Ovulation symptoms?

I'm feeling better, psychologically speaking. Thank you, everyone, for your prayers and support. I'm going to have a bad day now and then, so thanks for reminding me that God is good and that I should have hope. Today was much better and I also firmly believe it has something to do with hormones (I'm not saying my feelings are completely due to hormones, but I think hormones determine when I feel the heartache more deeply). 

I'm not sure what cycle day it is off the top of my head (and I'm too lazy to walk into the other room to check), but I'm guessing it's like day eleven or twelve. Late tonight I started having abdominal pain. My entire abdominal region was rock hard and bloated, with pain mainly on the left side. It's not from food because I haven't eaten much today and haven't had anything out of the ordinary. I'm hoping this is just my ovaries getting ready to ovulate. I can't imagine I'm ovulating now, though, because my temp is still low and today was only my first day of mucus.

I haven't traditionally experienced a "feeling" of ovulation, like some women report, but the past couple cycles I have had some mid-cycle pain (further proving my point that this ovulation thing is fairly new for me). And speaking of ovulation, we are determined to use the right days this cycle. It seems like every time I look back on my chart we never used every opportunity. There's always a gap or I thought we'd have more time only to find out it was my last day of mucus. Or - and this happens almost like clockwork each month - we have a fight on what would have been our best day. What's with that? I'm sure it wouldn't have mattered, but it just makes you wonder!  

And one more update - the met is still going well. I experience a very slight upset feeling in my stomach a couple times each day but I definitely wouldn't go so far as to call it nausea. And I don't know if it's a coincidence, but I'm not as hungry as often (which is fine by me!). 

Alright, I'm off to bed.

Tired

Today I feel like the weight of this is too much. The prospect of living the rest of my life in a world full of fertile people, kids, commercials with babies, pregnant stomachs, abortion.. it's just incomprehensible. Can't we all live together on an island somewhere, and take trips back to the "mainland" when we're having a good week?

I'm trying to convince myself that these feelings will pass. There will come a time when I can handle the heartache better. It just seems impossible when you're in the middle of it.

I'm angry with God. I'm angry that he made me to want to grow up to be a mother. How can a loving God not take pity on me and at least design me to not be the girl who always talked about having kids? I know he could do that if he wanted to. And here's a question for ya: I know people say that suffering comes from Satan, but if so, then why wouldn't God want to eliminate what Satan caused? If people say that God allows our suffering because it is "part of his plan for us" then does that mean he's working with Satan? Surely they aren't in cahoots. It just isn't making sense to me right now.

I just feel like I've heard of very few people who have been trying nearly four years who actually end up pregnant, especially who are over 30. I hate even typing that because it sounds like a bad statistic.

Sorry, I just needed to vent.

Ask and you shall receive

So yesterday I realized that my medication that lowers my prolactin is about to run out. I need it refilled, but since I have unofficially switched from working with PPVI to my local doctor, I didn't want to call PPVI for the prescription. It immediately occured to me that it would be a perfect excuse opportunity to call my doctor and ask about my metformin dose!

So this is how the call went yesterday:

Me (after first asking my "cover" question): While I've got you on the phone, I mean, this isn't a big deal or anything, but I was just wondering about my metformin dosage. I'm on the lowest dose and my next appointment isn't for four months, so does the doctor plan on having me raise it at some point? I mean, it's not a big deal if he doesn't. I'm fine on the low dose. I was just curious.

As if the nurse was writing all that down. This was probably the message:

Patient wants to know if she should increase her metformin dose at some point.

It's just that I'm very afraid of sounding pushy. I never want the doctor to think that I think I know more than him, so I was very hesitant to even ask. But... the nurse called back this morning and said I am supposed to raise my dose to 1000 mg (500 mg 2x a day) in three weeks. So now I'm glad I called! He definitely didn't tell me that at my appointment, and perhaps didn't consider it until he got my message. He almost didn't even put me on the medication, since he thinks I might be able to correct it with diet alone.

I am still reacting just fine to the met, and I hope the increased dose doesn't affect me negatively either. I know that some people are fine on 500 mg and then have side-effects when the dose increases, but I am going to assume I'll be okay.

In the meantime, I've decided I really need to start praying more. I always say that, but nothing really ever changes. I've considered a nightly Rosary, novenas, a daily Divine Mercy Chaplet. I also know that saying formal prayers isn't the only way to go, so I'm also trying to find a way to encorporate some silent prayer time into my day. Going to adoration is a good way to do that and my church has it once a week, which I currently don't attend (yes, believe it or not I am ashamed to admit I don't go weekly. The girl doing a documentary on adoration hasn't gone in quite some time). Right now all I am doing is talking to God a few times a day and I know that isn't enough. I'm leaning towards a nightly Rosary with my husband and adoration once a week, with the occasional novena thrown in. Anyone have any advice for what to pray or what's worked for them?

