Tag: metformin
Status

Back To the Drawing Board…

Yesterday was my pre-op consultation for the diagnostic laparoscopy I have scheduled for late August.

Err… HAD scheduled for late August, I should say.

Yeah.  My doctor and her bulldog assistant effectively talked me out of having the lap.

Well, they talked me out of having the lap with them, for sure.  I haven’t made up my mind about the rest yet.

Before any of you get upset or start to demonize the good doctor, I can tell you that she’s coming from a place of honesty and realism.  She talked to me for a long, loooooong time yesterday, listening as I rattled off the finer points of multiple studies on laparoscopies in women with unexplained infertility, and gently explaining to me that no matter the outcome of the procedure, the next logical step in our journey is IVF.

It seems as though there are only two choices with this doctor performing the surgery:

One, she finds mild endometriosis, and removes anything that isn’t attached to important bits of my anatomy, such as the bowel, ovary, uterus, or fallopian tube.  Post surgery, the suggested treatment would be IVF if I didn’t manage to get pregnant on my own, which, let’s be honest, is not likely considering all of the other treatments I’ve tried that have failed, despite a good response.

Two, she finds moderate to severe endo, and leaves it alone.  Removal of endometrial adhesions that are more deeply attached to organs and tissues is more dangerous than it’s worth, and she won’t risk my organs to remove something that is, in the grand scheme of things, not causing me a terrible amount of discomfort.  Post surgery, the suggested treatment would also be IVF.

Hmmpph.

I feel cornered.

I really thought I was going into that consult yesterday to find out the gory details about the surgery, and to plan ahead for recovery.

I feel a little blindsided, and more than a little disappointed.

The thing I expected the least, though, was to feel relieved.

And I do feel that.  Relief.

I really don’t want to have surgery.  I don’t know if I want to have surgery more or less than I want answers, however…

Basically, Dr. F brought me gently to a realization that I’ve been avoiding for a very long time.

I may never know what’s causing my infertility, and I may have to move on to IVF without that knowledge.  I may have to take the gamble, when all I want is to calculate odds and create the most level playing field possible.

I may have to just take the plunge.

Those, however, are decisions for another day.

Today, I’m going to relax.  I have permission to stop taking Metformin, as long as my cycle doesn’t start getting wonky, which means that I can eat what I want, have a beer now and again, and gain some weight back that I lost during the Metformin Bowel-Voiding Frenzy that accompanied that first two months on the drug.

Today, I’m going to order some Maca Root and Royal Jelly, overhaul my diet and eat well, but healthfully, and give my body a break from drugs.  I’m going to schedule a few massages, and maybe get back to acupuncture.

Today, I’m going to set up a dedicated bank account for IVF funds, and make sure that money makes it’s way in there every week.

Today, I’m going to keep in mind that my doctor, and every single other doctor I’ve ever seen, has told me that the broad majority of women with true unexplained infertility tend to get pregnant at some point… It just never seems to happen as quickly as they would like, and it oftentimes happens when they are not in an active medicated cycle.

Thankfully she didn’t tell me outright to “just stop trying”

I may revisit the idea of the lap… I will probably send my medical file over to another doctor or surgeon to review for a second opinion – not because I don’t trust my doctor, because I do trust her – but because I think it’s always smart to have more than one set of eyes looking at your case.

I feel a little adrift today, but also a little relieved.  I know that I don’t have all the time in the world to conceive, and that my eggs are probably getting crappier by the day, but today…?

Today I’m taking back my sanity.

At least for a little while.

 

Status

Spring Has Sprung and Other Updates

Tuesday, April 30th, 2013.  CD18.

Howdy, folks.

I’m so sorry I’ve been slacking lately.  I expected to finish out NIAW with this grand Q & A post in vlog form, and then this lovely sinus infection/mucus overload/dry cough/croaky voice thing happened, and I both look and sound terrible.

Ain’t nobody wanna see that.

So that will have to be put off for another day when I can talk without sounding like Urkel.

Errmmm… what else?

Oh yes.  The weather here in Northwest Ohio has turned.

FINALLY.

It’s freaking gorgeous outside today, and I’m already dreaming of bonfires and barbecues and capri pants.  I suppose it’s about time we were exposed to some nice weather anyway, right?

may

 

So besides this ultra-sexy, mucusy sinus thing I have going on, the rest of my body seems to be confused as well.

Like this morning for example… I brushed my teeth, took my vitamin, grabbed my purse and started to walk out the door.

