Tuesday, February 28, 2012

Those bones, those bones

Today is CD5 so no shots scheduled for today but I will have to take my clomid before bed.  Yesterday's shot went much like CD3's shot except that Handsome and I were kidding around and I was laughing to the needle moved just a bit.  Usually there is almost no pain because the needle is so thin but with the laughing and movement it hurt a tiny bit (tiny pinch) and there was a small drop of blood, similar to what you would see from a in stick, that bothered my husband more than me.  He isn't afraid of blood he just doesn't like to hurt me and when there is any blood or bruising he feels badly for me.

When I set about to start this blog I wanted it to also be a patient perspective because I found that difficult to find when I was researching my treatment options.  So let me give you some more information about the shots and clomid.  I haven't had any significant side effects like nausea, pain, headache, etc. although maybe I could blame it for my slightly runny nose and acne..no the nose is from all the dust that's been in the air lately and the acne is just PCOS off of birth control.  The clomid does seem to make me sleep heavier than normal which means Handsome has to kick me when its my turn to let out the dogs.  One time, last injection cycle, I did have bruising around the injection site but I think it was perhaps we hit a blood vessel and/or the fact that my pant waistband kept hitting the site.  I highly recommend that when you choose your site you choose one below where your pants sit, if you go higher than when you sit your waistline usually goes higher and can aggravate the site.  Although I did have visible bruising there was no soreness associated with the bruise. 

I have spoken about the HSG, hysterosalpingogram, before but wanted to give a better description from a patient perspective.  I actually enjoyed it it was fascinating to watch and I almost recommend everyone go get one so they can see how cool it is.  I was taken to a bathroom that has two doors.  One door goes to the hallway and the other goes to the examining room.  The door to the examining room was locked and I was told to lock the hallway door.  I did so and as instructed removed all clothing from the waist down and wrapped the gown (a thin piece of tissue paper the size of a small blanket) around my waist.  When I was called into the examining room I got up on the table but unlike most doctor's tables I have been on this one was tilted backwards probably about 15 degrees so that my head was lower than the rest of me.  The x-ray machine was placed over my abdomen and turned on.  It took me a few moments to figure out what i was seeing because the aspect was weird.  I was seeing my hipbones but not flat on tiled like we were looking up at them if I was standing.  I could also see a little bit of my spine angling away.  Now this next part I couldn't really see what the doctor was doing so I will relate what I was told.  A thin tube was inserted through my cervix into my uterus, Dr. Moffitt kept asking me to cough and I finally asked why and he said it pushes the cervix so it opens a little bigger and makes it easier to thread the tube through the cervix.  There was no pain, almost no sensation at all.  I have heard that it is better to have an experienced doctor (usually a fertility expert) than a xray tech because the doctors have done the procedure more often.  Once the tube is in place they fill your uterus with a contrast dye that shows up on the xray screen.  It is really neat to watch your uterus suddenly blossom on the screen and you can see it floating between your hips.  Once the uterus fills the dye does into the fallopian tubes and you see them drawn on the screen.  This test tells the doctor about the shape of your uterus, if there are fibroids or pollyps, and blockage of one or both of the fallopian tubes. Mine looked fine.  I was expecting to then see my ovaries but this was before I knew that the ovaries aren't really connected to your fallopian tubes just nearby for egg transfer (maybe i should have paid more attention in sex ed?).  After the procedure is done you get up, get dressed, and leave.  They do recommend a pad for any discharge of the die but I don't remember there being an issue.

Well that's all for today.  I talk about some of the other procedures later.  TTYL
Sorry no pictures but I don't have good pictures of my HSG - I'll try to get them.

"With the hip bone connected
to the back bone,
and the back bone connected
to the neck bone"

Sunday, February 26, 2012

The Spindle

Things are really moving along.  Friday was CD1 (cycle day 1) and I got to go to lunch with Mom as she and Patsy were up here to go to the Container Store.  My first medication treatment is today, CD3, and I will be taking 2 Clomid pills before bed and an FSH shot at 9pm.  I am choosing 9pm because it is a time I know that we can hit each day.  On CD 9, Saturday, I will be going in for a midcycle follicle check to see how many follicles I produced.  Hopefully I have produced 2 – 6 and not one giant cyst or too many follicles.  I have added some pictures of the injections.  Although this injection seems easier than the trigger shots the way Handsome holds the shot is a little scary (it kinda reminds me of the knife scene in psycho) but there isn’t really a better way to hold it.
This is the follistim "pen" kit.  The pink items are needles that screw into the pen.  The vial is an old vial from my last injection cycle and it goes into the pen where a plunger dispenses it.  The yellow dial on the end of the pen can be dialed for the appropriate dosage.  Tonight's dosage was 125.

