So, it was AF and CD1 after all. At least, I think so. It's been 10 days and AF is just now tapering off and already I am having luteal phase symptoms. I am moody, I am hungry, and I feel ugly. It's like my body doesn't understand how to ovulate or cycle regularly anymore. It seems like it just understands AF and luteal phase right now.
In any case, I called my doctor (you always have to leave a message). Her nurse called me back and said the doctor feels it is just random anovulatory cycles and to call them with the next CD1 so we can schedule an ultrasound. And then, if I magically make it to CD21, they want to do a test for progesterone levels. So, that's where I'm at right now.
Tuesday, May 7, 2019
Sunday, April 28, 2019
The Best Laid Plans
My last normal cycle was in January. Twice now, I have been expecting to go into my fertile window only to be hit with surprise AF.
My March cycle started that way with the weirdest AF I've had in a long time. Normally, AF starts heavy, then gradually tapers off. That time, it stayed consistently medium before abruptly stopping at the usual time. However, it turned into a somewhat normal cycle, with fertile window and normal luteal phase, though the cycle length was shorter than my usual at only 27 days long.
The March cycle ended with a normal AF. I had my HSG on CD8 which caused some expected spotting. Things returned to normal and now here I am on what should be CD17 and I have no idea if this is actually a new CD1 or mid-cycle spotting. It's too heavy for spotting, too light for my normal AF.
If it really is AF, then that makes four periods in the last 63 days!!
I'm worried about peri-menopause or early menopause but I would think all the blood tests I've had recently might show that something like that was going on??
Maybe I've been under too much stress lately or maybe the tests and doctors missed something? Maybe this is a side-effect of the HSG?
It doesn't help that I also just crossed the age line into 35, the age whereby your fertility is thought to drop exponentially.
Early AF was neither an expected, nor wanted, birthday present.
My March cycle started that way with the weirdest AF I've had in a long time. Normally, AF starts heavy, then gradually tapers off. That time, it stayed consistently medium before abruptly stopping at the usual time. However, it turned into a somewhat normal cycle, with fertile window and normal luteal phase, though the cycle length was shorter than my usual at only 27 days long.
The March cycle ended with a normal AF. I had my HSG on CD8 which caused some expected spotting. Things returned to normal and now here I am on what should be CD17 and I have no idea if this is actually a new CD1 or mid-cycle spotting. It's too heavy for spotting, too light for my normal AF.
If it really is AF, then that makes four periods in the last 63 days!!
I'm worried about peri-menopause or early menopause but I would think all the blood tests I've had recently might show that something like that was going on??
Maybe I've been under too much stress lately or maybe the tests and doctors missed something? Maybe this is a side-effect of the HSG?
It doesn't help that I also just crossed the age line into 35, the age whereby your fertility is thought to drop exponentially.
Early AF was neither an expected, nor wanted, birthday present.
Monday, April 22, 2019
Test Results
So, this post has been sitting in my drafts for a while now. I forgot I didn't publish it earlier but now I need to add more anyway.
The blood tests have confirmed that I have PCOS. My A1C is riding just barely below the level of pre-diabetes and my doctor wants me to meet with a nutritionist, despite being at a normal BMI.
Remember this post and this post about wanting to get my MMR updated? I later found my immunization records and saw that I was vaccinated twice for it. I thought I was all good. However, one of the recent blood tests was for rubella. Apparently my level of immunity to it is what my doctor calls "equivocal", which means they can tell I've been vaccinated but that I'm probably not entirely immune anymore. So, I went and had that updated. I can't help but be a little annoyed that I asked for it to be updated last year and was refused.
I have to be on metformin. However, it said to not take it if you're having a procedure that uses X-rays and contrasting dyes. I filled the prescription but elected not to take it until after the HSG.