And then out the blue my stomach’s all like, “Hey gurl heeeeeey!  You know that vitamin you’ve been taking every day for the past 4.5 years?  Well eff that, because today we don’t want it anymore!”

*commence puking*

And then I was fine.  Drove to work.  Drank a smoothie.  On with the day.

The Metformin is slowly trying to kill me.  I’ve lost weight like whoa, and have had to cut my dosage back quite a bit to cope.  I feel like maybe I just need to give it more time and figure out what I can eat on the lowest dosage first, before attempting to move onto a higher dose at all.

I also really enjoy not feeling like absolute dog poo.

Another thing I’ve been reading (read: Googling) is that many people/doctors are saying that thin women with PCOS tend to respond better to the traditional Metformin, as opposed to the Metformin Extended Release.  I checked my prescription, and sure enough, I am taking the XR.  I have a note in to the doctor to ask about switching to the traditional dosage, although I know that may also do a number on my digestive system.

How much worse can it get, right?

Oh, and then this happened:  For a week straight, I was getting almost positive ovulation tests… I’m using the Wondfos, in case you were wondering.  Finally, yesterday morning’s result was the first obvious positive I’ve seen in a couple of months.

I tested again in the evening to be sure, and that test also showed a nice, dark test line, darker than the control line.  Textbook perfect, exactly what one would want to see.  I’ve had some fertile CM as well, and took advantage of the weekend at home with the husband to make good use of it.

I’m really happy that I seem to be ovulating this month, and assume that I’m ovulating on the right, as my CD3 scan showed a cyst on the left, which I also assume came from ovulating on the left last month.

My question then, is this…

I ovulated on the left last cycle, presumably – ovulation sucked/didn’t occur at all, I grew a cyst.

I now assume that I’m ovulating on the right this cycle, which is going well.

Should I expect to ovulate on the left again next cycle…?

And if so, does that mean that my left ovary may be compromised because of the cyst?

AND, should I then bother using expensive meds next month and risk wasting a cycle on what may be a bum ovary, or should I perhaps wait one more month before jumping in with both feet and a good ovary?

GAH.

Obviously I’m overthinking this, and no decision will be able to be made until I’m in the stirrups on my date with Dr. Dildocam on my next CD3, but of course I tend to speculate.  About everything.

…Ever notice that speculate and speculum come from the same root word?  Hmm…

Latin speculatus, past participle of speculari to spy out, examine, from specula lookout post, from specere to look, look at

…Errm.  Sorry.  I digress.

So anyway, that’s what’s up with me.

I’m sick, enjoying the weather despite the sickness, seem to be ovulating again, speculating about said ovulation and ovulations to come, and acting as an armchair etymologist in my copious free time.

Yeah.  Good times.  🙂

 

Status

Hysteroscopy

Just a quick update, as I am still feeling pretty crampy from the events of today’s office visit, and would like to remove this laptop from my pelvic region as soon as possible.

So, the hysteroscopy went well.  Dr. F and her colleagues didn’t find anything of concern while they were poking around in my business.  The video was cool to watch, and was a welcome distraction from the discomfort I was feeling with a camera up in my hoo-ha.

She also did an AFC (antral follicle count) and checked to make sure fluid was flowing between my tubes and uterus properly.  My AFC was slightly high, as is the norm with PCOS patients, but Dr. F said that the follicles she counted looked to be healthy sizes, for whatever that’s worth.

Everything today looked normal, as per usual.  Dr. F said as she was leaving that she has great faith that we can do this thing without IVF, and that all signs point toward a very healthy reproductive system that just can’t get its business together.  She aims to help me with that, and I feel good about my chances.

In other news, I had my full thyroid panel drawn today, including thyroid antibodies, which I’ve wondered about for some time.  I’ll be interested to hear those results in a few days when they come back.

I also had my Vitamin B-12 levels checked.  I’ve been reading a lot lately about B-12 deficiency and its effects on the body.  I have many of the symptoms of B-12 deficiency, but those could be attributed to other issues as well, so I will just wait on the results to find out my next step, if there is one.

I’ve decided to move forward with Metformin.  Not today, but soon.  I have the prescription waiting for me at the pharmacy, but I want to get my B-12 results first.  I have read that taking Metformin can actually cause B-12 deficiency, and I want to gauge my levels before I start taking the drug.  I know my acupuncturist won’t be thrilled with me taking the Met, but I know she will accept that I’m doing what I feel is best based on doctor recommendations.

