Doctor's appointment

I'm just writing a quick post because I am exhausted from a long car ride that included being stuck in D.C. rush-hour traffic. I just wanted to say that my appointment went great. My doctor is really encouraged by my cycles, is sure that I am ovulating and thinks I will get pregnant without the help of drugs. That being said, I asked him if I could start taking Clomid or Femara, and he said that'd be fine. He suggested Tamoxifen, since another doctor in the practice, who is a NaPro doctor, has been starting to use it with patients. Does anyone have experience with this drug? I've read about it on wikipedia and I know it's used to treat breast cancer. I was just wondering if anyone has any personal experience

I will start taking it probably this week, since it's taken on days three through seven. I am getting estradiol drawn on day three and then estradiol and progesterone drawn on peak +7. I think. I don't have the information in front of me.

I also am now officially at forty pounds lost on the doctor's office scale. And that was even with a full bladder (although I did get to take my shoes off. The nurse actually told me I could disrobe as much as I'd like. I'm like, "Don't tempt me!"). My doctor was really happy that I'd lost another five pounds, despite the fact that he said last time I could maintain now. I have been maintaining - adding back in some fats - but I still lost. Then when I got home, I weighed myself here, bladder completely empty and fully disrobed of course, and weighed the lowest I've weighed yet and the lowest I've weighed since college. The amount put me into a new decade of weight and one that I only dreamed about being in for years.

I just can't wait until I get pregnant so the positive effects of this diet can be fully seen. I hope it will be the encouragement that others need to stick to it. I mean, my weight loss might inspire some, but not as much as a pregnancy would. And for selfish reasons, I hope God decides to use me in that way!

I did get the adoption physical done, except for the TB test, and my doctor even commented that I'll probably get pregnant after I send it in. I know that is often a myth, but he is my doctor and he does happen to think I'm going to get pregnant real soon. He even said he expects a call about a positive test in the near future.

I also told him how way back at our first appointment with him, he said how the metformin and the diet will make me feel "whole" again. I said that for many months after starting treatment, I still didn't feel whole. That is, until November. I said I now know what he means. He was happy about that and said usually when a patient tells him they feel whole, they're pregnant within six months! 

So I feel very positive and upbeat right now. I hope this feeling lasts through a new cycle starting. I'm on 12 days post peak (by the way, he said my luteal phases are a great length), and will probably start a new cycle tomorrow. I start the Tamoxifen on day three, so that is right around the corner. 

I also listened to a book on CD during my drive, and it gave me great insights into my struggle with infertility and my faith. It's called Left To Tell by Immaculee Ilibagiza and is on loan from Lifehopes. I'm sure some of you have heard of it. I didn't finish it yet, but already it has really made me excited to go deeper into my faith. I don't want to waste this time of struggle and hardship. I often think about how if I am to become pregnant, that I'd look back on how I handled this painful time and wish I'd suffered more gracefully. I want to turn over a new leaf and do just that before it's too late. I'm going to post more about my thoughts in the coming days.

Oh, and one more thing. I know some of you have asked in the past about my progesterone level I talked about in October, that my doctor had deemed perfect. I found out today it was 16.7. He reiterated that it is ideal. I know sometimes blood work can't be compared to other blood work taken at a different lab, but that is mine, for what it is worth. I also asked him about my LH and FSH, and he said when it was tested in October, one was 5 and the other was 4, making it a 1:1 ratio (he told me which was which, but I can't remember). He said that for all intents and purposes, I don't have PCOS anymore, but obviously that's because it is being controlled with medication and diet. If that were to be stopped, it would come back. I just love knowing that I am currently free of it, though!

So this obviously didn't end up being a short post. I always have good intentions to be quick, but then I just write and write! I am about to bake some low G.I. Christmas cookies so I will take pictures and do a post about them. My mom made the cookies last week and they were delicious. You'd never know they were made with Splenda and white wheat flour! I am going to go one step further, though, and make a low G.I. frosting as well. I hope it comes out good!

Cycle update and Carmie J.

Isn't it funny how once we ovulate (or have an "ovulatory event" - I'm not going to believe I ovulated until I get pregnant), we forget what cycle day we're on? At least I do. I started to write what day I'm on and I have no idea. So, instead, I will say that I am eleven days past peak. Eleven days and no spotting in sight, at least at this very moment.