Apparently I ovulate

So metformin is working its wonders on me and being kind so far. Thank you, God. I do realize that I am on a very low dose. Very low. I take one 500 mg pill once a day. I'm not sure why I'm on such a low dose and, of course, I didn't ask. Add that to the list of questions that didn't occur to me until I left my doctor's office. 

Now that a few days have passed and I've had sufficient time to ponder the incredible amount of information that was thrown my way at my doctor's appointment, I've realized something important - I ovulated in May. Somehow I managed to overlook that until now. It's weird how that happens. Almost seconds after my doctor announced it, I brushed it off like it was old news. "Ya, I'm an ovulator. Big deal." Seriously. I entered the club of ovulating women like I had always been a member. Not until tonight did it hit me - it is a HUGE deal. In the days leading up to my appointment I remember telling my husband, "wouldn't it be amazing if the saliva test shows I ovulated?" which I always followed up with, "but that would be too good to be true. It will never happen." But it did! And I barely noticed! 

I have a new theory. My new theory is that I wasn't ovulating before May. I personally believe that I ovulated in May because it was the same month as the start of my diet. I began my diet on cycle day four. There is some proof to back up this theory: Last July, my ultrasound series clearly showed my follicle did not rupture. I grew to a size that a follicle should be at when it ruptures, but then it stopped growing and just stayed there, unruptured. We don't know what happened each cycle between July and May, but I doubt I was ovulating. My charts looked just as screwy as ever... until May. 

It might not have been my diet alone. I started taking bromocriptine for my high prolactin in March and I've read it takes two months to work. My April 28th blood work shows my prolactin was normal, as was my testosterone (how did that go down, by the way?), so a lot was beginning to work in my favor.

I should have asked my doctor if he thought I've been ovulating all along. Actually, I think I did ask him, but what I should have done was remind him about my ultrasound series last summer. And, at the time that I asked him about ovulating, I hadn't yet told him I started the diet. Ugh! Doctor's appointments go so fast!

The good thing about not ovulating until May is that it means I haven't had a real shot at conceiving until now. It means something is moving in the right direction, rather than just being screwed up all along. It means things are improving. I think I will go with that, rather than thinking I've always ovulated. That's my story and I'm sticking to it.

So far, so good

Well I took my first dose of metformin this morning. Nothing to really report yet, except in just the last half hour or so I've felt like my stomach is a little off and my head hurts a bit. But that might just be me looking for it. Just in case, though, I'm going to lay down for a while and take it easy. I think my dose is pretty low, though, so I have a feeling I'll be okay.

In the good news department, we have found the perfect place for our movie premiere. It's at a really classy art museum in the city we used to live in (and the city that the movie is set in). They have a theater that seats the perfect number - not too big and not too small - and it is (surprisingly) affordable. So we're excited!

In other good news, I am all set to go to a water park in about a week and a half. Did I mention we're going to a water park? It's something I haven't done since I was a kid (mainly because we didn't live in a part of the country where they existed), but it's always been something I've absolutely loved. So as I've been trying to find fun things to do to get my mind off of infertility, this came up. I haven't wanted to do it in years mainly due to not wanting to wear a bathing suit. Well, I still don't want to wear a bathing suit, but since I feel so much better about myself I have at least found a solution. This might sound weird, but I found men's swim trunks at J Cr.ew that, when worn in a smaller size, don't appear to be men's swim trunks (hopefully), and I'm going to wear them with a tankini on top. I figured that even if I was skinny, I wouldn't want to parade around in bathing suit bottoms anyway! I'll have to post a picture of myself in my "bathing suit" at some point!

Right now I'm watching my hubby on t.v. He isn't normally on at this hour, but he's filling in for someone. He's wearing a new suit that he bought on Monday, which looks really good! I'm so proud of him for dropping so much weight, too. It has made it SO much easier that he is dieting right along with me.

Sorry for the boring post, but I figured after a couple heavy ones, I needed to lighten up!

Dealing with the diagnosis

So it's been more than 24 hours since getting my long-awaited diagnosis. I'm doing pretty well, considering, but I have been feeling a little sorry for myself at times. My thoughts have ranged from, 'why me?' to 'why can't it just be endometriosis?' to 'why did God make me want children if I can't have them?' I've been doing a whole lot of comparing myself to others, which is always good, and my pregnant-woman and mother-with-kid-in-stroller radar has been extra sensitive and seeing them has been extra painful.