This is one of those pink packets.  You can see one end of the needle inside which goes into the vial and screws on to the pen.  You can also see the cat's dish and Heidel's new harness in the background.  We do this in the kitchen so these aren't the prettiest pictures.  We do this in the kitchen because the follistim has to be refrigerated.

Handsome is screwing the needle on to the pen, while he is doing that he has me clean the injection site with alcohol.

Here is the pen all set to go with the cap still on the needle.

These next two pictures are at a weird angle because I wanted to try and get the actual injection.  You can see here how my husband holds the pen and it looks very stabby.  Look how fine the needle is!

Contact!  Here is the needle in my stomach (I am pinching the skin as shown by the nurse) and my husband is pushing the plunger to get all the medication in.  It doesn't really hurt because the needle is so fine.  So now I am off to take my clomid and then to bed.  Talk to you guys soon!

"And, in the very moment when she felt the prick, she fell down upon the bed that stood there, and lay in a deep sleep."
Grimm, Jacob; Grimm, Wilhelm; Charles River Editors; Taylor, Edgar (2011-11-29). The Complete Brothers Grimm's Fairy Tales (Illustrated) (Kindle Locations 3451-3452). Unknown. Kindle Edition.

Wednesday, February 22, 2012

Doctors and Puddles

YAY!!!  My doctor's appointment was this morning and although it went long it was confirmed that the cyst has gone!!!  My appointment was at 7:45 and they didn't see me until after 8 and then after the ultrasound I had to wait for a quick teaching visit for my meds so this appointment was much longer than I was used to.  I think the delay was the fact that they apparently had had a bad leak and were cleaning up many of the offices.  I heard someone say that one computer had been immersed in 6 inches of water but they had dried it out and it was still working.  The were trying to soak up and vacuum up as much of the water as they could.  Handsome asked if it cost us bags of money but a cyst check is covered by insurance so we just had our $35 copay.  The cyst check is a vaginal ultrasound like all of my mid-cycle ultrasounds have been.  When I saw the image on the screen and saw my normal chocolate chip cookie PCOS ovaries instead of a large black cyst I was so happy.  I have no done this so many times I can actually identify much of what is on the screen.

So I am off the Aygestin as of now (good thing since I took my last one last night) and if I start bleeding I will start my medication on cycle day 3 (CD3) otherwise if I don't bleed I will start Monday.  Dr. Moffitt warned me that I most likely won't have a normal cycle and may even only have a drop.  So below you can see some pictures of my goodie bag with all my medications.

  • The white tablets in the upper right corner are Clomiphene Citrate, Clomid, and help stimulate ovulation.  I will take 2 pills each night before bedtime CD3 - CD7
  • The grey box under the syringes is my Follicle Stimulating Hormone (FSH), Follistim which goes into a epi-pen like device and I will take 125 units on CD3, 100 units on CD4, 75 units on CD6, 75 units on CD8, and 50 units on CD10 if my midcycle ultrasound indicates it.
  • The small white box in the middle (its kind of hard to see) is my trigger shot and is mixed and given using the two syringes
  • Finally the ziplock bag is Ciprone suppositories which are for after the IUI to make sure the luteal phase of my cycle is long enough
I will go in on CD9 for my midcycle ultrasound to discover if I have made 2 - 6 follicles or if I have created another cyst.  The hope is that I will have 2 - 6 follicles in which case we will proceed with the IUI and BAM! hopefully I will get pregnant.  The cost of all of this medication was $341.77 and the midcycle ultrasound will be another $290.  I have a sheet of paper with everything I am supposed to take, how much and when, mapped out. 

"Doctor Foster
Doctor Foster went to Glo'ster,
In a shower of rain;
He stepped in a puddle, up to his middle,
And never went there again."


