The struggle continues with obstacles

It has been such a long time since I have been here.  I read my last post and realize how much I failed with my goal.  I think it took a backburner when our family arrangements changed. 

Long story short – my hubby and I are not living in the same house, not even the same state, which makes for trying to conceive IMPOSSIBLE.  In September, the children and I went to Ohio for an education vacation and we are still here.  Needless to say, I haven’t even focused on the weight battle to help improve my health and hopefully my fertility. 

Since my hubby and I aren’t physically together, in October and November I didn’t expect anything but my monthly visitor and when it arrived I was not disappointed because there wasn’t any thread of a chance of being pregnant.  My husband was here for a visit in November and believe it or not it my monthly visitor was cooperative and it could have happened.  Unfortunately, it didn’t so when my monthly visitor recently arrived all those emotions and disappointments consumed me. 

Last month I visited my old doc for my annual.  A year ago I was diagnosed with Simply Hyperplasia without atypia and then in Feb. ‘09 I had a D&C to rid the bad uterine tissue.  Since it has been six months since my surgery, she wanted to do another uterine biopsy and ultrasound.  YAY!!  The uterine lining is healthy – not too thick and no bad cells.  Well, with that said, the doctor here – who I so adore because she is wonderful and completely understands my history – has decided it is best to put me on birth control to help sustain a healthy uterine lining.  So, until my hubby and I are back together when we can aggressively try to conceive, I will be on birth control to help maintain a healthy thin uterine lining.

Maybe I should revamp that goal and still try to attain it!  Losing weight and exercising is a win win situation regardless.  Okay, so here is my new goal.  To lose 10% of my current body weight in six months.  So, between now and June 5, 2011 I will focus on losing weight and exercising – in one form or another – everyday. 

The Next Step

I was thinking the other day about what to do differently to help encourage any ounce of fertility I might have.  We’ve done various things over the years, and still have not been successful.  Even though I tried the “losing 10% of your body weight,” cycles of oral meds, and cycles with oral meds & a HCG shot to stimulate ovulation and none of those worked for us, I am still willing to go back to the basics and try to figure this out and hopefully have it happen on its own. 

Jay and I feel very blessed to have our three beautiful children.  There is something in me that really feels some of the fertility treatments/methods should be reserved for those couples and families who haven’t been blessed with a child or a sibling for the first born.  It still amazes me how many women/couples are struggling to have that child and on the flip side how many families, we know, that are having or have had six plus children – even in the double digits.  I still struggle with the ‘why’?  Why is that family been blessed with eleven or twelve children when there are so many couples that haven’t had yet one? 

For us, our family plan was four.  Four seemed like a nice round number -good size family, and we wanted to have them no more than two years apart.  That was our plan, but apparently our plan wasn’t good enough for His plan.  I’m still not sure what His plan is and why we have had to bear so many losses – because in my heart I still feel four is the right number.  So, that is where my focus still is.

We were hoping the D&C would help regulate my cycles and help with getting pregnant, but that hasn’t been the case.  Matter of fact, my cycles are just as crazy, if not more now.  I explained how I bled and bled after the procedure in a previous post.  Well, my next cycle was really short (23 days) and then the next was really long (45 days) but when the two average out it falls in line with my normal 33 – 35 day cycles.  That’s my explanation for the craziness.

Well, I postponed my May 12th doctor appointment because I had just returned from our long trip.  We’re scheduled to go in July, but I’m thinking about postponing it too.  I have some new personal goals to attain before we go down the road of fertility treatments.  I told Jay the other day I have a mission. 

Unfortunately, since our move to ND I have put on some weight. I am now back to my highest weight again and I think it’s time to get rid of it.  This time though hasn’t been as easy. Last time I just changed my eating habits – smaller portions & eating healthier things, but that’s not working this time around.  So, now the focus is to get moving so I can lose weight and get fit at the same time. 

