Let the Crazy begin...

I know. It's been a week since our return consult with the doctor, and I still haven't written about it. In my defense, I've been crazy busy at work, and then I was out of town for the past two nights. But now things have slowed down and I'm back in town and now I'm ready to write about it.

To keep things brief, he officially diagnosed me with PCOS. It's the diagnosis that I was expecting, so it didn't really surprise me at all. He also said that he wanted to try to figure out what is going on with J. He recommended that J get some bloodwork done to see where things stood with him. He also mentioned with me that I have some underlying health things that aren't really issues yet, but could be in the future...things like the potential for high blood pressure, heart disease, high cholesterol, and diabetes. He said we had two options...we could try to get the some of the underlying health issues under control through diet and exercise to see if that would help my body regulate itself again, or we could start using medication and go that route. The surprising thing was that if we wanted to go the medication route, the doctor said that I wouldn't have to wait for my next period...if I went in and got a baseline ultrasound and bloodwork to see how my hormones and uterine lining look, and everything checked out, I could get started right away. If my uterine lining was too thick, they'd give me something to induce my period and then I'd get started. If we decided to go the medication route, he recommended that we do an IUI as well as intercourse to increase our chances of getting pregnant. He also said that I could either use ovulation predictor kits at home to monitor my progress after I finish the medication to see when I was getting ready to ovulate, or I could do in-office monitoring. If I did in-office monitoring, they would also do an hCG trigger shot and then do the IUI about 36 hours later. J and I looked at each other, and we were both pretty sure that we would want to go the medication route since we're in a bit of a hurry, but we didn't want to make the decision right there in his office. J went ahead and made his appointment for bloodwork for last Friday. Then we talked about it on Wednesday evening, and officially made our decision to go the medication route.

I called on Thursday to figure out what I would need to do. The lady I talked to in the doctor's office mentioned that they still needed to get authorization from my insurance company, so we tentatively set up an appointment for me to go in this morning for the baseline bloodwork and ultrasound so that they would have time to get all of the proper authorizations.

On Friday J got his bloodwork done. The doctor's office called him that afternoon and told him that they want him to take Clomid for a month. He and I had a little chuckle over the fact that we were both going to be taking Clomid.

I called the doctor's office on Monday afternoon to check on the status of the authorization. It's a good thing that I did, because the nurse that I talked to said that she had to re-submit some stuff, but that everything should be taken care of.

Yesterday I spent way more time on the phone than I should have trying to get all of the medication stuff sorted out. First there was a call from the company that manages fertility care for our insurance company to verify whether I had any hCG from a previous cycle...and that would be a no. When I told the lady that it was my first cycle, she gave me a brief runthrough of what I would need to do, and then she said that I should be getting a call from the pharmacy my doctor's office uses for their fertility meds to talk about my copayment and schedule delivery. Then, about an hour later, I got a call from the pharmacy. They wanted to verify my insurance info and discuss delivery. When I mentioned that I might possibly need to start Clomid today, the lady said that I would be able to have that portion of the order tranferred to a local pharmacy and get the rest delivered. She asked when I would know for sure about when I would start the Clomid, and I told her today. She said that they also needed to verify my copayment amounts for the various drugs in the order, so they would call me back today. I got the call this afternoon, and I told them that I still didn't know about when I would be starting the Clomid, so the lady that I talked to today put my order on hold until I could call them back. About five minutes after I got off the phone with her, the doctor's office called and said that everything looked ok for me to go on the Clomid tonight so I called the pharmacy back and gave them my payment and scheduled delivery of everything except the Clomid for tomorrow. Then I called a local pharmacy to have them call the fertility meds pharmacy to get the prescription tranferred and get it filled. And then I took my first dose tonight.

So now I'm waiting for the Crazy to begin...

Sorry to leave you hanging...

