I passed! (26 weeks)

I have a bunch of exciting updates today:

I passed the glucose test! Yahoo! No GD here!  I am actually shocked I passed and attribute it to being on Metformin. My result was 120 which is good. They want to see it under 140 (although some places say under 130). I am so relieved.  I remember eating a glazed donut last week (still my only true pregnancy craving) and savoring every morsel as I mentally prepared myself to say goodbye to them for the next few months. It was a sad day, haha.  But NOPE!  No GD so bring on the sugary goodness!
 
I had a prenatal appt earlier this week and everything went well. My BP was good, baby's HB was good, and my belly is measuring right at 26 weeks! I've also finally starting gaining weight appropriately and am now up 6 pounds. If I'm somehow magically able to maintain a 1 lb/week gain that would only be a total of about 20 lbs which would be amazing.  We'll see though. 
Here's this week's bump:

Pregnancy wise, I can no longer:

• see my feet (not to mention my lady bits),
• roll over in bed without grunting and huffing like a hippopotamus,
• wear socks without them leaving indents in my ankles (I use the term 'ankles' loosely), or
• wear my engagement ring.

And I think my hand is slowly eating my wedding band. For now it's okay but eventually I'm sure I will need to take it off and run the risk of looking like a teen mom.


NEXT:
We bought a crib last weekend! Ta da!:

It matches the dresser that we already had in the spare room which will stay in the nursery and double as a changing table.  I'm also excited because this is a convertible crib so it will grow with the baby - into a toddler bed, day bed (if we want it to) and then eventually to a full sized (double) bed.  This kid better like it.

It's amazing how much better I feel just getting that ONE thing done. I am feeling slightly less crazy.  Now if I could only get to the 40 million other things on my To Do list...

Last but not least, as of today I officially have just 99 days left until my EDD! Double digits!! Yahoo!  And as Ana pointed out, soon enough I will have just single digit WEEKS left! Ahhh!!  I'm now knocking on 3rd Tri's door.  I'm a bit sad I never did get that elusive 2nd Tri energy everyone talks about (especially since I'm STILL on Zofran daily for nausea - the doc thinks that at this point I'm just going to be one of those women who has nausea throughout the pregnancy) but that's okay. I'm just happy to be moving forward :-)

Pricks.

Finger pricks that is! I've been doing a lot of this lately:

 Luckily, I have some experience with sticking myself with needles thanks to IF...

Funny story; when I searched googleimages for "finger prick" this gem appeared:

LOL!

Anywho, I've been sticking needles into my fingers 4 times/day lately because I met with an OB and high-risk nurse at my clinic earlier this week to discuss how my PCOS/insulin resistance might affect my pregnancy, and they decided I should test my blood sugar for the next week to see what we're working with. If my levels indicate that I already have issues regulating my blood sugar then they'll consider me 'high-risk'; I'll have to go in twice a week every week until the end of my pregnancy for monitoring (yikes), and they'll pretty much treat me like I've got the 'Diabeetus' even if I don't actually have it.

It's only been a couple days but so far so good with most of the BS readings. I reaaaaaally hope I don't fail this test.  As long as everything is good I don't need to worry and can just continue on like normal and then go in and do the regular fasting glucose test that all pregnant women take around 26 weeks (that's the one where you fast then drink the gross sugary drink and get your blood tested 1 hr later and 2 hrs later). Fingers crossed!

At the appointment we also discussed me continuing on 1500mg Metformin daily.  Apparently the medical community is somewhat divided on whether or not pregnant women who were on Met prior to pregnancy should stay on it or not. I personally want to stay on it because I feel better on it,  there have been studies showing it actually helps with breastfeeding (women will PCOS can have troubles BF), and there have been no adverse effects found in infants born to pregnant women taking Met. Soooo, it seems silly to me that I should go off of a medication that is helping me with my insulin resistance, when pregnancy already increases a normal (non-IR) woman's resistance to insulin! Wouldn't that be rather counter-productive and just ensure that I would indeed end up developing gestational diabetes?  Luckily, my doctors agree and all seem to come down on the same side of the debate that I do so I'll be staying on it. Victory!

Wednesday, Bloody Wednesday

Well, it's cycle day 16 and I'm STILL bleeding. This is a first.  I think I choose the extremely long cycles over the extremely long period. Unfortunately, I'll probably have both this cycle. Yuck.  And my ultrasound is tomorrow morning so that should be fun.  Luckily, the nurse said that u/s are often done around CD3 so they're likely used to the bleeding. Can't say I'm really looking forward to it though.

Also, I ended up starting the double dose of Metformin on Monday since I had a couple of okay days in there so I'm now at 1500mg/day.  The first day was alright but this morning was ugly. I HAD to go into the office today though so I pumped myself full of Immodium and powered through. We'll see how tomorrow goes.

