Endocrinologist Visit

Today, after waking up sick and in pain and taking the day off from work, I kept a previously scheduled appointment with an endocrinologist. I haven't seen one since the first year after my initial diagnosis of PCOS. When I moved, my new insurance wouldn't cover the visits to my old endocrinologist so he told me that my normal GYN could manage the care. I don't think it's been managed all that well...

Metformin treatment is common for women with PCOS and a standard dose is 2000-2500 mg/day. My GYN reduced my met to 1500/day. Then, 2 years ago, she took me off it completely because it wasn't aiding in ovulation. She's been saying my testosterone is fine and within normal limits. She's been saying my thyroid is normal. Of course they're normal, if they fall within an "acceptable" range and you're not looking for patterns from a hormonal standpoint.

I've been wanting to re-establish with an endocrinologist for awhile now, at least the past year. I figure, whether I ever get pregnant or not, I will still have PCOS... and that needs to be addressed. Today, Dr. F was awesome. She essentially took my life's history, all my symptoms that led up the diagnosis of PCOS and what's been done since. When she looked at my labs and ultrasound from the past couple of years and then did her exam, she said I was a very classic case of PCOS. Because I have practically all the symptoms that comprise the syndrome of PCO, she kept looking at my hair, amazed that I don't have any evidence of alopecia (male pattern baldness or hair loss in women). I have to say, I do have a very full head of hair!

Dr. F said that even though my thyroid and testosterone have fallen within "normal" levels for the past few years, they're still showing a pattern of abnormality. My thyroid is still acting like it's hypo (I took synthroid for 4 years in my early 20's before my hypothyroidism "cured" itself) but it's likely just another symptom of the PCOS and will hopefully return to a real normal once my insulin and testosterone reduce. Weight loss - of course - is the best way I can attack those hormones.

She really stressed the low-carb diet (the low GI falls into that category) and exercise. But I'm also going to restart the metformin. Thankfully, she only prescribes the extended release form which is way, way easier on my stomach. I go back to see her in 3 months and we'll re-assess my testosterone. If the metformin isn't working the way she expects it to, we'll add Actose to the mix.

So that's where we're at with that. I have to say I'm glad I made this appt. My GYN is fabulous and I love her, but I needed a different specialist to address this issue separately from the infertility.

Flashback to Early 90's

Monday's Meme

A High School Meme

1. Can you sing the fight song?
Yes… here goes! “Three cheers for our school, Mission High. May our banner so proudly fly. Our team in the blue and the white goes to battle to fight, fight, fight. Rah! Rah! Rah!” Okay that’s only the first half but it’s enough. Now I can’t get the tune out of my head.

2. Who was your favorite teacher?
Hmm… Probably Ms. K in 4th grade. Oh wait. The title says high school… that would have to be my science teacher, Mr. L.

3. What was your school mascot?
Bulldog.

4. Did you go to the Prom?
I went to two my sophomore year and then senior year. I also showed up in pants for junior year because I was on the appetizer committee and took a couple pics with different friends. It wasn’t a huge deal for me.

5. If you could go back, would you?
No. I enjoyed my high school years but I like where I am now and what I’ve done since then.

6. What do you remember most about graduation?
Unfortunately, our horrible commencement speaker. As a class, we elected NOT to have one. Our teachers over-rode our vote and asked a history professor from the university. Boooorrring.

7. Where were you on Senior Skip Day?
We were threatened with discipline for having a senior skip day so I don’t think we did… honestly don’t remember, though.

8. Did you have a job your senior year?
Not during the school year… I was so busy with full class schedules and extra-curriculars, I only worked during the summers.

9. Where did you go most often for lunch?
To the store or to our friend Amy’s house.

Meme courtesy of Saturday 9.

Honorary Degrees

Honorary Degrees... degrees given to people of some esteem who've done nothing to actually earn them. I have a hard time with them. I don't believe one should receive a degree if they haven't done the work to deserve it.