Believe it or not, I do have a bit of a life. Granted, it's not much of one these days, but my I am an active member a sorority alumnae association (yes, I'm a sorority girl!) that meets once a month. Our monthly get-together was Thursday night and by the time I got home all I wanted to do was crawl into bed. It's been a long week both work-wise and TTC-wise, so I needed some sleep (which I didn't get for various reasons). (I'm sure that before long I'll write a post about how I love to sleep but my work hours don't jive with my body's internal clock. It's a problem that has plagued me my entire adult life and it seems to be getting worse as I become older. But I digress.)

I went on Thursday morning to get blood drawn for the re-do of my TSH and Prolactin labs. I got a call mid-afternoon that both my TSH and Prolactin levels were in the normal range. The nurse that called me chalked it up to a lab error the first time around. So I guess I'm in the clear there. But I also checked my doctor's website today and got one more result...my AMH was high. According to this page anything over 3 ng/ml is high, and usually associated with PCOS. I'm well above 3 ng/ml. (I actually saw another website that showed that cutoff as 5 ng/ml, but I'm well above that, too.)

That's really all I have to report at the moment. It's going to be a busy weekend for me. We're in one of our busy seasons at work and I'm up to my eyeballs in things that I need to get done this weekend either because I didn't get a chance to work on them during the week or because I intentionally put them off for the weekend. I'm hoping to be able to stay at home to work on them, but, depending on how distracted I get, I may wind up spending several hours both over both days in my office, which will make me sad. Since I may be otherwise occupied until then, don't be surprised if I don't post anything before the return consult with our RE next Wednesday. I'm hoping to come out of that meeting with a clear picture with what's going on, an official diagnosis or two, and a game plan. I'll be sure to post more when I know more.

With that in mind, plus the fact that it's going on 2 am, I need to head towards bed so I can get a halfway early start to the day. Good night!

Well, huh...

I got a call from my RE's office this morning. Out of all of the test results, they're most concerned about my Prolactin and TSH, which were borderline high. They want me to come back in tomorrow so they can test them again, which means fasting again. At least we were able to time dinner so that I finished just in time to meet my 12-hour requirement.

I also got my fasting glucose results, and they were good.

Once again, when I get more results, I'll be sure to share them.

I'm not sure what this all means, but...

(Determinations of good/high/low based on based on this website, for the most part. Cholesterol good/high/low based on this website.)
TSH was high, which is bad.
Prolactin was high, which is bad.
Progesterone was good.
Cholesterol...overall is ok, but HDL is really low, and the Total/HDL is high, and my Triglicerides are borderline high.
LH was really high, which is bad.
Fasting insulin levels may be high, which is bad.
FSH was good (actually, it was in the excellent category).
Estradiol was low, which I think means good.
DHEAS was good.

Like I said, I'm not sure what all of that means. And that isn't everything. That's just what my RE's lab could do in-house. The rest they had to send offsite...I'll get those results in 3-5 days, they were estimating.

In addition to all of the blood I had drawn today, I had an ultrasound. And I have to say, getting up close and personal with an vaginal ultrasound wand during your period isn't as much fun as it's cracked up to be. Sure, you get to see your ovaries and uterus and apparently some cysts, but it's a bit painful, especially when your left ovary is trying to hide. And it's messy. Having said that, though, I was able to see what was going on a lot better this time, and I felt more comfortable asking questions.

I'm not sure what my test results mean...I guess I'll have to wait until we have a return consultation with our RE to figure out what the combination of J's test results and my test results means for us. And speaking of our return consultation, I made an appointment for that. It's next Wednesday. I'm not sure how I'm going to be able to justify the time away from work right now, but the other alternative was four weeks from today and I just don't want to wait that long.

If I see results for my other bloodwork, I'll be sure to post good/high/low thing again.

09-11-09 HSG results, and a play-by-play of my procedure

The results were good. Both of my fallopian tubes were clear and my uterus looked ok. The experience was...interesting.