So my mission or goals if you will . . . *  to lose at least 30 lbs – only if I had the time those Biggest Losers have at the ranch – by the end of December, so six months; *  start having more positive thoughts – according to my old doctor our mind has a lot to do with it too; and then it will be time to focus 110% on getting pregnant. 

It’s been a while . . .

Well, it’s been a while since I’ve been here.  I have been a little preoccupied by all the mommies-to-be around me.  My brother’s wife is due any day now and my husband’s sister is expecting her first in December.  Plus a friend back home is due in the next month and a cousin’s wife is due in October.  It’s wonderful news for these mommies-to-be and I am truly excited for them. 

I have to admit, each time I heard about someone new expecting I’d get a little twinge and wish I was joining their ranks, but it’s the first time I wasn’t absolutely devastated by the good news. 

Of course, as we approach the arrival of our nephew, the kids’ cousin, Zack more so than any of the others is asking questions.  He has had the whole “sex talk” so he knows about the birds and the bees, but he is asking about our previous pregnancies and miscarriages.  Then of course, today in his health – we school year round – he started a chapter about his changing body and it started off with the beginning of life with pictures of babies in utero and talked about conception to birth. 

So, then he was curious how far along I was with the pregnancies when the miscarriages occurred.  He even remembered that our last miscarriage was over two years ago – two years and eight months ago.  Those conversations are getting easier to have. 

I know when I see my nephew for the first time, my heart will ache, but I will also be so happy he is part of our extended family and that my brother and his wife have been blessed with such a wonderful gift. 

Just a thought . . .

Is it possible??

Okay,  when I visited the doctor last week, we discussed ways to stop my bleeding and spotting that occurred after my D&C surgery.  Well, I got to thinking about what she said.  She laid out two options, but recommended me taking progesterine for ten days to promote a withdrawal bleed.  Which made me think, keep in mind she had the same info and didn't come to the same conclusion, but I figure what the heck lets see what happens.

Let me explain why I came to the current thought process by exlpaining how the last couple of months have been.  On Dec. 14, 2009 the doctor put me on a daily dose of Progesterine to see if it would help thin my already way too thick endometrium lining (Simple Hyperplasia without Atypia).  The game plan was to have me on it for two months and then reevaluate the endometrium lining to see if it helped.  After nine days on the progesterine, I started bleeding and I bled for a two weeks before they doubled the dosage and then I still bled for another fifteen days before I finally stopped.  By this time they had already done another ultrasound and the lining wasn't thinning so I was scheduled for a D&C.  I was advised to continue taking the Progesterine up till the surgery.  I took my last dose of Progesterine two nights before the surgery.

Now, if you recall in my last post, the doctor said that by taking the Progesterine for ten days and then coming off it would cause me to have a withdrawal bleed two to nine days after my last dose, and then we would move forward with ovulatoring meds to promote ovulation since I was still bleeding after the D&C.  This got me to thinking and looking back at my most trusty calendar where I write everything down, have been for the last nine and a half years.

What if?? What if this crazy unexplained bleeding after the D&C was a withdrawal bleed.  You see, if you count from the days from my last dose of progesterine before the surgery I started to 'flow' three days after the D&C and flowed for five days followed by a few days of spotting, then nothing, then a day of spotting, and then nothing over a span of five days, and then the night before my follow-up I was having severe lower pelvic pain for a few hours and then passed some bright red blood.  I have now been three days free of bleeding, spotting, and yukiness. 

I know the doctor gave me the script to have the progesterine filled so I could proceed and try to get the bleeding/spotting to stop, but I told Jay since I was going to be gone the whole month of April, I'd much rather see if over the next month my body and cycle would regulate themselves.  You see that's why I had the D&C.  I was tired of the sporatic cycles (20-42 days in length) and the heavy heavy bleeding, 5-7 days with days 2-3 so heavy I had to change every hour!!

So now we'll wait.  We'll wait and see if I can actually cycle within reason within the next month.  That would be so nice if this 'what if' is an actual 'what if' and I start to cycle, oh yeah and ovulate without fertility meds, on my own. 