Lastly, today my pregnant next door neighbor's water broke so they're at the hospital tonight. She's almost 3 weeks early so we're all hoping everything goes well and that they'll be bringing home their healthy baby girl soon.  I'm so excited and happy for them and wishing them all the best but I also can't help but feel a little jealous and sad for myself.  It makes me want to be pregnant SO BADLY. I would love for our kids to be close in age so we could hang out together while the kids play in the yard...sigh. I could go on and on about my feelings on this but I really don't feel like dwelling on it tonight and making myself feel bad.  Instead I'm gonna keep watching the Bruins kick the Habs' ass!

In other news...

In the midst of unnecessarily feeling bad for myself, I forgot to write down my other news:

1) The nurse gave me my repeat bloodwork results and my potassium levels are fine. I celebrated by immediately gobbling down a banana.

2) They want me to double the Metformin dose to 1500mg/day starting on Monday so I am thinking I should buy some stock in Charmin UltraSoft. 

Here's how I plan to decorate my bathroom next week:

Lastly,
3) The nurse scheduled me for a pelvic exam & ultrasound for next Thurs AM so it's back the hospital I go! Fingers crossed:  this should be the last testing that needs to be done before my next RE appt (rescheduled for May 2nd)!

Next Steps: HSG & b/w

I forgot to post an update last Friday regarding my bloodwork results:  I am NOT a carrier for Cystic Fibrosis or Spinal Muscular Atrophy (look who figured out what SMA stands for!) and I had previously learned that my Rubella immunity and RH factor are positive so that's good. 

Besides that, the nurse said my Potassium levels were high so they want me to lay off the bananas and spinach for the next week and then come in for repeat b/w this Thursday. That's a bummer because A) I hate getting blood drawn (although I am getting quite used to it lately) and B) I eat both spinach and a banana almost every day. Now that I'm on Metformin and having almost constant upset stomach/diarrhea, I would really like to eat a banana since it's one of the better foods to help calm the tummy (I am quite familiar with the BRAT diet - Bananas, Rice, Applesauce & Toast for those of you who aren't lucky enough to have a touch of IBS all their lives like I seem to) but, too bad.

Additionally, my HSG is scheduled for Tuesday morning (CD8)  so I'll have to start antibiotics tomorrow (which will apparently also make me poop, hurrah!)  since it's invasive. I'm not exactly looking forward to the procedure since it sounds like it could be very painful (at a minimum, quite uncomfortable) but I'm glad it's scheduled.  It will be one more thing off the checklist and hopefully my tubes will be clear and we'll be good to go!  Hubby is coming with me because my sister said that hers hurt SO badly that she'd actually take the day off to be with me if Hubs couldn't make it just in case I have the same experience she did. FX that it won't be bad!

I've heard quite a few times from many different people that the cycle you have the HSG done seems to be extra fertile (b/c the dye clears everything out?) so I really hope the Metformin (and acupuncture? still skeptical)  will help me ovulate this month so that we'll have a chance this time without needing Clomid. My follow up appt with the RE is on April 25 so I assume at that point if I have not gotten my period and am not KU he will want to give me Provera to jumpstart the next cycle and then we'll start Clomid.

FX for clear tubes and ovulation this cycle! 

ONWARD AND UPWARD!
 

 

First RE Appt Today

I had my first RE appt today!  It went well and was...enlightening. It also totally gave me the sense that with this appt, I just voluntarily hopped aboard a fast-moving train and there will really be no slowing down until I'm pregnant or if we happen to hit some sort of unavoidable roadblock. I guess I'm just gonna hang on and hope for the best.

Warning: This is probably going to be a SUPER long post because A) I want to write things down before I forget in case I want to review it and B) I want to provide details in the off-chance that someone reading this who is in a similar situation might actually get something from it!

So here's what happened today:
Hubby & I had a good discussion with the RE and I got to ask all my questions (more about that in a minute). They drew blood to make sure I'm not a carrier for cystic fibrosis and SMA (? I can't remember what that is).  They also tested something with my liver to make sure my body can handle Metformin. As long as the b/w results are good I will be starting Metformin (extended release) tomorrow night. The plan is to start with one 750mg pill every night before bed and once my body is used to that dose (he said it would likely take a few weeks) I'll add a 2nd pill each night so it'll be 1500mg/day every day, through (at the VERY least) 10 weeks into my pregnancy since he said it cuts down the chances of early miscarriage. I also will be having my HSG next week on either Tues or Wed so that we can make sure my tubes are clear and my uterus is shaped correctly. (It ended up being a very good thing that I timed the most recent dose of Provera to make sure I was only a couple days into my cycle at this point so that we can get the HSG done now instead of wasting another 2+ months until I can be at the beginning of my cycle again.)  I'll also have a pelvic exam and ultrasound to determine just how cystfull (totally a word) my ovaries are.  I think that's all that's scheduled for now. Once it's all done I will be going in to meet with him again in another 4-6 weeks and I will be starting Clomid shortly after that (more about that below).

