Our Journey

Matthew and I have been actively trying to conceive since 2007. We continue to wait for our miracle...This is our journey.

Saturday, January 24, 2009

Under Construction

This afternoon, I realized just how crammed my blog has become over the past few weeks. I know very little about html but am learning. Please bear with me as my page goes through some much needed construction.

Thanks for your patience!

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RELAX!!!

My ten tiny "magic" Clomid pills are tucked safely away in the medicine cabinet waiting for cd 3 to arrive. I'm excited...Matthew and I are that much closer to starting a family!!! But I'm also terrified. What if I forget to take the pills? What about the crazy side effects? What if they don't work? What if Matthew or I get sick and can't bd? It is cold and flu season, you know. What if they work...and I get pregnant with triplets? The probability of that happening is less than 1%, but my body has a mind of its own. It's possible. Besides, a friend of mine (also a cyster) gave birth to fraternal triplets after only two months on 100 mgs. of Clomid--my exact dosage! The unknown is always scary, and my mind tends to wander...I'm destined to worry myself (and my poor husband!) to death next month.

In preparation for a psychotic month, I'm trying to refocus. Those crazy questions will always be in the back of my mind, but I don't want them to take over. Anyone trying to conceive has heard that stress can hinder conception efforts. So my new goal is to RELAX!

I've replaced our Glade Plug-ins throughout the house with aromatherapy oils (even hid one at my office!). I've also added candles to nearly every room for a relaxing ambience. And yes, I've busted out that relaxing music cd that somebody gave me for Christmas four or five years ago (I never even bothered to take it out of the wrapper until last night). A close friend specializes in reflexology and another in massage therapy. I've read articles online about the miraculous impact of reflexology on infertility. Not sure if I buy into that (many of the studies are questionable), but for the relaxation benefits alone, it's worth a shot.

As I find more articles connecting stress to infertility, I'll post them.

I'd like to hear your thoughts...How do you relax during stressful cycles? How do you avoid becoming just another neurotic woman obsessed with trying to conceive?

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Saturday, January 17, 2009

Clomid...The Next Chapter

I survived my doctor's appointment on Thursday. As most of you already know, I had stressed for several weeks about the visit--nightmares, upset stomach, the works. My previous doctor had the "I'm the doctor and you're the patient" attitude so I went in prepared for battle. I knew that I was ready for Clomid. I had researched its dosages, side effects and success rates and knew that was the medication that I wanted to try. I didn't need my armor and weapons afterall. :)

After reading every issue of Parenting in the lobby, the nurse finally called my name. She completed the usual vitals and pregnancy test (negative, of course) and led me back to the exam room. "Undress completely and cover up with the sheet provided." At my house, sheets are soft rectangles of cotton that are large enough to cover at least a twin sized bed. The "sheet" provided was a 3x3 scratchy thing. I'm still unsure if it was paper or just cheap fabric. After about thirty seconds of deliberation, I decided that it wasn't worth the effort. So the "sheet" lay in the chair and I sat buck naked on the exam table waiting for the doctor.

When Dr. B. arrived, she began with the usual small talk. "How's the weather outside?" It was -3 degrees that afternoon--how did she THINK the weather was?!? LOL She, then, proceeded to ask me how I had been since our last visit. I explained that the metformin was making a difference--my headaches are nearly gone, my cycles have regulated to 28-30 days (compared to my previous 42 day cycles), but no pregnancy. Then, I boldly announced that I was ready to try Clomid. Dr. B. looked at me and began to laugh. I was prepared for the worst. She went on to explain that during that morning's chart review session, she had noted in my chart to recommend Clomid. I accepted that irony as a positive sign. Then, Dr. B. really suprised me. She said, "From what I remember, you do a lot of research online about PCOS and treatments. What dosage would you like to start with?" When you visit a physician, you prepare for questions about your medical history, your symptoms, and, of course, your insurance coverage. But never in my life have I had a doctor who actually asked what dosage of a medication I would like to use. Hers was not a question that I had prepared to answer! We went on to discuss the general practice of beginning with 50 mgs. because it is the lowest dosage available. We, then, discussed the number of women with PCOS who waste time and Clomid cycles on such a low dosage. We agreed to begin Clomid at 100 mgs.

After the physical exam, I met Dr. B. in the Consultation Room to pick up the prescriptions and discuss the plan for follow up. When my next cycle starts, I'm to take 100 mgs. of Clomid on cycle days 3-7. I'm to continue charting my basal body temperature and begin using ovulation predictor sticks around cycle day 10. After that, I'm to call Dr. B. when my period arrives for a "Clomid check" or on cycle day 35 for a beta. Dr. B. assured me that she'll be there each step of the way. And I believe her.