Hopefully this will all subside. Hopefully, through prayer, I will find peace with this. There's a lot wrong with me and I might never get pregnant. That's the reality. Part of me wants to stop hoping and move on. But, for some weird reason, I don't feel like moving forward with adoption yet (which leads me to another question: 'if adoption is the only way we'll be parents, then why won't God place it on my heart?' It would be so much easier if woke up tomorrow knowing I should adopt).

So now I am left, once again, mourning this. In the last nearly four years I've experienced the death of the dream of being a young mother, the death of the dream of getting pregnant easily, the death of the dream of being pregnant in my twenties, the death of the dream of having my infertility fixed easily.. fixed by my first surgery.. fixed by my second surgery.. fixed by my prolactin medication. Each time I mourn. Each time I try to see value in such a sad situation, and look toward the future.

This is the least amount of hope I've ever had. It's interesting though, because it's like my mind won't let me think about it. I'm not thinking in grand terms. I'm not thinking about living my life childless, or what I'll miss out on. I am, by the grace of God, living in the moment and just thinking about picking up my medication in the morning. That's all I can do if I want to maintain my sanity.

I'm also focusing on finding joy. My husband has been great. He's made a concerted effort to make sure we've had fun the past two days. We went to lunch yesterday and went shopping. We don't have a lot of money, but he let me buy some new clothes yesterday (I have officially dropped two pants sizes!). I need to focus on my weight loss, and use it as a way to get my mind off of other things.

I have also drowned my sorrows in low-G.I., low-fat, and low-calorie brownies. They are truly amazing. I've had about three today, which is my version of going absolutely crazy. I've been like, 'I just don't care! Bring on another healthy brownie!'

I also received some help from a post on another blog. Bobbi from Revolution of Love actually came across my blog, and posted today on her own about her struggle with infertility. I think the post is incredibly insightful and what she said really struck me. I love tangible advice on how to make the suffering easier. Here's an excerpt:

When I suffered through this pain, I just tried to take all my tears and offer them to Our Lady. I told her I couldn’t make sense of any of it but please take it all as my prayer to God. Learning to embrace this suffering is like spiritual childbirth. The pain comes in incredible waves that at once seem to overwhelm you. You just have to go with it and focus on Christ and know that the pain has a purpose and will eventually end. Like childbirth, there are times when the suffering subsides and you feel better. Then here comes another spiritual contraction and you are engulfed by the suffering all over again. Just breathe. Focus on Christ. Cry out if need be, but remember that it will be over soon. You just need to hang in there and keep at it. Let Our Lady be your midwife. She’ll comfort you and support you because she knows acutely the pain of spiritual anguish. She will help you through.

I'm going to really try to remember this. I'll offer my tears to Our Lady. I'll focus on Christ. This also made me realize that I don't need to make sense of it. I think I use up a lot of energy trying to make sense of it all, and if I let myself off the hook with that, well, that kind of feels like a huge weight lifted off of my shoulders.

I know this post probably sounds pretty defeatist. While I am struggling with just how much hope I should continue to have, it isn't all bad. I shouldn't give the impression that there's no chance I'll get pregnant. I know this medication could work. The diet could work even faster. God could work a miracle. Technically, it wouldn't even qualify as a miracle, which is a good way to look at it! Women in my situation get pregnant. I may not, but I also may.

Okay, my post tomorrow will be more positive. I promise!

We know what's wrong

Where to begin? I've decided that tonight I'm going to just post all the information I learned today at my appointment and not comment too much on it (or at least that's my plan). I just want to put it all out there and begin to process it. I will say, though, that I'm not sure how I feel about it right now. I go back and forth from being upset to being slightly hopeful. My husband, on the other hand, thinks everything we learned is great news, but I don't necessarily trust him. It's his job to say that. It's also kind of odd to finally, after all these years, know what is standing between me and having babies. Anyways, here goes...

I learned that from the blood taken at my last appointment on April 28, all my chemistry is good. I'm not anemic, my organs are good, and everything is normal. Also normal is my thyroid, my prolactin and my testosterone (my testosterone being normal was a big surprise because I thought that was high due to PCOS, which hadn't been treated at all when the blood was taken). It also showed that my LH and FSH ratio is still 2:1. That is bad and is a sign of PCOS.

