Show & Tell 2: Fish!

It's that time again. Be sure to see what the other kids are showing off this week!

Once again, I have a camping related S&T post. Ari and I went camping on Burton Island, off the VT coast of Lake Champlain this past weekend. We had an amazing time with lots of firsts: first time camping w/o a tent (we slept under a lean-to with just a mosquito net to cover us), first time camping on an island, first time catching fish- then cleaning and eating them! On to the pics.


This is looking out on Lake Champlain. The weather held up for the most part- rain at night, but hot and sunny during the day.

A nice view of the docks at Burton Island.

Our very sacrilicious marshmallow roasting. It rained the first night, and we REALLY wanted campfire marshmallows, so we roasted them over the tea lights we brought as Shabbos candles... and it totally worked.


We caught three fish! From the top: Sunfish (I cast, but Ari reeled in), Smallmouth Bass (I caught), Yellow Perch (Ari caught). We cleaned and ate them and they were delicious. It was important we catch dinner b/c I forgot to pack Saturday night's dinner in the cooler!


A perfect end to our weekend: driving home, we saw a kickass thunderhead form a beautiful rainbow :)

Open your mouth and say "Ah-cupunture."

A bit sluggish this morning... had a very cathartic conversation with Ari last night about how generally awful I feel on a daily basis. And not just emotionally awful- I'm able to pick myself up 99% of the time- I mean physically worn out. I have virtually zero stamina or energy lately. I'm concerned that the 88mcg of Levoxyl just aren't cutting it. I'm just desperate to feel like my old self again- I don't really dig this newer, moodier, constantly exhausted version of me.

Monday, I went to a Red Tent Temple that my friend organized. It was nice to connect with other women in all stages of their Goddess paths. It meets close to the new moon each month, and I felt so wonderful and invigorated and inspired. I'm hoping to keep up with this group as a way to a) meet new people and b) mark a sense of cyclical time. I've really missed my period - I can't believe it's the last week in July! I've had no way ot marking my monthly time anymore and it's really thrown me off. The women were so open and supportive and bold and strong and vulnerable... it was a really wonderful night. I even had energy work done on me, which I haven't had done in years and I felt amazing afterward. I also got to share my story of how I'm at where I'm at medically, and it was so cathartic and comforting. Sadly, I can't make the next RTT, but I'm looking forward to September's.

Last night I had my free consultation at an acupuncture clinic. No needles yet- just a medical history and TCM (traditional Chinese medicine) diagnosis via the tongue inspection. That's right- she looked at my tongue and pointed out all these things that were big issues. The crack in the center of my tongue indicates a systemic imbalance. The little lumps along the back of my tongue correlate to PCOS. The scalloped edge (where my tongue basically presses into my teeth) indicate metabolic issues. The veins underneath my tongue were almost black they were so purple, which had to do with my migraines and blood stagnation in my neck and head. I forget what she said about the coating, but it indicated that my problems are rather severe.

They see a ton of infertilty patients, and a large number of folks with Hashimoto's and/or POF. She's recommended 4 initial sessions to get me started, as a way to see a) how fast I respond to treatment and b) if this clinic is a good fit for me. And while I have an insurance discount b/c of our particular carrier, it's still not cheap. (Hello tax deduction.)

I am pretty nervous about the needles. Before I start cooking Chinese herbs at home and pulling out the big guns, I've got an email into my doc about combining Western and Chinese medical approaches to my problems. I know he's receptive to it: at my first appt with him, he had a stack of "Infertility & Acupuncture" brochures on his desk. But apparently, if I get treated for my thyroid via acupuncture, I have to monitor my thyroid levels even more closely so that my dosage isn't too high. Considering I feel like I'm not even taking a thyroid med right now, I don't think that's going to be an issue right away.