Monday, February 20, 2012

Stone Soup

Today's entry will have a little bit of everything and anything.  I would like to start off with some politics.  I try and stay away from discussing politics in an open forum because I don't like to argue with people who have different opinions since it is rare that either one of us will convince the other.  However sometimes I get so passionate about an event or viewpoint that I must speak up - this is one of these times.  I think that EVERY American women should be furious that the House Oversight and Government Reform Committee had their first hearing regarding the Obama contraceptive care decision without one woman on the panel and without any testimony for women.  I do not think that every women should be angry because I believe they would all agree with me, I don't I am very aware that many women have different views than mine, but this is a panel discussing women's rights and access to health care and to not have even one women is mind boggling.  Personally I think this panel should be made up of primarily women from both sides of the argument.  In response to Rep. Issa's declaration that "the hearing is meant to be more broadly about religious freedom and not specifically about the contraception mandate in the Health Reform law." is ludicrous when the mandate was the primary item of discussion and object of the witnesses hypothetical examples.  Rather than hypothetical examples wouldn't it be better to get real examples from women?!  I will concede that the second hearing will include two female witnesses but it is sad that the first hearing included none, that the second will still have women in the minority, and that there is not one woman on the panel.

Okay, enough about politics... want to hear some good news... no, some GREAT news (no not pregnant yet).  I am getting a new job!  I was made the offer last week and accepted.  I gave my current company 2.5 weeks and will be starting my new job March 5th.  I think there is more room for career growth at this new company, I will be on the cutting edge of semiconductor process engineering research and so will expand my resume and skill set, and let us knot forget that it is a SIGNIFICANT increase in pay - woo hoo!  So part of me is a nervous wreck but the other part of me is super excited and I just have to keep telling myself I had to get trained for my current job and now am comfortable and it will be the same with this new job.  They have already discussed training with me and I don't think I'll be thrown directly into the fire on my first day ;)

I also finished the stuffed owl I was making for my friend Beth.  It turned out really well and I love the colors she picked.  It really has a masculine feel to it, perfect for her upcoming little boy.  The second picture is the back of the owl which shows the little caterpillar on his butt.  All the owls I make (only two so far) have something cute on their bum.  Mom helped with this one and the machine sewing - I HAVE to get a sewing machine now, made things so much faster.

I call him Winston but like any adopted pet Beth and her family may decide to change his name and that is fine too.  I really enjoy making these owls and if someone has a request let me know just don't all ask for one at the same time.  The decorative stitching is all hand embroidery and I find it relaxing to do while watching TV.

So I think that is about it today.  Only two days until my next doctor's appointment!  Hopefully that cyst is GONE and we can move on.  TTYL

"More and more villagers walk by, each adding another ingredient. Finally, a delicious and nourishing pot of soup is enjoyed by all."

Sunday, February 12, 2012

Red Roses

No, I didn't get red roses for Valentines day but my husband did take me out to Cheuvront's for dinner last night.  I have been wanting to try it and it was good! Didn't get any pictures this time but for an appetizer I had the Salad Caprese with Burratta cheese which is the freshest most delicious mozzarella you can get.  Handsome got the house salad and then he got the chicken breast over wild arugula, mushrooms and hand made gnocci.  He let me try some and it was really good and I usually don't eat chicken at restaurants (has to do with my OCD... too much to go into now just take it from me I am fairly picky).  I got the fillet with crab risotto - the fillet was delicious and although the risotto was a  tad undercooked (Ramsey would have yelled at the chefs and thrown it back) the flavor was amazing!  On Friday night we didn't have anything ready for dinner so we went to The House which is our standby since the food is always fabulous and it is so close!  I had the cauliflower soup and smoked trout salad and I am drooling right now thinking about it.  Tonight Handsome is making bison burgers with onion rolls for buns.  Need I say how much I like to eat good food?  Just a short post today because I have to go eat - YUM- but wanted to just drop a note.

10 more days until my next check up!

Rose are red
Violets are blue
I love good food
How about you?

Friday, February 10, 2012

Chocolate Chip Cookies

In the picture above the thing that looks like a chocolate chip cookie is a polycystic ovary.  This one isn't mine (I'll try and get a picture of mine) but it looks similar.  The last couple of appointments I had seen PCOS with an x marked next to it so at my last appointment I flat out asked the doctor is I had polycystic ovarian syndrome, PCOS.  He seemed kind of quiet and surprised but he told me yes.  I asked if this had anything to do with my fertility issues and he said it was likely.  Why wasn't I made aware of this earlier - it may not have changed things but I would like to know exactly what is going on with my body.

