Just add water

Today I came across an interesting article in the NY Times about a family that came to be through the use of surrogates, written by the happy mom of two babies born 5 days apart from separate surrogates. 

Though the article itself was lovely, I was a little disturbed by the title of the attached media article, "The Futuristic Insta-Family."  I'm not sure who thought they were being clever here, but I personally found it rather stupid and offensive.  There was nothing "Futuristic" or "Insta" about the years of struggle or the amazing strength and compromise discussed in this article, and to suggest some kind of new-age Chia Pet advertisement in the title is to undervalue and otherwise demean the pain, heartache, love, patience, and caring that went into the making of this family.  

Badly done NYT, badly done.

As an aside, I found this amazing quote in the main article and thought I would share:

"Infertility feels like a death, but because it’s not the death of a person but the death of a hope — a fantasy about the children that our dead embryos might have become — that grief vanishes when you first hear the beating of real hearts."

I can only hope that my own grief and the grief of all of us out there in the IF universe, will one day vanish with the sound of the beating of real hearts.  

Happy New Year!

No really, I'm just fine

Hey Everyone,

I hope you enjoyed your respective holiday seasons, and thank you so much for all the thoughtful comments on my last post.  Christmas was not so bad as I had anticipated; I found out about some infertility troubles among the family that I hadn't known about before, and I had a nice chat with one former infertile about IVF, fertility drugs, mean doctors saying stupid, asinine things.  Plus, I only cried once which is a step up for me.  I named this post for that bit of crying, seeing as how I keep telling everyone I really am doing better, handling everything well, etc., and yet somehow I tear up every time I have to explain the situation to anyone.  If I'm so fine, why do I completely lose control of my emotions discussing anything related to my infertility issues and what I've been going through over the last year.

The one amusing thing was when said former infertile was discussing all this, she mentioned that it was only after she had gone through all the drugs and IVF and basically given up all hope, that she conceived naturally.  She timidly started the next sentence, "It is really hard to say this, cause I know I would have punched anyone who said this to me while I was going through what you are going through right now, and actually you have permission to punch me in the face, but I truly believe you need to take a calm, Zen kind of attitude towards this, and stop worrying so much and it will happen for you."  I didn't have a response for this...and I didn't punch her for anyone who is wondering.  I think I just quietly sniffed and wiped a tear...then we hugged, she told me I will be an amazing mother, and that was about it.

Clomid: little, white, different

Anyway, the good news right now, the Clomid seems to be doing its job.  I have ovulated at a normal, healthy time (cycle day 15/16), and though I seem to have also developed a cyst which is causing me some discomfort, I think I will overall I consider this a success.  Now, the wait...

When good times go bad

So, with all the fun-filled and well-meaning family time of this time of year I'm feeling a little nervous about the fertility questions that may arise over the next week -- not to mention a few that have already arisen.

Just last month, during Thanksgiving with DH's family, I was confronted with two uncomfortable situations: 1) DH's aunt made a comment about someone else getting pregnant immediately after marriage, and then chidingly/jokingly (I'm not sure which, I only know she didn't mean it to hurt me) mentioned, "but, I guess you didn't want to go that route?" For three, seemingly infinite seconds... crickets... then I recovered enough to smile, blush innocently and say something like, "no, I guess not."

Mind you, my husband is Indian, and as any Indian daughter or DIL can probably tell you, the pressure to have a baby starts immediately upon marriage; making any DIL who fails in this most simple task, to be left open for chiding and discussion by the rest of the family.  Not exactly being the first choice DIL material (what with being American and Jewish and all that), I at least thought this would be the one task I could and would succeed in, and I truly wanted to succeed (with every childless part of my being), but sadly we all know the outcome.  Luckily, my sweet and wonderful MIL knows somewhat of our trials and difficulties, and she has lovingly held back from asking any questions during our recent telephone calls.

Anyway...on to the second scene:
Same vacation, different day, DH's cousins brings up a much feared (by me) conversation. You see, when DH and I were married, his cousins jokingly bet on how long it would take for us to get "knocked up".  It was all good fun to talk about back then, back when I was innocent and thought one month off the pill would see me preggers and already buying nursery items... Anyway, fun cousin #1 made a joke about losing the bet (she bet it would take less than 12 months), and scolded me for making her lose.  I really wanted to laugh, and it would actually have been funny had we not found out we are infertile and had I not been crying like a banshee a week earlier over getting my period, but in that moment I just wanted to curl up and die.  It's time like this, I wonder if I should just tell them the whole awful truth. 

Next week we will be visiting with my best friend's family, who are basically my extended family, and I just know there will be comments and questions...especially since one of the sisters, who will be there, recently had a beauty of a baby and she got married after us.  I am right now pre-wincing with pain, and hoping to get it all out of my system here on this blog.  Wish me luck, and good luck to all you ladies wading in the same waters. 

