Midwife appointment Thursday

This wasn't the fun post I thought I'd be making but I got hold of the midwifery practice this morning and I'm meeting my midwife on Thursday afternoon!  Well, the one who is currently filling in for the midwife who will be there for delivery.  I feel a bit odd developing a relationship with a midwife who isn't scheduled to be there for the birth but this is a large, joint practice so it isn't unusual for more than one midwife to be involved in a mom-to-be's care. 

They didn't balk when I told them my health issues during the initial screening phone call many months ago ... I think I called within a week of being released from the RE and I still ended up on a waiting list because my due date falls at the end of the Christmas/New Year's vacation period.  I've got my fingers crossed that my PCOS, which seems to have taken a temporary hiatus during pregnancy (yippee!), holds off and doesn't give me the usual potential complications such as gestational diabetes or pre-eclampsia.  I really want to remain under the care of a midwife until baby arrives.  But I guess I should look at the bright side.  If I do need to be under an OB's care at the end the midwife is supposed to follow me through right to post-partum check ups.  She doesn't just pass me off to an OB.  She is supposed to be there for delivery just as much as if she and her partner ('cause apparently they have 2 in the room at the crucial moment) were caring for me alone.  At least that is what the website says.  I'll get more info at my first appointment on Thursday. 

I still don't have a huge appetite but notice that I'm enjoying the carbs more this week which has resulted in a severely distended belly.  I don't think the PCOS agrees with the carbs even in pregnancy.  So, I think I've got to manage that a little better.  I refuse to gain 50 pounds during the last 4 1/2 months of pregnancy because I got lazy.  But before I started this carb fest I could tell that the belly was finally starting to pop albeit not that much.  (Just don't count today which was severely affected by post-carb absorption PCOS gut reaction.)  Here is a shot from Sunday at 22w1d.

Belly at 22w1d

Kitty wanted to be in the picture too ... especially after the vet drama.  lol

Next post?  Can't promise I'll be able to update you on the midwife appointment Thursday because I have a meeting that evening.  I do hope to update everyone about it as soon as I can plus add a post about the fun stuff that I've received or purchased ... and the niece and nephew.  ;-)

19 weeks ... It's a ...

...........................




BOY!

I'm totally flabbergasted.  Now, I had a feeling right from the start this was a boy.  I think my IUI timing was perfect for a boy so much so I thought this one was horribly mistimed.  I had a feeling that since I had girl names all sorted it would, of course, be a boy.  lol  And when I started feeling kicks, albeit intermittently, 3 weeks ago I was sure it had to be a boy as I've heard that boys kick harder than girls so you might notice their movements earlier.

I told the tech at the scan yesterday that I was interested in finding out if the little bean was cooperative.  I even had a glass of orange juice before hand to try to get the bean to move but to no avail.  I think the bean was snoozing or in deep rest ... or something else that equaled chilling out.  lol  He was on his side with the knees tucked up to his chest and his hands tucked behind his head.  His butt is literally sitting right on my cervix in perfect breech position so that would explain the cervical pressure and pain I've been feeling.  He was content to sit like that the entire time even when she moved the probe around.  The tech showed me his developing brain which is developing on both sides, his 2 kidneys, bladder, etc. and he has everything they look for at this stage.  The heart was working well and the heartbeat came in at 147 beats per minute so nice and strong again.

Halfway through the scan she was covering the nether regions and couldn't get a good look so she zoomed in and pointed out the protrusion to me on the screen.  She said that was a boy.  She continued on with the scan and at the end tried to get a better look but he would NOT cooperate.  She did point out the bottom of the butt and all I saw was baby butt.  However, she is trained and pointed out something that must be a scrotum.  She told me that had she not seen that and the protrusion she wouldn't even have guessed.  So, I'm going to trust her and believe this is a boy.  Girls don't come with protrusions between their legs.  LOL  Although if she is wrong my mom is going to have an awful lot of boy clothing she purchased today to return.