I'm not sure if every doctor does this, but my doctor had me go to an outpatient surgery center for the procedure. It was one of those regimented places, where they have the same instructions for everyone, regardless of what they're there for. They neglected to call me ahead of time to tell me to a) not wear jewelry and b) not wear contacts. My procedure was scheduled for mid-morning on Friday so I went to work first and had to return to work afterwards, and thus I showed up wearing both jewelry and contacts and didn't have a contacts case or my glasses with me. Luckily they allowed me to leave my contacts in since I wasn't being knocked out. (They also neglected to call to tell me when to show up. I got impatient around lunchtime on Thursday, so I called them to find out because I needed to tell my boss when I would in and out of the office on Friday.)

I signed in and a few minutes later they took me back to squeeze out a few drops of urine for a pregnancy test and get changed. They took my blood pressure, my pulse, and my temperature. Then they brought my husband back to keep me company until the doctor was ready for me. After about 10 minutes or so, a nurse came to get me for the procedure. She took me back to the room and it was scary. I've had tubes put in my ears twice, I had my wisdom teeth removed, and I've had surgery on my jaw, but I don't remember every being this scared of a room.

The nurse who took me back to the room introduced the other nurse and the radiographer. They helped me get up on the table and guided me into position. The doctor had me state my name and the reason that I was there. They put a blood pressure cuff on my arm and a heart rate monitor on my finger. The doctor talked me through everything at first. He pointed out the radiography machine and monitors where I could watch what he was doing. (BTW, it was really neat to see what he was doing. It made it a lot less scary). Then he got into position and got things started. He inserted a speculum. Then he used an iodine solution to clean the opening of my cervix. Next he put on a local anesthetic. So far it was about the same as a PAP smear, comfort-level-wise. Then he inserted the catheter, which was slightly uncomfortable but bearable, and removed the speculum. I got to watch as the dye started filling up my uterus...it was pretty instantaneous, and I thought it was pretty cool. So far so good. He asked the radiographer to take a picture. And then he started moving the catheter around, and that was not at all pleasant. I'd actually go so far as to say that it was painful. He asked the radiographer to take another picture. And then, the next thing I knew, there was a balloon showing up on the screen, and he was moving that around, too. That hurt like a b*tch. I couldn't keep from moving a little bit as he was wiggling it, despite my best effort to stay still. Eventually he seemed satisfied with everything so he asked the radiographer to take a third picture, and then he started draining the dye. I could feel it running down my butt...it was pretty gross. Then the nurses helped me take my legs out of the stirrups and put some mesh panties that had been fortified with a super-strength maxi pad on me and pulled them part of the way up. (I was supposed to pull them up the rest of the way when I stood up.) The doctor went over the pictures with me. The first one showed that my fallopian tubes were nice and clear...good results. He also pointed out a whitish blob in the middle of my uterus that had the dye surrounding it. That wasn't so good. He explained that it could have been some rogue uterine lining or scar tissue (from what I'm not sure, because I've never had surgery on my uterus or an abortion, and I've never (to my knowledge) had a miscarriage). He said that he'd first tried using the catheter to get it to move, and when that didn't work, he used the balloon. He said that since he was able to break the spot up using the balloon he wasn't concerned about what, exactly, it was...all he cared about was that it went away, and my uterus looked good otherwise. Then I was free to stand up and pull on my granny panties with the pad and be escorted back to the recovery area.

The nurse in the recovery area took my blood pressure again and my pulse again and gave me some apple juice and cookies. She also gave me some ibuprofen to help with the cramping, which was pretty rough. (To be fair, I had forgotten to take any before my procedure, which was strongly advised. But even if I had taken some before the procedure, I don't think that it would have prevented all of the pain.) Then she went and found my husband and brought him back to keep me company while I "recovered". She came back about 10 minutes later to take my temperature and give us a survey to fill out, instructions from my doctor's office, and my discharge paperwork. She told me that I was free to get dressed. I had remembered the advice to bring some sort of sanitary product with me, so I changed out of the surgery center-provided undies and into my own. I was surprised to see that I had bled quite a bit following the procedure. Then the nurse walked me outside, and I kissed my husband goodbye and went back to work. I didn't stay for very long...just long enough for a meeting and to get some paperwork done. I left a little after lunchtime and came home and slept. Although I wasn't sedated during the procedure, it still really wiped me out.

