Category Archives: Doctor Doctor

5+5+5+5 = 201

200thepisodeI missed my 200th post!  That is monumental and yet instead of shouting from the roof tops that I had hit post #200 and still had some readers to boot I wrote about operating systems, and bum power cords!  To say that this blog has changed its pace is a total understatement.

The above explains the 201 in the title, as this is my 201st post.

The 5+5+5+5 is not in regard to Subw@y’s $5 footlongs.

No, its in regard to the insulin dose that finally seems to be working.  My endocrinologist is slowly coming to realize that I am not placated by trial and error, but she is at least a good sport about it.   I also realize that I never did fully explain the reason behind poking myself 4 times a day in both the belly and what ever finger happens to be the unlucky sport at any given time of the day.

My old endocrinologist was satisfied enough with my over all glucose levels however the new endocrinologist as well as myself was not.  As I mentioned before my A1C was climbing.  Under ordinary circumstances the first course of treatment would have been to add a secondary oral to my current oral regime.  Those would have been Glyburide, Actos, or Avandia.  The endocrinologist was not comfortable prescribing those to a woman of child bearing age so that gave us two options.  Do nothing, and continue with an OK A1C, for after all I was below 7.0, or to put me on a low dose of insulin.  We originally discussed a low dose after breakfast, lunch, dinner and then at bed but first she wanted me to check my levels and we would re-evaluate.  Of course in doing so we discovered a pattern, and that pattern was that I didn’t have a pattern.  For no reason other than the sky is blue and the grass is green I would go from 200+ before a meal to normal 2 hours after a meal, and back again.  Hence the decision for low and slow.

When that didn’t work I called the nurses line and requested that Dr. T call me back.  As before she did so almost immediately, half expecting me to tell her that I had bottomed out.  She wanted me to continue on the same regime only with an increase at bed time, where as I demanded that we try the original protocal.  She relented, and with a little tweaking we found what works.  5 at breakfast, 5 at lunch, 5 at dinner, and 5 at bed.  That dose keeps me at roughly 100 give or take 10-20 points.  In other words perfect.

Someone asked how I felt about going on it.  I am ambivilent.  As the endocrinologist pointed out, I am of child bearing age–and given that I have recently achieved a pregnancy why risk being on a drug that would put another at higher risk.  This wasn’t the deciding factor in my decision to do it, but given that we aren’t preventing a pregnancy at this time it makes sense not to rock an already precariously placed boat.  I figure that within the year if I am not pregnant again that we will be preventing it, and at that time we can always switch to one of the orals that was above mentioned.

Insulin Insolence…

I am most looking forward to Friday.  On Friday I will fax over my first week of insulin induced numbers to my endocrinologist.  In case there is any doubt, I am so very much not amused for  like the Metformin its not working, and its pissing me off.

The ring finger on my right hand looks like it has been moon lighting as a seamstress’ pin cushion.  Which I suppose isn’t far from the truth.  The shots aren’t bad at all.  The needles are super tiny.  They are about half the length of a Follistim needle, but about the same diameter.  Very tiny.  They only hurt if I fail to “pinch an inch” but that is more from the jab than the medication its self.

What is unamusing is the fact that my doseage doesn’t appear to be doing anything.  The endocrinologist was worried about me bottoming out, but you can’t bottom out when you are still waking up with levels above freaking 100, and post prandial levels of 202.

I guess I had different expectations for this science experiment.  I suspected that 3 units before bed, and after meals was a “placebo” doseage and that it works for some, but it isn’t for me.  In talking to my sister, and to another who was on insulin their levels were much higher and much more controlled.  But, just like Follistim, or HCG, or any other injectables it trial and error…but I am renaming it insolence because only my body could be this uncooperative, and unpredictable.

Did I Tell You?

insulinI have to go on insulin. 

I know I told my other blog readers on  my “all infertility all the time” blog but not wanting to let you all out I decided to share with you guys too.  The decision has NOTHING to do with TTC, or the lack there of really.  It just turns out that my Metformin is no longer effective.  Which if I think about it could explain why I was having so much mid cycle spotting.  It may not have turned me into a “normal” ovulating PCOSer, but maybe it was doing enough to keep me from spotting?  Hmm, an interesting hypothosis now that I have thought about it.