Happy thoughts . . .fertile thoughts . . .  happy thoughts . . . fertile thoughts . . .

Post-Op Doctor appointment

I had my follow-up/post-op appointment on Tuesday.  I had some concerns, still bleeding and spotting some days and the irritating low pelvic burning sensation.  The appointment went as well as expected.  The doctor isn't reallly sure why the bleeding was still occurring.  When I went in for the appointment I had bleed or spotted for 12 of the 15 days post op. She said some minimal bleeding, but more spotting is normal after a D&C, but the heavy course of bleeding wasn't.  She reviewed my labs and notes from the D&C to see where I was in my cycle at the time of the surgery.  Evidently, based on the type of cells she could tell the stage of my cycle, and based on them she said I was at the beginning of the cycle not the end so I should not have had so much bleeding because the lining wasn't suppose to shed yet.  Keep in mind, none of this really makes any sense to me because with the D&C wasn't the lining scraped and thinned, so there wouldn't be much if any lining at all????

Well, the doctor said it would be an easy fix if we were not still trying to have another baby.  With us wanting to conceive she couldn't treat the bleeding like she would had we not wanted to get pregnant.  She said if we weren't trying to get pregnant, all she would do is put me on birth control to control the bleeding.  BUT, since we still would like to expand our family, she had to figure another way to control the bleeding.  As she explained it, as long as I'm bleeding, we definitely will not get pregnant because my body is shedding the most important habitat for the fertilized egg.

Her two possible resolutions were:
1.  Go on estrogen the first part of the cycle and then mid-cycle (after ovulation) put me on progesterine to support a potential pregnancy.  This approach would stop the bleeding, but wouldn't inhibit ovulation.  There would be no guarantee that I would ovulate, but the estrogen wouldn't, more like shouldn't, cease ovulation like putting me on progesterine would. 

OR

2.  Put me on progesterine for ten days to help stop the bleeding and to promote a withdrawal bleed.  She said after taking the progesterine for ten days and then stoppy this would cause the withdrawal bleed 2-9 days after the last dose.  Then on the third through seventh day of the withdrawal bleeding, the first day of actual flow would be day one, have me take Clomid to promote ovulation mid-cycle to increase our odds of conception. 

So she asked me which approach I would like to try.  Of course, I asked her what her recommendation was and her main question was, "Are you and your husband ACTIVELY trying?"  As I explained to her, "We have been TRYING for nine and a half years. We are not doing anything to prevent pregnancy and we have tried to be more active in what we have determined to be the fertile part of my crazy cycles.  Granted over the last two years we haven't used any ovulatory predicting methods."  She was quick to ask what our ultimate goal is - if it is to get pregnant and have another baby?  When I confirmed it was, her recommendation was to go with option #2.

She said it seems we have been more passive and it was time to be more aggressive in our attempts to conceive.  She recommended doing a progesterine withdrawal bleed and see if it would get me to stop bleeding and to cycle.  She also recommended not actively trying till I can get two cycle bleeds, which put us meeting with her in April and being aggressive starting in April.  Well, I explained to her that I will be gone the whole month of April and my husband will be here so we will not be trying the month of April.  So, we have scheduled an appointment for May 12, 2010 to meet, discuss in greater detail, and go from there.

I have to say, I was so hopeful that having the D&C would help with our unexplained secondary infertility and discourage early miscarriages.  I had done some reading about Simply Hyperplasia without Atypia, which is what I was diagnosed with and the ultimate reason for the D&C.  Anyway, what I had read said that this condition can actually be a cause of infertility and/or early miscarriages, and is usually not diagnosed because it isn't a common ailment.  I was SO hopeful that this would be a quick fix and we could continue to try without any assistance.  I personally would like to get pregnant on our own without the assistance of fertility meds. 