Here are my overall observations:
1. It was cool to be able to get results that day, in real time, and to see what was going on.
2. I should have taken ibuprofen ahead of time. As I said before, I don't think it would have prevented the pain completely, but I'm sure that it would have helped.
3. It would have been nice if the doctor had told me why he was wiggling the catheter and balloon around while he was doing it. Getting the explanation after the fact was ok, but I think I would have relaxed a bit more if he had told me why he was doing it as he was doing it.
4. The staff at the surgery center, overall, was really nice in person. Apparently they have some issues with calling people, though...they didn't call to give me instructions the day before the procedure, and they called today to find out how I was doing but, rather than calling me even though my husband told them that they could, they just talked to him. And, according to my husband, the lady who called today didn't seem too terribly concerned by the fact that I'm still bleeding (which I'll get to in a minute).
5. The paperwork I got from my doctor's office said that bleeding was to be expected, but no timeframe as to when that bleeding could be expected was given. As I mentioned before, I was surprised at how much I bled that morning but it seemed to taper off by around lunch time. I came home and slept all afternoon, and thus was up pretty late that night, but there wasn't much bleeding the rest of the night. Nor was there much bleeding on Saturday. But then I started bleeding pretty heavily again yesterday, which meant that either a) I was having some sort of side effect or b) my last "period" wasn't really a period, and I actually started my real period yesterday. So I called my doctor's office this morning. I told one of the nurses what was going on, and she agreed that I probably was starting my real period so we arranged for me to go in tomorrow morning for my Day 3 bloodwork and an ultrasound.
6. I think part of the vast amount of pain that I felt during the procedure was due to the fact that I was about to start my period but I didn't know it. If I ever have to do this again, I'll try to make sure that I schedule it after a good period, and not a "Is it? Or isn't it?" bleeding spell like I had a couple of weeks ago. I'll also be sure to take ibuprofen ahead of time.

So...those are the results. I've got to get up bright and early to get my blood taken and an ultrasound, so I should probably start heading toward bed. When I get the results of tomorrow's testing, I'll be sure to post.

Still nothing new to report

This is a slow process apparently.

We had our consultation about a month ago. The doctor suggested that J get another semen analysis, which he did. The doctor also recommended that I call on the first day of my next period to schedule some day 3 bloodwork and set up an appointment for a hysterosalpingogram (HSG). He said that prior to the HSG he'd like for me to have a good, medium-to-heavy flow period so that my lining gets good and flushed out. I expected to get my period within a week of that appointment because my temperatures indicated that I had ovulated about 9 days previously and my temperature dropped like a rock very shortly thereafter, but I didn't. It finally showed up on a Sunday night almost three weeks later, which also happened to be the night before I left to go on a business trip, a trip which precluded me from going in to get my bloodwork taken care of but I went ahead and scheduled the HSG. And then the period turned out to be really short (~1 day) and really light and therefore not at all what the doctor had said that he would like for me to have. Since I wasn't sure if I wanted to waste our time with the procedure if it was going to give us screwy results as a result of my lousy period, I called the doctor's office yesterday and talked to a nurse. She talked to the doctor and they had me go in this morning for a pregnancy test and, since it was negative, I'll be going in again on Friday morning for the HSG. I'll have to wait until after my next period (and hopefully it's a good one!!) to do my day 3 bloodwork, and then we'll meet again and talk about the results of J's test and my tests and figure out where to go from there.

So...that's where things stand. After the HSG on Friday, if I'm up for it, I'll provide another update.