Couple of things to share:
1) I had to start using the OPKs again this morning so I went to CVS last night to buy them. $28 for 7. I knew that Walmart had them for a few bucks cheaper but didn’t feel like driving that far when I was already at CVS. So I took them up to the register to buy them and they rang up as $5.70!!! I went back and got another box, but only one because I thought for sure that would ring up right, and it rang up as $5.70 also! I should have bought a year’s supply but ended up with just the two boxes. I may try to go back today and see if they still do that. The receipt said something about $5.70 – savings of $22… I think maybe it got switched in the system and IF they were on sale they should have been for $22 something, with a savings of $5.70. The sign on the shelf didn’t say anything about a sale, just that they were $28 and some change. How awesome is that?
2) Kim just called and my u/s is scheduled for 9am on Saturday. It will either be her or Dr. S doing it, I'm not sure. If Dr. S does it, it will be the first time she's done the exam since that "well, it's not good" day. The appt with her a few weeks ago went well though, so hopefully she'll be a little more patient friendly on Saturday.
3) I just found a website with funny ways to pass the time in the 2ww. #13 on the list cracked me up so I may just have to implement it this cycle.
"Delegate the burden of the two-week wait. Clearly someone has to worry constantly during this time, but does it have to be you? Divide the days up among your best friends and closest family members. On their assigned day, they are required to think, wonder, and worry all day about whether you are pregnant. At the end of the day they have to call or send you email describing how agonizing it was. Also they have to report if they had any "symptom," such as, sore breasts, excessive urination, nausea, bleeding, fatigue. You'll be surprised how many people, male and female, have early pregnancy symptoms if they just look for them."
Thursday, May 29, 2008
Wednesday, May 28, 2008
CD9
Today is CD9 and I thought I'd post an update, although there really isn't much to report. I took the clomid from CD3-7 so thankfully that's over with. I managed to only have one semi psychotic breakdown and have had only a few hot flashes. I was pretty nauseaus while taking it, but I think it was a combo of the metformin, the clomid, and the antibiotic I was on for a sinus infection. Only 3 more days of the antibiotic so hopefully my digestive tract will be a little more normal soon. (Not that it's completely normal with the metformin, but I'm learning to deal with that.) On that note - I've managed to lose 6 1/2 lbs since we got back from vacation just over 3 weeks ago. Yay!
Some of you have asked what the plan is exactly for this cycle. I believe that I'll be going in on Saturday to check my lining and follies. There is a chance we might trigger if I have a mature follicle but not LH surge yet. The plan is to avoid doing an IUI this month unless absolutely necessary.
Oh, and a funny story from yesterday:
Do you remember the crazy older lady who came up and asked if we had kids and when I said no she wanted to know if we even wanted them, and when I said yes she asked if we were trying? And then proceeded to tell me that relaxing, a vacation, Jason wearing boxer shorts, and her super fertile relative could all help me get PG.
A few weeks ago she asked me if I was pregnant yet as I was walking by. I said no and kept going.
Just now she cornered me in the bathroom (while there were other women in there!) and asked me if I was expecting this month. I finally just asked her politely to not ask me that. It's been a long hard road and I don't need to be asked constantly. She apologized and said that she wasn't trying to pressure me, but would I at least tell her right when I find out I'm pregnant? ARGH! Oh, and then she patted my back and told me she was confident it would happen. Sheez!
Some of you have asked what the plan is exactly for this cycle. I believe that I'll be going in on Saturday to check my lining and follies. There is a chance we might trigger if I have a mature follicle but not LH surge yet. The plan is to avoid doing an IUI this month unless absolutely necessary.
Oh, and a funny story from yesterday:
Do you remember the crazy older lady who came up and asked if we had kids and when I said no she wanted to know if we even wanted them, and when I said yes she asked if we were trying? And then proceeded to tell me that relaxing, a vacation, Jason wearing boxer shorts, and her super fertile relative could all help me get PG.
A few weeks ago she asked me if I was pregnant yet as I was walking by. I said no and kept going.
Just now she cornered me in the bathroom (while there were other women in there!) and asked me if I was expecting this month. I finally just asked her politely to not ask me that. It's been a long hard road and I don't need to be asked constantly. She apologized and said that she wasn't trying to pressure me, but would I at least tell her right when I find out I'm pregnant? ARGH! Oh, and then she patted my back and told me she was confident it would happen. Sheez!