Last cycle I think my luteal phase was eleven days. The cycle before that it was twelve. So I might start tomorrow, or I might start on Tuesday. Or I might not start at all. Hahaha... Of course I am just kidding! What a jokester I am. I definitely do not feel like this cycle is any different than any other failed cycle. I feel pre-menstrual (whatever that means, since it always seems to manifests in different ways) and nothing feels out of the ordinary. I've had a sensation in my legs on an off through the entire cycle, so that can be checked off the list. I'm starting to get depressed, which always happens. And my bbs are sore, but, then again, that could be my new bra.

Not starting my cycle is a good thing, I guess, since I'm going to the doctor tomorrow. If I am able to start taking Femara, then at least I can start it this cycle. I have to say, my doctor's appointments always seem to be scheduled at just the right time (this has not gone unnoticed, God!), which usually means the perfect time for whatever necessary blood work. Tomorrow it will hopefully mean the perfect time for drugs.

The actual reason for tomorrow's appointment is for an adoption physical. I'm a little nervous about how it will all go down. See, at my last appointment I asked my infertility doctor (not that that's his official title) if he could do the physical when the time came. He said yes. I knew to ask because a friend of mine goes to him as well, and he did her adoption physical. But then when I called to make the appointment, the woman on the phone acted like that was nuts and said he can't do that. So, believing that she was nuts instead, I went ahead and made the appointment for an annual. I hope that when I get there tomorrow I will tell him why I'm really there, hand him the physical checklist and he will say okay.

Let's be honest - the adoption physical is just a front. More face time with him means more time to talk about my cycles, which means more time to figure out what's going on, which means more time to get me pregnant. If he says tomorrow that he can't do the physical, I will just schedule one with a primary care physician, and I will at least get a chance to show him my chart and ask for Femara. It will be more than worth the three-hour round-trip drive.

So hopefully I'll have a lot to update tomorrow!

On a completely unrelated topic, I got a new camera for my birthday and I love it. It's 13.6 megapixels. 13.6! To put it in perspective, the four-year old camera we got for our wedding that I have been using was only 3.1. That's like quadruple the megapixels!

To show the fruits of my new camera, I thought I'd post a picture of one of my cats, since they don't get a lot of attention on this blog (although they just did, in fact, get some play when I posted our Christmas card photo last week. Speaking of that picture, I later realized I messed up because I failed to post the actual Christmas card in which I included the bible verse for which this blog is named. It was a little shout out to anyone on our Christmas card list who knows about the blog, which is about three people, or so I hope. Anyways...)

So this is Carmie:



Or Carmie J. as Ryan likes to call him. He's definitely our most photogenic pet (sorry Sophie and Jasper). He's also the fattest, by a landslide. He's also on the bottom of the pet totem pole - he is dominated by both Sophie and Jasper and any other animal that visits our house, for that matter.


Isn't he cute, though?

He's named after Carmelo Anthony who played for our favorite college basketball team, Syracuse, when they won the national championship. At the end of that season we went out in search of an orange cat to name Carmelo. We attempted to call him Melo, which is his namesake's nickname, but it just didn't stick. He's definitely a Carmie.

We say that Carmie is a lover because when given the choice of where to sleep in the entire house, he chooses right next to you with at least one arm or leg wrapped around you. It's the sweetest thing, but also hot in the summer.

So that's one of our pets. To make use of my camera, I'll profile the others in the days ahead, so get excited!

News

So we had the homestudy today. It went fine. We basically just answered 50 questions about our relationship. Some of the time I felt like I was answering the interview question during a beauty pageant - trying quickly to come up with a good, concise answer without sounding completely unintelligent - while the rest of the time I felt like I was at a job interview. There were a lot of those "what is your greatest weakness" type of interview questions where everyone answers, "Well, I'm a perfectionist..." or "I just expect so much from my co-workers..." So we tried to answer honestly while balancing not coming across like weirdos yet also not seeming too perfect (I think I talked about fighting two times, but if someone said they never fought I hope that would be a red flag!). We were also given tons of paperwork which we need to finish by our third appointment. Things are moving along quickly, though, as our second homestudy appointment will be two weeks from today.

If it seems like I am moving through that pretty quickly, well, I am (normally I'm not exactly short-winded, but it's not like I had to tell you all that). Not to take anything away from it, but my focus tonight has shifted a little to some amazing news.

My blood work came back perfect. That's right. It's all normal.

My doctor's office called me tonight and left a message. Since I didn't answer in time, I seriously whimpered and cried for the next twenty minutes at the prospect of having to wait until morning to call them back (it was after hours) for what I assumed would be my test results. As I was just beginning to calm down, my phone rang again. It was the nurse.