But, I am fast approaching 40, which as the doctor explained once I hit that magic number getting pregnant definitely becomes more difficult.  I inquired about my current age being over 35 I thought that was a "magic number."  She explained that the maternal age of 35 is more about the increased odds of a having a down's syndrome baby not about the odds of getting pregnant.  I guess the next couple of months I will weigh that fast approaching magic number, and decide if it is in our best interest to go back on fertility meds. The doctor also explained with my medical history of difficulty getting pregnant and the multiple miscarriages, she would only do a few months of the Clomid with us and if we don't conceive her recommendation would be then to go to a reproductive specialist.  As she explained, to be VERY AGGRESSIVE in our trying to conceive. 

I'm really not too thrilled about that, but I guess we'll see what happens the next couple of months.  First, I have to stop bleeding and then cycle - preferably on my own.

Still out of whack!

Well, I did talk with my doctor's nurse last week.  I did phone the office last Monday to inquire about the bleeding, but I hesitated because the bleeding seemed to be letting up. No. Not stopping, but I could definitely tell it wasn't as heavy as it had been. 

After talking in detail with the nurse she got back with me later in the day to let me know that Dr. P said the bleeding was normal.  Okay, now wait.  According to the last nurse who was relaying info from the Dr. in office the week before, it was not normal.  The nurse said Dr. P said I could go back on the progesterine to help control/stop the bleeding or I could wait and see if the D&C helps to regulate the bleeding and my cycle.  Well, HELLO isn't that why I had the D&C done to regulate the bleeding and hopefully get my cycle back on track.  Why would I want to start progesterine right away.  Besides if I'm on the progesterine I won't be ovulating which means our odds of conceiving are nil to none.  Our odds of conceiving are challenging as it is why would I want to hamper them any greater? 

As far as the low pelvic burning sensation, still no explanation other than a possible kidney or bladder infection.  However, since I'm not having any pain while urinating I opted not to go in for a urine test.  Now, that low pelvic burning sensation has not been bothering me; however, I have been taking over the counter sinsus/cold medicine for over a week now.  So, I don't know if the pain reliever in the meds has helped controll that pain or if it has gone away for good. 

I go this week, Tuesday to be exact, for my follow-up/post-op appointment.  The bleeding has stopped; however, I have an occassional day of spotting here and there, so maybe my body is trying to figure out what is going on.  I'm not sure where to go from here.  I'm not sure what discussions to have with Dr. P.  I guess I better figure that out before Tues. morning.  I know I would like to do what I can to increase our odds of conception and reduce the odds of miscarriage, but I don't want to talk with a reproductive endocrinologist, yet. 

The D&C post-surgery . . .

Well, before I went in for surgery the nurse explained all the post-op scenarios because I might not be coherent after surgery because of the anesthesia.  She explained that there might be some mild discomfort and pain and then some light bleeding that will taper off and stop.  So, Jay said we would just expect the opposite because that is how it is for me/us.

Surgery was Monday.  I came home, took a brief nap, and by the end of the evening I was not bleeding nor spotting.  I had no pain, cramping or discomfort.  The same day surgery nurse called and checked on me Tuesday afternoon and I was able to tell her there was no discomfort, no cramping, no pain, and no bleeding. 

Now remember, I am not the typical patient and like Jay said we know to always expect the opposite.

So, by Wednesday morning I was spotting.  Then by Thursday I was bleeding and having some discomfort. Not cramping. No burning sensation while urinating.  But where I would feel menstrual cramps, in the lower pelvic area, I was (still) having a burning sensation and discomfort.  By Friday morning, I had a really good flow going on, which didn't make any sense to me because isn't a D&C basically scraping the uterine lining out, so how could (can) I be bleeding.  Jay had recommended calling the doctor, but at first I was resistant, but after some gushing I decided to call later that afternoon to inquire.

Well, my doctor is out of the office till Monday, Feb. 15th, so the doctor that was in the office reviewed my file and had his nurse call me back.  Apparently, this is NOT normal, but since I'm not saturating a pad every hour there's no immediate concern and I can wait till my doctor returns.  The nurse said that bleeding after a D&C is usually an indication that the D&C didn't work.  Okay, what does that mean?