Sunday, October 31, 2010

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. 


Thursday, October 28, 2010

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.

Monday, October 25, 2010

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!

Tuesday, October 19, 2010

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.

Monday, October 18, 2010

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

Wednesday, October 13, 2010

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.

Monday, October 11, 2010

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?

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.

Saturday, October 9, 2010

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!

Tuesday, October 5, 2010

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

Monday, October 4, 2010

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.