At any rate.  I switched physicians and this doctor was acutely interested in my case.  My HbA1C has creeped up by .50 points which I know doesn’t seem like a lot, but when your goal is to be below 7.0% and in 2 months you go from a 6.2 to a 6.7 while doing the same exact regime as before you tend to scratch your head and go “hmm”.  New Dr. T (notice how I stick with the same letter of the alphabet when going to new physicians) went all the way back to my April blood work and agreed that the upward trend is not normal given that I am on the max dose of Metformin.

There are some additional orals that  I could take, but they are not approved in pregnancy.  Dr. T’s thought is that since I have proven the ability to get pregnant and since we are not preventing pregnancy that the risk to be on them is too great.  So after much debate on her part she decided that a very low dose of insulin is the proper course of treatment.  In the event that we take permanent measures to not become pregnant then I can come off the insulin and go on Glyburide, or Actos or the like but as long as we aren’t preventing a pregnancy insulin it will be.

So there you have it.  Something other than my Cricut…just for a change of pace.

Poisoned I Say…Poisoned

staphThis is your one warning.  If you don’t wish to hear about evacuation of bodily fluids and weakness remenicent of near death then I suggest you close thise blog right now.  Still here?  Don’t say you haven’t been warned.

Last night around 7ish Jacob tells me he is bored.   Since we were going to go see a movie today after having dinner with our friends so we decided to see the lights at Hartwood Acres.  As we got of the Turnpike Jake and I decided we were hungry.  We hadn’t eaten since his moms so we decided to see what if anything was open.  This is where it all began.  We had a less than steller dinner-they messed up our order and it took forever to arrive.  I just so wish Jacob has taken my suggestion about just leaving…I would cook when we got home.

The lights were stellar as usual but would have been more so with snow but beggers can’t be choosers.  We came home and went to bed.  At 3 a.m the trouble began.  I felt dehydrated so I woke and had some water.  I then had an urgent need to go to the bathroom.  Followed moments later by another urgent need.  Followed even more closely with another.  I came to the couch and tried to sleep, but each time I got close the moment was puntuated by a trip to the bathroom.  At 5:30 it was Jacob’s turn to begin.  Now we were jockying for position and hoping that our tribulation did not occur at the same moments.

By 7:30 I had thrown up once, while Jacob was still in the early throws of the condition as I was.  Only we both were experiencing chills at this point which meant blankets were stolen from each other with abandon.    After throwing up I felt a bit better, but was still very week.  At this point we said “we will try to get to dinner with our friends…we might feel better”  At 9:30 when I was in the bathroom again I discovered how much I smelled, so it was shower time.  Well, I can say that like Jacob, I have now had the experience of loosing my contents of my tummy in the tub.   I literally crawled back to bed soaking wet, but managed to put on new pj’s before crashing again.

When we awoke again it was to signs and sounds that Jacobs symptoms were following the same course as mine.  One look at us and you would want to call us Casper.  I called and cancelled dinner and then went back to bed again.  I woke at 1:30 and have now been awake for 21 minutes…a record for me.  Jacob is about 3 hours and 1 vomitous experience behind.  Hopefully when he catches up we are both feeling better because darn it we are missing out on the after Christimas sales!

One In Every Crowd…

“Are you ready for the holidays?  Did you get all of your decorating and baking done?”  The question was asked innocuously enough at Jacob’s Christmas party.  To avoid the next obvious question “No, we didn’t do anything much this year.  I had a miscarriage early in the spring and our due date just passed so I didn’t feel like much of having Christmas” The woman whom I was answering was my husband’s bosses wife, Rosemary.

 

She reached over her husband and took my hands in hers.  “I understand, I went through infertility treatments and a miscarriage before we had our son 5 years ago.”  That opened a whole new line of conversation.  For once, I wasn’t the one being left out of the conversation—how many children, what did Johnny do for the school play this year, did Sara make honor roll, have I shown you my newest ultrasound.  Instead I was an active participant in a conversation while two other women sat in silence not knowing what to say. 

 

As it turns out Rosemary went to all of the RE’s that I have seen!  Dr. IVF is the only way you will get pregnant, told her she was TOO OLD at 38 to attempt a pregnancy with her own eggs!  This was at the consultations BEFORE she even saw the inside of an exam room!  He turned her away!  Now you tell me Dr IVF that its not all about your statistics!  Dr. T, our last RE did a cycle with them, but she found his office to be cold and uncaring during her cycle and her miscarriage-Not unlike my experience.  So at least I had validation that it wasn’t just me!  Dr. Original gives me a $1000 bill and little else screwed up her cycle.  She was to have an IUI, but they messed up the timing and she couldn’t have it done.  Miraculously that was the cycle she became pregnant on. 