Thursday, May 22, 2008
A sign
I have two bracelets that I love wearing. One is the fertility bracelet that Laura R. gave me a few months ago, and the other is called the Angie Fertility Bracelet. A girl on one of my message boards designed it, and all of the stones represent things like fertility, hope, healing, etc.
I've had that bracelet since before Christmas and just love it. About 6 weeks ago though I lost it. I still had the other one to wear, but was crushed that I lost the pink one. I looked everywhere I could think of and just couldn't find it.
I was making the bed yesterday, and at the same time picked up two decorative pillows off of the floor. I thought I heard something, and I looked down and right there in the middle of the floor was my bracelet! I've made the bed (and changed the sheets) in the last 6 weeks, those decorative pillows have been on and off the bed numerous times, and I vacuumed just the other day. I have no idea where it came from! Obviously either somewhere in the blanket on our bed or in the pillows, but it was so incredible to find it. I stood there dumbfounded for awhile and took a picture of it on the floor before I picked it up. I'm taking it as a good sign for this cycle!
Tuesday, May 20, 2008
Relaxing didn't do shit.
Surprise suprise, I'm not pregnant. I actually started spotting late Sunday night so knew then, but didn't fully start until this morning. I knew better than to get my hopes up, but I'm not going to lie, I did a tiny bit. I thought that maybe, just maybe, since we were on vacation, I was relaxed, and I was drinking (as you all know, key things to do when trying to get pregnant) around the time most women would ovulate, that we'd get lucky. Not so much. I didn't chart or do anything this cycle so have no idea when or even if I ovulated. Based on starting today I'd say that if I did ovulate it was probably around day 21 or so? Who knows.
I'm getting ready to call Kim to see what they say I should do, but based on Dr. Shepard last week, I'll be starting Clomid again. Oh boy, can't wait.
I'm getting ready to call Kim to see what they say I should do, but based on Dr. Shepard last week, I'll be starting Clomid again. Oh boy, can't wait.
Tuesday, May 13, 2008
5/13/08 Appointment update
Oh what a morning! We left in plenty of time, but there were accidents all over the place, I had to stop and go to the bathroom once, and because I was so flustered when we got there I left the notes in the car. I couldn’t go get them because I had it valet parked. I had enough time to call my mom and get the questions again, because they couldn’t find my chart. Kim had pulled it yesterday to look at something and she wasn’t there yet. Finally, around 8:50 (for an 8:15 appt) we saw Dr. Shepard.
It went really well I think. Things I learned:
- My insulin level was at 83 and my glucose was 103. At the point in the glucose tolerance test, normal for insulin would have been 6-50. Anything over 60 is considered insulin resistant. For the glucose, under 140 is what we wanted, although a truly normal response would be 110 or lower. Thankfully I fit into that range.
- The insulin resistance problem has probably been an issue all along. Even back when we first started trying my cycles were wonky, which indicates some ovulation issues. In the Fertility Diet book I was reading last night, they said that the increased insulin caused decreased “some big long phrase that I can’t remember” that is a protein that carries the sex hormones. Those would be estrogen, progesterone, and I’m not sure about LH and FSH but they are obviously closely related. If those aren’t traveling correctly, that obviously messes with ovulation. (For instance, in me – I had a large enough follicle on CD12, but my LH surge didn’t happen until CD18/19 (sometimes later) and by then the follicle was post mature. She didn’t go into this today, so this is all from my reading.) It also could explain why even when given 3 vials of the Lepori (which is a lot!) I only developed one follicle. They would have expected someone my age to produce a bunch then. She obviously can’t say for certain that it’s the only problem, but it’s enough of a problem that it’s what we’re going to focus on.
- I asked if my weight gain could have caused it and that was iffy. She said that it’s related, but whether or not it caused the weight gain or the weight gain caused it is up in the air. She was very surprised that I have no family history of diabetes though.
- I don’t need to go see any other doctors about it, although I obviously need to get it under control. If we weren’t trying to have a baby, they’d probably have me try diet/exercise for awhile first, but with TTC thrown in there they want me on the Metformin.
- It sounds like I will be on Metformin through a good chunk of a pregnancy. I have no other indicators of PCOS, but they have found that people with it have a slightly higher risk of miscarriage in the early part of the pregnancy. I will keep taking Metformin until they are sure that baby is burrowed nicely into the lining and will stick.
