July 27, 2014

First Cycle Review

So this was our first cycle really treating and I had my cycle review on Friday.  Though before discussing the review I should probably discuss what we were doing in the first place!

As I mentioned in the last post Dr. S noticed some TEBB (tail end brown bleeding), so she prescribed Biaxin for both my husband and me for the first 10 days of my cycle in case it was caused by an infection.  She prescribed clomid, at the lowest dose of 25mg for cycle days 3-5 to see how I would tolerate it.  She also prescribed progesterone for post peak.  For an honorable mention, I also take Metformin, but I've been on that for years.  So that's it for the prescriptions!  We also started a whole bunch of supplements, including Fertile CM (for CM quality), BioResponse DIM 150 mg (for something to do with estrogen? I can't remember), L-Methylfolateand Methylcobalamin (B12) (for MTHFR), and Cellgevity (I don't remember exactly what for, egg quality I think?).  Just to round it all out I add a women's one a day :). And I got myself a snazzy new pill box to put all of these in!

I think it looks like a caterpillar :)
All in all it wasn't too difficult to adjust to all of these.  I didn't notice any side effects from the supplements.  I tolerated the Biaxin fine, though it took poor hubs a few days to adjust.  The Clomid was ok... though I did get some hot flashes, night sweats, and mood swings (so fun).  They were worst when I was taking the pills and the few days after, then tapered down and were pretty much gone 10ish days later.  Unfortunately the absolutely worst day was on 4th of July... who doesn't love hot flashes and irritability while spending the day at the beach with 20 relatives? 

I now know how it feels to be  a firework
I didn't notice much from the progesterone at first.  Toward the end of my cycle my skin started breaking out (which never happens),the crazy mood swings came back, and my cramps, which are generally mild if anything, have been pretty bad and nonstop ugh. Dr. S did warn that things would be worse before getting better on progesterone, here's hoping next cycle is a breeze :).

So P+3 I did an ultrasound (supposed to be P+4 but I couldn't find an imaging center open on a Saturday) and P+7 a blood test.  On P+10 I had my follow up with Dr.S!  Good new was that the Biaxin appeared to work, TEBB was gone! So good news for the Hubs, we don't have to take Biaxin again this cycle!  The rest was bad news :(.  Ultrasound showed that I didn't ovulate, my body didn't even try. I kinda expected it as I didn't get any positive OPKs, but still not fun to confirm.  All the side effects from the Clomid for nothing :(.  

How I picture my system (sans the actual functioning)

The ultrasound also showed that my lining wasn't thick enough.  The most disappointing news was that there were small cysts on my ovaries, so either things have gotten worse since my last ultrasound a year and a half ago or that doctor wasn't paying attention (my guess is the latter). The blood test was consistent with no ovulation, with both my progesterone and estradiol being low.  My CM wasn't great and I only had one day of peak type... to be expected with Clomid I guess.

So, going forward, we're giving the Clomid one more shot, upping it to 50 mg for 5 days.  If it doesn't work, I guess I'll be switching meds.  Dr. S also added a B- Complex, L-Argenine, and Mucinex.  As I mentioned, the next cycle has already started up, so I'll see how this works soon!

July 23, 2014

My Journey with PCOS (Part 3)

Finally, October 2013 rolled around and it was time for our first appointment with Dr. S, the NaPro Doctor.  That first appointment was so great! I finally found a doctor who wanted to find any underlying issues, and treat the actual problems! And it was the first time a doctor knew more about PCOS than I had learned from just googling and reading a few books (much more at that).  This was the first glimmer of hope we had in so long! After the appointment, I was sent off to get blood tests and learn Creighton, and told to come back once we had a few cycles charted.

We attended an intro to Creighton in early November 2013 and got started charting.  While we learned so much from charting, it also scared me.  There seemed to be more and more things showing up that could signal problems :(. I would stare at my chart and reference every irregularity with the manual, which was seriously stressing me out.  My FCP urged me to get back to Dr. S. By March I finally had enough cycles charted to do so, and set a follow up for April 2014.

At the follow up we got good news and bad.  The blood test confirmed hormone levels expected with PCOS, no surprise there.  It also showed something new, a MTHFR defect which could cause infertility and miscarriages.  The good news was that Dr. S was able to suggest some supplements that should help. After that I was scheduled for an HSG so we could make sure everything looked good before starting treatment.

In May, I had the HSG.  Dr. S found that one of my tubes was partially blocked, but was able to clear it out!  On to finally making a plan!

After the HSG, we had a follow up with Dr. S at the end of June.  Dr. S noticed a pattern of tail end brown bleeding, and prescribed some antibiotics for both me and Hubs in case the spotting is due to an infection.  I hope they clear it up! I am starting treatment with Clomid and post peak progesterone.  I've also got a post peak blood test and ultra sound to take.  Here's to hoping we find something that works soon!