I'm just at a point, as I realized last night, that I've really felt betrayed by my doctors over the years. My current guy, Dr. G, is wonderful - no major qualms other than some bedside manner issues. But all the other doctors who barely treated my hypothyroidism, who allowed me to continue taking hormonal birth control despite my known migraine contraindication, who wrote off practically everything I've felt and experienced as stress or clinical depression - when, as I've been reading and researching on my own and becoming my own reproductive healthcare advocate, this is simply not the case. Those crazy 2 years of depression and anxiety that nearly kept me from graduating college? Those mind-numbing, personality-altering years of Lexapro and Wellbutrin? The 40 lbs in 4 years of college, thinking it was all just a part of eating poorly on the campus meal plan? That wasn't stress. That wasn't depression, in the classic sense - it was all mismanaged thyroid, and I probably could have met Hashi's at the pass if I'd caught it early enough.

And the thing that's really been bugging me is when, 2 years ago, I didn't have a period for 7 months while I was on birth control, my PCP (aka, Dr. Skinny Bitch), basically told me a) I'm fat; b) I'm stressed; and c) my body needed more estrogen so here's a higher dose of the pill which I shouldn't have been on in the first place - if I'd stopped the pill and done some of tests I'd had in March, perhaps I could've been in the realm of POI rather than POF. And Dr. Skinny Bitch offered the same diagnosis, minus C, when my period didn't come back when I finally stopped the pill.

Dear Dr. Skinny Bitch: NOW do you see that this isn't fucking stress?? That my obesity is not the fucking cause, but a frustrating result?




...Why yes, that is a lot of pent up anger and resentment you're reading.

So, it's probably a very good thing I'm seeing a therapist who works with IF patients tomorrow night.

It's time for professional help.

And I'm not afraid to admit it.

I have a call in to a fertility counselor my doc recommended whom he knows personally. Dr. G has been great about my care thus far, so I trust his recommendations. I did therapy in college, so I'm well aware of its benefits and I'm way beyond any kind of mental health stigma. Hell, I'd rather talk to someone than have to ever take an antidepressant ever again. (Which, oddly enough, the personal hell that was labeled clinical depression and panic disorders in college might have actually been the result of my hypothyroidism being poorly monitored the whole time.) B/c Miriam + antidepressants =/= Miriam. I am really not the cool, awesome person I normally am with antidepressants. That (combined with a period of reduced finances) is why I quit them cold turkey almost 2 years ago. I know that's a medical no-no, but probably one of the best decisions I've made for myself medically. I feel like a person again.

I've also got an email out for a free acupuncture consultation at one of the leading acupuncture clinics for IF in New England. I met the owner at an arts festival (of all places) this weekend. And she was cool enough to follow up with the email address I left her and send me a list of times she's available to meet this week. While I am generally terrified of acupuncture, I'm willing to give anything a shot at this point. And there's gotta be something to it otherwise ppl would have stopped doing it 3000 years ago. EDIT: Looks like I'm going to see her next Tuesday at 7pm. This should be interesting.

What brings me to my positively foul state of mind recently: disturbing realizations, guilt over good news, and doing some more research into hypothyroidism. I was particularly discouraged by reading more detailed info about thyroid hormones here online, and that the fact I am practically useless in the gym is a direct result of years of poorly managed thyroid disorder. I'm not feeling too great about myself right now- I've fallen off the WW wagon pretty hard (Ari has too), and I know that the old adage of "lose weight with diet and exercise" is next to fucking impossible when you're as hypothyroidic as I am.

The guilt over good news, which I finally broke down and told Ari last night, was that secretly... I hoped his SA would be disastrous, so that all of the IF problems wouldn't be just mine. So that fault doesn't sit squarely on my shoulders. While he totally understands why I would think that and knows that I'm not deliberately harboring ill will toward him; it was a desperation thought process not to feel so goddamned isolated and alone in our marriage. I am still reeling from this whole thing, that I couldn't just accept the good news and be happy.

And the disturbing realization: We have a good chunk of money in savings. A good net, if say, I got laid off (knock wood, b/c that's the last fucking thing we need right now). But we only have just enough right now for either one IVF cycle, or one paltry down payment on a house. And the choice we need to face right now is... do we want a child? Or a home of our own? I am so bitter, angry- no, infuriated- and depressed by this.

This is just not how it was supposed to be, for fuck's sake.