Pres.ident Ob.ama is going to be the latest recipient of one. I'm not going to post anything political, rep vs. dem or any of that crap because, honestly, I tend to fall somewhere in-between and choose not to ally myself 100% with either party. I will proclaim my stance of being pro-life (all life, not just the unborn). Our current head of state, however, is anything but. It doesn't matter that our soldiers are dying, it doesn't matter that our economy is going to pot, but let's make the right to kill babies in the name of science one of our first acts as leader of this great country. (Please note the dripping sarcasm in that last statement.)

Apparently Not.re Dam.e - one of the most famous Catholic institutions in the U.S. - has asked the prez to speak at its commencement this year and, in addition, are going to grant him an honorary law degree. Doesn't this hugely public honor go against one of the Church's biggest values - the value of life?

Here's a blurb from Fr. Jona.than Mor.ris' blog. I encourage you to click here to read his post in its entirety.

The Catholic Church teaches the defense of the unborn is not just one value among many others, but rather the irreplaceable cornerstone of human rights and social justice. Once you rationalize the killing of an entire class of human beings, all the jumping up and down about other rights should seem rather insincere.

Pope John Paul II put it like this:

“Above all the common outcry, which is justly made on behalf of human rights–for example, the right to health, to home, to work, to family, to culture–is false and illusory if the right to life, the most basic and fundamental right and the condition for all other personal rights, is not defended with the maximum determination.”

This is moral reasoning that respects a hierarchy of values. And with this in mind, in June 2004 the United States Conference of Catholic Bishops issued a statement that speaks directly to what Notre Dame has done:

“Catholic institutions should not honor those who act in defiance of our fundamental moral principles. They should not be given awards, honors or platforms which would suggest support for their actions”.

The question is how Notre Dame Officials can reconcile their choice to honor a president who has rejected — and continues to reject so aggressively — their cornerstone value of the right to life.

Emphasis on the USCCB statement above is added by me.

Mojo's Surgery Update

Our little monkey's home. In addition to removing the tumor/growth on his leg, they removed a couple of cysts on his upper eyelid. We were able to pick him up after work but they weren't able to get him into surgery until 3:00 this afternoon so he had just barely come out of anesthesia. Poor little guy couldn't walk very straight or hold himself up on three legs to pee. He got sick in his crate during the little bit of time we had to run over to see Grandma and Uncle. We just barely got him and his crate cleaned up. We're now relaxing and he's getting antsy... you can tell the pain meds are wearing off because he's starting to wimper. He's pacing around like he's afraid to cave in to the desire to sleep. His bandage is slipping and I think we're going to have to remove it because the swelling distal to the bandage is getting worse and I think it may be too tight. His tumor/growth was in an odd location for keeping a bandage on. Things are okay, though. I just wish I could comfort him better.

*** UPDATE ***

Friday morning: Mojo cried and wimpered throughout the night and is continuing to do so as I write this. He's not allowing himslef to fall asleep; you can tell he's confused about what's going on. I just got off the phone with the vet and the shot they gave him before we brought him home was "supposed to last" but it apparently didn't. I have to wait another hour or two because there's currently no doc at the clinic and we need doctor approval for a prescription, but I'll be getting him some help hopefully in time for him to be able to take a nap over the lunch hour.

Mojo Monkey

Tomorrow, we take our Mojo in to have surgery on his leg. It's definitely a bittersweet feeling...

Last Thursday, we noticed Mojo really licking at the upper front of his left leg so we checked it out. Until then, there was nothing distinguishing that would've caught our eye. Once we started examining him, however, we noticed a slightly nodular and irregular growth coming out of his skin. We watched him and it for a day and decided it was time to take him to the vet on Monday.