Nurse: "Dr. B wanted me to call and let you know that your lab results are in. [Holding my breath at this point] The tests came back normal. Everything was perfect. It says here to continue your medicine and it also says that you can go ahead and try to... conceive? Is that the word he wrote? Conceive?"

Me: [In shock at this point] "Yes, that's the word."

Nurse: "Oh, you are starting to try to conceive. Okay."

Even in my utter disbelief at my good fortune, I had to chuckle at the nurse's assumption that we were just starting to try. But then I realized, oh my God! We are starting to try!!!! I think I was in shock after I hung up. Seconds after telling my husband the news, I had to ask him, did that really happen? She might as well have told me I was pregnant.

What does this mean? Well, I assume it means my PCOS is under control (I say "assume" because I didn't speak directly with my doctor tonight, although he did tell me this was the case at my appointment last week, so I shouldn't be hesitant to write that). If I went off the medication and started eating normal again, it would come back. But for all intents and purposes, my hormones are behaving like someone who doesn't have PCOS right now.

When my doctor first told me I had PCOS, he said he'd treat me like he treats all his patients, but there's no guarantee I'd react how he hoped to the protocal. Some women do and some women don't. At my appointment last week he was actually excited because, he said, he lays out a treatment plan and when it works like it is supposed to, it's exciting. Now we know for certain it worked like it was supposed to. My body actually did what it was supposed to!!

So here we are. I'm not used to getting good news. The world seems a little brighter, like a dark cloud lifted. I'm not kidding. I know I still might never conceive (I'm a pessimist, don't forget.. or a "realist" as my husband so affectionately kept referring to me during our homestudy meeting today). And I know that my peak plus seven blood draw coming up this cycle might show a problem (although I have to believe if something is wrong with my progesterone, it wouldn't be as difficult a fix as what I've already overcome). But right now my hormones are back to normal, my prolactin is normal, my testosterone is normal and most importantly, my LH/FSH ratio that was crazy before is back to normal. For all this I thank God. I still don't know or understand his plan - and I know the ride is a lot easier to take when things are looking up - but we still have a long road ahead and I just hope that I can continue to trust in him the whole way.

Now I am going to go celebrate with some strawberries dipped in a little bit of chocolate.

Doctors appointment

Sorry it took so long to write this update! We just got home. So here are the details:

We left late to get to the one o'clock appointment, raced there and arrived 15 minutes late only to find out that the appointment was at three. They probably tried to call me to change the time, but my phone number changed and of course I never thought to call my doctor's office and let them know. Thank God, though, that it was changed to three and not earlier today. Whew!

After sitting at a Star.bucks for an hour (I'm starving at this point since I refused to eat before my weigh in), we headed back over.

So the big weigh in. Well, with my clothes on (obviously) I weighed the lowest I've weighed since starting this diet (and the lowest I've weighed in about seven years). I have officially lost 35 pounds! That was my original overall goal! I couldn't believe it. I was hoping to make the 30 mark today, since it's with clothes on and everything. As I walked back to the examination room, I heard the nurse mumble, "That can't be right." I asked, "What, my weight?" And I told her yes, I had in fact lost 35 pounds since my April 29 appointment. She's like, "I'm thinking, she's so tiny, that couldn't have been her weight!" Oh my goodness, I don't think anyone's ever called me tiny before! But it gets better. When my doctor came in, he starts looking at my chart. He looks at me, back at my chart, then at me, then at my chart. I was starting to think he didn't remember me and was trying to remind himself who I was! But actually, he was in shock at my weight loss! When I told him that yes, I had lost 35 pounds, he got up and hugged me! He was blown away. I definitely got an even better reaction that I'd ever dreamed!

Okay, so on to the appointment. Let me just say that I LOVE my doctor. He's amazing. He immediately started telling me what the weight loss meant. First of all, it meant that I definitely was insulin resistant and I definitely have drastically changed my body, my hormones and my PCOS by this weight loss. He confirmed my hope that the fact that the diet worked so well is great news - it means my body reacted just like it was supposed to to the diet and the metformin (I'm getting blood drawn tomorrow to confirm this, as well as a peak +7 draw, but I assume that if the blood work comes back that my levels are still off, that he'll say my body just needs more time. He thinks we're definitely on the right track).

I just can't explain how encouraged he was. I went through my questions and brought up several things I was worried were problems. He got more and more excited at every "problem":

The spotting mid cycle? He thought this was great news. He thinks it is a definite sign of ovulation.

More spotting a few days later? More good news! He thinks this is a sign that my body is working to correct itself. He even said it might have been the step before implantation (not sure what he meant and I didn't ask, but, hey, it sounded good!).