And I'm at a point in my own personal development that I can recognize when it's time to call in the big guns and get some help. B/c I am way too angry and sad this far out from my original diagnosis.

Results are in.

Our Dr called us from his home yesterday. Everything has come in as normal. Low end of normal (21 million), but normal enough. Motility was a bit low, but isn't a big deal if/when we go IVF since a lab will inject sperm directly into the egg. Our dr's only concern is that if I had no IF issues of my own, we might run into trouble trying to conceive naturally. I wonder if the birth control stim experiment then, is worth it. But for now, we celebrate, b/c we're going to take our victories where we can get them. This news has also done wonders for Ari's mood lately, so I certainly count this as good news.

Results are in.

(So, I thought this posted from my phone last night, but my mobile messaging posting thing didn't work. Weird.)

Our doc called us from his home Friday night. Everything has come in as normal; low end of normal (21 million) but normal enough that he's not worried. Motility was a bit low, but isn't a big deal if/when we go IVF since a lab will be injecting sperm into the egg directly into the egg. My doc did say that if I had no IF problems of my own and we were trying to conceive naturally, we might have a slightly harder time than most, but it's a moot point really. Although, it makes me wonder if the birth control stimming "experiment" as my doc calls it, will actually be worth it in a few months. I just don't want to set us up for disappointment, or wasted time.

For now, this is a victory. A small one, but we choose to celebrate any win we can score at this point. It's the first victory we've encountered throughout this whole ordeal. For the first time in months, Ari has a sense of calm about him.

It's nice to have gotten some good news for once.

Facepalm Update.

Results have been faxed to our practice, but no word from Dr. G yet.

Ari called a few minutes ago and spoke to our very wonderful E, who we've learned is the Dir. of Patient Services. Ari was trying to see if there was any way to get the results since Dr. G is still in surgery.

E specifically sent directions to Dr. G's assistant to forward the results to Dr. D... and it sounds like the assistant didn't do this. (We're not sure if "assistant" refers to a static admin who works in the practice, or one of Dr. G's rotating med students. There's a new med student assistant every time I've been there.)

So E (God love her) got the office manager to personally walk the results over to Dr. D, who should hopefully being calling Ari shortly.

I cannot believe how many hoops we have had to go through for this one test result- it's theoretically the easiest and least invasive diagnostic, with fairly quick turnaround, so I find the hold up just a tad frustrating.

I'm goin' nuts over here.

Facepalm.

Still no results yet.

I love my practice, I do. I love my doctor. He's a bit gruff with bedside manner and a lil spacey when it comes to technology, but the man knows his shit, and is practically a pioneer for women's reproductive health in the Boston region.

However, the admin staff at our practice sucks.

Backstory: Dr. Gross wanted Ari to have an SA done, but took his sweet ass time calling in the order. So, just to be safe, we had Ari's PCP, Dr. D., write him up an SA in our practice's system. Dr. G. then called the fertility clinic at MGH directly, and had it put directly in their system. So, theoretically, there's still an SA lab order floating around in the computers at our practice.

Ari's SA was Tuesday. They have to act fast, b/c well, it's not like the sample's going to keep overnight, right? So theoretically, we should have heard by yesterday. When we didn't hear anything by 4pm, Ari called our practice. The admin who answered the phone said there was a message in for Dr. G. to call us back once the results came in.

I explained to Ari that Dr. G had told me to call and ask for him directly, and that he would call the fertility clinic and have it faxed directly to him and then call us. What usually happens is that the results are faxed to our practice's Medical Records office, which takes upwards of 2 weeks to spit it back out to the doctors. Lame, right?

So Ari called back yesterday, and asked to speak with Dr. G directly. The überbitchy receptionist said there was already a message in and basically to stop calling.

Cut to this morning. Dr. D. (Ari's PCP) calls him back and says "I don't even know where you had your SA done; the lab order is still sitting here unfilled in the system." Um, thanks for calling us, but the message was to have Dr. G. call us back.