I'm sort of at a loss about this.  I'm not disappointed.  That is definitely the wrong word for it.  I think I'm just really surprised because I've never imagined myself as a mom to a boy.  Never.  I always thought that if I had one or more kids it would be all girl.  I'm used to being around little girls even though I have a bunch of nephews.  Three of those nephews are overseas and I've only met the oldest one.  Most of my cousins are girls and they are a lot younger than me and my sister.  I asked my mom today, "What do you do with a boy?".  Really, I just don't know once they get past baby stage.  My mom was like that too but the complete opposite.  My mom had a younger sister and brother but 2 nephews so she was used to boys and didn't quite know what to do with a girl.  And my mom isn't super girly either so I can only imagine being surrounded by pink. 

There are positives to both girls and boys.  I was thinking it would be easier to have a girl in a very practical sense ... when out in public I never have to worry about her being too old to use the same washroom as me.  I'm not quite sure when I can trust my son to do that and be safe.  My job makes me slightly paranoid.  I'd also love to be able to give my niece's wardrobe another turn as would my sister.  She had so many lovely girl things and as the first grandchild on both sides she had a LOT of really cute stuff.  But I've asked my mom to tell my sister not to get rid of anything yet.  Just in case ...

Boys?  I've heard they're actually a lot easier in many ways after you get past the hard spots when they are young.  The massive appetite as teenager does scare me a bit but maybe that is because I lived with a family with 3 teenage boys who are all now 6'2" and over.  lol  One great thing is that since boys don't have ovaries they can't get PCOS.  That is a huge relief.  I did have a bit of a breakdown last night and started crying because I got sad over the fact that my son won't have a father in the house to be a role model.  But I know that this will affect a little girl as well just in different ways perhaps.  No matter what, any child of mine is definitely wanted and will be loved and he will know that.  I just wish I lived nearer to my family.  My dad is great: he's respectful of everyone, especially women, smart and incredibly funny and great with little kids.  We'll just have to make due with visits and hopefully quite a few business trips home from age 13 months to 2 years when he can fly free on my lap. 

I still have no intentions on going all blue with the baby room or with the clothes.  My mom said she found lots of really cute non-blue 'boys' clothes at Cos.tco today and I'm happy with that.  I'm leaning towards primary colours since I found some really cute vegetable garden theme curtains at Ik.ea. 

I'm a bit stuck on a name and will have to spend some time researching that one to find just the right one.

Other than that I'm feeling fine.  I've had a headache for 3 days now and nothing helps so I think this is just a hormonal shift thing that I've had before with this pregnancy and just have to wait for it to go away.  Hopefully sooner rather than later because I've done nothing all day except sit on the couch.  Kitty may be happy but I'm not.  I've got way too much to do to be sitting around all day on a Saturday. 

Anyway, if you've made it this far and you don't already know Shannon please head over to her blog Chasing Rainbows to give her some support.  Her little guy was born in May and she just received very difficult news about a tumor found with an MRI scan.  I just can't imagine going through what she did only to get this diagnosis.  She has a good support system but I think there is no such thing as too big a support system.  It sounds like this was caught very early so I'm hoping for a good prognosis.

CD10 ... Photo Bonus

Back to another CD10.  Not much going on.  I started monitoring blood work for this cycle this morning:

• E2 = 377
• LH = 9

Definitely no surge yet.  I need that LH >30 for surge.  I'm trying my best to keep my stress levels down this week.  I'm certain that stress during O-week last month delayed my O by a day.  Not a good thing.