K

Ready, Set, Report

I'm back from the snowy slopes of Aspen, and ready to report, but first a quick shout out to Sarah Q.  Miss Sarah recently got that elusive BFP we all hope and pray for, followed by an amazingly awesome beta, and I just want to heartily congratulate her, and wish her all the best.  It really was so nice to come home to a little good news from my ladies in the blogosphere.

Also, a quick word about side effects.  Someone commented recently, asking about the side effects of Clomid.  MissConception posted a great, detailed account of the many wonderful, potential side effects of this infamous little, white pill.  So please feel free to take a look at her post for more information.

My first experience with Clomid has so far been pretty uneventful.  My biggest complaint - hot flashes.  I swear, for a second I thought I was losing my mind...then I remembered it was a side effect of the meds, and I calmed down a little.  The first hot flash, not too terrible, but the next one had me stripping layers and holding an ice cold cup of water to my steaming cheeks (in the middle of party in Aspen mind you).  Well, at least I know now what my mom's been complaining about. 

I've had a bit of mood-swingyness, and some bloat, but overall, I would call this a pretty good run for a first timer.  I have no idea if or when I will ovulate, and my doc hasn't ordered any U/S's, so I guess I'll just be OPKing temping away and hoping for the best.

In other news, our insurance company has totally screwed us over, again.  I was told, very specifically, that both my sonohysterogram and HSG would be covered, but we just received two bills for $1000 each.  I am going to argue with them tomorrow, but I'm scared I might lose.  They put the exception as not covering anything pertaining to IVF or other insemination treatments, but these tests didn't have anything to do with that, and were purely diagnostic! Grrr...

Well, that's all the news for the moment.  Good night to everyone, and best wishes for more successful cycles.

Quickie

A quick post before I leave for vacation...

So, AF did indeed arrive this morning, and I am indeed in painful, crampy misery.  The good news - I get to start Clomid in two days and counting (that's right, staying positive) 

Thanks to everyone for the comments you've been sending, and I'm sorry if I haven't been able to reply to them all.  Wish me luck on the slopes.

Mommas of all shapes and sizes

My aunt, mother to 6 feline fur babies and major animal enthusiast, sent me this rather sweet little video today about mothers and animals adopting other animals.  I thought I would share...enjoy:

Addendum

A short addendum to my last post...

This December marks our one year anniversary of TTC.  Happy anniversary to us - we are now officially considered medically "infertile" (something we already knew) by the whole of the medical community and our insurance company...oh happy day.  At least maybe now I won't have to hear from anyone else, "Oh it's only been (8,9,10...months, you shouldn't worry, you're still young, just relax a little and it will happen."  

11 dpo and waiting

I'll start by saying that I'm not one of those women who has a nice short cycle that culminates with a strong, long 14 day luteal phase - though there doesn't seem to be anything wrong with my post O progesterone levels, just the fact that I O so late to begin with.  I generally expect my LH phase to be about 11 days, + or - a day, so I guess I'm a little annoyed that AF hasn't arrived already in all her glory, and that my temps haven't gone down (which usually happens 24 hours before AF's arrival).  I'm annoyed because I've already gotten my BFN this cycle, and I just want to get started on my new cycle already.  The Clomid is primed and ready, DH and I are ready, the only somebody not getting in line - AF. 

Further annoyance...we leave on Saturday for a week long ski trip with our friends, and I just know AF is going to come right before our plane leaves the tarmac: the cramps, the heavy flow, the tears, the crazies, the headache, the backache, and the bloat will all be waiting for me Saturday morning and will continue into our long awaited vacation.  I am okay with giving up coffee (my first love) and alcohol even when I know everyone on the trip will be drinking and partying every night (hey, it's for the baby, small sacrifice there), I am okay with possible, nasty Clomid side effects throughout much of the trip (hey, it's for the baby), but I am so not cool with a miserable week of AF (the antithesis of baby) destroying my overpriced vacation and any chance for some relaxed, vacation, non-temping sexy time with DH.

Grrr...

Waiting...

Hope springs eternal

So I am about 99.9% sure I did not conceive this cycle, but I'm actually feeling kind of okay about that.  The reason - my doc has given me the go ahead for Clomid next cycle so I'm feeling excited to just get my period already and get started on a new cycle.

In other world news...has anyone picked up a copy of the magazine Conceive?  They have this little gem in the waiting room of my Gyne's office.  I suppose I might not mind it so much if I were still in the "honeymoon" phase of TTC, but at this point I am more of a mind to write them a nasty letter.  Think Cosmo for people trying to conceive.  