The other big thing is that I will now be very focused on trying to lose weight since he said that my chances of becoming pregnant would increase dramatically with weight loss and that I should focus on getting my BMI into a healthy range.  I asked if the Metformin could help with that and he said if it does it would really just be because of appetite suppression and since the Met will almost undoubtedly give me diarrhea, I likely won't feel like eating as much or the same kinds of foods I have been. So that will be tough but I am motivated.

So here's some not great news: (And let me first preface this by saying that I really do trust that he knows his shit, understands the cutting edge research, and has proven success regarding his patients' pregnancy rates. He has stellar credentials and works at one of the top hospitals in the COUNTRY. His bedside manner is somewhat lacking but I don't mind if it means I am receiving great care. In spite of all that, I WAS surprised at some things he said and asked him many questions, and do not plan to just blindly follow exactly what he says without first doing some more research on my own.) Okay, so:

1. Apparently with PCOS, not only is it harder to get pregnant but my chances of miscarriage are greater as well. Direct quote: "The problem won't be GETTING you pregnant, it will be KEEPING you pregnant." Silly me, and I thought this was the hard part. Now I have something else to worry about.

2. He doesn't think depression and PCOS are really linked and that I should ask my PCP about it if I'm having a problem. He doesn't know if it's connected to my hormones and said if it IS, it would be due to increased progesterone but based on my charts, that doesn't really make sense when I look at my most depressive days (it looks to me like increased estrogen and/or LH and/or FSH cause it). So I don't know what's up there.  Hopefully eating better/exercising/losing weight will help. If is doesn't, I guess I'll go back to my incompetent PCP.

3. He puts zero stock in charting BBT, etc. and seems to think it is outdated.  I brought copies of my charts for him and he was completely uninterested. Charting over the past 10 mos was helpful in that I was able to confirm that I do NOT ovulate but other than that, now that I've 'graduated' to fertility medications, it seems like he thinks there is no need. (I plan to still chart while on meds even though my temps may be elevated, in order to see if I can still capture a temp shift to confirm O.)

4. He told me that he does not prescribe Metformin without also prescribing Clomid (except he did make the distinction that I need to take the Met alone for 6 weeks to get it fully into my system before starting the Clomid), because he says there is not much point and we'd just be wasting more time. He says it's proven time and again that the two work very well in conjunction with one another so that is the path he follows. I take it to mean that he takes a more aggressive approach to infertility than some other drs might. I guess that is not a problem for me.

5. The thing that MAY be a problem for me is that he does not think monitoring on the first dose of Clomid (i.e. CD3 & CD10 b/w and u/s) is necessary. (Note that he DOES monitor each dose after the first) The reason why he said he never does it is because the risks are SO rare that it's not necessary and in his thousands of patients, not ONE has ever had a problem. When I mentioned the risk of large and/or ruptured cysts he said that if I have a problem I will have pain so we will know something is not right and that the monitoring would not head that off. When I mentioned the risk of overstimulated follicles (i.e. too many follies and increased risk of multiples) he said having a lot of follies is what we WANT because I would have a higher chance of getting pregnant and that the risk of actually getting pregnant with multiples (esp. 3+) is very low anyway.  And when I mentioned uterine lining thinning he said that is really only a concern if you take about 12 rounds of Clomid which he would NEVER let happen, and that the generally accepted "limit" of 6 cycles among medical professionals is not truly a limit but just the consensus they came to based on the hard "limit" of 12.

So this was very surprising to me since I've been on The Bump for almost a year now and have seen it repeated time and time again that you "MUST BE MONITORED EACH AND EVERY TIME!!!".  After a year, that kind of got drilled into my head.  So I'm not sure what to think now.  Is this dr just extremely headstrong, has seen what works, has never had a patient with serious issues and so he is convinced that this is the best/right way to do it? He IS the professional... is he right and the women on TB are just overly afraid? I don't know. He DID say that if I really want to have the monitoring done (even though he made a point to restate that he finds it completely unnecessary) then we can do that. So that's good I guess.  I haven't made up my mind about it. He told me about some studies regarding this that I can take a look at and I will be doing some more researching on my own as well.  Thankfully, it's just the first dose that he finds no need to monitor so if it is taking a chance, it is only ONE chance, not every month. We'll see.

Okay, I think those are the main points.  HSG early next week, and I should be starting the Metformin tomorrow night! Let the diarrhea commence!