July 16, 2014

My Journey with PCOS (Part 2)

So I left off last post with getting married, and not particularly trying to avoid or conceive.  The irregular cycles that are part of my PCOS became maddening.  So many negative pregnancy tests :(.  As the months went by we moved more and more from neutral to hoping for a positive.

In late 2011, after some googling around, I bought a book, Taking Charge of Your Fertility (TCOYF), a thermometer, some ovulation prediction kits (OPKs), and downloaded a sympto-thermal charting app and got started. I noticed right off the bat that my temps were low and erratic, and was never able to confirm an ovulation.  Similarly, I was never able to identify an ovulation with OPKs.  This had me a bit worried.

Our anniversary rolled around but still no positive, confirming that we technically fit the definition of infertile.  I was upset, but not quite ready to get medical assistance to conceive.  At that point, I was at my heaviest weight ever, and I wanted to lose weight before getting treatment to give myself the best chance possible.  So in October 2012 I started weight watchers.  I decided that I wouldn't seek help conceiving until the earlier of hitting my goal weight or my next birthday.

Around January 2013, the Hubs and I found a new primary care doctor.  I told the doctor about some pain I had been having and that it'd been years since the first ultrasound I had confirming PCOS, so he had me get another.  The result of the ultrasound was unexpected, they didn't even see one cyst.  I believe the exact phrasing was that the ultrasound was an "unremarkable ultrasound of the female reproductive system."  So.... I have PCOS without the polycystic ovaries?  The primary care doctor sent me along to an endocrinologist to see if any more treatments could be done to control my symptoms.  The endocronologist upped my dose of metformin and then insisted that the only other available treatment was birth control.  Again, I politely refused, upset that my new doctor, a supposed specialist in hormones, knew less than I did about PCOS.

By May 2013 I had lost 60 lbs, but I kinda fell off the weight watches bandwagon after that and my weight started climbing again.  In August 2013, around our second anniversary, I got impatient and looked into booking an appointment with a Napro.  Unfortunately, a great job change for the hubs meant we had to wait a while for our insurance coverage to kick back in.  Finally, we set our appointment... for less than a week before my birthday, hah!

July 6, 2014

My Journey with PCOS (Part 1)

I've posted a page with a summary of our journey so far, but I thought I'd give a more detailed story.  Just a warning, there may be some TMI involved.  So here goes:

From the time I got them, I knew something was off with my cycles.  From the get go, they were never regular, months would go without a new one starting.  When I finally convinced my mom to take me to the doctor about it, when I was around 16, the doctors would just laugh at me, make jokes about whether I was pregnant (impossible), and tell me I would get more regular with age.  Not something I appreciated.  It wasn't until I was in college that I finally got a doctor to take me seriously.  After some testing I was diagnosed with PCOS.  The doctor tried to convince me to go on birth control but I refused, so she just proscribed me prometrium (progesterone) to take to bring on a cycle every few months.

My sophomore year of college I treated with a chiropractor/ naturopath.  After several months of adjustments and supplements, my cycle did start to regulate.  However, the cost of treatment got prohibitive, and I got lazy about taking the supplements, so I stopped treatment and eventually the irregularity returned. For the rest of college I didn't give it much thought or get much more treatment.  For the most part, I considered myself lucky to not have to deal with periods.  I got lazy with taking the prometrium for the same reasons...

After college I went to law school and, as a stress eater, began to gain weight which in turn made the PCOS worse.  I had a blood test and tested positive for insulin resistance.  After again urging and failing to convince me to get on birth control, my doctor proscribed me Metformin.  However, for the same reasons I didn't take the prometrium regularly in college, I was pretty bad about regularly taking the metformin (I was a bad patient). At that point I got a cycle about once every 6 months, which was fine with me.  PMS made me too moody and foggy headed, which made studying more difficult.

Another important development in law school was meeting the hubs.  While its a story for a different post, we clicked from day one, and I think both of us had a feeling that this might be it :).  A little after a year we were engaged, and we were married a month before our second dating anniversary. We had a lot of talks about whether we would try to avoid pregnancy or not, considering I still had to finish law school and he had to find a  job.  In the end, we figured we would just wait to see what would happen, as we figured it might take a little longer to conceive with my PCOS.  Plus, my doctor and others at the time told me that NFP wouldn't work with my PCOS and irregular cycles, so I shouldn't waste time learning it.  Oh if I only knew...

(To be continued)

July 5, 2014

A(nother) Direction

So since my last post... lets just say the eating healthy thing hasn't gone as planned.... I've had a hard time getting my act together.  I have been learning how to cook, but haven't quite been remembering to blog about it.  So... here's for giving it another shot?  Also, after some thought, I think I'll start blogging about the biggest reason I have for losing weight that I haven't mentioned yet... infertility.  It seemed too private to blog about before, but I think it might be helpful to talk about to work out my feelings.  So lets see how this goes.