My complaints:
The front cover image (not the cover shown here) - a husband, lovingly holding and kissing his very pregnant and adorable wife - hand on belly- yet all around this photograph are article titles geared towards those not yet happily knocked up and glistening with baby glow.
Featured articles:
1) "Absolutely Crazy! the Nutty Things Women Will Do to Get Pregnant" (I kid you not - I copied the title verbatim. This offensive article is full of cartoons of women standing on their head or praying to fertility statues)
2) "A Baby or Your Money Back" (somehow the idea of  a $4.99 magazine reimbursement seems a cruel joke compared to mounting infertility medical bills)
3) "GET PREGNANT 2011! A New Year's Plan that Works" (Yup ladies, that's right, Conceive magazine has figured out what we've all been missing, and for just $4.99 plus sales tax - guaranteed or your money back)
4) and finally...a special section on all the things you should buy once knocked up "Conceived: Our Regular Guide to Early Pregnancy"

Meh, is all I have to say...

TWW Update

So a lot has been happening with this cycle, and I'm almost completely set on trying Clomid next time around.  I ovulated on either day 25 or 26, so I have pretty much written this cycle off as a failure to conceive, and I've been busy making myself crazy reading about the low chance of fertility for a woman like me (one who regularly ovulates after day 20) and the fact that even if I did magically manage to conceive I would probably miscarry.

I have been taking Insulite Labs supplements this whole cycle, a recommendation from my sister, and so far there seems to be no effect.  I've been told it can take time, but I'm losing faith very quickly.  Plus the price tag is so high, I could probably be seeing an acupuncturist each month for the same amount.   I am also taking B6 supplements, Vitex (though I've gone off it for the tww), and using progesterone cream (though I had to start it after my post-ovulatory progesterone test for the sake of accuracy).  I will let you all know if this has any effect at all.

Today is either day 6 or day 7po, and I was so excited to see my BBT jump up to 99 - possible triphasic - that is until I realized I am sick with the same cold as my husband.  This evening I'm running a real fever, and I've now lost all hope once again. 

Anyway, meeting with my least favorite OB/Gyne on Monday, and I'm going to discuss Clomid with her for the next cycle.  Does anyone have experience using Clomid to have earlier ovulation, and has it worked for them?

Luck to all the other ladies out there suffering through their respective tww's!

Back in the saddle again...

After a slightly longer than anticipated hiatus from blogging, I've decided to get back in the saddle and start writing again as well as checking in my ladies (all of whose blogs have kept me company and often entertained as I muddle through this stage of my life).  To those of you who have had important news to share, or just needed some reassuring connections, I apologize for being so out of touch. 

Turning 29 was not quite as tragic an event as I had anticipated.  My wonderful husband, who I am ever grateful for, made it an incredibly special birthday and gave me a new camera that I had been drooling over for months.  I was traveling so much over the holidays that I was able to re-celebrate in every new city, with each new group of friends and family, and I was certainly feeling the love.  Overall, a pretty god vacation.

In fertility news, I ovulated waaay late this cycle, but it has finally happened.  Don't think that bodes well for a healthy egg, or potential pregnancy, so I'm mentally preparing myself for the mental breakdown to come in oohhh...8 days.  Maybe it won't be so bad...maybe I can maintain my promise to myself not breakdown this time.  Guess, only time will tell. 

HSGs, SHGs, stirrups oh my...

I am now finished with both my HSG and my SHG (sonohystogram), and am proud to say that there was nothing, I repeat, nothing to be seen.  This is happy news, especially after enduring the pain of both procedures, but it leaves me to wonder where I go from here.  What's next for us?  DH went for a semen analysis this morning, and we are waiting on those results, but my next meeting with the OB/Gyne (AKA Dr. No Good News) is not till December, so for now it's just more of the same and lots of waiting.

My birthday is in two days, and this has led to a lot of mixed emotions.  I will be 29, and I always imagined I would be working on baby number 2 at this point, and of course be exceedingly successful and living life to the fullest. Instead, I'm jumping from lab table to lab table, dropping everything for pointless doctor appointments and lab results, and working as a temp in a job wholly unrelated to my field and/or interests.  I want to be better in the year to come. I want to start living my life again, and more than that I want to be free of the crippling emotional pain that comes with the end of each menstrual cycle...I'm not really sure how to do this, but I think I need to find a way.  I can't avoid my pregnant friends, and those with kids for forever, I can't keep beating myself up inside with every new ovarian cyst or visit from AF, and I can't keep planning my every move around a possible pregnancy that may never come.  It's time to embrace my 29th year of life, dust off the cobwebs that have gathered on my dreams and ambitions, and remember how to live.

 

Memories

I was thinking the other day how sometimes a good memory can lift me right out of a funk.  I was watching the very silly, but kind of cute live action Popeye movie, the one with Robin Williams as Popeye, and I realized that the last time I watched it I was maybe 6 or 7 years old.  Suddenly I was right back on the old sofa (old even at that time) in my parents' house, in the den that doesn't exist anymore, and mentally back before life became complicated and the worst part of my day was being told it was bed time when it the summer sun was still out.