Dr. K. suggested surgery as soon as possible so he's going in tomorrow. If we were to choose to have the tumor tested (sent in for histopathology, which alone costs more than the whole rest of the procedure and anesthesia combined), we would then know if the tumor is benign (non-cancerous) or malignant (the dreaded C word). If it is cancer, we would then have to choose whether or not to proceed with chemotherapy and other therapeutic and diagnostic measures.

Gil and I don't believe in going to those extensive means for dogs, as much of a part of our family that they are... especially with our own medical issues, surgeries and other treatments we have ahead of us in the coming year(s). To keep from having to be faced with a diagnosis of cancer and needing to choose NOT to do chemo, we're choosing to remain ignorant and not have his tumor tested. We'll just have it removed and go about our merry ways. That may make us bad parents and caretakers in the eyes of some, but honestly, he IS just a dog.

But he's MY dog. My first baby. This whole thing is making my heart ache something fierce.

Baby Mojo... isn't he sweet?

Crazy Mojo at about 8 weeks... I love this look on his face! He continues to almost constantly wear the same expression.

Here, he's perched on a deck at the edge of steps... he was so scared of stairs when he was a baby; he hated even being carried up or down them.

We were finally able to pick Mojo up when he was 10 weeks old.

The crazy Monkey loves mud and water... this was before our backyard was landscaped and it was nothing but a hug mud swamp. He's about 1 y/o in this picture.

This was when he was 2 y/o, just prior to us landscaping the backyard. We had a huge pile of dirt in the middle of the yard that we were working to remove and he loved digging and plowing through it. How could a mother get upset with her furbaby with a face like that?!?!

An unnaturally stoic poise.

At 3 y/o, just this past October.

Working in the Coalmines

Monday's Meme

Working in the Coalmines... reminds me of that song by Le.e Dor.sey...

Workin' in a coal mine
Goin' down, down, down
Workin' in a coal mine
Whoop! About to slip down

I don't know how the "writer" of these memes chooses questions to put together... they don't make sense as a "group" to me... no rhyme nor reason, no relationship whatsoever.

1. What is your job and do you like it?
I am a Coding Education Specialist at a local hospital/clinic. I “educate” (and I use the term loosely!) the providers (physicians, PA’s, nurses) in several different departments on correct coding and documentation guidelines. I perform audits and research new technologies and coding methodologies. I like the auditing and research portion of my job. I even like interacting with the different providers but I find it "challenging" to educate intelligent physicians who get frustrated with the “system” enough to throw it all out the window.

2. What do you do to unwind after work?
Most nights, I don’t get to “unwind” right away. I come home and take care of the furbabies and get dinner going. After things are cleaned up, I’ll sit on the couch for maybe an hour and either read, surf the net, or watch tv with the hubby.

3. Who have you known the longest of your friends?
I have several friends I’ve known since daycare and head start. Such is life when you grow up in a small town. Amazingly, a few of them remain some of the closest friends I've ever had and the rest still remain friends on the rare chance I get to see them.

4. Who do you go to for advice?
It all depends on the subject matter. I go to Gil first for just about everything, I go to my mom for a lot and I have a handful of other close friends that I’ll call. If it pertains to IF and/or adoption, I go to my "sisters" at HP.

5. Not counting your current relationship, how many times have you been in love?
In retrospect, I don’t believe it was true love. There are two men I had “serious” relationships with in my life before Gil and with whom I thought I was totally in love with at the time. I still love them - or love who they were - for the purposes they served in my life, but I never truly loved or was loved in return until Gil.

6. What is your favorite snack food?
Popcorn. Love popcorn. Hate getting kernel shells stuck in my gums, though. I also like ice cream.

7. What is the best meal you ate this week?
That would probably be the buffalo wings this past Thursday. We frequently do boneless wing night at BWW with our friends, T & S. YUM-O!

8. What, to you, is the most important factor in romantic attraction?
The things that attracts me the most romantically aren’t physical at all. The depth of love, respect, concern, sense of humor even… the deeper we get emotionally, the better the romance is.