Cue: *facepalm*

Ari called the practice and spoke to a much more helpful woman, E. She apologizes for the mixed-up message and assures us that Dr. G will call us this afternoon, as he's in surgery this morning. She calls back a few minutes later and says that the fertility clinic hasn't completed the results yet (why is this taking so long??) but will fax them over directly to Dr. G this morning once completed. E also said that Dr. G. might be in surgery this afternoon, so we might have to wait until Monday to get the results.

Are you kidding me? There's no way in hell I'm waiting through the weekend for the results of a goddamned SA! Now, I know I'm Ari's wife, and there are perks to it, but when it comes to medical records and test results, that whole HIPAA thing gets in the way, so Ari has to be the one to call, since it was his test. B/c if I could call, I would flip a shit on them right now.

EDIT: Results are in. Doc is still in surgery, could be all day. Will try to call us today, otherwise first thing Monday morning.

The waiting never ends...

Ari had his SA yesterday. Guys have it so easy initially ;) I got 7 vials of blood drawn for my first round of Dx, he gets to... well, you now how it works.

He called the dr's office today, but the results aren't in yet. I'm chomping at the bit to find out how his swimmers are. We have no reason to believe they'd be anything less than Michael Phelps or Greg Louganis. And yet, as I've so quickly learned in this process, you worry about everything. Even the stuff that you know should be solid. Ari's going to call again tomorrow- I hope my dr will give him the results right over the phone rather than waiting to have it mailed to us. Or he could email it. Either way, I just want to know now.

I'm already mentally preparing myself for the worst... yet I'm trying to remain optimistic. It's a fine line. I was so railroaded with my own Dx (I mean, I knew POF was a possibility but I never thought it would actually happen to me) that I feel like I need to dig my heels in and be ready to take whatever additional bad news might be down the pike.

My S.O.P. is that I'm perpetually waiting for the other shoe to fall.

. . .

In other news, visited friends of ours who just had their first child at the end of June. She's just beautiful- so alert! I was nervous for this visit, but I realized my toughest emotional moments aren't around babies - it's more around pregnant women and situations like showers. It's the expectation and the likelihood of conversation turning to "So who's next?" as opposed to hanging out with the bundle of joy we've been waiting for.

Two things that were awesome about the weekend and made me super excited about having kids one day:

1. I changed not one, not two, but three, yes three (ah ah ah) poopy diapers. 2 from the newborn, 1 from a 10-month-old infant, a child of another friend also visiting. It's no walk in the park, but it's not the absolute worst thing about parenting, I'm sure ;)
2. Baby had a moment where she was just inconsolable... until I managed to bounce and rock and shshsh her to calming and eventually to sleep. It was like a magic trick and it really felt magical.

. . .

*frustrated sigh* Still no qualifying round results yet on my husband's Olympiads? *taps toe impatiently* Come on already, MGH Fertility Clinic!

I feel like an old lady.

Follow up appointment today went well, for the most part. Latest b/w results:

Thyroid Panel:

• TSH (Thyroid Stimulating Hormone) = 5.69 uIU/mL [0.34-5.60] Status: High
• Free T3 (Triiodothyronine) = 3.25 pg/mL [2.50-3.90] Status: Normal (slightly lower than last time)
  
• Free T4 (Thyroxine) = 0.82 ng/dL [0.54-1.24] Status: Normal (slightly lower than last time)

My vitamin D is at 30, which they want levels of 30 or higher. So, right on target, for the most part.

What's next on my ever growing list of figuring shit out:

1. Re-up the Levoxyl to 88mcg. Retest in 6 weeks. Adjust as necessary (I may need to go up to 100 mcg).
2. Start taking a calcium supplement. 1200mg of calcium/day, 600mg at lunch, 600mg at dinner.
3. Limit consumption of soy and strangely enough, broccoli. These futz with my thyroid.
   
4. Continue the vitamin D supplements.
5. Bone density exam scheduled for July 24. Non-invasive, 15-min procedure lying down on a table, fully clothed. I can handle that.
6. Ari's semen analysis scheduled for Tuesday. Will know results by Thursday afternoon or Friday morning at the latest.
7. Call Dr. Gross Monday morning for list of contacts with RESOLVE fertility counselors.