In that moment, I could actually feel the scratchy fabric of the couch beneath me and visualize what might have been happening at that exact moment (e.g. my mom in the kitchen upstairs making dinner, our old hamster running in his wheel, my dad coming in the front door, asking, "What's cooking" - I haven't heard my dad say this phrase in years, but he used to say it almost every day when he came home.  It was his usual greeting to my sister and me).   

Anyway, I just thought I would share my musings in hopes it might trigger some happy memories for you ladies and lift your spirits.
Thanks for being there -- oh, and the HSG went pretty well.  It hurt like anything, but my tubes were open and my uterus is not in fact bicorunate!

A letter to your unborn baby

Sometimes we just have to laugh...

A letter to your unborn baby

A letter FROM your unborn baby

Thanks to one of my favorite blogs: http://www.999reasonstolaugh.com/

Poking and Prodding

Last week I had blood drawn for another series of tests.  The nice lady who took my blood, bruised me in three places and left me with one very angry vein.  The results have been trickling in, and so far things look pretty good - even my thyroid levels are looking much prettier thanks to the Synthroid.  The results are both a relief and misery, as I now have to ask the question: what do we fix if nothing is broken?

I was able to get my HSG scheduled for tomorrow, and a sonohystogram scheduled for next week, so maybe we'll have some answers soon.  The waiting is killing me, but I'm trying to distract myself with work and friends as much as possible.

DH is also going for a test, hopefully next week, so fingers crossed that all is well in that department.  He's been incredibly sweet about everything, and I truly couldn't be more grateful.  Having him as my husband and partner is one of the greatest blessings of my life, and the one thing that continues to give me hope that everything will work out just fine.

I'm worried that if we have to go see an RE, the next step from here and one we've been avoiding, it is going to be completely out-of-pocket and outside our budget.  Our state mandates at least partial infertility coverage, but our insurance company has found a loop hole out of that, and they won't cover anything, even an initial appointment.  We will be changing to a better insurance company next year, but that isn't until August, and I just can't imagine waiting that long just to start the process, especially when we don't even know if it will help.
Unfortunately, the most my OB/Gyne can do, is give me Clomid, and right now, I really don't think that will be enough. 

Anyway, more worries for another time.  I'm going to go to work and try to forget all this, even if just for a little while...

A lighter note

So, I'm finally in a better place - having recovered from my period and subsequent emotional melt down - and I'm ready to share a link a friend of mine recently sent.  It's a short cartoon about Facebook and its potentially negative effect on infertile couples.  The writer based it on an article from the Washington Post. 

Enjoy, and Happy Diwali to all those celebrating it!

Trouble and woe

Well, I haven't started my period, but today, at 12 dpo, my BBT dropped like a stone, and I had a BFN to great me this morning along with the sun. 

I don't know what's wrong with me.  I don't know why I haven't gotten pregnant.  All I know is how tired I am: tired of feeling broken, tired of feeling like a disappointment and a failure, tired of the painful, awful looking acne and chronic pelvic pain that no one seems to be able to diagnose, tired of seeing birth announcements and ultrasound photos on Facebook, tired of feeling sorry for myself and yet unable to shake the emotion, tired tired tired. 

I'm angry, frustrated and slightly beaten.  I felt so close this time.  My thyroid levels have normalized, and even though the PCOS is still there, I had ovulated and had all these symptoms of pregnancy to boot.  I really believed I was going to see two pink lines...I hate pregnancy tests.  I hate looking at that miserable one pink line, willing it to change with all my heart and soul.  Willing myself to actually be pregnant, when I'm not.

I have a friend right now who is sick as dog with morning sickness, and is in pretty bad shape, but the crazy person I am, I keep thinking how grateful I would be to be in her shoes.  One month they tried, and just like that, it happened.  I'm so happy for her, and yet I cried myself silly when I found out.  It only made me feel worse, knowing I couldn't just be over the moon for my friend, but instead broke down into uncontrollable weeping ad self pity.  What's wrong with me?  Why is this happening?

Help...I'm an emotional, weepy wreck!

Happy Halloween to everyone!

To get into the Halloween spirit, I've apparently turned into some kind of red-eyed, unwashed, weepy monster.  It is 10 dpo, I'm in pain and have been for days, I've no interest in a shower, I can't seem to nap even though I'm exhausted and can usually nap like my life depended on it. Tylenol is doing nothing to help, and I can't stop freaking out about whether or not this could be the month. 
So far nothing but BFN's on the horizon, but I've made a pact with myself and my husband not to test again unless I miss my period. 