I kind of disappeared from my online places over the last week.  I was so tired, angry, and sad that I just couldn't stand looking at pregnancy tic.kers, happy BFP announcements, or condescending "oh, I'm sorry but I know it will happen for you" pronouncements.  I just needed time to grieve another BFN and to come to the realization that adding Clo.mid is probably a good thing and not a sign of defeat.  For years I refused to add met.formin to my fight against PCOS.  Eventually I realized I had done all I could by myself and that the medication could only help me get to that next step.  And now I'm coming to the same conclusion about Clo.mid.  I had so hoped that I could get a sticky BFP without it.  I don't know ... part of me thought that if I could get that BFP Clo.mid free it would feel like I was giving PCOS the big middle finger.  But I can't focus on feeling defeated without a sticky BFP without Clo.mid.  I'm just trying to give myself a better chance at a BFP, possibly more than one good follicle for a better chance at a sticky BFP, and to push up the time table a little bit.  I turn 38 in December and I cannot keep going month after month without stepping up the protocol to get more aggressive.  Adding Clo.mid does NOT mean I am a failure or that my body is a failure. It is just another weapon in my arsenal on the way to getting my sticky BFP.

Not much else to tell here.  We had our first thunderstorm of the season, a major one.  The power went out some time over night and came on again around 4 or 4:15 according to my clock.  The thunder and lightning was very intense and woke me up.  I thought it was about 3 but thought I'd better check what time it was since the clock had been out.  5:30!  Time to take my temp and get up.  Nothing like nature being your alarm clock.  The rain was pretty intense but no damage on our street.  It was way warmer than normal today at 23 degrees C and very humid, a taste of what is to come in summer.  Yuck!

I've noticed this blog is a little short on photos so I thought I'd share a few. 

Kitty hanging out on top of my dresser in the old condo.

This is my kitty, P.  She is officially 'P' but most of the time she gets called kitty.  I've had her for 8 years.  She was estimated to be 8 years old when I got her at the shelter making her about 16 today.  She's mostly well behaved but she has a certain fascination with carpet.  That's why our main floor is wood and tile. 

Me and The Fifi

This is me with my niece, F.  She was exactly 17 months old in this photo.  She'll turn 5 in July.  Her name is unnicknameable but she still ended up with the nickname Fifi.  She couldn't be any more my clone if she were actually mine.  Strange, really.  She has awesome auburn hair with a patch of orange on the side and a patch of blonde in the back.  She also had dark brown eyes, way darker than mine.  And she has the craziest, biggest imagination for a 4-year old I've ever seen.  I love that she's always super excited to see me.  It is 'auntie this' and 'auntie that' the first day she sees me after I've been away a while.  Love that!

Baby gifts ... obviously not for me. :-(

I did some shopping over the last little while.  With 6 new babies around me (5 in 5 months plus one this upcoming June) I've had to spend a lot of time in the baby aisles.  It used to be fun but it isn't really fun any more.  And that makes me sad.  The red one is for The Fifi's little brother, due in June.  The other 2 are for my niece R in Denmark.  I took a look at the tag on the pink one and realized it may be too small already.  R was 22 inches long at birth.  The pink one, my favourite, is supposed to be size 6 months.  But I looked at the tag and it is for kids up to 27 inches long.  And since it has feet it can't work for longer kids.  By the time it gets to R I think it will be too small.  I'll send the snail one instead since she'll still have time to grow into a 12 month sleeper.  And she'll look awesome in blue.  ;-)  I'm going to keep the pink one for now as I'm sure one of my friends or someone at work will have another baby soon.  Then, at least I have something at home and I don't have to brave the baby aisles at the stores again.

10dpIUI, 9dpo

Nothing new to report on the IUI front except that I had a really nice temp drop below cover line yesterday morning.  Crossing my fingers this is an implantation dip.  I had a corresponding drop both orally and vaginally.  Today I had a temp rise although the vaginal temp didn't rise as much as the oral one did.

• Cover line this month (vaginal temps) = 98
• Temp yesterday: vaginal = 97.9, oral = 97
• Temp today: vaginal = 98.2, oral = 97.6

My temp is definitely above cover line, as high as it was the first 2 days after ovulation so that isn't bad.  I had just hoped that it would have jumped higher today.  Maybe I'll see it tomorrow.

