Making it work for us

2 posts in 2 days?! What the what?!

I am going to try to document a little bit about the good (and maybe not-so-good) things as I learn to navigate being home full-time.

What is making it work for us right now:

1. I prep or start dinner during the babe's nap. She takes one nap nowadays (I know I am LUCKY!). Sometimes long (almost 3 hours yesterday!) sometimes short (35 minutes one day last week). Even if it is pretty short, I seem to have time to at least chop veggies/lay out ingredients for dinner. Right now, I have these sizzling on the stove:

Vegetarian Lettuce Wraps from The Pioneer Woman Cooks

We don't eat much tofu these days, but these are SO good and SO easy! I use coconut oil for cooking the tofu, add 2 cups cooked brown rice, a clove or 2 of minced garlic, and chopped green onion to ours, too. We use gluten free soy sauce to keep them friendly for my gf diet (which is going strong, although I have fallen off the endo diet...I love me some chocolate and red wine!). 

If my husband was home in time to entertain our daughter while I did dinner prep, I probably wouldn't spend her nap this way. But, it is what it is! He still gets home about 2 hours after Felicia and I eat (which is creeping up on Felicia's bed time). Cooking with a very "helpful" 18-month-old can be a challenge. So for now, this is the easiest way for me to get good, whole foods on the table for all three of us. 

2. We go to the park everyday before lunch as long as it is not raining or too hot (today was a too hot day so we've been a bit cooped up). Round trip, it is about an hour of walking/playing. It gets us out of our little 2 bedroom apartment and gets me some much needed exercise. Soon I'll have a running stroller, thanks to my sister who no longer needs the one she used with her kiddos. 

3. I try to read for at least 30 minutes a day after Felicia is down for the night. I just finished this one:

source

Which I really enjoyed! I highly recommend it for anyone who wants or has kids.

I just started this one last night:

source

I am in a book club with 4 girlfriends and this is the book we'll be meeting about in August. It seems a little fluffy so far, but I think it will be fun.

What I did differently

I know there was a lot of luck involved in us getting pregnant in April. There was also a lot of prayer (I truly believe my Grandma had something to do with it! When we told her we were pregnant she said, "There's only one baby in there? With how hard I've been praying I was expecting at least two!").

In addition to luck and prayers, I made some pretty big changes to my diet and daily habits in the 3-4 months prior to Ponyo. I made the changes because I wanted to feel like I was doing something to increase our chances of success even though my husband and I had both resigned ourselves to the fact that nothing would be possible until after my laparoscopy. I am by no means a medical expert, and I don't claim to be, but here are the changes I made based on what a friend dealing with infertility told me, lots of research online, and reading these books:

The Infertility Cure: The Ancient Chinese Wellness Program for Getting Pregnant and Having Healthy Babies by Randine Lewis  

Recipes for the Endometriosis Diet by Carolyn Levett 

Endometriosis: A Key to Healing and Fertility Through Nutrition by Dian Shepperson Mills & Michael Vernon

The 9-Day Liver Detox Diet by Patrick Holford and Fiona McDonald Joyce

First, what my friend told me: She and her husband were seeing a specialist who was trained in NFP. Their doctor told them that over 30% of couples struggling with infertility conceive after 3 months of taking this combination of vitamins:

Vitamin C (1000 mg)
Calcium made with D3 (500mg)
D3 (2000 I.U.)
Magnesium (250 mg)
Stress B-Complex
Zinc (30 mg)
(My friend also took Flaxseed oil, which I skipped due to the warning about blood clotting and surgery risks)

I did some research and found that endometriosis and low progesterone can be linked to deficiencies in some of these vitamins (especially Magnesium). PCOS is also affected by these vitamins! I picked up the vitamins and the nice pharmacist at the grocery store even gave me a pill case to use so I wouldn't have to open 6 bottles every night when I took my many pills with dinner. I also gave my husband the same Vitamin C and D3 that I was taking as well as a normal multivitamin. Maybe it was a coincidence, but both my friend and I are now pregnant (due about 3 weeks apart) after both of us trying for about 2 years, which seems too weird.