Oh for goodness sake, I'm about to start tearing up again...why?  I don't know?  Someone help me.  Promise me that this is all just because of some wonderful pregnancy hormones circulating in my body, playing games with my brain, and not the alternative...a warning sign of AF to come.  Tell me the pain is actually my uterus stretching and pinching around the embryo, keeping it safe and warm, and not some cyst rupturing or crazy early menstrual cramps. 

Meh.

Book Review - PCOS and Your Fertility, by Colette Harris

Haven't posted in a while, so I thought I was get back into the swing of things with another book review.

I recently skimmed through, PCOS and Your Fertility, by Colette Harris, and I have to admit to being a little disappointed with at least the first 1/2 of the book... 

This book is heavy on the natural or alternative approach to healing, with discussion on herbal medicine, homeopathy and other alternative treatments, which can be great, and helpful, but I found the information a little biased towards these type of alternative therapies with a sort of thumbing of the nose at western medical practices - even though Harris' own contributing author utilized fertility drugs in getting pregnant.

As I've mentioned before, I'm not one to thumb my nose at any possible source of healing, from prescription drugs to reiki, particularly if I've tried it and it makes me feel better, so I get annoyed when practitioners try to convince me otherwise. 

The good: I think this book offers some useful advice on natural approaches to treatment and diet, as well as coping with grief/loss in the case of a miscarriage.  Harris also provides the reader with a useful chapter on the healthy PCOS pregnancy - something you don't see too often as most material on PCOS and fertility is focused on the getting pregnant part and not so much the being pregnant part.

Harris also speaks to empowering you, the PCOS patient, on not allowing yourself to be bullied or bossed around by your doctor.  She points out, what many of us have probably already realized, that keeping quiet in front of your doc will get you nowhere, and that sometimes it is just necessary to find someone new.

The moral of the story then: if you are interested in learning more about how natural fertility options can help you, this book will provide you with a nice, general picture of what's out there.  It also supplies a lot of potentially useful, detailed information on the PCOS diet, meal planning, and supplements.

Happier note...the big O

Feeling a lot more optimistic today than I have in a while. I've officially ovulated, at least according to my BBT chart.  Sure, it was a little late, and sure, I had two previous LH surges with ewcm prior to the real one, but it has happened.  Three days in a row of significantly higher body temps, and a smile on my face.

Amazing, how something so simple can make me feel so good.  It worked, my body worked.  Now, if only I can get pregnant this month. 

Still worried about the bicornuate uterus, and whether or not it is right now, as I'm writing this, affecting implantation, or my ability to carry a baby to term, but trying not to think about it much. Just focusing on the positive - I ovulated all on my own! Huzzah!

The follow-up

My visit with the OB/GYN revealed some scary news about anovulation and fertility drugs, along with a mile long to do list of tests to be done over the course of my next menstrual cycle.  Among these tests, an anxiety inducing procedure called a hysterosalpingogram, will be used to find out the extent of my bicornuate uterus, and whether or not this may become yet another factor of concern in my quest to get pregnant...seriously, one more thing going wrong?

The part of me trying to stay positive, focuses on my sister's two beautiful children, both conceived despite her PCOS diagnosis, and both perfectly healthy (thank goodness).  Then the negative sneaks in with taunts that I'll never know the feeling of growing a new life inside me, and I'll never see the face of my own baby - part me and part my wonderful husband - hold it in my arms, breathe in his/her newness, and fall asleep knowing that he/she exists and is all mine.

I won't stop hoping that someday, somehow I will get pregnant and I will deliver a healthy baby.

Off to the doctor I go...again...

It's the night before my visit with my OB/GYN, and I'm actually feeling a little nervous.  I know that's silly, especially as I've visited plenty of doctors in the recent past, but I feel like I've invested a lot of emotional energy in this particular appointment.  Will I get good news, or bad, or no news at all?  Will it be a big waste of time?  Will I find myself back at square one? And, the biggest question of all...can she help me get pregnant? 

Health-wise, I've reason to be concerned: The little bit of weight I've taken off since starting the Synthroid, is sneaking back on me, and I've been sleeping every chance I get.  Work time is losing out to my half asleep, spaced out, staring at the monitor mode, and for the most part I just feel like a huge waste of space.  I've also had two LH surges already this month, with no sign of actual ovulation.

It's all very disheartening, but I'm trying to stay optimistic -- at least till I get to the doctor's office.  I guess that's where the heavy emotional weight of this one appointment comes in.  Wish me luck.

 

Polycystic Ovarian Syndrome

Finally some hope

Yesterday I hit one of those lows that comes every now and again, the ones where everything you try to do seems pointless, hopeless, wrong.  I felt sick and lost, and couldn't seem to shake it.  Then, just like that, relief arrived in the shape of a phone call from my doctor... 