After several unsuccessful months of trying to conceive, sex becomes just another mundane task. But Dr. B.'s kindness and willingness to ask for my input has helped me to feel more in control of my body. Matthew and I have hope again. We're actually excited about trying to conceive for the first time in several months. We even had a couple of practice "babymaking sessions" since the doctor's visit. :) We're ready for this chapter of our journey and welcome it with open arms.

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Monday, January 12, 2009

To my fertile friends...

You complain about morning sickness...
but I long for the morning when I can wake up and vomit with a purpose.

You complain about stretch marks...
but I dream about the day when my belly carries a new life inside.

You complain about weird cravings...
but sometimes, I eat pickles and ice cream just to see what it would be like.

You complain about your overprotective husband...
but I can't wait for the day when my husband becomes a father.

You complain about your frequent ob appointments...
but I look forward to the day when I can visit a regular ob instead of the infertility clinic.

You complain about the costs of formula and diapers...
but I can't wait to put those things on my grocery list.

You complain about the duplicate gifts you received at the shower...
but I long for the day when people give me things to celebrate a miracle.

You complain about sleepless nights...
but I look forward to cuddling my baby in my arms at 2 am.

You complain about the neverending visits from your parents and in-laws...
but I can't wait for the day when I make them grandparents.

You complain about how much your life has changed since having the baby...
but I dream about us becoming a family.

You complain a lot...
but you have so much to be thankful for.

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Sunday, January 11, 2009

My Countdown to Clomid

My doctor's appointment is just four days away. After a full year of ttc, I will finally bite the bullet and ask her for Clomid. Our health insurance doesn't cover any costs related to fertility, but thank goodness generic Clomid is on Wal-Mart's $9 prescription list. I have mixed emotions...I'm excited about the possibility of beginning a medication that will help us conceive. But at the same time, I'm terrified. Infertility has become "real". When I started metformin, I was able to justify that the medication was to balance the havoc that PCOS has wreaked on my hormones. It was just a pill. But Clomid? It's actually a fertility drug. And beginning that medication means that we are only six months away from more aggressive treatment. Matthew and I can afford a child (or even twins), but we aren't financially prepared for injections, IUIs and IVF. Because my doctor specializes in PCOS, insurance will pay for office visits related to the condition--not the fertility aspect of it. Each office visit alone is $375. Matthew and I want children, but we aren't emotionally ready to take out a second mortage to cover the costs. I know, I know...One step at a time. Just keep us in your thoughts this week. Clomid shouldn't really be that big of a deal, but to us, it's a huge step.

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Wednesday, January 7, 2009

You know you're trying to conceive when...

You've ever groped your breasts in traffic to check for tenderness...until you noticed the overweight, bald toothless man in the car beside you fully enjoying the show (he must have taken his little blue pill that day!).

You've ever stopped by the local Rite Aid on your way home from work to pick up a pregnancy test, two cigars, a super size box of tampons and a fifth of Jack Daniels (gotta cover all the bases, right?).

You refer to your husband as "dh", your doctor as "re", your period as "af" and call all of your future children by their first, middle and last names...at the water cooler.

You've ever caught a touch of the flu and cried tears of joy--THIS COULD BE OUR MONTH!

Your husband knows more about the inner workings of the female reproductive system than your last female gynocologist.

You've ever had to convince your sweet, innocent grandmother that the track marks on your arms are the results of lab work and not because you've become a heroin junkie (Does she really have to watch Cops every time it's on tv?!?) .

You've ever purchased infant clothing, bibs, toys or nursery decor...and hidden them away in a closet for the moment. You'll get pregnant someday, right?

You've ever responded "cd 23--only 10 days away from testing" when a stranger at the supermarket asks you what day it is.


These are just a few thoughts off the top of my head. Feel free to add your own...

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Sunday, January 4, 2009

Trudging Onward with Hope

I've finally reached a point of peace and excitement about starting clomid in January. Matthew and I are ready to be parents and if this step will help us reach that dream, then, that's where we're headed. I've been pretty down in the dumps for the past few cycles. I even made the mistake of asking Matt "when do we give up trying?" His response? "Give up??? Honey, we're just getting started!" I cried and it felt like a huge weight had been lifted off my shoulders. He's right, you know. We're just at the beginning. I don't have to worry about what happens next. We just need to take this journey one step at a time. The unknown is scary, but I have a loving husband who's willing to stand beside me and encourage me. I'm very lucky to have the support system that I have. PCOS...you can kiss my ass! This is a fight that I'm going to win.