We learned a lot from my saliva test (which was taken two cycles ago in May, and shows my hormones throughout the entire cycle). This is where it gets tricky, and this is where we learned what is truly the cause of my infertility. First off, I am ovulating (yes, I was shocked). At the beginning of the cycle, my estrogen starts good and my progesterone is low like it should be. Then all goes awry. You know how estrogen (or is it estradiol? whatever) goes down at the very same time that progesterone rises? I remember my Creighton teacher teaching me that and commenting on how amazing it is that God designed it so perfectly. Well, mine doesn't do that. My estradiol did whatever it's supposed to do to show that I'm ovulating, but then my progesterone didn't rise until about three days later. Three days! I think it's supposed to happen instantaneously. Then the progesterone got really high, like it's supposed to, but then it dropped off a few days before it should.

The doctor described my ovaries like this:

"You know how on Dancing With the Stars there's the really awesome couple who is smooth and in step and looks great? And then there's the goofy couple who is never quite in sync? Your ovaries are the goofy couple." He also used a golf analogy for my husband's benefit. Something about my ovaries not being like Tiger Wood's swing.

He said my ovaries are dysfunctional. I probably release an egg every month but instead of being this nice, smooth, precise process, it's slow and clunky and pretty messed up. So my ovaries are losers. They're ugly and dorky and probably get picked on by all my other organs.

He thinks the LH/FSH problem is causing it, and the whole ovarian dysfunction probably even caused my endometriosis.

It was at this point that he told me no one knows why this happens or how to treat it. He then said "this is when people do IVF" (he, of course, is against it, but just meant that this is when others would typically consider it their only option). So that was when I zoned out. I didn't hear much of anything else he said for a few minutes. I concentrated on holding back tears and I think I nodded my head a lot, probably inappropriately.

Somehow I came back around and picked back up when he was describing PCOS and insulin resistance. So I told him about my diet and weight loss (Oh my goodness! I didn't even tell you about my big weigh in! I did it! I met my goal, surpassed it even, and was down 16 pounds on his scale! Woo hoo!). His immediate response was "Praise the Lord!" He thought this was GREAT news and he thinks it is likely helping me already. He toyed with just treating me with diet and exercise. He had written out a prescription for metformin, and told me not to fill it right away. Then he changed his mind and said to fill it. He also doesn't think the drug will affect me negatively. He takes it himself and said it makes him feel whole again and will likely do the same for me. He also said that even if getting pregnant wasn't an issue for me, I need to treat this as a medical issue. It could lead to diabetes, heart disease or a heart attack at a younger than normal age.

On a sidenote, he said that metformin will likely make me lose even more weight, and faster. Looking forward to that! (And, hopefully, it won't be because I'm too nauseous to keep anything down! Please, Lord!)

So my doctor didn't come right out and say what my chances are of getting pregnant. He also didn't say it won't work. He basically just said that this happens to work for a lot of patients. He said it could take six to nine months to work, so we have a long wait ahead. He doesn't think surgery is in my future because apparently the wedge resection surgery is done to help lower the testosterone and, in turn, help the PCOS. Since my testosterone is already back to normal, that isn't my problem.

My next appointment is in four months. It's so far away that they're not even scheduling that far in advance, so I have to call in August. He also said that if by my next appointment it appears that the metformin is helping, he'll put me on either Clomid or Letrozole to help the ovulation. I'm hoping that combination will be what eventually leads to a pregnancy.

So that's it. I probably left some stuff out. For a recap: I am ovulating.. but my ovaries are bad.. my estrogen and progesterone don't switch off at the same time.. this somehow causes my egg to not do the right thing after leaving my ovary.. this is caused by my LH and FSH ratio being off.. this is all caused by insulin resistance (I didn't ask how).. and this is all part of PCOS.. my diet and exercise is likely helping to treat it already.. I'm going to start metformin tomorrow to help it as well.. but it will likely take at least six months before we even know if it's helping.. and if it is, he'll put me on clomid or something like it to help ovulation. I think that's it, but I have a feeling I'll remember something else in a little while and have to update this.

I would appreciate hearing what you think. Is this not that big of a deal? Have you ever heard of it (the estradiol/progesterone problem)? Is the situation more dire than I yet realize? Anyone know anyone who has fixed this problem and gotten pregnant?

I'm going to post tomorrow on how I feel about this. I will make a final observation, though. I left the appointment sure of one thing: If I do become pregnant, it will be through prayer. I feel now that nearly everything has been stripped away and I am left to lean on the Lord. I know I still have medication to try and my diet may help as well, but ultimately, whether any of that helps to correct my hormones is up to God. I know that it is always up to God, but for some reason I am now more accutely aware of this than ever before.