- As long as I keep my diet/exercise ok, I should be alright on the gestational diabetes. They’ll know to especially pay attention to that possibility, but I shouldn’t have any greater risk than anyone else.
Our plan for now:
- If AF shows this week then we’ll be taking another month of not really trying (although we don’t have to abstain either) while we wait for the metformin/diet/exercise to do its thing. Then we’ll move forward with the plan.
- If AF wait until at least next week, then she thinks that will be enough time for the Metformin to start working, so I’ll do a cycle of Clomid. I was concerned because my lining thinned out while on it, but we never watched it during the first two months, and I think it tends to get worse as you go along. We’ll try one month and see how it is. I’ll have an ultrasound on CD12 to check my lining and see how the follicles are developing. We may or may not get an HCG shot, and most likely won’t do IUI (that’s completely up to us.) I’ll probably have b/w done 7dpo to check P4 levels.
- If that doesn’t work, and especially if it thinned my lining, I’ll move to a drug called Letrozole. She doesn’t like to use it as often as Clomid (she thinks Clomid works so much better) but in some people who react poorly to in regards to lining, it can work better. Same protocol with u/s and b/w.
- If that doesn’t work then I’ll go back to the Lepori (the generic Repronex.) I have 14 vials left of that, so it makes sense to use them. That will involve more monitoring with u/s every few days. We’ll do the HCG trigger shot for sure and will also do IUI for that.
- After that if we’re still not PG, we’ll re-evaluate and see where we are.
Something we didn’t talk about:
- I’m not sure if they’re going to check my insulin again to see if it’s better or since I’ll be on metformin regardless into the PG they won’t bother.
- We also didn’t talk about IVF at all. I am happy that we’re starting back over, but that we’re only doing a month or so at each level. Once we get to injectables, we’ll still have to figure my response out before moving to IVF. It would make no sense to do that if I can’t seem to produce enough follicles. However, IF we do get to the point of IVF, I want to do it this calendar year. The office is SO good about coding everything so my insurance covers it and I’ve already met my deductible this year. If we waited until October/November then we’ll be in our 20th cycle or so, and I’m comfortable with that.
So that’s my update!
Laura
It went really well I think. Things I learned:
- My insulin level was at 83 and my glucose was 103. At the point in the glucose tolerance test, normal for insulin would have been 6-50. Anything over 60 is considered insulin resistant. For the glucose, under 140 is what we wanted, although a truly normal response would be 110 or lower. Thankfully I fit into that range.
- The insulin resistance problem has probably been an issue all along. Even back when we first started trying my cycles were wonky, which indicates some ovulation issues. In the Fertility Diet book I was reading last night, they said that the increased insulin caused decreased “some big long phrase that I can’t remember” that is a protein that carries the sex hormones. Those would be estrogen, progesterone, and I’m not sure about LH and FSH but they are obviously closely related. If those aren’t traveling correctly, that obviously messes with ovulation. (For instance, in me – I had a large enough follicle on CD12, but my LH surge didn’t happen until CD18/19 (sometimes later) and by then the follicle was post mature. She didn’t go into this today, so this is all from my reading.) It also could explain why even when given 3 vials of the Lepori (which is a lot!) I only developed one follicle. They would have expected someone my age to produce a bunch then. She obviously can’t say for certain that it’s the only problem, but it’s enough of a problem that it’s what we’re going to focus on.
- I asked if my weight gain could have caused it and that was iffy. She said that it’s related, but whether or not it caused the weight gain or the weight gain caused it is up in the air. She was very surprised that I have no family history of diabetes though.
- I don’t need to go see any other doctors about it, although I obviously need to get it under control. If we weren’t trying to have a baby, they’d probably have me try diet/exercise for awhile first, but with TTC thrown in there they want me on the Metformin.
- It sounds like I will be on Metformin through a good chunk of a pregnancy. I have no other indicators of PCOS, but they have found that people with it have a slightly higher risk of miscarriage in the early part of the pregnancy. I will keep taking Metformin until they are sure that baby is burrowed nicely into the lining and will stick.
- As long as I keep my diet/exercise ok, I should be alright on the gestational diabetes. They’ll know to especially pay attention to that possibility, but I shouldn’t have any greater risk than anyone else.
Our plan for now:
- If AF shows this week then we’ll be taking another month of not really trying (although we don’t have to abstain either) while we wait for the metformin/diet/exercise to do its thing. Then we’ll move forward with the plan.