Speaking of the HSG, the timing didn't work for March but I was able to schedule it for April. In fact, I just had it last week. I was really dreading it based on other people's horror stories but, for me, the worst part was the extra large speculum. Once they took the speculum out it was smooth sailing. I did not feel the balloon catheter and only experienced very mild cramping when the contrast was injected. My doctor said I passed the "natural childbirth" test. Though that pleases me, I kinda doubt natural childbirth is as easy as that.
When the HSG was over she showed me the X-rays and how everything looked normal. So, the good news is my tubes are not blocked. Yay!
Then she proceeded to tell me I could go ahead and have intercourse every couple days this cycle and to call her with a positive pregnancy test or CD1. *sigh*
This is where I really suck at being a patient. I get so nervous in the presence of doctors (and other authority figures) that I forget to ask questions, feel bad about contradicting them, and generally just want to get things over with as quickly as possible. I am not my own best advocate. I probably should have spoken up and reminded my doctor that I can't currently fulfill that prescription for penis-cillin. I should have asked what my steps are going forward with an IUI cycle, especially as it will have to be coordinated between two towns and more than one clinic. But, there were also two nurses listening in and HIPPA-be-damned, it's still nerve-wracking explaining to an audience of strangers that I am pursuing this as a single person. Plus, I just wanted to get out of the hospital gown and get dressed. Besides, I don't plan on cycling again until July for a few different reasons. The timetable could move up, but hopefully I can just call up the doctor's office and arrange things when I'm ready.
Also, right before the HSG the doctor informed me that my DHEA was elevated and that she wanted me on a second prescription for cycling but she never said what that med was and I forgot to ask after the procedure. I also forgot to ask when I should start the metformin and how long I should be taking it. I really need to be better about asking and remembering questions.
The blood tests have confirmed that I have PCOS. My A1C is riding just barely below the level of pre-diabetes and my doctor wants me to meet with a nutritionist, despite being at a normal BMI.
Remember this post and this post about wanting to get my MMR updated? I later found my immunization records and saw that I was vaccinated twice for it. I thought I was all good. However, one of the recent blood tests was for rubella. Apparently my level of immunity to it is what my doctor calls "equivocal", which means they can tell I've been vaccinated but that I'm probably not entirely immune anymore. So, I went and had that updated. I can't help but be a little annoyed that I asked for it to be updated last year and was refused.
I have to be on metformin. However, it said to not take it if you're having a procedure that uses X-rays and contrasting dyes. I filled the prescription but elected not to take it until after the HSG.
Speaking of the HSG, the timing didn't work for March but I was able to schedule it for April. In fact, I just had it last week. I was really dreading it based on other people's horror stories but, for me, the worst part was the extra large speculum. Once they took the speculum out it was smooth sailing. I did not feel the balloon catheter and only experienced very mild cramping when the contrast was injected. My doctor said I passed the "natural childbirth" test. Though that pleases me, I kinda doubt natural childbirth is as easy as that.
When the HSG was over she showed me the X-rays and how everything looked normal. So, the good news is my tubes are not blocked. Yay!
Then she proceeded to tell me I could go ahead and have intercourse every couple days this cycle and to call her with a positive pregnancy test or CD1. *sigh*
This is where I really suck at being a patient. I get so nervous in the presence of doctors (and other authority figures) that I forget to ask questions, feel bad about contradicting them, and generally just want to get things over with as quickly as possible. I am not my own best advocate. I probably should have spoken up and reminded my doctor that I can't currently fulfill that prescription for penis-cillin. I should have asked what my steps are going forward with an IUI cycle, especially as it will have to be coordinated between two towns and more than one clinic. But, there were also two nurses listening in and HIPPA-be-damned, it's still nerve-wracking explaining to an audience of strangers that I am pursuing this as a single person. Plus, I just wanted to get out of the hospital gown and get dressed. Besides, I don't plan on cycling again until July for a few different reasons. The timetable could move up, but hopefully I can just call up the doctor's office and arrange things when I'm ready.
