Thursday, November 1, 2007

Overwhelmed

We had our first RE appointment today. The appointment was overwhelming to say the least. I just have to say I'm in love with Dr. Hutchison though - he's very thorough, has a great bedside manner, a good sense of humor and explains things thoroughly.

Anyway, we did the history and when he realized I was on cycle day 10 of my 3rd Clomid cycle he wanted to pull out the internal ultrasound cam and take a look at things before moving on. After some painful prodding (apparently my bowels were blocking the left ovary and had to be manhandled to get out of the way) I have two very large ovaries. They're both polycystic looking. But, I do have two dominant follicles on the left ovary at 14mm each. Unfortunately, the Clomid is thinning my uterine lining. It's only at 3mm and should be around 8. I'll go back on Saturday to check the follicles and lining again. If the lining thickens we can either try naturally or increase the odds and do an IUI (Interuterine Insemination). If it hasn't thickened, I probably can't get pregnant this time because there's no place for the egg to latch on. He suspects that actually happened last cycle.

So for the bad news. I have several symptoms of PCOS (Polycystic Ovarian Syndrome), but he feels mine is more a metabolic disorder due to my Dad's diabetes and hypertension. Meaning I'm insulin resistant and my body is producing too much insulin causing my ovaries to produce too much testosterone. Oh yeah, my BP was high today, too (maybe Dr. A wasn't too crazy after all). Anyway, if this cycle results in a pregnancy I'll be put on Metformin (a diabetes drug) to reduce the chance of miscarriage and gestational diabetes. If it doesn't, I'll likely be put on the Met anyway.

If I move on to a new cycle (around Thanksgiving), I'll have to do a bunch of bloodwork. My last was 6 months ago and he wants more up-to-date info. I'll also have an HSG (Hysterosalpingogram) to check my fallopian tubes, too. That's where they'll inject a contrast die into my uterus and tubes. The best part of that will be the 2 Valiums I get to take prior to the procedure!

I have to cut out all sugars and refined carbs pretty much permanently. That means no potatoes, rice, pasta, ice cream, breakfast cereal, yogurt, soda, fruit juice, sweets and a few other things. This metabolic disorder is a precursor to diabetes - it doesn't mean I'm diabetic but, like my Dad, could end up getting it later in life if I didn't try preventing it now. He also wants me to exercise a minimum of 1 hour a day. Cardio every day. Weights 3 to 5 times a week and crunches on a yoga ball. I have to work up to 200 crunches a day. Yikes! All of that should help the metabolic disorder and my blood pressure. I go back in two weeks after the exercise regimen starts and check on the BP again. While I am overweight he wasn't worried about it. My weight, BP and ovulation problems are due to the metabolic disorder. My body is telling my ovaries to produce testosterone instead of healthy eggs which is causing me not to ovulate correctly and produce small follicles. The increased testosterone and my insulin resistance is causing my BP to increase and the weight issues. It's all my parent's fault. The odd are stacked against me on this one.

So I have no idea what the heck I'm going to eat now. I was close to tears when I realized no more potatoes, rice and pasta. I know all of this is so I can be healthier and have a healthy pregnancy and baby but it's a lot to take in all at once. If we're not able to get pregnant this cycle, he did say we can plan on being pregnant in 6 to 9 months. I like his optimism!

So, I have a bunch of meds to take. I'm on a mercury-free Omega-3 supplement 4 times a day. The mercury could harm a fetus so that's why I have to go with the mercury free. I'll also be taking a new prenatal with folic acid and an additional folic acid supplement. Once some more tests are run I'll probably be put on the Metformin and, if needed, on blood pressure meds so I won't have complications during pregnancy.

So I'm a bit stressed. I have NO idea what I'm going to eat now and have to try to find wild rice and possibly some whole grain pasta. I'm supposed to completely cut out the stuff but the word 'minimize' was there, too so I think I can have some potatoes and carbs occasionally. If I'm taking the Metformin though it will make me physically sick if I eat those foods. He flat out told me I'd end up with diarrhea and vomiting if I ate those things while on the meds.

I'll know more Saturday if we're moving forward with this cycle. If not we'll just wait for the next one to start and start the testing. He said if my lining gets too thin he may have us take a month or two off so that when we do start again things will be good. It'll be tough to make the diet changes but it has to be done.

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