I also ordered a month’s worth of Pregnitude.  For those of you who have never heard of this product, Pregnitude is a powdered supplement of Folic Acid and Myo-inositol, both of which are essential B vitamins that your body needs.  This particular combination is a high dose, and many women with PCOS have found that it has helped regulate their hormone levels when used with (and without) Metformin.  I figure I might as well give it a shot.

I’ve also eased up on my self-placed dietary restrictions.  I am allowing myself gluten again, but being sure to only consume whole grains if possible.  I’m still avoiding processed foods, and having sugars only in extreme moderation, and mainly from fruit or honey.  I’m trying to keep with a low-glycemic index diet as much as I can, and I feel that the regulations help me to make better choices all around.

I received my blood work results from my PCP this morning, and they came back with a slightly low glucose level (72) and a very slightly elevated VLDL level (which is a triglyceride, apparently), so I am seeing more clearly that while I may not be insulin resistant, I am sensitive to the peaks and valleys of my blood sugar.  I was told not to be terribly concerned about the VLDL as it was just a bit high, but it’s one more thing pointing toward pre-diabetic tendencies, insulin issues, and PCOS.

So that’s what’s up in my neighborhood.  Pieces are falling into place, little by little.

For now, I’m going to sit with my feet up and relax till my acupuncture appointment in a couple of hours, and then I’m going to make myself a dinner  high in protein and low in carbs, and watch Hell’s Kitchen till I fall asleep.

To each their own, am I right?  🙂

Status

What To Do, What To Do…

Friday, March 15th, 2013.  CD3.

So with this “lean PCOS” diagnosis, comes a whole line of decisions yet to be made.

On the one hand, I am having acupuncture, and am using a line of Chinese herbs to help regulate my cycle (which is regular in its timing, but irregular in its awful, terrible, painful heaviness).  My acupuncturist is skeptical of some of the Western treatments for PCOS, and feels that since I am of a healthy weight, and am maintaining a healthy diet, that she can regulate my cycle and hormones to a natural balance with the use of herbs and acupuncture alone.

On the other hand, my new RE has offered Metformin.  While I don’t appear to be insulin-resistant, there are many studies showing that Met can help regulate the balance of androgens and estrogens, which is a large part of my problem.  My testosterone levels are a bit high, and my estrogens are a bit low, which I’m sure is causing crappy eggs to emerge.  The husband’s swimmers are turning up their nose at said crappy eggs, or they are attempting to fertilize and failing because they are just so damaged.

Metformin could help over the course of a few months… And so could the herbs and acupuncture combo.  What about combining the Eastern and Western treatments?  What about adding Pregnitude, which sounds like a more natural alternative to Met?  What about adding supplements to my already hefty list of pills?  I’ve heard good things about the combination of CoQ10, myo-inositol (one of the ingredients of Pregnitude), and L-Arginine?

If I was younger, I would try each for four to six months until one of them worked, but let’s face it – I’m not getting any younger, and neither are my eggs.

Oy.  So many choices.

I sometimes wish that I was the type of person I used to be.  The type of person who could just take the doctor’s orders without question and proceed happily.

Not so.  Not anymore.

I’m the person who asks questions with every recommendation.  I’m the person who brings such a disturbing amount of knowledge into the exam room that the doctor asks what she can do for me, rather than telling me what I’m going to do.

Now, instead of orders, I have options.

Rather than making up my mind, I am going to the internet for help.

I know we talked about this recently, but can anyone out there shed any light on lean PCOS and the effectiveness of Metformin vs. Pregnitude vs. TCM and acupuncture vs. egg-quality-improvement supplement cocktails?

Help, internet!  Help!!

 

Video

Whatever. I’m Getting Cheese Fries.

April 21st, 2011.  CD26.

Well, my temp did rise this morning, but not by an impressive amount.  I guess my Ob-Gyn was right–I do have a weak natural ovulation.

I’ve been wondering why that is a lot lately.  I think that’s why I started reading about PCOS.  Now, I know I’ve said in the past that self-diagnosing is not the way to handle things, but it’s tough to sit patiently and wait for my appointment with the fertility clinic in June.  Maybe if we don’t call it “Google Diagnosis” and refer to it as something like “educating myself on the possibilities”, it will all sound less crazy.

Who’s in favor of less crazy?

Oooh, ooh–ME!

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