks.

Did you hear a heartbeat?  Yes.

Yes?  Yes.

Hmm.

I had been told that we were so early that there was really no way to tell what caused the miscarriage.  These things just happen sometimes.  1 in 4.  It was hard, but I had accepted it.  Dr. P informed me that he didn’t think this was the case at all.

In his professional opinion, he said that once you hear a good healthy heartbeat, there is usually a reason behind the miscarriage.  In my case, the clotting problem.  It decreases and cuts off the bloodflow to my uterus and to the placenta, effectively cutting off the blood flow to the baby.  There’s no way to know for sure, but Dr. P believes this is what happened to me at 8 weeks and 1 day.

I’m not gonna lie, that’s a tough pill to swallow.  To know that I had a perfectly healthy baby growing inside of me, and my body betrayed me, betrayed my baby.  To know that I could have a 7 month old son or daughter right now if I had just been taking a frickin’ baby aspirin?!  It’s hard to wrap my head around.

So, game plan.  Dr. P proposes that the day I get a positive pregnancy test I will immediately begin heparin or lovenox injections every day.  I started a baby aspirin everyday when I had this bloodwork done and I will continue to do this.  {I will likely be on an aspirin regimen for the rest of my life.}  He seems pretty confident that I will be able to carry a healthy pregnancy this way.  Now, about the getting pregnant part..

Like I said, we’ll most likely stick to the letrozole for now and add FSH injectables.  But all of this depends on the results of the bloodwork I’ve had done this week.  Dr. P said depending on what the results show will depend on how he treats me.  I also had to be checked for insulin resistance, since it usually goes hand in hand with PCOS.  We discussed the fact that I was put on Metformin before but it did nothing but make me race to the bathroom every 5 minutes, so he’s not sure if its actually an issue with me or not.  At least if it was it would help explain all the weight gain!

He said he usually likes to start out doing 3-5 cycles of IUI before he moves on to IVF.  Depending on how I respond to the meds will determine how many cycles we try.  I’m ok with that.

After we talked and the poor man finally got to go home to bed, we were sent to the lab to get some blood drawn.  They use a separate lab company, which is convenient because they have a lab a couple towns over from where we live, which happens to be in the same town that we both work in.  We went straight from the clinic to the lab in Tulsa {which was in a kind of shady location behind a grocery store} and since they wanted a karyotype test from both of us, the Hubs had to get stuck with a needle this time, too!  I enjoyed it a little too much, haha!  Then later this week I went to the local lab here to have my insulin resistance test.

We go back to see Dr. P on December 31st to discuss what the results were and how he plans to go about treating me.  He also talked about probably getting an ultrasound of my ovaries this visit or shortly after, as well.  Dr. L’s office sent a short novel to him, so he’s already got a lot of the info that he needs to start off with.

So far, thats all she wrote!  I’m excited for the 31st to get here and see what we’re going to do.  I’m anxious to get started.  I still haven’t started my period since my last cycle {November 8th} and I don’t like not being in a cycle.  After counting cycle days for 2 years its like a way of life!  Although, I can’t say that I’m excited to meet up with my old friend, Provera.  Ugh.

Merry Christmas, everyone!