Also, right before the HSG the doctor informed me that my DHEA was elevated and that she wanted me on a second prescription for cycling but she never said what that med was and I forgot to ask after the procedure. I also forgot to ask when I should start the metformin and how long I should be taking it. I really need to be better about asking and remembering questions.
Sunday, February 24, 2019
The Appointment
This is going to be long.
I wanted to wait to update until I had actually gone to the appointment.
I didn't receive a call back from the doctor's office until the following Wednesday (I had originally called on a Friday). The person I talked to for that call seemed to be fairly nice and non-judgemental. We set up the appointment for a few weeks from that date and I was instructed that a packet of papers would be sent to me.
It wasn't until later that I realized that AF would be around on the appointment date. So, I ended up having to call back and reschedule it for another date.
About a week before my appointment, I realized my packet had never arrived. I ended up calling the office but it wasn't until a Friday afternoon (my appointment was the following Thursday). I asked about my packet not arriving and the lady said they had sent one on the 10th of January (this was about a month later that I was calling). We confirmed my address was correct and she said she'd send another one on Monday and hoped it would arrive in time.
The Thursday of my appointment rolled around and I still hadn't gotten the packet. I decided to check the mail before leaving, just in case, and there it was. So, I hurriedly filled it out as best I could before getting on the road. The clinic is only about an hour and a half away but, because of snow, I decided to leave at least three hours ahead of appointment time. The snow was really bad in town and I was worried how the highway would be. Fortunately, it was a lot less snowy out of town and I was able to make good time going over.
By the time I got to the clinic the wind had started to pick up and I could see that another winter storm was predicted to come in around 6:00pm. My appointment was supposed to be an hour long, starting at 2:30, so I figured I'd be nearly home by the time the storm hit.
Inside the clinic, I was surprised by how busy it was. I didn't actually end up seeing the doctor until sometime after 3:30. Though, with all the activity I could hear, it sounded like they were a bit short-staffed that day and even the doctor was spread thin dealing with multiple patients. It seemed like it was not a typical day, so I'm going to try not to hold that against them.
However, when I did finally see the doctor she was very nice and welcoming. She seemed very knowledgeable. I mainly wanted to know what the likelihood was of me having PCOS and endometriosis, as well as how to go forward with getting pregnant.
Based on my symptoms, she believes it is highly likely that I do have PCOS, though she wouldn't officially give me the diagnosis until she gets some test results back. We did an ultrasound which showed I had likely just ovulated (which matched with my BBT chart). One ovary seemed to have activity that indicated PCOS but the other (the ovulatory one) didn't. She saw something on the ovulatory ovary that, if not resolved later, might indicate a possibility of endometriosis, though it was likely related to the recent ovulation.
The good news is that I still ovulate, despite the PCOS. However, the doctor thinks my eggs are just not high quality enough by the time I ovulate, and that may be why I have not gotten pregnant. She said she would like to see me on metformin. She also believes I should take even more Vitamin D, though we are waiting on results from my Vitamin D blood test. I ended up having to get about seven vials of blood drawn for all the tests the doctor wanted.
She also wants me to get my blood drawn for CD3 hormone testing and I'm supposed to call on CD1 to schedule an HSG. She said she prefers to do the HSG at her clinic because apparently they don't do them often in my town and there have been horror stories of them being long and drawn out. She said she does them all the time, so it's better there. The HSG is one thing that is freaking me out because I've heard varying accounts of how painful it is, but I know it is important to see that the tubes are open. However, I don't think the timing will work this month as I suspect the dates for doing one will fall during a coworker's vacation and I cannot take off a whole day of work, or even a half day at that time.
She said that if I want to go through their clinic for cycles that they coordinate all the time with an ultrasound clinic that is in my town. The only difficulty, of course, is being able to get time off work, especially for specific days and times at short notice. I'm not exactly sure how that is going to work though I might only need to take a half-day when the roads are better.
Anyway, for now we are waiting on the results of my blood tests and CD1. Also, the possibility of endometriosis is not off the table but the doctor would like to hold off on any kind of exploratory surgery at this time. I am happy to hold off, though I worry about wasting more time and money if it is present.