I did some simple liver detox. In The Infertility Cure, I read that endometriosis can be caused by "stagnation of the liver." Sounds awesome, right? So I decided to read The 9-Day Liver Detox Diet. The detox book listed 5 habits to break:
1. Wheat
2. Milk
3. Caffeine
4. Alcohol
5. Bad fats

Interestingly, ALL FIVE of these things are to be avoided by women dealing with endometriosis (as mentioned in Recipes for the Endometriosis Diet and Endometriosis: A Key to Healing and Fertility Through Nutrition). So, I got super serious about going gluten free. No more cookies. No more sandwiches, or Triscuits (my fave snack!), or pita bread, or traditional pasta. I cut back on dairy. No more Kefir, limited cheese, limited yogurt, limited ice cream. I stopped drinking coffee, tea and alcohol. Once you cut out all of that, you pretty much cut out all bad fats, too, so that was taken care of!

I started drinking lemon water every morning. I started eating at least one serving of broccoli, spinach, or kale every day (these green veggies are good for you and also are known to help your body get rid of excess estrogens). 

To help rid my body of even more excess estrogen (excess estrogen is what causes endometriosis) I started using natural body products. I gave up scented soaps and used Kirk's Castile which is a coconut and vegetable glycerin soap. I started making my own deodorant out of coconut oil, baking soda, and arrowroot powder (I do still use normal deodorant for working out or very hot days even though the coconut deodorant works really well). I am still using my normal make-up and shampoo/conditioner although I am thinking of moving to healthier brands after I use everything I already have.

Because this post is getting so long, I'll do another where I'll write about the results I noticed after the changes.

Ponyo

Today we had our first pregnancy ultrasound (definitely not my first ultrasound, though, given the 2 pelvic ultrasounds and several follicle ultrasounds I've had along this journey). When I arrived I had to give a urine sample (not sure what they are testing with that) and I was told blood labs would be drawn after the ultrasound.

The ultrasound tech was very nice. She asked some routine questions: When was the first day of your last menstrual period? April 7. Did you conceive using fertility drugs? No. Have you had any spotting or bleeding? No. Do you have any concerns? Well, I was supposed to be having surgery for endometriosis tomorrow so we hope everything is where it should be. Then she smiled and said, Oh so we just need to threaten surgery and then you get pregnant, huh? I guess so...

She found the baby right away and we saw the heartbeat immediately. Thankfully everything is inside of my uterus - no concerns about this being an ectopic pregnancy anymore. Then she said they had to measure my cervix, which she didn't tell me anything about. Hopefully it is how it is supposed to be! Then she went back to the baby and measured the heartbeat. It came in on the fast end of normal at 198bpm and then later at 189bpm. I started crying, partially out of happiness and relief and partially out of concern over the fast heartbeat. She said it wasn't anything to worry about; a fast heartbeat is generally better than a slow one and it could just mean that the baby had been moving around. We got to see arm buds and leg buds as well as the yolk sack, the beginning of the umbilical cord and placenta. The baby was upside down and wiggled a few times. That made me laugh. She measured the baby and on first measurement said 8w6d but then measured again at 8w4d (which is right on track).

She also checked my ovaries. My right ovary was easy to find. I asked about the cysts (my chocolate cysts or endometrioma) and she pointed to a dark circle on my right ovary and said that was likely one of them. She had trouble finding my left ovary so I mentioned that at my last follicle ultrasound in January the ultrasound tech said my ovaries were very close together and then she found it, right next to my right ovary. I will be asking if my ovaries being so close together 1. is anything to worry about and 2. could be caused endometrial tissue binding my organs together. I'll have to wait to ask that, though, because my doctor was out delivering a baby during our appointment so we are going back next Wednesday to meet with her and do the blood work that we were supposed to do today. 

