Showing posts with label Metformin. Show all posts
Showing posts with label Metformin. Show all posts

Saturday, May 30, 2015

Trying again.

Bee is two, almost 2 1/2. Last April, DH and I started not preventing, just to see what would happen. I got another prescription for Metformin, although I didn't really take any. Life went along. My cycles were fairly regular for a while, and then slowly but surely they got longer. This March I went to my new doctor in a new town (we moved again within Germany last July). I told her we had been trying a year with no success. I was referred to a gyn. I did one cycle where I showed up with a 16mm follicle and got a trigger shot within a couple of days. No luck. The next cycle (the current one) I got the vag cam a couple of times. At CD 16, my biggest follicle was 10 mm. So, now I'm on CD 41, having ovulated last weekend. I have a referral to an infertility specialist in Nuremberg for 19 June, the day after we get back from vacation. I don't have high hopes because I'll be 2ish weeks into that cycle and I'm leaving in August to go back to the States for three weeks to visit my parents. And if I have another baby, I want it to be in Germany because of several various reasons.

So this is my plan. I will give it until 1 October of this year/finish out whatever treatment I'm on as of 1 October. If nothing happens, I'll go back to not preventing. If still nothing happens (which it probably won't), then we'll close up shop and be happy with one.

Tuesday, May 1, 2012

Erste OB Besuch und tiefe Gedanken oder first OB visit and deep thoughts

Today was my first visit with the OB, Dr. H. I went in and the receptionist/nurse asked me if I could urinate. Um, yes, yes I can. In fact I was about to ask you where the bathroom is. Then I sat in the waiting room which had English magazines! This was such a luxury. I brought some hand sewing with me, but promptly lost the needle so I needed the magazines.

I was shown into Dr. H's office and asked questions by the nurse. Had my cycles been regular? No. Am I on any medications? Still on Metformin. Was I still spotting? No, that stopped last week.

Then Dr. H came in. We discussed my history with Herr Doktor. I told him I wanted to stay on the Metformin if possible. He said that I could stay on it for a few more weeks, and then I need to go off. I said okay. I'm thinking if I start splitting pills so I can wean down, it might be okay. I asked if I could go to the sauna. He said that after the first trimester it's okay as long as I don't spend too long in there and I feel okay. Cool.

Then we went into the exam room. Dr. H works with lots of American patients, so they have more of a drape. Since he handed it to me, I went ahead and used it. And, with Herr Doktor it was just me and him in the exam room. Dr H's nurse came in too. He did a pap and then it was time for my date with Wanda. This time when the uterus was on the screen it was a lot easier to see the blob. Not much searching around for it. It is about the shape you would expect from a nine weeks pregnant picture online. Measuring nine weeks exactly. Heartbeat 161. I got to hear the heartbeat this time and I could really see it on the ultrasound clearly, whereas last time Frau Doktor was having to point it out to me. The he checked my ovaries and they looked good. They weren't all covered in cysts, which is good news.

Then I got dressed and the nurse and I went into another room for the blood draw. Now, I have been dreading this because I don't like doing blood draws and everyone talks about how much blood they take from you. She  was very good and I hardly felt the poke, but I jumped anyway because I'm wimpy. Then she took four vials of blood. Two big and two little. Not so bad! The way people have been talking, I thought it would be a pint!

The nurse and I went over to the desk and I made my next appointment for May 21st. DH will be able to come to that one (he's out of town on an exercise) and so it will be his first time hearing the heartbeat and it will have changed a lot in the almost six weeks since he'll have seen it. We might even be able to see it moving on the screen. That would be pretty cool.

Ok, deep thoughts time.

As far as all this pregnancy stuff goes, I'm doing okay, but I have to say I feel a little disconnected. I'm still on guard, worried about something happening. It feels surreal. The only thing that's really assuring me that it is real is the morning sickness that lasts all day and being tired all of the time. But even that's not that bad. I was tired all of the time like this on birth control. I'm grateful and so thankful but most of the time it doesn't even feel real. I'm just wondering when I will start feeling feelings for this blob. I know DH is going to want to talk about names soon. If it were up to me, I would wait until viability, but I know that that is really a bit kooky.