My OB/GYN called, during her off hours, just to check in with me.  I hadn't heard from her since before my last ultrasound, and I was feeling angry and frustrated not only with her, but with the entire medical community.  It turned out she had been thinking about my test results, but was waiting to consult with another radiologist for a second opinion before returning my phone calls and emails.  She patiently listened to my hysterical rambling about the last few months - my symptoms and the various tests I'd had, my frustrations with getting appointments and insurance coverage, and the lack of guidance or support from any of my doctors - and then she said something wonderful; she told me to come see her next week so we can talk about it and review everything and figure out what to do next. 

I don't know if this doctor knows what her phone call meant to me, or how in that instant I woke from my state of self-imposed misery, and actually started to hope, but it really was that important to me, and I really did and do feel that way.  I've been my own advocate this whole time: arguing with the insurance company, reading every book at the library on hormone disorders, looking for a doctor who actually knows something about PCOS, Hypothyroidism, and fertility problems, and can actually guide me as opposed to just writing me another prescription to treat one of the many symptoms, calling various doctors around town trying to get in to see someone--anyone before January/February, and worst of all, living with the fear that with each passing month, I might actually be getting worse and further destroying my chances of conceiving.  But now, someone wants to sit down and look at all the tests, and talk to me, and really find out what's going on with my body.  Someone wants to help me get healthy and pregnant, without charging $500 per visit.  If she'd been in the room, I would have hugged her. 

I doubt many women have ever been this psyched for a visit with their Gynecologist.  Wish me luck.

How to talk to a "subfertile" woman

I recently read an interesting book called The Conception Chronicles, penned by three best friends who had all gone through varying degrees of fertility and infertility drama.  The book was humorous, and enjoyable, but also full of deeply honest, thoughtful, and useful information.  I bring it up, because of slightly embarrassing incident which happened this evening, during an otherwise normal conversation with my husband...

The Setting: our apartment's uncomfortably small galley kitchen
The Hour: just before dinner

Enter Dear Husband (DH), home from a tiring day at school and a visit with the student health office.  Finally, after much coercion, I had convinced DH to see the doctor for a much overdue physical exam.  I asked him to discuss my fertility concerns with the doctor, and what would be covered by our lousy student health insurance plan.  There was good news, his blood pressure - perfect, tests - covered, joyous news indeed.  This however, was when the trouble started.

With a cheerful grin, DH announced to me that the doctor had informed him not to be overly worried about our poor luck so far in reproducing, and that we should "just have patience, and it will happen."  This may seem to the outsider as a perfectly normal, possibly responsible remark on the doctor's part, but to me, this was the end of my pleasant mood, and an invitation for a tongue lashing, and possibly tears.  Recognizing the ridiculousness of my sudden rise in temper, and not feeling much like picking a fight with unsuspecting DH, I kept as quiet as possible, and let the horrible feelings subside - though I may have quickly spit out some quick remark about the doctor knowing nothing of my medical history, and maybe keeping those opinions to herself...

When I read about this kind of over-reaction in The Conception Chronicles, I may have laughed at it, agreed to some of the sentiment (as I am regularly told this very thing by my loved ones who are just trying to help), but overall I don't think I took the issue too much to heart.  Now, after many more months of trying to conceive, and of navigating the emotional ups and downs of each new cycle, and the pain of feeling like a failure in what should be the most natural thing in the world for any "normal" woman, etc., I understand the truth of what those women were saying.

For a woman trying to get pregnant, especially for one considered "subfertile," comments such as, "just be patient, it will happen," should never be uttered.  Such a statement feels less like a mild platitude, and more like an actual slap in the face; adding guilt to an already troubled mind, and further fueling her feelings of inadequacy as a woman, a wife, etc.

I realize it can seem difficult to know the right thing to say in such a situation, so I've decided to put together a little list of other comments which you should avoid uttering to friends and family alike, if you know or suspect that they are worried about their chances of conceiving.

Never say:
1) Just have lots of sex/get drunk and have lots of sex
2) It will happen when you least expect it
3) It will happen when it is meant to happen
4) Just stop worrying/stressing so much, and it will happen in no time
5) Why do you bother with all those ovulation tests and stuff, just let it happen and it will
6) I wish I had that problem, my husband just looks at me and I get pregnant
7) I just went off the pill, and the next month I was pregnant
8) Just relax

If you are thinking, okay, great, so what do I say then...well here goes.  Why not try keeping it simple and just being honest?

Examples:
1) I'm here for you/I'm here with you
2) It will happen, and if for some reason it doesn't, we will make it through this, and we will figure it out
3) I love you
4) You aren't doing anything wrong, this isn't your fault

Trust me when I say that the woman in question is most likely feeling guilty, broken, sad, drained, discouraged, frustrated, scared, and alone, and that these are feelings you should be trying to address rather than making blanket statements about the power of positive thinking.  Comments, like, "Don't worry, once you stop stressing it will happen in no time," will most likely just make things worse.