Thank you all for your hope, support, and prayers; they mean so much to us! We hope that things continue to go well and that little Ponyo (that is what we named them for now so we don't have to call our little one "the baby, " "it" or "baby") grows healthy and strong. For anyone wondering where Ponyo came from, yes, it is from the movie of that title. Ponyo was a magical goldfish-girl and we know this baby is quite a miracle. Translated to English, Ponyo loosely means soft, squishy, and chubby.

The Plan

We had our surgery consult this afternoon. The doctor (we'll call her Dr. D) started out by saying that we know a lot more now than we did last time we met with her. She said there is some good news:

• my prolactin levels are normal
• my FSH level was very good
• The Bee's SA came back with good results

All of these are things we have working for us.

Some news that we now know that is not so good:

• my progesterone level was borderline low
• we don't know from last cycle if I am ovulating (ever or irregularly)
• my DHEAS level, which is a precursor to testosterone, was a little elevated, which can be a sign of PCOS
• I have cysts on both of my ovaries
• I have endometriosis on both of my ovaries (most likely, but they cannot diagnose for sure without a laparoscopy)

The next step, as we have known, is a laparoscopy to diagnose and treat endometriosis. She suggested that within the 6-9 month window of opportunity after the laparoscopy that I take Clomid to stimulate ovulation, since "a titch" of PCOS could be at play here, too. She kept saying that there is inconclusive evidence pointing towards PCOS:

• The slightly elevated DHEAS levels, but so slightly elevated that if there weren't infertility issues, they wouldn't even pay attention to it
• The cysts on my ovaries, but they are not typical of PCOS - mine are larger and fewer. These "chocolate cysts" which are common in endometriosis, could be kind of obscuring the true appearance of my ovaries, though
• The irregular ovulation or anovulation, since nobody could tell what was going on last cycle

Whether or not I have PCOS, the Clomid would help us take full advantage of my fertility while the endometriosis is more under control.

Dr. D said that waiting until June or July would be just fine. I am young and there is no time pressure yet. She seemed to think it might be good for me and The Bee to take a few months off from the whole fertility circus anyway, to give my body some time to recover from stress.

She talked about the mind body connection and, more than once, mentioned that both endometriosis and PCOS are treatable and usually have pretty good success rates as far as treatment and pregnancy go. She said that I need to think positively and suggested that we try to relax and maybe even go on a vacation before having the laparoscopy done. To her credit, she did preface the "relax and go on a vacay" with "I know you have probably been told this and it is hard to do, but taking care of yourself, both physically and mentally/emotionally is very important in all of this. I truly believe that positive thoughts are important." I, the ultimate pessimist as of late, know that nothing is a given. There is a chance that we'll follow through with this and be the most positive, enthusiastic people in the universe and still won't have a baby. But there is also a chance that we will.

So, the plan is to call the surgery scheduler when I get my period in June. Somewhere between day 5 and 11 of that cycle I will have the laparoscopy where they will go in through three 5mm incisions (one through my belly button - yuck!) and remove the cysts from my ovaries, the endometriosis from my ovaries (and any other endo they see) and they will assess my fallopian tubes. After that, we'll have to decide if we want to chance it and see if I can ovulate on my own and get pregnant or if we want to start Clomid the following cycle, which would be July.

In the meantime, I am going to try to take care of myself. I am not going to use OPK's or chart BBT (you have no idea how much I have LOVED not charting the horrible and hideous BBT!!). I will still keep track of my cycle using NFP but will try not to obsess. Dr. D said, "You never know...if you are ovulating irregularly, something could happen between now and June." I appreciated her encouragement and kindness, but I have a hard time believing anything will make the next 5 cycles more successful than the last 17 have been.

So, here we go, waiting for June or a miracle!

Infertility clinic visit #3: Follicle u/s #2

Last Friday, The Bee and I went in for another follicle u/s as I hadn't gotten a + on the OPK's yet. I actually may have gotten a + that day...it was the darkest line I had seen, but that would mean I ovulated pretty late this cycle (OPK taken CD 16) and I am not sure if it was a true positive. Who knows? I am not certain of anything these days, why should a simple at home ovulation test be any different?