The other thing I've noticed is odd abdominal pains between my belly button and my pubic bone.  It doesn't feel like ovarian or O-pain and it doesn't feel like what I was sure was implantation cramping last month.  It feels a little different than the pain I had last month but is still sharp and short-lived when I do feel it. And it just doesn't feel deep enough to be uterine, either. Very weird.  Could be anything but I'm sure it isn't muscle strain.  I haven't done anything to strain my stomach muscles!  LOL

My appointment with the specialist went well on Friday.  I met a nice resident Dr. D. who didn't treat me like an idiot.  Well, not all of my specialists have done that.  I had a very nice one a few years ago who was retraining in Canada and said he couldn't understand why Canadian doctors seemed so reluctant to prescribe metformin for PCOS patients when it was fairly standard where he was from.  Dr. D. was the one who suggested that they prescribe me 2000 mg of metformin from now on instead of 1500 mg.  I told her that since going off Cyclen to ttc that I had been feeling hungry a lot faster, nothing intolerable but definitely annoying when you are used to not feeling hungry.  I thought for sure that my specialist was going to say no way.  Boy, was I surprised when she agreed!  My 2 hour insulin levels aren't sky high like they used to be but they think this will help with insulin control and might give my body the extra help it needs ttc-wise as well.  They told me to take 1000 mg at breakfast and 1000 mg at supper but I know that isn't going to work for me.  I need to take it with meals.  So, I'm splitting the extra 500 mg pill and will take half at breakfast and half at supper.

The clinic has gone electronic so I didn't get a paper copy of my test results.  Boo!  But Dr. D. said that everything looks really good, unlike many patients she sees.  My BP was 118/70.  The 118 is a little high for me but not bad.  Dr. D. said my good cholesterol is higher than normal so she isn't worried about my slightly higher than normal bad cholesterol levels.  She said they aim to have their patient's bad cholesterol under 2 and mine is 1.98.  My weight is up 13 pounds from 1 year ago but I'm sure that 3 pounds of that can be attributed to the progesterone bloat, air travel and lack of sleep last week pre-appointment, and some salty sunflower seeds I ate the 2 days before my appointment.  The other 10 I can definitely work on getting rid of once this blasted Arctic air and bitter north wind leaves.

They're not concerned about my test results at all.  I'm essentially my specialist's poster child for living with PCOS.  Haha!  They do want to run a few tests on the hormones that aren't being monitored every month while ttcing:  DHEA, SHBG, testosterone and TSH.  But in the confusion over the end of the appointment and the fact they started discussing another patient while Dr. D. was writing my prescription they forgot to give me a requisition form for blood work.  I couldn't find anyone after the appointment on Friday as they were either all with patients or leaving as it was towards the end of the day.

I told them I had an early loss last month and Dr. J., my specialist, told me that is probably a good thing because it indicates I can get pregnant.  I told her I'm trying to think of it that way and that we just need to find the right month.  Of course, she used this as a teaching moment and she asked me all kinds of questions about what happened and explained the likely scenario to Dr. D.  Ugh!  But good news is that Dr. J. thinks Dr. V., my RE, is great.  She did a tour through her clinic and also did fellowships so I feel confident that she knows what she is doing and isn't just the new doctor in the clinic all the seemingly uncomplicated patients get sent to first.

On the iron front, I started supplements Saturday morning.  Temp at 5:50, go to the bathroom, head downstairs to take the supplement with a little orange juice then head back upstairs to finish the glass before jumping back to bed.  I'm not sure if it is coincidental but I feel better today.  And no stomach trouble yet.  Crossing my fingers things will continue to go this way tomorrow when I have to eat about an hour after taking the iron.  And hopefully this is just related to the m/c at the beginning of March and things will go back to normal soon and I can get off these things.

12 dpiui ... and I'm Out

Well, I was actually out yesterday but I just didn't feel like posting.  Sorry.  I was just filled with so much anger about what my body is not doing and anger at the clinic staff for not listening to me when I told them I needed a 7 dpo progesterone test.

My temps have been strangely consistent over the past 4-6 days so I thought that maybe my progesterone levels had evened out.  I decided to test yesterday even though I had a feeling this cycle would be a wash.  I used a digital to avoid the evil blue dye tests (or perhaps the satan of the home pregnancy test collection ... sorry, couldn't resist) and I got a big fat negative.  I thought, ok, it isn't over until AF shows. 