My wacky cycle two months ago, just as my cycles seemed to be getting more normal? Perfectly fine! He says that my body is trying to catch up to my weight loss and he entirely expected me to have a crazy cycle. He says my estrogen is changing due to my weight loss, and my body is kind of shell-shocked and is trying to adjust.

My recent pain that I thought could have been due to endo? Since I realized once I thought about it that it was right before my peak day, he's sure it was from ovulation. He wants me to start charting my pain (which I'm supposed to be doing anyways) and he wrote a prescription for an u/s if it gets bad again, just to see if it's a cyst or anything. He also said that if it comes to the point where we want to do another surgery, that the NaPro doctor/surgeon in his practice can definitely do it, but he thinks I'll get pregnant before that.

Yes, that's right! He thinks I will get pregnant! To put it in a nutshell, he is extremely excited and thinks we might even conceive on our own! ON OUR OWN! He said that we should start counting this cycle as our first that we ever even had a chance. Sure, the blood work might come back that my hormones aren't perfect yet, but he is convinced my body is on the right track. All the right things are happening and there is a chance it might take a little longer. Even if the blood work comes back good, he said he wants us to try on our own for six to nine months before trying Clomid or Femara. I'm fine with that, surprisingly, because he thinks we have a shot! And also because 1) I know that throwing Clomid at someone before they're ready for it does no good, 2) I suddenly have much more patience (which probably has to do with receiving this good news and also with adoption [I swear I'll blog about this soon]), and 3) he actually told me that if, through my prayer life, I decide I want to try Clomid sooner to just give him a call. Is he not the best doctor ever? How many doctors say that?! My husband later commented what a great aspect of the Catholic faith this is - the combination of science and prayer.

A couple other extraneous things we talked about - the spotting before and after my period that I had been seeing he says is normal in infertile cycles, as well as the stopping and starting mucus that was pretty normal for me in the past. The fact that my mucus is now a constant eight or so days, and that during this last cycle the spotting after my period and before this current one was much less, he says is great news. He says when that spotting clears up (thanks to my hormones getting back to normal), that's when I really have a shot at getting pregnant. He also says that it's not a problem that I go from red stickers right to white ones at the beginning of a cycle. He says it's perfectly fine and makes complete sense, since I have about 5-7 days for my period, 8 days of mucus, and then an 11-14 day luteal phase.

So it was a great appointment. I went into it thinking it wasn't going to be very informative, since we had no results of any kind to look at. I figured he'd ask for some blood draws and that'd be it. We were blown away at what he said, his reaction, and his positive outlook. And all of this was based on my weight loss and my report to him of my recent cycles (plus, I forgot my charts. Can you believe it?).

I am on cloud nine. I hope during the coming months, when I'm sure I'll have many "cycle day ones," that I don't lose this hope I now have. It's always easier to have patience and trust when you're coming off of a good appointment. I just really, truly feel that this is God's plan for us. Now, let's hope that good blood work results are also part of his plan! Kidding. With his help, I'll deal with whatever that plan may be.

Questions for the big appointment

So, if you haven't heard, my doctor's appointment is tomorrow. Sorry, I kind of have a one-track mind. It will be my third appointment with my NFP-expert doctor (not a PPVI-trained doctor, but very, very familiar with NaPro) at the wonderful Catholic, pro-life medical center that I am so lucky to live near. He will be checking to see if the metformin has helped my problem with insulin resistance and my LH/FSH ratio. If it has (which I assume we won't know tomorrow), he'll supposedly put me on either Clomid or Femara. If it hasn't, I'm hoping that just means more time on the met, giving it more time to work, and maybe even upping the dosage. As you can probably tell, I'm already trying to convince myself that finding out it hasn't worked yet won't be the worst news in the world.

I've been thinking a lot about questions I need to ask him. This time I am actually going to print out the list, bring it into the doctor's office and read from it, unlike last time when I forgot to write them down and my mind completely blanked.

Here are the questions I have so far. Feel free to offer any insight you may have on any of these!

*I have had some abdominal pain on a pretty regular basis around the end/beginning of my cycles, and it feels a lot like lower G.I. pain. Could it be endometriosis returning?

*Will I need another laparoscopy at some point? How do we know my ovaries aren't re-stuck?

*This cycle I've had a lot of pain near where I assume my left ovary is.

*I often feel a ton of pressure on my bladder, to the point of it being painful, even after I have just peed (yet it doesn't burn like a uti). Should I be concerned?