I'm just trying to wrap my head and heart around this. Some women say they loved their baby from the time that they knew they were pregnant. Don't get me wrong, I am excited to be pregnant and I am looking forward to meeting this blob when it's a baby, but I can't say that I feel love like I thought I would. I feel terrible even putting that into words, like it's a betrayal of everything I've gone through and infertility itself. I hope I start feeling more connected in the weeks and months to come. If I don't, what will I do? And how can I justify all of the things that I've been through to get me to this point if I don't feel the right feelings? Deep thoughts to ponder.

Monday, March 19, 2012

The journey to now, part one, oder Reise zum Teil jetzt zwei

If you didn't read the first part, you can find it here.

It was so frustrating....

On 11 May, we flew with our suitcases and our cats and, at least for me, without enthusiasm or patience. I didn't want to be back in Germany. I wanted to be close to home, to Mom and Dad, because I expected to be getting pregnant soon and wanted to be close enough for my parents to get to be grandparents.

We landed on 12 May. It was beautiful weather, and in some ways I relaxed a little bit. Our house in Colorado still hadn't sold, and we would have to establish ourselves in this new community, but at least we were here and could begin the process. On the way from the airport to the new base, I could hear Shadow yowling from the luggage compartment under the bus. Poor thing.

Imagine this, but smaller with less chairs.
When you get to a new place with the military, they put you in a hotel until you can find housing. In our room, there was a bed, a desk, a dresser, and one chair. It was DH and I and the two cats in that room for a month. The cats don't get along that well, so we ended up putting the luggage rack in one corner with a suitcase on top so that Shadow could sleep on there and Moo could sleep on the bed with us.

We went about getting settled. When you move overseas, there are a lot of things to do to establish normal life in your new location. There are driver's licenses, some basic language classes, finding a home, getting put into the medical system at the new MTF. Lots to do. We moved into our house (the only one that we had been able to look at) in the middle of June. At the end of June, I finally got in to see the OB/GYN on post. This was the next step in the referral process.

This doctor seemed nice enough, but he was dismissive of what I had been doing to try to help things along. We hadn't been trying quite a year at that point, so he seemed hesitant to work with us, but since I had been diagnosed with PCOS he deigned to give us his expertise. I'll call him Dr. Insensitive.

Dr. Insensitive told me to stop charting, that that didn't do anything anyway. He didn't seem to like that I was on Metformin, but refilled the prescription since I had already been taking it for six months. He prescribed Clomid at 50 mg, told me to get a blood test on CD 21, and we would go from there. He was very sure that I would be able to get pregnant, no problem.
Clomid, the crazy maker

I didn't stop charting, mostly because it's one of the very few things that makes me feel like I have some control over this process. Round one of Clomid was determined to be non-ovulatory by blood test. I was given another round at 50 mg. Same result. The next round was 100 mg, and that was determined to be a proper dosage, due to the bloodwork. That was August. I did another 100 mg cycle in September during which I know that I ovulated late, but Dr. Insensitive had stopped ordering blood tests since one came back positive at 100 mg.

Early September of 2011, my mom had had surgery on her stomach to repair some lingering problems from childhood. The surgery didn't go well and she had another one three weeks later. After I heard about the second surgery being scheduled, I went ahead and got a ticket back home. I left in early October and returned in early November. Those cycles I did not take Clomid; October, because DH stayed in Germany and November because I didn't have access to the medication early enough in my cycle.

In December, I called Dr. Insensitive's office. I hadn't seen him since June and I wanted to have a change in prescription or blood work done to verify ovulation (or lack thereof) or something to move this process along. The receptionist went ahead and scheduled an appointment with the doctor for the week after Christmas. At this point, I felt so discouraged and broken down. We had passed the year mark and the officially infertile status rang loudly in my head.