- If AF wait until at least next week, then she thinks that will be enough time for the Metformin to start working, so I’ll do a cycle of Clomid. I was concerned because my lining thinned out while on it, but we never watched it during the first two months, and I think it tends to get worse as you go along. We’ll try one month and see how it is. I’ll have an ultrasound on CD12 to check my lining and see how the follicles are developing. We may or may not get an HCG shot, and most likely won’t do IUI (that’s completely up to us.) I’ll probably have b/w done 7dpo to check P4 levels.
- If that doesn’t work, and especially if it thinned my lining, I’ll move to a drug called Letrozole. She doesn’t like to use it as often as Clomid (she thinks Clomid works so much better) but in some people who react poorly to in regards to lining, it can work better. Same protocol with u/s and b/w.
- If that doesn’t work then I’ll go back to the Lepori (the generic Repronex.) I have 14 vials left of that, so it makes sense to use them. That will involve more monitoring with u/s every few days. We’ll do the HCG trigger shot for sure and will also do IUI for that.
- After that if we’re still not PG, we’ll re-evaluate and see where we are.
Something we didn’t talk about:
- I’m not sure if they’re going to check my insulin again to see if it’s better or since I’ll be on metformin regardless into the PG they won’t bother.
- We also didn’t talk about IVF at all. I am happy that we’re starting back over, but that we’re only doing a month or so at each level. Once we get to injectables, we’ll still have to figure my response out before moving to IVF. It would make no sense to do that if I can’t seem to produce enough follicles. However, IF we do get to the point of IVF, I want to do it this calendar year. The office is SO good about coding everything so my insurance covers it and I’ve already met my deductible this year. If we waited until October/November then we’ll be in our 20th cycle or so, and I’m comfortable with that.
So that’s my update!
Laura
Monday, May 5, 2008
Saturday, May 3, 2008
Update
First, we're back from vacation and it was everything we wanted/needed. There are pictures up on our other blog (www.the-fletchers.blogspot.com)
While we were there I got a phone call from Irena. My test results were back and she wanted to let me know. The MTHFR came back negative which was very good. Even though it might have helped explain some things, it seems to go hand in hand with multiple miscarriages and that's obviously not something I want to deal with. So very good news there.
The bad news came from the glucose tolerance test. While my blood sugar levels were fine, my insulin levels were pretty elevated. I didn't think to ask what the number was, but will at our next appt. It was hard to grasp what it meant because I was on a beach drinking a daiquiri when she called and we had very limited access.
In the brief research I've done since we got home, here is what I've found. Insulin is a hormone that is produced by the pancreas that carries glucose (sugar) from my blood into my cells so that it can be burned for energy. Insulin resistance is when my cells don't respond to the insulin appropriately, so the sugar in my blood can't get into my cells. To compensate, my pancreas pumps out more insulin to try to get the sugar out of my blood and into my cells. A more simplified version: being insulin resistant means that I need higher levels of insulin to keep my blood sugar level normal.
In the nonfertility world, this is bad because it's an independent risk factor for heart disease. Also, because the pancreas is working in overtime it can eventually wear out and won't be able to produce the excess insulin to keep my blood sugar levels normal. When that happens, diabetes develops. Third, it contributes to increased appetite which obviously leads to weight gain. Lastly, more insulin makes it easier to store (vs burn) body fat, thus worsening the weight gain problem and making weight loss difficult.
In the infertility world, it is often linked to PCOS (polycystic ovary syndrome.) They have never mentioned that being a possibility with me, and from what I've read I don't fit any of the other symptoms so I'm not worried about that. It's also clearly linked to abnormal ovarian function, which I think is where I fit in.
I have really struggled with this because I read that while there is a genetic predisposition for it, whether or not it develops can depend on eating and exercise habits. So now I feel like this whole thing is my fault. On the other side, it can cause weight gain, so maybe that's why I've gained weight. While I know I've talked about emotional eating, it's not like I do that daily.
I don't know - there is still so much I don't understand about it. Is this a huge factor in my infertility or something that is just adding to it? If this is the only problem, do we try to fix this before doing anything else? Do we keep trying, but on our own? Do we combine this with continuing down the treatment road? We have an appointment on May 13th to talk about that, our next steps, and who knows what else.