Book Review - What Nurses Know: PCOS, by Karen Roush, RN, MSN, FNP

When I started researching PCOS, this was one of the first books I came across, and honestly, I can't recommend it enough - esp. for those who have been newly diagnosed. 

Ms. Roush writes with empathetic and optimistic voice, covering PCOS diagnosis, diet and lifestyle changes, fertility and mental counseling.  Her writing on the emotional impact of PCOS is a major highlight of the book, and a feature somewhat overlooked by other published medical authorities.  Sure, others may mention something about depression being a "symptom" of the syndrome, etc. etc., but Ms. Roush actually dives into the waves of negative thoughts and fears that so often plague the minds of those living with PCOS.  At times, I actually found myself reading the exact words I had used only and day or two before, to describe my own emotions and worries to my husband...those hurtful, paining thoughts that made me feel so lost and alone, and here they were, printed in a book, apparently shared by so many women going through the same disorder.  It was a relief in an odd sort of way, just to know that even in my abnormal state, I am apparently fairly normal...

Another important, and wonderful component to Ms. Roush's book, is her insistence on the PCOS patient taking charge of her health and diagnosis.  She gives excellent advise, not only why you should take charge of your medical treatment, but also HOW to do it.
Anyone who has gone through the medical rigmarole of doctors who don't know anything about the disorder, giving you random prescriptions, or sending you to specialist upon specialist, and then telling you that you are fine, when you know something is actually wrong, will understand just how important this advise is.  If you don't take charge of your diagnosis and treatment, and direct your doctors like and orchestra, chances are good, you are not going to get the help you need.  Very few doctors actually understand and specialize in PCOS, and even those that do, can get caught up in their own specialized part of the body, ignoring the other issues going on in your body, and treating you for individual symptoms that do nothing to help the underlying issues. 

The bad: For those focused on more non-Western medical treatments or other alternative medical practices, Ms. Roush can be a little unfairly biased towards Western medicine.  Though she certainly discusses some of the options, and attempts to give the reader some "facts" on these alternative treatments, I do think her bias towards what she considers tried and tested medical methods, shines through.  Personally, I believe both traditional western medicine, and alternative medicine have their place in treating hormonal disorders, and I think Ms. Roush would generally agree with that statement, but I do think I'm a bit more biased towards giving both an equal opportunity to help me through this than she might be. 

Overall, a great, easy and insightful read.  Highly recommend!

PCOS -- Lifestyle Changes and Medications That May Help

PCOS: Clinical presentation guides treatment of this multifaceted disease - JAAPA

PCOS: Clinical presentation guides treatment of this multifaceted disease - JAAPA

The Hypothyroidism-PCOS Link

**I found this tidbit while hunting around on the internet, attempting to comprehend the supposed connection between Hypothyroidism and PCOS. The information here has been reprinted on various sites, and appears consistent with other, more reputable sites and articles I've read, so I feel pretty comfortable sharing it on my blog.

This news was particularly interesting to me based on my own shaky experience with TSH testing. My old doctor tested my TSH levels twice. The second time, it was still below 4.0 and though that's on the higher side of "normal" and though the level had more than doubled in 6 months, she told me everything was normal and fine -- the tiredness was probably just depression because I wasn't getting pregnant, the weight gain was obviously just my own fault, and my claims that I had been keeping to a 1500 calorie per day diet and exercising regularly were apparently lies, the acne was probably from stress, the hair loss in my head, etc. My frustrations eventually led me to a new doctor, who looked over my old test results on the first visit and immediately ordered a T3 ad T4 test. Two days later I was told my T4 levels were quite low, and I would need to start medication for hypothyroidism.

The moral of the story...never let a doctor, or anyone for that matter, tell you everything is fine and normal, when you know you aren't feeling right. You know you body better than anyone, and to be fair, doctors simply don't know everything.** 


Hypothyroidism and PCOS

A number of women with PCOS may also have an under-active thyroid gland, according to some researchers.

Hypothyroidism (an under-active thyroid) can lead to a reduction of sex hormone binding globulin and increase in free testosterone. Free testosterone is one of the factors contributing to PCOS symptoms -- infertility, polycystic ovaries, hirsutism, male pattern hair loss, and acne.

Women with hypothyroidism also are more likely to have velvety, hyperpigmented skin folds called acanthosis nigrans.

The thyroid gland is located at the base of your neck in front of your windpipe. It makes, stores, and releases two hormones - T4 (thyroxine) and T3 (triiodothyronine). Thyroid hormones control your metabolic rate, the rate at which every part of your body works. If there is not enough thyroid hormone in your bloodstream, your metabolism slows down. This is called hypothyroidism.

Symptoms of hypothyroidism may include: fatigue or weakness, weight gain, menstrual problems, lower body temperature, cold extremities, inability to focus, constipation, depression, muscle aches, brittle nails, dry skin, and hair loss.