At our appointment, Dr. Insensitive was, well, insensitive. I told him that the Clomid wasn't working, that I wasn't ovulating. He said that the blood work proved otherwise. I tried to show him my charts and he told me that those were useless and that I really shouldn't bother with them. He asked if I wanted to keep going on Clomid. I said no, but I wouldn't mind trying Femara. He harrumphed at that, and told me to go get an HSG done, and after that, he would put in the referral. His parting words were, "Maybe you won't even need the referral. You could be pregnant by then." His false confidence made me break down. I needed some real hope, not placating words.

DH and I went over to the lab. They used to do HSGs, but didn't any longer because the community that we are in is in the process of shutting down. I had to go to Landstuhl, the big military hospital over here, to get the HSG done. I called them and they said that I should call on CD 1 of my next cycle to schedule the HSG. I was on CD 3, but it couldn't be scheduled for that cycle due to New Year's being in just a couple of days. I had to wait out another cycle.

February came around, and with it, the chance to do the HSG. I called the lab and scheduled the test. I had to get a blood test done for pregnancy beforehand, which is kind of crappy. Dr. Insensitive had put the order in wrong, but the people at Landstuhl were able to work it out. (I got a call the next week, asking if I was going to be in the next day for my HSG. Dr. Insensitive was apparently having some major problems with getting the orders in correctly.)

Ouch
The HSG was painful. I wouldn't call it excruciating, but I would rather not to have to do it again. I had been researching HSGs as soon as I heard about them, so I pretty much knew what was going to happen. There were four people in the room, six including DH and I. I have gotten to the point that I really don't care who is doing or seeing things, if it's going to help get me pregnant. One tube had some adhesions, but the radiology doc managed to get it to open up and the dye spilled through on both sides. I was uncomfortable for about half an hour afterwards and took it easy for the rest of the day, but was fully recovered very shortly.

After the HSG was done, I called and got the ball rolling on getting the referral the rest of the way through. At the end of February, I finally had my referral in hand. I saw Herr Doktor for the first time on February 27th, 2012.

It's been a long road getting here. I've learned that I need to be my own advocate, that no one else is going to push things as much as I will. I've learned that research can be my best friend. Knowing what the next step typically is is very helpful for me. I can anticipate what is coming next and ask about the next step if the doctor doesn't mention it. I've learned that you have to know the system to be able to use it. Checking and double checking is okay.

Through all of this, I have tried to hold on to hope. Hope is the most elusive, slippery, crazy thing that I've found on this journey. The ups and downs of each cycle and the hope that keeps me going despite so much heartbreak. I hope to get pregnant. I hope to have a healthy baby. I hope to be a mother.

CD 22, 9 dp trigger

Tuesday, March 6, 2012

The journey to now, part one, oder Reise zum Teil jetzt ein

I started writing this post last Monday before my first appointment with Herr Doktor. It's a bit long, so I'm going to break it down into two posts. Here is the first part.

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It's been a long time getting to today. In about an hour I am heading over to the Women's Clinic in my town to see the professor of reproductive endocrinology and gynecology. Also, today marks the start of a new cycle.

Thinking in earnest about having a baby started a little over two years ago. My husband was deployed, but we had decided it was finally time. I went off birth control. I started taking over the counter prenatal vitamins. I started paying attention to things that I had never, ever even considered like where my cervix was sitting and what was coming out of it. Things were going well. In June of 2010, I started charting. DH came home for R&R and we gave it a go. It was only two weeks and the timing was off, so it didn't happen. No big deal.

I'll be honest with you. During the time leading up to R&R, I had been paying attention to the length of my cycles and there was a hiccup on the horizon. My cycle was going to involve me being on my period when my husband was home. My period at that time usually lasted for a week. Out of two weeks. I know some people don't mind having sex when they are bleeding, but I'm a little more squeamish. It seems icky to me. (Or did then.) So, I took the pill for one cycle to try and control when the bleeding would happen. I waited until a week into my cycle and then started the pill. It didn't really work, but I think that's where things started to go wonky.