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Saturday, January 3, 2009

Dear Matthew,

I know that it's lame to write you a letter when we live in the same house and brush against each other in the hallway a million times each day. But when I write, I am more apt to think about what I say before I say it and hopefully, avoid that all too common instance of me opening my mouth and inserting my big foot. Just bear with me.I know that you're frustrated. So am I. You're tired. I'm tired. And the LAST thing we want to do some nights is try to fake excitement because some stupid pee stick says that we have to have sex. How romantic! Sex is supposed to fun and spontaneous. But we have a little purple line with the power of Adolph Hitler demanding that we get busy. It's been 8 months now since we decided to begin trying to conceive. December and January were fun. We'd mischievously look at each other, raise eyebrows and dash for the bedroom. We were going to make a baby! But then, the months rolled past. The excitement diminished and was replaced with frustration and doubt. I hate that my body is broken. It doesn't do what it should do when it should do it. The metformin has helped some. But I still spend 4-5 times a week camped out in the bathroom because I ate something stupid. I keep telling myself that it's worth it--I've lost weight, my shedding has slowed down some and at some point, we'll have a beautiful baby. I hate that our health insurance doesn't cover anything related to fertility. There's no way in the world that we can afford thousands of dollars on treatment. Dr. Basham will write a prescription for Clomid, but I can't see her again until January. So we're basically on our own until then. Sometimes I wonder if we'll ever be able to become parents. Neither of us is old by far, but I'd like to be young enough to endure those sleepless nights, to play catch in the front yard and to see my future grandchildren. The fear of missing those moments or being too old to enjoy them, terrifies me. Our parents are getting older. I want them to see and hold our children. I want your dad to be around to feed them their first bites of chocolate cake and your mom to spoil them rotten and send them home. I want Lasca to hold my dad's grandchildren in her arms. I want my grandparents to see our children and know that everything is okay. Your craziness is over each month after that last round of "just in case sex", but my worrying has just begun. For the next two weeks, I analyze and over analyze each and every possible symptom of pregnancy. I catch myself groping my boobs at stoplights just to see if they're more tender than usual. Of course, by the end of the two weeks, my boobs just ache because I've been poking and prodding at them a thousand times a day. I pray every night that this will be our month--that the mysterious little blue line will magically appear. Of course, even if that does happen, my fears won't subside. Due to that stupid blood clotting abnormality, I'll most likely be shipped off to a specialist and given a prescription for Lovenox injections. Without treatment, my risk of miscarriage is strong. That terrifies me. After all these months of trying to conceive, I can't imagine losing a baby that we were so close to holding in our arms. I know that I can be a little crazy at times, but know that it's just my fears surfacing. I know that you're going to be a great dad someday. I just hope like hell that we're able to prove that. Know that no matter where this crazy journey takes us, I love you. Please be patient with me. It's really tough.

Originally written 10/1/2008

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Introduction

My name is Michelle and I have polycystic ovarian syndrome (commonly referred to as "PCOS"). My husband, Matthew, and I have been married since 2006 and have been trying to conceive ("ttc") since December 2007. Sadly, there are thousands of other couples facing the same challenges. Some studies show that 1 in 10 women suffer from some degree of PCOS. My purpose in writing is threefold. Journaling has always been a powerful therapeutic tool in my life. It allows me to put words with emotion and find oft hidden insights during times of struggle. I also hope and pray that our written journey brings awareness to the forefront. Many teenage girls and adult women are misdiagnosed each year, even with the assistance of modern technology. Women need to know the symptoms of PCOS and know what questions to ask their physicians. My biggest hope, however, is that other couples facing fertility issues as a result of PCOS will find encouragement, strength and a sense of belonging. You aren't alone in your journey. Other couples have been where you are and understand your hurt and fears.


The Beginning

My periods have always been irregular. As a teenager, the doctors said that I would eventually grow into a regular cycle. I married my high school sweetheart at the ripe old age of 19 and we began trying to conceive the next year. After only two months, I became frustrated and purchased a fertility monitor. I followed the instructions perfectly but never saw a "high" on the monitor. At that point, I began researching what could be causing my annovulatory cycles and self-diagnosed PCOS with the help of WebMD. Around that same time, I realized that my marriage was a sham. My husband was having multiple affairs and we divorced. Since conceiving was out of the picture at the time, I put PCOS on the back burner. I understood that PCOS was connected to infertility, but I didn't understand which internal systems were affected by the condition or the list of other possible symptoms.