Get to work and go to the washroom, cause that commute is always a killer after a nice cup of tea with breakfast.  ;-)  I was spotting.  Bright red.  I don't understand, not because I expected this cycle to work, but because this is WAY too early for me.  That means I might, with the operative word being 'might', have had a decent 10 day luteal phase before my body decided it was time to throw out the bath water ... so to speak. 

It did get worse in the afternoon but nothing more than heavy spotting.  I decided to wait until today to see what happened.  More spotting.  Still not at CD1.  Based on past cycles since coming of bcps last summer I can expect a total of 2 or 3 days of spotting before AF shows its ugly face.  Unless you consider my previous cycle in which I spotted red for a full 6 days before AF showed.  But I'd rather ignore that one.

I still think I have a luteal phase problem, probably a progesterone issue linked to the PCOS and crappy ovulation.  I've asked my Dr.'s secretary if I can send updated cycle info by e-mail (and voice my concerns about the nursing staff) or come in to speak with her (and do the same thing in person).  I believe a little more investigation is warranted and a 7dpo progesterone test should be routine for me.  I'm even willing to pay for it myself if it becomes an issue. 

I just want to get the info to the Dr. and have this week end.  I  might feel just a teensy bit better if I can get to CD1.

Still waiting ... 5dpo

So after the crazy temp drop two days ago my temp shot up to 97.5.  I was pretty pleased.  Then this morning it dropped to 97.05.  *sigh*  Sadly, I think this is just the PCOS playing around.  I still think I have a progesterone issue post-o but since the clinic won't test my levels as 7 dpo I can't prove it to them. 

I also think my ovaries are full of little follicles giving me trouble.  This is a common thing for me, every cycle, but usually of differing depths of pain and duration.  This time feels different, i.e. not as severe and seems to be centred more towards my uterus.  But since I know that pain radiates in the pelvic region (thanks AF for giving me cramps I feel into my toes) and it is way, way, way too early for it to be anything else I just have to use my x-ray vision to stare at my ovaries and tell them to behave. 

Thankfully tomorrow is Friday.  Work hasn't been busy for me since I cut out a bunch of travel but I'm still exhausted.  I'm looking forward to sleeping in on Saturday.  Kitty approves.  ;-)

Temp Drop

So instead of my temp going up today, it dropped.  From a 97.3 to a 96.9.  WTH?  Really?  I'm telling myself that one temperature drop doesn't mean anything but with PCOS I'm a little a.nal about the temp issues. 

I called the clinic to rearrange my pregnancy test.  No problem moving it back a day.  I also asked if I could do a 7 dpo progesterone test to confirm ovulation.  The Dr. wanted one done in December but I couldn't go due to being out of province for 3 weeks.  It was a no go.  I was told that because my LH bloodwork showed a surge that there was no possible way I couldn't have ovulated this cycle.  Maybe the ovulation would be weak this month, but I would have o'd.  Really?  I didn't know that.  (Insert sarcasm here.)  I'm not sure how they can tell beforehand especially with rocky temperatures that are caused, no doubt, by PCOS hormone issues in my post-o phase. I'm not very happy with that.

But, on the good news front I have a new GP.  Well, more like a whole clinic.  My doctor, who is downtown, has been saying she wants to retire for some time now.  I think she's trying to get a young doctor to take over her sole practice but I decided to be proactive and find a new one now that I'm out in the suburbs.  I found a community clinic where the doctors are salaried (I'm a huge believer in that), there are nurse practitioners and other health professionals on staff, and other community services are provided right in the same clinic. 

I went for my meet and greet and met the nurse practitioner who I love!  I'm so excited.  I'll be seeing her for most things as the meds I have to take are all things she can prescribe.  I asked her about an antihistamine I can take in the 2ww and after and she ran to grab the 'pregnancy and meds' bible they use.  And absolutely no judgment about attempting to become a single mom either ... which I love!  So far the clinic seems really quiet but that might change once more people know it exists.  But, so far so good.  And I will no longer be stuck needing a prescription refill while my doc is on 5 weeks of previously unannounced vacation out of the country. 