We're holding off on starting me back on birth control until my thyroid is in the right levels. So, yanno, enough to be expected right now. He liked the fact that I've stopped consuming caffeine b/c it has made a dramatic difference in the number of hot flashes I get.

Women keep adding to their bone density up until about age 35, then plateau for a couple of years, and then start declining. Based on my POF, Dr. Gross speculates I'm already in the plateau phase, thus, necessitating the bone density test. I'll need to have it done every 3-4 years and course correct with calcium supplementation as appropriate. I feel like an old lady- I'm getting a bone density exam at 27, for fuck's sake. This is what like, 50 year-old ladies get.

The "ouch, that stings" moment of the appointment: calling the use of birth control to stim my ovary an "experiment." B/c in his 50+ year career, he's only had 5 or 6 pregnancies result from this method. In his career. Ugh.

Hannah wept: A(nother) Sad Realization

I live at the college campus where I work. My commute consists of exiting my building, walking through the Arts building, and then entering the building where I work. This morning, as I have for the last couple of weeks, I've waded through a herd of 7-10 year old summer music theatre campers.

The thought process started like this: At what point do you start sending your kids to camp for the summer? Wouldn't you just want to keep them home all summer? Oh right, not if you're working 9-5 like most folks. I wonder at what age you start cultivating hobbies for children? How do you do that? Do you just say, "Hey Johnny, want to learn to play the piano?" What about voice lessons? Voice is an easily manageable hobby and requires no instrument purchase, just the cost of lessons.

And besides, any child we have will have an amazing voice like I -

Well, actually, they probably won't. The voice that I got from my grandmother is not something that will most likely get passed on, since DE seems to be our best chances for children.

Add this to the list of things that won't get passed on: my unusually soft skin, my smile, my eyes... Similarly, at least they won't get thyroid problems, fertility issues, predisposition for heart disease and diabetes, my awful myopia. And I know that it's not about what kids look like, or sound like, but how they grow and develop and are nurtured.

Still, that hit me like a ton of bricks on my walk in to work this morning.

Edited to add: showed this post to Ari. His reply? "Sorry, honey. Look at it this way, at least they can probably still get MY predisposition for heart disease, diabetes, and bad eyes." And this is why I love my husband :)

Whirlwind week.

July 4th weekend was fantastic. Had friends from out of town at our place this weekend, with their adorable 10 month old in tow. Babies are exhausting! And cute, and fun, and wonderful. I particularly enjoyed seeing Ari with the baby- he's going to be a great dad someday.

Blood work this morning: thyroid workup and vitamin D levels checked. We're looking to see how this new lower dose of Levoxyl is working, and to make sure I'm not too much of a vampire and am getting enough sunlight (lol, with a little help from my liqui-gel Vitamin D tabs). Also, I might go on birth control again. That should be fun... we'll see if I get to keep my sex drive or not.

Still on WW. Gained 1.1 lbs this last week. Trying not to get discouraged by it, had a fluke weekend where we ate out a ton. Trying to remain focused on why I'm on this diet in the first place: gotta get my body healthy to have kids.

Ari has a semen analysis scheduled for next week. Fingers crossed, everything should be normal; we don't have much reason to suspect otherwise. And if there is something wrong, God help me b/c I might have a mental break at that point.

So my Dr. just called, and I need to up my thyroid medication back up to 88mcg. 75mcg isn't cutting it. Awesome, especially since I just got my 75mcg refilled... yesterday. Whatever, I have it on hand for the future.

In other news, outed myself to another friend. It's still bittersweet telling people in person. Good to let it out, but yanno, generally sucky to share that sort of news. Also, another friend just had their first child, a beautiful baby girl. When I got the picture message waiting in the airport flying out from my conference last week, I smiled, and then burst into tears. Who loves emotional roller coasters? *waves frantically* I do!

Still taking everything a day at a time. Still in that weird "we're not actively trying but we have this diagnosis looming over us" phase. Still in the Land of IF.