Also, after waiting for the doctor, waiting for the ultrasound room, and waiting to get my blood drawn, it was after 6:00pm by the time I finally got out of there.
The wind had really picked up and it was absolutely nasty in the parking lot. When I went to leave, the snow was blowing so hard it was practically whiteout conditions. I could barely see the roadway or any other cars. I figured if it was like that on the interstate, I would pull over and get a hotel. Also, it was rapidly getting dark as the sun had pretty much set. However, by the time I got to the interstate, I could see that the road was just wet, not snowy or icy. It wasn't until I got to the two-lane highway that there started to be snow on the road. It was full dark by this time and the snowplows had not plowed the passing lanes so I'm afraid some people were stuck behind me until we made it into town. I'm so thankful it wasn't worse and that I made it back safe. The snow keeps falling though, so maybe it's a good thing the timing for the HSG won't work out for March. Maybe the roads will be better in April?
I wanted to wait to update until I had actually gone to the appointment.
I didn't receive a call back from the doctor's office until the following Wednesday (I had originally called on a Friday). The person I talked to for that call seemed to be fairly nice and non-judgemental. We set up the appointment for a few weeks from that date and I was instructed that a packet of papers would be sent to me.
It wasn't until later that I realized that AF would be around on the appointment date. So, I ended up having to call back and reschedule it for another date.
About a week before my appointment, I realized my packet had never arrived. I ended up calling the office but it wasn't until a Friday afternoon (my appointment was the following Thursday). I asked about my packet not arriving and the lady said they had sent one on the 10th of January (this was about a month later that I was calling). We confirmed my address was correct and she said she'd send another one on Monday and hoped it would arrive in time.
The Thursday of my appointment rolled around and I still hadn't gotten the packet. I decided to check the mail before leaving, just in case, and there it was. So, I hurriedly filled it out as best I could before getting on the road. The clinic is only about an hour and a half away but, because of snow, I decided to leave at least three hours ahead of appointment time. The snow was really bad in town and I was worried how the highway would be. Fortunately, it was a lot less snowy out of town and I was able to make good time going over.
By the time I got to the clinic the wind had started to pick up and I could see that another winter storm was predicted to come in around 6:00pm. My appointment was supposed to be an hour long, starting at 2:30, so I figured I'd be nearly home by the time the storm hit.
Inside the clinic, I was surprised by how busy it was. I didn't actually end up seeing the doctor until sometime after 3:30. Though, with all the activity I could hear, it sounded like they were a bit short-staffed that day and even the doctor was spread thin dealing with multiple patients. It seemed like it was not a typical day, so I'm going to try not to hold that against them.
However, when I did finally see the doctor she was very nice and welcoming. She seemed very knowledgeable. I mainly wanted to know what the likelihood was of me having PCOS and endometriosis, as well as how to go forward with getting pregnant.
Based on my symptoms, she believes it is highly likely that I do have PCOS, though she wouldn't officially give me the diagnosis until she gets some test results back. We did an ultrasound which showed I had likely just ovulated (which matched with my BBT chart). One ovary seemed to have activity that indicated PCOS but the other (the ovulatory one) didn't. She saw something on the ovulatory ovary that, if not resolved later, might indicate a possibility of endometriosis, though it was likely related to the recent ovulation.
The good news is that I still ovulate, despite the PCOS. However, the doctor thinks my eggs are just not high quality enough by the time I ovulate, and that may be why I have not gotten pregnant. She said she would like to see me on metformin. She also believes I should take even more Vitamin D, though we are waiting on results from my Vitamin D blood test. I ended up having to get about seven vials of blood drawn for all the tests the doctor wanted.
