Category Archives: INJECTABLES

Full Disclosure

I have been debating on updating or just letting Familyoftwo fade away.

The truth of the matter is the blog has come full circle.  I came to word press as a way to grieve Aaron, and grieve I did.  Yet a new adventure is about to unfold and it isn’t right to share it here.  This blog, and my life changed after loosing him.  Life was no longer obsessively concerned with conceiving.  Even when we tried it wasn’t shared here.  You guys weren’t privy to the shots, or the let down when once again AF started up at 10 days post ovulation despite having an E2 of over 1500.  Life went on and so did I.  We talked about Cricut projects, and my unstable mother in law (whom incidentally we haven’t seen in six weeks), or my psycho mother-who recently apologized for being a bad parent.  Life is eventful, but not in teh way we all come to expect but that is about to change.

Earlier this month I consulted with the last RE in the area.  The RE who is affiliated with my place of employment,the RE whom two different gynecologists highly recommended, the RE whom I recommended to an “invisible” friend who now has gone through 3 miscarriages, and has one child thanks to his help while I sit here with none.  During my consult all of my preconceived fears came true.  I was met not by him, but by another doctor who took my history, and only met with him for all of 15 minutes while he reviewed my history, ordered some tests, and demanded that Dr. T’s office send my history from their office.  The next day I walked back in on cycle day 3 and was probed by “an angry ultrasound tech”  after being poked in the vein so that they could aquire my blood.

Ten days later I walked back in and had an emotional break down that caused the RE to question my sanity I am sure.  After he preformed my first ever saline ultrasound he asked me the question of the hour, “how are YOU handling all of this?”  Not, lets jump right into IVF because that is what I am trained to say but rather he wanted to know how I was feeling.  I waked out and called the social worker he recommended and cried my way home.  That night I talked to Jacob and told him I was not scared to try again, but scared of becoming pregnant again and I wasn’t sure if I could proceed as planned.  The next day, I walked back into the same hospital with a sense of calm yet with no real direction.  Even so I underwent my fourth HSG in 8 years.  Before we began however the doctor sat and held my hand as I told him about Jacob’s and my conversation.  He told me that I was wise, and that we would go slow, but it feels like we are moving full speed ahead.  And yes, most of my fears about the baby corral have been quelled.

Bottom line:

FSH 7.6, I have the ovaries of a 30 year old.  Prolactin 15.9 (down from 30.6).  I am HIV, and STD negative.  I am Rubella positive which means I do not have to worry about the German Measles should I become pergnant or not pregnant.   My ultrasound showed 30 antral follicles on CD 3, which is high for a “normal” woman but to be expected for a woman with PCOS, which is why we over stimulate on even the lowest of Follistim doses.   The HSG shows patency and a clear path.  My Saline Ultrasound however showed a problem.  On the left posterier wall I have a growth and a gross thickening of my uterus below it.  If you remember my GYN said that my uterus “felt enlarged” when she saw me in September.  Speculation is that while the polyp was noted during my hysteroscopy in February of last year, it was not removed and could have been the cause of my miscarriage though that can’t be confirmed.  Ironically, had Dr. T been willing to do a D&C in May this would have been a mute issue, and my chemical pregnancy in August may have been a “real” pregnancy as well but we shall never know.

At any rate, I have to have another surgery.  This time its a polypectomy, a D&C, and a hysteroscopy.  The remenents will be sent out for pathology to test, but we do not forsee any issues.  However he did say that women with PCOS have a higher risk of problems from these growths than a woman without.

We come full circle now.  My surgery was orignally offered for February 12th, but that gave me too great a risk of having a March 10th cycle, and thus if I do become pregnant another December 15th due date.  The plan after the surgery providing that the pathology is A-Ok is to try again.  The RE feels that given the labs, and the patentcy equals a good chance of pregnancy on my own (with help from injections), but I want to wait until afterwards until we decide…even so…I need to step away from the key board in this particular venue.  I do have an all infertility all the time blog…but to keep both is dishonest.

Thanks to everyone who was with me through two RE’s, a failed pregnancy, my mother in laws antics, and my many many many cycles of PMS and rage.  I will keep up with everyones blogs, and will comment, so your not rid of me.  I just feel that this blog has come full circle.

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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.