 

She would like to have another child, but is afraid of being turned away at 44 like she was by Dr. K at WPAHS.  I told her that I work for WPAHS’s competition and we have our own baby factory.  She said “I never went there because I didn’t think they took our insurance” I assured her that we do and that we have diagnostic coverage—something she wasn’t aware of either.  She tugged on her husband’s sleeve, and I watched as a smile appeared on her lips and a glint in her eye.  She said “honey we won’t have to pay all that money out of pocket for an IUI this time” He rolled his eyes and patted her hand.

 

Knowingly she looked at me.  “I don’t know about Jacob, but JC is on board, but doesn’t want to be involved” I looked over at Jacob, and smiled.  “He is onboard, but he doesn’t want to be disappointed again.”  Jacob took my hand and squeezed it, and I knew what that meant.  Later when I told him I owed him an apology he asked why?  I told him because he is a normal guy-he wants me to be happy, but I get that he can’t go to my appointments because he doesn’t want to see me be disappointed. 

 

Before we left the party I told Rosemary that I would email the information for the Baby Factory to Jacob for JC.  JC told me please do it quickly because she would do nothing but harass him for it later.  Rosemary hugged me and whispered “Never give up hope…”

 

I haven’t which is why I am going to the baby factory in January myself…who knows, maybe we will run into each other before next years Christmas party…

The Best Laid Plans…

We are 1 week from moving.  At this time next weekend Jacob and I will be collapsing on our couch exhausted from moving 5 years of stuff into a 2 bedroom apartment.  So all I asked for this weekend was to have NOTHING to do for two whole days.  Of course my weekend was totally screwed from the begining.  Typically I am off on Friday’s, but had to switch days to accomadate a co-worker.  So instead of my normal 3 days off I only had 2.  Then I feel like I am coming down with a cold.  However the stupid thing won’t manifest its self into the coughing hacking cold.  Instead it is sitting square in my throat and ears as both hurt.  I came home on Friday night with one goal…to not do anything on Saturday…then the phone rang.

My brother in law is in the hospital again.  This time for a clot in his lung.  Now I am furious with both he and my sister who works in the medical field.  See, he had a dental proceedure done on Wednesday.  He was off work Thursday to recover.  That evening he was short of breath and having chest pains.  Now in this situation the only vote Jake gets is how are we getting to the ER?  Are we taking the amublance or are we driving?  There would be ZERO discussion of going or not going, but that is exactly what transpired between my sister and her husband.   They opted to wait to see the doctor the next day.  Well it turns out he has a blood clot in his lung and needs to be admitted to the hospital urgently.

So today I was asked if I could take the kids for awhile, which I agreed to and now I have the littlest one sleeping on my chest as I type this because he too has a cold…only his is full blown.

I keep saying “I want just one weekend where nothing is going on”  But that being my best laid plan isn’t likely to transpire any time soon.  Sigh.

What Goes Up…

Must come down right?

Today was my follow up with Dr. L, my PCP for my blood pressure.  I was a bit nervous going in to be honest.  All that talk of ACE inhibitors, beta blockers, and the like scared the creeping crud out of me.  Each of those brought with them varying degrees of “is this or is this not safe” during TTC time.  So imagine my delight when Dr. L’s medical assistant took my pressure and it was 136/83.  Basically a little elevated, but otherwise completely innocuous pressure.

Bottom line, I do NOT need any medication as of right now.  I have been told that in 10, 15, maybe even 20 that I will but right now I do not.  However the pill is NEVER an option for me.  So IVF then is NEVER an option because they control the cycle with birth control pills.  He said this in non negotiable.  He said it was remarkable that my BP after one week on BC was 150/90, and then just a month later even after being on Provera that I am totally normal.  He said if I am going to ever consider taking the pill again that he would advise that I see another PCP because he would not be pleased.  However as far as IUI goes since there is no birth control prep he has issued the all clear!  So I am really excited about that.

I can’t believe the upswing that Jacob and I are on!  First his clean bill of health and then mine.  How do you get so lucky after such a swing of bad?  Or is this like the economy…eliptical?  Yes, perhaps that is it…what goes up much come down and vice versa!