She also wants me to get my blood drawn for CD3 hormone testing and I'm supposed to call on CD1 to schedule an HSG. She said she prefers to do the HSG at her clinic because apparently they don't do them often in my town and there have been horror stories of them being long and drawn out. She said she does them all the time, so it's better there. The HSG is one thing that is freaking me out because I've heard varying accounts of how painful it is, but I know it is important to see that the tubes are open. However, I don't think the timing will work this month as I suspect the dates for doing one will fall during a coworker's vacation and I cannot take off a whole day of work, or even a half day at that time.
She said that if I want to go through their clinic for cycles that they coordinate all the time with an ultrasound clinic that is in my town. The only difficulty, of course, is being able to get time off work, especially for specific days and times at short notice. I'm not exactly sure how that is going to work though I might only need to take a half-day when the roads are better.
Anyway, for now we are waiting on the results of my blood tests and CD1. Also, the possibility of endometriosis is not off the table but the doctor would like to hold off on any kind of exploratory surgery at this time. I am happy to hold off, though I worry about wasting more time and money if it is present.
Also, after waiting for the doctor, waiting for the ultrasound room, and waiting to get my blood drawn, it was after 6:00pm by the time I finally got out of there.
The wind had really picked up and it was absolutely nasty in the parking lot. When I went to leave, the snow was blowing so hard it was practically whiteout conditions. I could barely see the roadway or any other cars. I figured if it was like that on the interstate, I would pull over and get a hotel. Also, it was rapidly getting dark as the sun had pretty much set. However, by the time I got to the interstate, I could see that the road was just wet, not snowy or icy. It wasn't until I got to the two-lane highway that there started to be snow on the road. It was full dark by this time and the snowplows had not plowed the passing lanes so I'm afraid some people were stuck behind me until we made it into town. I'm so thankful it wasn't worse and that I made it back safe. The snow keeps falling though, so maybe it's a good thing the timing for the HSG won't work out for March. Maybe the roads will be better in April?
Monday, January 7, 2019
Of Anxiety and Appointment-making
There's nothing like going to the doctor to make you feel judged and like a hypochondriac, even when you have a completely legitimate reason for going.
Does that happen to anyone else? It may be my anxiety around doctor's offices but it feels like everyone from the receptionist, to the nurses, to the doctors, is judging me and secretly thinking I shouldn't be there. When I actually get to an appointment I have to try really hard to emphasize my concerns because my brain likes to take the easy way out and tries to convince me (and the doctors) that nothing is wrong.
So, there's only one RE in my state and their clinic is about 3.5 hours and hundreds of miles away. Fortunately, for everything (except IVF) they have a satellite clinic in a town that is only about 1.5 hours away.
In my family, there is a history of endometriosis and I have some, though not all, of the symptoms. I also have some, though not all, of the symptoms of PCOS.
I figured, rather than waste more money on sperm when there might be a problem, I should at least get checked out so I know if there's anything I'm up against. Also, many SMCs go straight to an RE before they try even one cycle. So, I figured, with two cycles under my belt and my concerns about possible fertility issues, it would be worth it to schedule an appointment. This way, I would also have a history with the clinic should I need to try IUI or IVF in the future.
I have never felt worse about being on this journey as a single person - and that was just scheduling the appointment (or not, but more on that later).
I don't think my state has a particularly high percentage of SMCs, so I'm not surprised if even the RE's office doesn't encounter this situation much, but I didn't realize it would make for such an awkward conversation when just trying to schedule an appointment. I could tell the receptionist didn't exactly know what to say and was kind of stumbling around on what to do with me. It seemed fine that I was asking for an appointment, rather than being referred by a doctor, so I don't think that was the problem. Is wanting to get your fertility evaluated when you're concerned about potential problems just not a thing that is done? Especially if you're single?
(ETA: This clinic's website specifically states that they deal with evaluating and taking steps to overcome fertility issues like PCOS and endo. They also deal with IUIs and fertility procedures, as well as high-risk pregnancies and other things in the realm of a regular OBGyn. So, I don't think my request to be evaluated is what the receptionist was stumbling over, though it's probably not a request that comes up often. Also, the receptionist wasn't mean but she did seem very flustered.)