Looking up PCOS came up with lots of scary information:
  • Its actually a suite of possible causes and effects and there are different "types" of PCOS depending on what drives the issue (hormones, ovaries, both) and the effects
  • It is easier for women with PCOS to gain wait and harder for them to lose it
  • They can have anovulation (lack of ovulation) issues which leads to infertility
  • Many with PCOS have acne - that explains why my skin still acts like I am a teenager
  • Many with PCOS have male pattern hair - whatever hair I am not supposed to have will stay between my salon aesthetician and me
  • Women with PCOS have a higher rate of pre-eclampsia, gestational diabetes, early birth and high weight babies
  • Miscarriage is reported to be higher in women with PCOS
Those last two points are terrifying.  I have had one miscarriage and it is an experience I would like to avoid in the future.  Online literature seemed to recommend metformin to help women with PCOS ovulate and reduce the chance of miscarriage.  Sounds like a miracle drug BUT (and it is one big but) people have to be ramped up to the standard dose because it is so hard on your system.  They have to monitor your kidney and liver as it can harm those systems and it does a real number on your digestive system causing both nausea and diarrhea (FUN - sarcasm... there needs to be a sarcasm font). 

I wanted to talk to my doctor about this and I'm top impatient to wait until my next scheduled appointment (12 days and counting!) so I called ARMS' nurse line and left a message basically asking if based on the fact that I have had a previous miscarriage and have PCOS if there was a reason why or why not metformin would be suggested.  I have to say that ARMS got back to me super quick.  The nurse called and got some more information from me and let me know a little more about the drug (that big BUT I talked about) and said she would speak to Dr. Moffitt.  Dr. Moffitt himself actually called me back!  He said that he had recently been to a seminar/conference about metformin and that more and more research was pointing away from metformin that it might not be the miracle drug they had first thought in terms of both ovulation and miscarriage.  He said they were fully turning away from metformin for PCOS in the UK and that here in the US they are not seeing the prevention of miscarriages through the use of metformin.  He also said that metformin for ovulation is typically only pursued when clomid doesn't work and we know that I have ovulated on clomid.  He also indicated that there would be little benefit to metformin with the super ovulation and IUI cycles that Handsome and I want to do.  So do I trust my doctor or the internet - my doctor of course.  The problem, in my opinion, with getting medical information from the internet is that many times the information is old, traditional thought while my doctor is constantly updating himself based on new data.  In addition, You never know exactly who is putting out that information and if it applies to your case.  That is the biggie - Dr. Moffitt knows MY case, what is happening with me and so I think he can make the best decision but I am glad I asked so I don't have to regret not asking later.

Well that is all for today, check out my new "Kindle Corner" section below where I talk about all the books I am reading.  I am currently on the 3rd article/essay in Women of the Cousins War - I love the information but the pure history is dry and I need to go back to fiction for a while.

"C is for cookie, that's good enough for me Oh, cookie, cookie, cookie starts with C, yeah!" 
Yeah I know its not a nursery rhyme or faerie tale but come on its Sesame Street!

Read more: SESAME STREET - C IS FOR COOKIE LYRICS http://www.metrolyrics.com/c-is-for-cookie-lyrics-sesame-street.html#ixzz1m1GZbQxq
Copied from MetroLyrics.com

Monday, February 6, 2012

Sleeping Beauty

So sorry not to have posted in so long but it seems I have been spending most of my time sleeping.  I make sure to go to work, attend my personal training sessions and other appointments and scheduled things but any free time and I am usually asleep or at least laying down.  I think it is a combination of the medication I am on to prevent a cycle while I wait for the cyst to resolve, Norethindrone Acetate, which can cause drowsiness and the cough that I can't seem to get rid of.  When I sleep it isn't a good sleep because I am always waking up to cough and it feels like I am drowning.  I was taking mucinex and that seemed to help but I hate being on so many pills! 

I tried taking cough medicine but as my Mom could tell you I never was any good at taking my cough medicine.  I thought surely it can't be that bad - I'll just knock it back and be good for most of the day.  Ugghh!!!!  I gagged and almost threw up - it was as bad as a I remembered maybe even worse.  Just thinking about it makes me nauseous and I had to breathe deep until I could get some water to wash it down.  So no cough medicine for me thank you!  Tonight Handsome was also tired after work and came to nap with me but i couldn't stop coughing so I finally got up so he could rest.