9. What do you think is your worst habit?
Yikes… I have a lot of them, mostly expressing myself through attitude rather than physically. Gil says chewing my fingernails, which I do when I’m stressed. Unfortunately, I’ve been stressed a lot in the past year.

"Working in the Coalmines" meme courtesy of Saturday 9.

Back in the Saddle

*** Warning: This post contains "female" information some will consider TMI. ***




A bit of history first...

It's been one year since our trial with Clomid failed. It's been one year since my GYN told us our next step was trying IUI and wanted to proceed right away. We felt like we were missing some steps and didn't wish to pursue that aggressively. It's also been a year since we sent our charts to Dr. Hilgers at the Pope Paul VI Institute, hoping we'd be able to proceed with a doctor who believed and practiced fertility-based medicine within his Catholic morality. Unfortunately, it's been a little under a year since those hopes were dashed because none of it would be covered with insurance and diagnostic testing alone would cost - up front - ten grand. Yikes.

Because it's been one year since I've been on any menstruation or supposed ovulation inducing medication, I have had problems with performing those actions on my own. My body is broken and doesn't function as it's meant to. But, because of all our preparation in trying to work with Dr. H at PPVI, I discovered through NaPro charting that I have chronic ovarian pain. I also have a combination of other symptoms that are commonly seen with endometriosis. However, I never would've thought about endometriosis until Dr. H mentioned that, in his experience, about 50% of women with PCOS also have some stage of endo.

When the Clomid failed, I fell into a depression. Not just from all the hormonal changes, but because of the bleary outlook on our chances to conceive. Then PPVI fell through. I started focusing on our adoption process - which is a parallel path, not an alternate route, in achieving parenthood. I thought the "distraction" would help... but it didn't. It truly wasn't until about January of THIS year that I started feeling "back to normal".

Except for the fact that I'm not normal. Not physically, anyway.

I had two non-drug induced AFs last year, bringing the yearly total up to 4 periods. I don't and really can't call them "cycles" because there's no cycle to it. I don't ovulate. I don't have the typical stages in the average 4-6 week cycle that women are supposed to have. AF last reared her ugly head in August... on our anniversary, no less. Haven't seen her since.

Fast-forward 7 months. I had my annual GYN appointment scheduled yesterday. As I told my nurse, to us in the infertile world, a sure-fire way of making AF start is to POAS (pee on a stick, as in taking a pg test). LOL. I think I found a new way to make it start. Schedule your annual GYN exam!

That's right. AF decided that 7 months was apparently too long of an absence and couldn't wait just one more freaking day! Because of the extreme pain I get with AF, yesterday's exam was horrific. I was also told that the "contamination" on my pap could possibly result in endometrial cells on the path report, probably causing me to have to undergo a biopsy. I'd think I would have another pap before proceeding straight to biopsy, especially when there's an excuse for the potential abnormality, but she didn't make that sound like an option. However...

The counseling portion of yesterday's visit was excellent! In discussion of "the next step" and reviewing all my symptoms, Dr. J told me I would definitely need to undergo an HSG (hysterosalpingogram) to check f-tube flow/patency or a lap (laparoscopy) to check for endo and, if present, remove it. She truly doesn't think I have a flow problem; I don't, either. The nature of PCOS is that my ovaries don't release anything to flow, not that the flow couldn't get through. So... in May, I am going to be put under general anesthesia for the first time since ear tubes in 3rd grade and have the lap. I scheduled my pre-op appointments today.

We're waiting until May because if I should have endo that needs to be removed, I will be clean and optimal for any type of treatment the new REI may have in store for me! Yep, our region is getting its first REI (reproductive endocrinologist and infertility specialist) and he'll work in my facility! He starts in July and Dr. J is excited for me to be able to see him to work on my issues.

So... we're back in the saddle again as far as diagnostics and focusing on our issues to try and create an optimal environment for conceiving. Now I just have to work on Gil to get in to see the urologist...