At 23, I looked in the mirror and noticed that my body had changed. My once thick hair had begun to thin slightly around my hairline. If I wore certain clothes, I looked pregnant. Not even rounds of crunches made that go away. My symptoms were becoming more prominent. Matthew and I had been dating for only a few months at the time, but he pushed me to make a doctor's appointment just to make sure that I was okay. Sure enough, she diagnosed me with PCOS. The doctor prescribed birth control pills ("BCPS") and spironolactone, but also ordered lab work to ensure that I was a candidate for oral contraceptives (my family has a history of stroke and heart disease). The labs came back abnormal so I was forced to stop taking the meds and was referred to a hematologist to review and repeat the lab work. The ob/gyn wasn't able to explain anything about the labs--just that they weren't normal. The only hematologists in our area specialized in oncology so I was terrified when I when in for a consultation--patients were doing chemo in the next room. I didn't understand what was going on. The doctor didn't know anything at all about PCOS (he specialized in CANCER treatments, for pete's sake!!!). I was strung along repeating the same lab work for over a year, unable to take any PCOS meds because the ob/gyn refused to prescribe them until the hematologist cleared me for the BCPS (the ob/gyn did not prescribe spironalactone without BCPS due to the risks of birth defects). Finally, the hematologist confirmed that the "abnormal" clotting factor was just the result of my family history and nothing major to be concerned about at that time. Anyone with half a brain could deduct that someone with a family history of stroke probably has a genetic predisposition to clotting. It's not rocket science!!!

During this time, Matthew and I were married. We knew that we wanted children someday, so I began researching PCOS. I spent hours online, desperate to understand the medical condition that had changed my life. I was determined to be a knowledgeable patient and to avoid repeating the experiences with the ob/gyn and hematologist.

After I was finally cleared, I began searching for a doctor who specialized in PCOS and found an Reproductive Endocrinologist ("RE") at the local university. My health insurance does not cover any infertility related expenses, so RE's are normally excluded from coverage; however, because the treatment was for PCOS and not conception, the insurance company paid without question. Again, I was a pin cushion for about 6 months. But at least the tests were related to PCOS. Labs confirmed that my testosterone was about twice the normal range for women. The RE prescribed spironalactone without BCPS, but I suffered a severe allergic reaction to the meds.

When I went back to the office, Matthew and I had decided that we were ready to begin trying to conceive and I asked the RE for metformin (brand name "Glucophage"), a diabetic drug that works with the endocrine system and has become popular treatment for PCOS in recent years. Studies show that the medication regulates cycles in many PCOS patients after about six months of treatment (sometimes restoring ovulation). The RE laughed and said that their office only prescribed metformin with clomid. I expressed concern because Matthew and I weren't ready to go from not trying to conceive to fertility drugs immediately. I had brought several articles about metformin with me, but the RE and his assistant refused to listen. After arguing with the doctor for nearly a half hour, he finally wrote me a one month's script just for the metformin and made snide remarks about it as I left. Before I left the parking lot, I had already found a new ob/gyn, scheduled an appointment before the script was up and had requested that my medical records be forwarded to the new doctor. No, I did not attend medical school. No, I am not a physician. But I am a patient who has educated herself and is aware of her body. I have the right to ask questions, be treated with respect and seek a second opinion.

The transition to the new doctor went smoothly. She sat with me for over 45 minutes reviewing my charts, asking questions and answering mine. Then, she wrote a script for a year's supply of metformin, suggested that I take prenatal vitamins and encouraged me to chart my basal body temperature. That was in January 2008.

The first few months of trying to conceive were fun. Matthew and I "were making a baby" and sex was still fun. By the fifth month, I realized that I had not ovulated on the metformin.
Through research, I discovered that many women take soy isoflavones for five days at the beginning of their cycles to improve their chances of ovulating (soy isoflavones work in a manner similar to Clomid--I'll post a link to one of the articles later). Several women on multiple message boards actually conceived using soy so I gave it a shot. Sure enough, I ovulated, but no pregnancy. Then, I read that some women use Instead Soft Cups after intercourse to keep sperm near the cervix. I tried that too. No pregnancy. I also tried using ovulation predictor sticks, but they were very difficult to interpret (the test line must be "as dark as or darker than" the control line in order for the test to be positive).

Matthew and I have now been trying to conceive for over a year. Technically, we should have sought medical assistance six months ago (the recommended time frame for couples who have a preexisting condition that could cause infertility), but our health insurance doesn't cover fertility treatments or office visits directly related to infertility. We are financially secure and could afford the expenses of a child, but we aren't ready to spend thousands of dollars on medical expenses that won't guarantee a baby (without insurance, office visits are $350 each, plus lab work, medications, etc.). I'm due for my annual exam January 15th and the doctor said that she will prescribe up to six cycles of unmonitored Clomid at that time (given that the annual comes back clear). So here I am...hoping, praying and waiting to wait.

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