So in the end my day turned out okay.  Crossing my fingers for my temp to go up again tomorrow, even by just a little.

Follow up with the RE

Back in July I was quickly referred to the fertility clinic in town.  Really quickly.  Think a week between asking my specialist for a referral and getting the call from the clinic.  I had expected 2 - 3 months based on what I was told.

At my appointment Dr. V, my RE, told me that I'd have to go off bcps so we could do a full fertility workup on me.  I understood that would happen but had a momentary panic thinking that my ovaries would take this opportunity to have a follicle party leading to major trouble.  Thanks PCOS!  So I went off after the last week of pills and was able to get in to the clinic lab for my CD3 bloodwork, a baseline ultrasound on CD6 and a SIS (saline infusion sonogram) on CD11.  All of the testing was done by August 26th and my follow up was scheduled for October 19th.

I met with Dr. V. on the 19th and got great news!  I had no worries about the ultrasounds, particularly the results from the SIS.  I had the same tech (S) for both and she said that at the SIS the Dr. would be able to give me the results right away.  Dr. H, who I like to call Dr. Happy because he just seems that way, called my tubes "beautiful".  Thanks, I guess!  lol  I was a little anxious because with PCOS I've just come to expect something else will be wrong or go wrong with my body.  Not this time.  Everything appears to be in perfect working order:  uterus, lining, ovarian shape, size and volume, and follicles.

At my appointment with Dr. V. I got all the results.  She said I have good ovarian reserve.  And at 36 I'm relieved to hear that.  You never know what is going on inside.  Here are my CD3 results:

• DHE-S - 3.24 umol/L
• Prolactin - 13.37 ug/L
• TSH - 0.66 mIU/L (perfect for my hypothyroidism)
• Testosterone - 0.91 nmol/L
• FSH - 5.94 IU/L (super excited about this result!)
• LH - 7.66 IU/L (very happy with this)

I'm pleased with my LH:FSH ratio.  The last time I had my bloodwork done off bcps the ratio was off, as in 3:1 off, highly indicative of PCOS.  I now have a ratio of 1.28:1, a HUGE improvement.

I hadn't begun charting with temperature taking that month so I wasn't exactly sure if I had ovulated.  I could only take a guess, based on a positive OPK, that I was 7 or 8 days post-ovulation on CD22 when I went in for my post-ovulation progesterone test.  The results, 40.80 nmol/L, showed what Dr. V. called a "really nice ovulation".  Good to know I guessed the day correctly.

My antral follicle count seems to be a little high according to any reference ranges I've found.  My AFC was 33.  But Dr. V. didn't seem concerned at all.  I mean, we all know I have PCOS, so if my AFC results were a little high that wouldn't exactly be a surprise.  I've felt my ovaries come to life since stopping bcps so I'm hoping that as my hormones settle out a bit that my AFC will come down just a little.

And one of my biggest questions was answered:  CMV-.  This was the result I was most interested in getting because it would determine the number of donors I could consider.  In some ways I was a little disappointed because my donor options are really limited.  My mom asked, "What?  You wanted to be CMV+?"  She's a lab technologist so it isn't like she doesn't know what it is.  But yes, a + would mean I have more options to choose from.  So, after I got the results I had to go into my list and delete a huge number of profiles.  Luckily my current 1st choice is CMV-.  I still want to give the European donors a fair chance so I'm going to get a few of those profiles so I at least have a backup.

On to next steps.  I have to see Dr. G., a psychologist specializing in reproductive psychology at the clinic, to discuss the implications of using a donor.  I have an appointment scheduled for November 1st.  And I get to order the donor sperm.  Dr. V. recommended 2 - 3 vials at once in case I'm interested in doing procedures in back-to-back months.  Once I've seen Dr. G. my file will go back to Dr. V.'s nurses and then we'll be ready to roll.