A common cause is Hashimoto’s thyroiditis, an autoimmune disease of the thyroid gland. Other possible causes are: thyroid surgery or radiation, some drugs, hormone therapy, dietary deficiencies, and exposure to toxic environmental chemicals and metals.

How Is Hypothyroidism Diagnosed?

Thyroid disease is diagnosed by your symptoms, an exam and lab tests.

Physicians usually screen thyroid function by measuring TSH (thyroid stimulating hormone). TSH is a hormone produced by the pituitary gland, which "reads" the blood passing through it for proper amounts of thyroid hormone. If thyroid hormone levels are low, the pituitary sends out a TSH signal to the thyroid to produce more thyroid hormone. As thyroid hormone production drops, TSH usually increases. Therefore a higher than normal TSH level indicates a hypothyroid condition.

Unfortunately, TSH doesn’t always respond correctly to low thyroid hormone levels. If symptoms persist, and the TSH is in the normal range, the thyroid hormones (T4 and T3) should also be checked. In some cases, a diagnosis of hypothyroidism can be missed if TSH is the only hormone that is measured.

There is a growing awareness in the medical community that the current reference range for determining what is a "normal" TSH is too wide. Based on new data, the American Association of Clinical Endocrinologists recommends that the normal reference range for the TSH blood test be reduced by nearly half, down to 0.50-2.50 from the current 0.50-5.00. Other sources suggest the new upper range should be 3.33. (The higher the number, the more hypothyroid you are.) Until all physicians and labs can agree on a new range for TSH, many women will continue to be frustrated by inaccurate diagnosis.

BOTTOM LINE: You may have undiagnosed mild hypothyroidism which is complicating your PCOS problems -- especially if you have a weight problem in spite of consistent efforts with diet and exercise. Remember, thyroid hormones set your metabolic "thermostat". If your metabolic thermostat is set on "low", it can be very difficult to lose weight and avoid cellular sluggishness.

Mild hypothyroidism can be difficult to diagnose and is often overlooked. Proper diagnosis may require: (1) lab tests more extensive than the typical TSH test; (2) a body temperature assessment over a period of time; and (3) a careful assessment of symptoms and medical history. Licensed naturopathic physicians are well qualified to identify subtle hypothyroidism.

If you discover that you have an under-active thyroid, and you get it back to optimal function, some of your PCOS symptoms may diminish.

Sources: Ghosh, S et al, Subclinical hypothyroidism: a determinant of polycystic ovary syndrome, Horm Res, 1993, 39(1-2):61-6
Wu X, et al, [Functional states of pituitary-ovary, adrenal and thyroid axes in women with polycystic ovarian syndrome], Zhonghua Fu Chan Ke Za Ahi, 1998, 33(3):153-6

Entering the Blogosphere

Welcome to my first post.  I don't know if anyone will read this blog, besides myself, but my hope is that a) it will help me work through some of my own infertility and PCOS demons, and b) maybe there are others out there, going through the same things, who might read this and benefit from my experiences in some way. 

I am 28 years old, and up until this past year, I had no idea my many years of birth control pill usage had masked underlying fertility and hormone issues.  I did not know I would soon be diagnosed with  hypothyroidism, and placed on Synthroid, and I certainly didn't know, or even suspect that I would find out I have PCOS (Poly-cystic Ovary Syndrome), and probably have since adolescence. 

10 months ago, my husband and I were on our honeymoon, discussing our plans to start trying for a baby the following month.  I was scared, excited, overjoyed.  We had talked about it many times before, and here we were, finally taking the plunge, and going off the Pill  The 9 months since that trip have been an exhausting roller coaster of fear, excitement, confusion, hope, depression, and bewilderment.  The exaggerated feelings of "flying and thud" of  every month we've spent trying to conceive, have taken me from soaring up high, to drowning at the bottom of the deepest well of self-pity & disappointment.  Then as rampant acne on my face and back turned my skin's biological clock back to adolescence, and I began to sleep through large portions of the day, I realized something was really wrong.  Why was I gaining so much weight, why couldn't I stay awake, what was going on with these uncomfortable cysts in my left ovary, and the recurring abdominal pain...finally, why wasn't I getting pregnant? 

I titled this blog, "Uncommon nonsense," a phrase hijacked from Lewis Carroll's, Alice in Wonderland, because I feel the phrase best describes the litany of crazy truths, falsehoods, half-truths, misunderstandings, misinterpretations, and just plan lack of helpfulness I have encountered from the medical professionals and insurance people I've encountered since starting down this 'subfertile' road.  In the future, you can check back here to see updates on my medical progress, and fertility issues, information on diagnosing and treating endocrine disorders - including PCOS, advice and suggestions, words of encouragement, and even book and internet site reviews. 

Thank you for visiting my blog, and please feel free to share your stories and comments.