It would be one thing if I had tried the old-fashioned way for two cycles and hadn't yet conceived - it would at least be free to try that way for six months to a year before getting checked out. But donor sperm is expensive, even when using just one vial per cycle. Trying for even six months is a major expense, especially when there might be a problem.
So, I tried to schedule an appointment. The receptionist told me she would pass on my info to the doctor's nurses who would then call me to schedule the actual appointment. I kept my phone on me all day Friday (something that is inconvenient for me to do at work) but never received a single call. I guess I'll have to keep my phone with me on Monday again as well.
I really hate making doctor's appointments, and I hate going to the doctor, so being in limbo about this appointment is so annoying and discouraging. At this point, anxiety brain has me hoping they forget to call me, but the rest of me recognizes that I do have a legitimate need to be checked out by a doctor, for peace of mind if for nothing else.
In other news, my donor is out of stock at the moment and I was not able to try in November or December.
Does that happen to anyone else? It may be my anxiety around doctor's offices but it feels like everyone from the receptionist, to the nurses, to the doctors, is judging me and secretly thinking I shouldn't be there. When I actually get to an appointment I have to try really hard to emphasize my concerns because my brain likes to take the easy way out and tries to convince me (and the doctors) that nothing is wrong.
So, there's only one RE in my state and their clinic is about 3.5 hours and hundreds of miles away. Fortunately, for everything (except IVF) they have a satellite clinic in a town that is only about 1.5 hours away.
In my family, there is a history of endometriosis and I have some, though not all, of the symptoms. I also have some, though not all, of the symptoms of PCOS.
I figured, rather than waste more money on sperm when there might be a problem, I should at least get checked out so I know if there's anything I'm up against. Also, many SMCs go straight to an RE before they try even one cycle. So, I figured, with two cycles under my belt and my concerns about possible fertility issues, it would be worth it to schedule an appointment. This way, I would also have a history with the clinic should I need to try IUI or IVF in the future.
I have never felt worse about being on this journey as a single person - and that was just scheduling the appointment (or not, but more on that later).
I don't think my state has a particularly high percentage of SMCs, so I'm not surprised if even the RE's office doesn't encounter this situation much, but I didn't realize it would make for such an awkward conversation when just trying to schedule an appointment. I could tell the receptionist didn't exactly know what to say and was kind of stumbling around on what to do with me. It seemed fine that I was asking for an appointment, rather than being referred by a doctor, so I don't think that was the problem. Is wanting to get your fertility evaluated when you're concerned about potential problems just not a thing that is done? Especially if you're single?
(ETA: This clinic's website specifically states that they deal with evaluating and taking steps to overcome fertility issues like PCOS and endo. They also deal with IUIs and fertility procedures, as well as high-risk pregnancies and other things in the realm of a regular OBGyn. So, I don't think my request to be evaluated is what the receptionist was stumbling over, though it's probably not a request that comes up often. Also, the receptionist wasn't mean but she did seem very flustered.)
It would be one thing if I had tried the old-fashioned way for two cycles and hadn't yet conceived - it would at least be free to try that way for six months to a year before getting checked out. But donor sperm is expensive, even when using just one vial per cycle. Trying for even six months is a major expense, especially when there might be a problem.
So, I tried to schedule an appointment. The receptionist told me she would pass on my info to the doctor's nurses who would then call me to schedule the actual appointment. I kept my phone on me all day Friday (something that is inconvenient for me to do at work) but never received a single call. I guess I'll have to keep my phone with me on Monday again as well.
I really hate making doctor's appointments, and I hate going to the doctor, so being in limbo about this appointment is so annoying and discouraging. At this point, anxiety brain has me hoping they forget to call me, but the rest of me recognizes that I do have a legitimate need to be checked out by a doctor, for peace of mind if for nothing else.
In other news, my donor is out of stock at the moment and I was not able to try in November or December.
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