*I usually go right from red stickers to white stickers. Is that normal?

*I often have a lot of spotting at the end of my cycle and at the end of my period. Should that be treated?

*This cycle I had spotting in the middle of my cycle and in the middle of my luteal phase.

*If my insulin resistance/LH FSH ratio hasn't been helped by the met, can we raise the dose?

*My husband hasn't had any tests done in three years. Should he get tested again?

*Can you explain what it actually means that my ovaries are slow, and if I ovulate, then where's the problem?

*And what exactly is my estrogen and progesterone doing wrong again?

*Oh, and can I have a photo copy of my last hormone series?

I don't want to forget that last one! I want to bring it home and stare at it with all my medical expertise and decipher what is really going on. Kidding, of course. Actually, I really want it so I can post it on this blog for you to all also ponder with all of your medical knowledge. I'll take anything I can get in between doctor's appointments!

Hopefully I'll have some good news to report tomorrow night. At least I'll hopefully have good news that my weight loss on the doctor's scale was more than thirty pounds. Is my extreme focus on my weight tomorrow a sign I'm diverting attention from infertility? Perhaps. I guess, now that I think about it, I'm doing this because it is something I can control. The one thing I can control. Suddenly it all makes sense! The hardly eating this weekend, the trying on of several outfits to see which weighs the less but is also weather appropriate... sorry. A light bulb just went off.

I also wanted to thank everyone for their very kind comments lately. You're all just so sweet! And it makes dealing with this a lot easier.

Cycle update and prayer requests - Updated

I haven't posted about my cycle in a while, so I thought I'd give a little update. I should point out, though, that I didn't chart while we were gone this week and so I'm not entirely sure how it all went down.

What I do know:

• Today is cycle day 15.
• My period lasted for five days with the fifth day being just spotting.
• Mucus started on day six and, with the exception of a dry day on day nine, lasted through til day 13.
• Yesterday, day 14, I saw 8 PC; I think this would normally be a yellow stamp day, but because it follows a peak day, I believe it should get a light green post-peak sticker instead.
• My bbt was low on Sunday (97.4) and high yesterday (98.1) and again today (98.3). I did not take it Monday or Tuesday since we were away.

So what's different? Well, a lot of things. My period was about three days shorter than it normally is for me. My mucus started three days earlier and ended about three days earlier.

If I ovulated, I'm guessing it could have happened on Monday or Tuesday. I'm basing this on a couple things: 1) Tuesday was my last peak-type mucus day, and, 2) while I did not take my bbt on Monday or Tuesday, it was low on Sunday morning and high on Wednesday morning.

As for other possible symptoms of ovulation or anovulation (depending on what these symptoms may mean), I had pretty severe cramping over the weekend (a day or two prior to ovulation if, in fact, I did ovulate early this week) and even had to use a heating pad. I also had a bad headache Sunday night. I have also experienced back pains since the weekend, which is very unusual for me.

I'm trying to be patient for my next doctor's appointment on Oct. 6. I'm just getting nervous that I'll just come out of it with nothing but another appointment in another four months. If that does happen, well, I have to trust God that it will be best. I also can't be scared of finding out that the met isn't working because that won't necessarily be a bad thing. We can probably raise the dose and it might be that it just needs more time.

Before I go, I have some prayer requests. Please pray for T.C., a mother in her thirties who was just diagnosed with an aggressive form of breast cancer. Also, for K.P. who is dying of breast cancer and may have just a few days left.

I am also taking part in the 40 Days For Life campaign today and will be praying outside of a clinic in Richmond. Please join me in praying for the unborn, especially those whose mothers will visit abortion clinics today. I will also pray for all those who are unable to bare children themselves, because I can't help but connect these two things - the millions of women who kill their unwanted babies and the millions of women who pray and hope that one day they'll be able to have life within their womb. Maybe all of us struggling with infertility should adopt spiritual children - those in the wombs of women currently deciding whether to keep the child or abort - and pray for them especially. We may not have our own, but we can give our love to their children in the meantime.

Update: Okay, something is up. I just had some spotting. Sorry for the gory details, but it was brown and slightly mucusy. But it's day 15. Day 15! I've never got my period this early. In past cycles, the earliest I ever got my period was day 26 and the earliest I ever started spotting was day 24. Heck, when I first started charting my cycles went 40+ days! Oh well, I'm fine. This is truly a rollercoaster ride and I trust in God that everything will be okay. And if I do oddly get my period super early this cycle, at least I have a doctor's appointment in a week and a half.