Anyhow, it was a different person doing the u/s so it was hard to know if she was seeing the same things or different things from the u/s I had on New Year's Eve. This u/s lady gave me this information:

• My ovaries are apparently very close together.
• She could see 3 things that she was guessing were cysts. Based on the size of them, I am inclined to believe they are some of the same 3 found on the ultrasound from 12/07/11  (from that u/s I was told I had 2 cysts on the left and 3 on the right. At THIS u/s she only mentioned 3 altogether...2 on one ovary and 1 on the other)
• She said these cysts looked like "chocolate cysts" which are a sign of endometriosis.
• In addition to the endometriosis on my left ovary (found on the u/s New Year's Eve) there is some on my right ovary as well. (See where this is going??)
• There was some fluid around my right ovary (which was the one we thought had a mature follicle New Year's Eve) but she said it was very hard to tell if it was a sign of ovulation or not.

She ordered a blood test to check my progesterone since it was unclear whether I ovulated or not. The clinic called the next day and gave me this info:

• My progesterone level was 3.3 which indicates that ovulation likely didn't occur this cycle or that it occurred very recently and the blood test was taken too early (they like to test 5-6 days after assumed ovulation).
• A progesterone level of greater than 4 means that ovulation likely occurred.
• A progesterone level of 15 or more indicates pregnancy.
• My doctor wants me to set up an appointment to discuss a laparoscopy to check for endometriosis.

So that is where we are. I probably haven't been ovulating and it could be a result of endometriosis. I called my Mom to tell her the latest news. Endometriosis is found in women on both my Mom's and Dad's sides of my family. She told me that I have at least one aunt on each side who had surgery for it (after being unable to conceive) and then had success having at least one child, which I didn't know until yesterday. Unfortunately, I think that if I have the laparoscopy, it will need to wait until June so that I can take whatever recovery time I need without getting overly stressed about work (standing all day = not the best for recovery)/sub plans/little kids running into my sore abdomen. I feel very broken right now. I feel like I need to be fixed!

Oh Lord, please fix me! Or help the surgery fix me! I want this so badly and I am turning into a sad, unpleasant person through this painful experience! I don't even like myself most days. I feel angry, jealous, embarrassed, guilty, unworthy, hopeless. I ask You to create in me a clean heart, O God, and renew a right spirit within me. 

I asked my Mom to talk to my Grandmother, a retired nurse specializing in gynecologic oncology, about the laparoscopy and if waiting 6 more months will allow for too much more damage. Her opinion was that, no, it would be fine to wait until summer but if it is causing me too much worry to do it asap. My Grandma also asked the name of my doctor so she can check up on her at the hospital she used to work at (that made me laugh a little but warmed my heart knowing my Grandma is looking out for me and The Bee and hoping for the same successes we are!).

We won't know if endometriosis is what we are facing unless I have the laparoscopy, though. The Bee asked me to wait until after his SA (scheduled for this Wednesday) to call to set up the appointment to discuss the procedure. I guess I would not be surprised if I have endometriosis. All along I've been answering the question, "Do you have painful periods?" with "No, I just take some ibuprofen and then I am usually fine. I've never missed work because of my period." But after talking to my Mom, I realize that cramping for a week and a half before my period is not normal. And the few times I've needed to sit down to prevent blacking out on the way to the kitchen to get ibuprofen when my period starts in the middle of the night is not normal. And my period getting heavier over the last 2 years is not a good sign. I always thought I had a less severe period than my older sister, who has endometriosis, and who used to actually pass out from the pain. She had my beautiful nephew relatively easily, though. It took her 9 months all together to conceive my nephew but she did sadly lose a pregnancy due to Rh factor 2 months before her successful pregnancy.

I feel angry that I didn't have kids sooner or take birth control pills. Both of those things help keep endometriosis at bay. I am digging deep to find hope and to believe that we will have a baby someday. Right now I just feel so lost.