Until then, she did tell me some things I need to do to help correct it. First, I start taking Metformin, today. I think that some of you have taken it - I'd love to hear about it. I've heard it can make you feel sick but that it should eventually go away. I start taking one with dinner tonight and then in a week I'll add to it. Luckily it's on the Walmart $4 prescription list so shouldn't break the bank.
I'm also supposed to start using the Fertility Diet book. It's not a diet as in trying to lose weight diet, but more of a changing my diet. It's supposed to be a moderate carb diet - too many carbs stimulate the most insulin secretion after you eat them. I'm supposed to make sure and have many nonstarchy veggies, whole fruits, high fiber, whole grains/legumes, protein-rich foods, and monounsaturated fats. I also have to do some form of exercise every day - even just 30 minutes of walking. Regular exercise will increase my cell's sensitivity to insulin.
That's all stuff I should be doing anyways, and now that I have to, it will hopefully be some good motivation. I want to have a baby so badly and want to do anything I can to help with that. I guess in the end it doesn't matter why I ended up with the high insulin, it just needs fixed.
While we were there I got a phone call from Irena. My test results were back and she wanted to let me know. The MTHFR came back negative which was very good. Even though it might have helped explain some things, it seems to go hand in hand with multiple miscarriages and that's obviously not something I want to deal with. So very good news there.
The bad news came from the glucose tolerance test. While my blood sugar levels were fine, my insulin levels were pretty elevated. I didn't think to ask what the number was, but will at our next appt. It was hard to grasp what it meant because I was on a beach drinking a daiquiri when she called and we had very limited access.
In the brief research I've done since we got home, here is what I've found. Insulin is a hormone that is produced by the pancreas that carries glucose (sugar) from my blood into my cells so that it can be burned for energy. Insulin resistance is when my cells don't respond to the insulin appropriately, so the sugar in my blood can't get into my cells. To compensate, my pancreas pumps out more insulin to try to get the sugar out of my blood and into my cells. A more simplified version: being insulin resistant means that I need higher levels of insulin to keep my blood sugar level normal.
In the nonfertility world, this is bad because it's an independent risk factor for heart disease. Also, because the pancreas is working in overtime it can eventually wear out and won't be able to produce the excess insulin to keep my blood sugar levels normal. When that happens, diabetes develops. Third, it contributes to increased appetite which obviously leads to weight gain. Lastly, more insulin makes it easier to store (vs burn) body fat, thus worsening the weight gain problem and making weight loss difficult.
In the infertility world, it is often linked to PCOS (polycystic ovary syndrome.) They have never mentioned that being a possibility with me, and from what I've read I don't fit any of the other symptoms so I'm not worried about that. It's also clearly linked to abnormal ovarian function, which I think is where I fit in.
I have really struggled with this because I read that while there is a genetic predisposition for it, whether or not it develops can depend on eating and exercise habits. So now I feel like this whole thing is my fault. On the other side, it can cause weight gain, so maybe that's why I've gained weight. While I know I've talked about emotional eating, it's not like I do that daily.
I don't know - there is still so much I don't understand about it. Is this a huge factor in my infertility or something that is just adding to it? If this is the only problem, do we try to fix this before doing anything else? Do we keep trying, but on our own? Do we combine this with continuing down the treatment road? We have an appointment on May 13th to talk about that, our next steps, and who knows what else.
Until then, she did tell me some things I need to do to help correct it. First, I start taking Metformin, today. I think that some of you have taken it - I'd love to hear about it. I've heard it can make you feel sick but that it should eventually go away. I start taking one with dinner tonight and then in a week I'll add to it. Luckily it's on the Walmart $4 prescription list so shouldn't break the bank.
I'm also supposed to start using the Fertility Diet book. It's not a diet as in trying to lose weight diet, but more of a changing my diet. It's supposed to be a moderate carb diet - too many carbs stimulate the most insulin secretion after you eat them. I'm supposed to make sure and have many nonstarchy veggies, whole fruits, high fiber, whole grains/legumes, protein-rich foods, and monounsaturated fats. I also have to do some form of exercise every day - even just 30 minutes of walking. Regular exercise will increase my cell's sensitivity to insulin.
That's all stuff I should be doing anyways, and now that I have to, it will hopefully be some good motivation. I want to have a baby so badly and want to do anything I can to help with that. I guess in the end it doesn't matter why I ended up with the high insulin, it just needs fixed.
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