This weekend was lots of fun, I went to a Dream Dinners tasting with my friend Beth as part of a group.  It is a pretty neat idea where you can prepare dinners all at once (using their spoons and stuff so no clean up) and then take them home , throw them in the freezer, and bring them out for dinner.  I made a mandarin orange chicken with vegetables that we may have tonight if my husband ever wakes up.  The only drawback is that there weren't a lot of choices that would fit the picky tastes of both my husband and me, and that you had to buy so many servings at once.  36 servings was at least $150 and I don't know that I have that much room in my freezer but it is something to consider.  I also got to go to a baby shower for my friend Beth - congratulations again Beth!  She is considering both cloth diapers and disposable so I made her a diaper cake with prefolds.  Well actually my Mom was the one who constructed it and I just decorated it.  It looked fabulous if I do say so myself.  I even won a prize in the diaper raffle (you entered the raffle by bringing diapers to the shower)

Some people I know who have had issues with fertility have said they had a hard time being around friends and family who were pregnant.  I won't deny that I sometimes find it hard as well and think "why me", "it's so unfair" etc. but I try to look at the positive side that someday I WILL get pregnant and I'll want and need the same support I am giving them.  Plus who doesn't like babies?  With my close friends I am so excited for them that it usually doesn't bother me but I will say that sometimes when an acquaintance says they are pregnant (usually on facebook) I kind of want to punch them.  I know its not their fault and I know that i don't know their whole story - maybe they had fertility issues too but sometimes that feeling is there.

A friend of mine commented that it was "difficult to know what to say that will be a comfort to you during this time" to me so I thought I would compose a little DOs and DON'Ts as they apply to me.  Everyone is different so other women might feel differently about this list but I think at least a few will be universal:

DO ask questions.  Yes it is sometimes hard for me to talk about but it is also cathartic and I would rather talk about it than you be afraid to bring it up making it seem secret and shameful.
DON'T tell me if I just relax or just stop trying that then I will get pregnant.  This isn't magic people, I have an ovulation issue and a doctor's help in trying to work through it - relaxing isn't going to do anything - I already tried that.
DO offer sympathy.  I don't need you to fix my problems I am already working on that with my husband and my doctor but a shoulder to cry on, a friend to lean on, the affirming words "that sucks!" are all things that I want and need.
DON'T tell me its all in God's plan.  I don't mean to offend all of my religious friends and family but guess what I have my own plans and they don't include spending thousands of dollars and over two years struggling with infertility.
DO tell me about your own experiences.  Only if you feel comfortable of course but when others tell me their stories it helps me not feel so alone in this struggle
DON'T ask if I had the miscarriage because I drank some tea (caffeine) or in any way insinuate in the smallest degree that it is somehow my fault I had a miscarriage.  It isn't and although I can say that from a logical viewpoint I am already blaming myself enough I don't need your help.  My miscarriage was almost certainly due to the non-viability of the embryo something chromosomally wrong.  None of my eating, drinking, or activities were adverse to pregnancy.
DO feel free to laugh about the funny things.  Sometimes if I'm not laughing I'd be crying and there are some things that are funny
DON'T expect me to take all your advice.  Advise is a tricky thing.  I don't mind you giving advise with things that helped you or helped friends of yours get pregnant, but realize that I am an engineer; I beleive in science and medicine and I am going to vet everything through my doctor.  So don't get offended if I don't try your acupunturist, or your homemade soup, or dancing naked under the moon - it may have worked for you but I'll stick with what I know.
DO DO DO keep me in your thoughts or your prayers and feel free to reach out.  A little good energy never hurt anyone and if nothing else it will make me feel better.

Please try not to be offended by anything I put in my Do's and Don'ts list.  Again I can only say that this applies to me.  If you have other friends or family going through fertility or pregnancy issues then please talk to them and find out their Do's and Don'ts list.  The worst thing you can do is be afraid to talk to us, I think we would all rather you tried to reach out and say the wrong thing than cutting us off altogether because you don't know what to say.

"And, in the very moment when she felt the prick, she fell down upon the bed that stood there, and lay in a deep sleep. And this sleep extended over the whole palace; the King and Queen who had just come home, and had entered the great hall, began to go to sleep, and the whole of the court with them. The horses, too, went to sleep in the stable, the dogs in the yard, the pigeons upon the roof, the flies on the wall; even the fire that was flaming on the hearth became quiet and slept, the roast meat left off frizzling, and the cook, who was just going to pull the hair of the scullery boy, because he had forgotten something, let him go, and went to sleep. And the wind fell, and on the trees before the castle not a leaf moved again."
Grimm, Jacob; Grimm, Wilhelm; Charles River Editors; Taylor, Edgar (2011-11-29). The Complete Brothers Grimm's Fairy Tales (Illustrated) (Kindle Locations 3451-3456). Unknown. Kindle Edition.