The two weeks of R&R were over much to quickly. DH left, and I went back to real life. I started running in July of 2010. I ran my first 5k in September at an embarrassingly slow time (56:35). I bought a dress for my husband's homecoming. I ran another 5k, at a better time. (Not sure what that time was because I didn't have a watch and the race wasn't timed.) November 6, 2010 DH came home from his fourth deployment. It was wonderful to see him. We started trying for realsies.

Meanwhile, between June and November, something strange had happened to my cycles. When I first came off birth control, they were "normal" (But we all know there is no such thing. Only average.) But in June, they shifted. Changed. They were longer. Much longer. My charting showed mountains and valleys instead of the plateaus and buttes I was expecting. The cycles were maddening because I couldn't figure out what was going on. My longest cycle so far was 59 days. June 2010 to August 2010.

Anyway, back to DH and trying. A return from a deployment or long term separation from my husband always institutes a kind of honeymoon period for us. We weren't getting anyway closer to making a baby, but we sure were having fun in the process! (Let me tell you, the process is less fun now.) In November of 2010 I had a 17 day cycle. The next cycle was 57 days. I went to the doctor for my annual pap smear in January 2011. I told him how crazy things had been. He listened. I now realize that this is somewhat of a miracle in a military treatment facility. The doctor put me on Metformin, told me that I needed to take some blood tests and get an ultrasound. All of that got done. DH got a semen analysis. He results were great. Then we got the not so good news. I had PCOS.

You have to know something about me. I am a researcher. If there is something that I am interested in, I will find any information available and use it. I read books, blogs, articles, reviews. Thoroughly. When DH and I were getting ready to buy a house, I did my research. I knew neighborhoods, school districts, and average days on market. I took every piece of information available to me and used it. I'm the same way with TTC.

I had read about PCOS, back when things were hunky-dory, and I had thought, "Thank goodness I don't have that! That must be terrible!" Ah the naivety.

There I am, diagnosed. But, I was on Metformin. That should help things. DH and I went back in to talk with the doctor. He said that he would like to give me a referral to a fertility specialist. This freaked me out a bit. I asked what the steps were on the fertility spectrum. He said for PCOS patients usually the first step is Metformin, then adding Clomid to the mix, followed by birth control pills for a few months to regulate cycles and a few months off of them, trying. After that, artificial insemination and then IVF. This scared me. Lots of pills I could deal with, but going straight from that to physical medical intervention seemed like a big jump in level of care. But, we were a long way from that, so I wasn't really worried.

March 10, 2011 was our 10th anniversary. We got married young (18 for me, 20 for him), but things have worked out and we have a good marriage. We like each other. We get along. We like spending time together, and we like spending time apart. For the 10th anniversary, we went to a very ritzy hotel for the weekend. We had room service, which was a first. We ate breakfast overlooking the lake and the golf course. We spent Saturday in the spa, enjoying the different rooms. It was great.

Around that same time, we were waiting for the next assignment. We had hoped to be in Colorado for at least five years, but the Army had other plans. When DH contacted his branch manager (A kind of a career manager for the Army. They work with assigning you to your next job/location.) about the next step in his career, the branch manager thought that we had just moved in December. So, out of the thirty-two months we were in Colorado, five months were "extra".

Anyway, we were hoping to be in the States somewhere and hopefully close-ish to family. That did not happen. Instead, we got the assignment to Germany with less than sixty days notice from orders being given to the day we would fly. Not only did this throw a wrench into our everyday lives, but it put a hold on further progress with TTC. I got a call about a week before we flew out in May letting me know that I had finally gotten the approval to see an OB/GYN on post, but I couldn't go because by that time my medical records were already cleared and I was officially off their books. It was so frustrating.

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I think that's enough for now. I will continue this story sometime. Tomorrow is my second u/s for this cycle. I'm looking forward to see how much further along those follicles are! Grow, follicles, grow!

CD 9