A second opinion on everything, really.

Doc Awesome: Artist's rendition.

My second opinion appointment went really well yesterday. The staff at the clinic were very professional and rather friendly. I tweeted from the office that the patients sitting in the waiting room, however, looked a bit somber, but I can't blame them. It just made the contrast between the friendliness of the staff that much more apparent.

Dr. "I have an incredibly awesome/sexy South African accent" who I suppose I should just shorten to Doc Awesome was equally as warm and friendly. (I would've called him Dr. Sexy, but that's reserved for our vet: a post for another day.) I came armed with my list of a dozen questions and a folder full of test results. What astounded me was that I didn't have to sit and give my schpiel (menarch at 9, PCOS Dx at 18, ovary out the same year, thyroid problems at 20, POF/Hashi's at 26 blah blah blah)... he had actually read my file prior to my appointment and was able to give me my own summary back to me.

I find this astounding because with Dr. G, I could count on at least 20 minutes of repeat dialogue at every appointment, including having to go through my medical history at nearly every other appointment. Egads, a doctor that does his homework?? What is the world coming to?

Doc Awesome let me ask my myriad questions and many of the answers were ones that I had expected. Based on my various hormonal tests throughout the last year, it's POF. And like any POF-er, it's entirely possible to experience spontaneous ovarian function and even become pregnant, but that occurs in about 1% or less of the POF population. Bummer.

That being said, Doc Awesome said I'm a fantastic candidate for donor egg, and that POF-er's in general usually are great candidates for DE/IVF. Doc Awesome also oversees all of the donor cycles at this clinic, so I'm in capable hands. They run pretty aggressive treatments for donors and say they get as many as 20 eggs in one shot. Their success rates are also well into the 50-60% range with DE. I asked if my Hashi's could play in a role in the success of DE/IVF and he said that so long as it's maintained, it's a non-issue.

As far at the actual cycle itself, once we pick a donor and she is screened (and the screening process at this clinic is intimidating bordering on absurd- his words, not mine), I'd stop taking my birth control pills and switch to estrogen only. Meanwhile, she'd go on a stim protocol and trigger. The day of retrieval, Larry obviously has to do his thing in a cup, I'll add progesterone gel (sounds goo-tastic!), and the eggs are retrieved from the donor. Depending on how Larry's army looks, we'll either let them do the rumba in the petri dish or directly inject his sperm into the egg via ICSI. About 4 days later, I would come in for a 10 minute procedure to insert either 1 or 2 embryos into my lady parts... and then, voila, the 2ww. Should I choose, I can also add an hour of acupuncture/pressure before and about 45 minutes of the same after the transfer. All told, apart from the actual transfer and using donor gametes, it's par-for-par hormonally and experientially as any other woman experiencing pregnancy.

I mean, I wouldn't even get the giganto box o' needles from the fertility pharmacy. I could avoid needles.

This is huge for me folks. Huge.

All told, we're looking at about $15-17K when you factor in donor agency fees, donor fees, legal feels, and donor screening. (It seems silly that insurance wouldn't cover donor screening, since they are medical procedures, but apparently it's the one medical part of the process they don't cover, which can run anywhere from $2-4K.)

I'm not going to lie: this is WAY cheaper and potentially faster than adoption. And given my age, my other relative health, there's a good chance of this working on the first shot. I know DE/IVF is no guarantee, but even Larry brought up the point: if it didn't work, we would potentially still have other embryos on ice to work with again, given the aggressive retrieval protocol they run on donors.

And you know what? I do want to experience pregnancy and birth. I have resolved that I'll still be just as much of a woman and mother if I don't, but the pregnancy experience is still important to me after all. There's also a good bit of halachic vaguery about the Jewish status of a child born via donor egg, so believe it or not, according to Jewish law, donor egg is easier to navigate that adoption. I wouldn't necessarily need a Jewish donor if pursuing DE/IVF, but absolutely would need a Jewish birthmother if pursuing adoption, domestic or international.

After talking the appointment through with Larry yesterday, I think we're changing our minds... again. Once we save up the money, we're going to go for DE/IVF. I don't think adoption is off the table for us completely, but just not as our first shot.


In sum: Doc Awesome is pretty awesome. (He even complimented me for coming in armed with all of my info noting that I was "a lot more researched than the average patient, which is a great thing.") And when we're ready to go for donor egg... we'll be going with him. I feel really confident in his ability and he has a wonderful candor and sense of professionalism.

So yeah, there you have it. Donor egg is back on the table... and I'm really excited about it. The timeline all depends on how quickly we can hide away the cash, but I think we could probably do this by the end of next year.

I suppose I should start working on a new blog header image this weekend!

NaBloPoMo: And so it begins.

30 posts. 30 days. It's NaBloPoMo time, people: National Blog Posting Month.

I think it's time to build off of my 7 posts in 7 days bit and move to something more advanced. I know I wrote recently that I should man up and do NaNoWriMo (also starting today) but I just don't have the energy. But blogging? Blogging for 30 days? I can do that. This is more attainable. I have to work my way up to NaNoWriMo.

If you don't feel like joining the official NaBloPoMo ranks, Suzy over at Not a Fertile Myrtle has a great blogroll of other NaBloPoMo participating IF bloggers up for the challenge. Check it out - let's keep each other motivated! More updates/news and a question after the cut.

Other updates in my life...

Tonight I'm being interviewed by Isadora Leidenfrost for her forthcoming film, Things We Don't Talk About. From her film website:

Things We Don’t Talk About is a groundbreaking documentary film about women’s healing narratives from the red rent that serves to empower women and girls. The Red Tent is a red textile space that is changing the way that women think about their bodies.

Tomorrow night, Isadora will be filming the Salem Red Tent Temple. I'm so excited! The Red Tent Temple has been such a joy in my life. When I stopped having periods, I missed my Woman's Blood Rhythm. Now that I meet near each new moon with other women in all stages of life and Blood Rhythm, it has brought that sense of monthly cycle back. I can't wait to talk and explore more about this with Isadora tonight.

Just had another thyroid panel done. I've had brain fog like whoa and my energy is pretty much non-existent. I'm starting to feel like I did in June/July of 2009, when my TSH was at its highest and thus my thyroid function at its lowest. Well, don't know what's going on then b/c my numbers came back normal: TSH is 1.027. I need to find a good endocrinologist up in the North Shore area. Anyone have any recommendations for a good North Shore, MA area endo?

And finally, it's just 5 days until the RESOLVE of New England Annual Conference! You can still register in advance. Come check out dozens of vendors, doctors, and other patients, and meet the Infertility Blogging Goddess, Melissa Ford, author of Stirrup Queens! Also, we have some pretty awesome raffles. I can't wait to meet folks there :)

Oh, and one other thing: my Fertile Fall Fundraiser is underway, so if you have a few dollars to spare, I'd love it if you could help out this special cause: $2000 for RESOLVE of New England by Christmas. We can totally make that goal with your help!

Happy blogging all.

1 post down. 29 to go.

PS. Get off your butts and VOTE tomorrow! (I don't care for whom you vote, just vote dagnabit!)

June ICLW: Elementally Speaking

Howdy! Thanks for stopping by for June's ICLW. (Learn more about the ICLW here and see how you can sign up for next month.) I've got a few previous ICLW intro posts to get you up to speed: ABC's of Me (November 2009), April 2010, and May 2010. For this month's intro, I think I'll try something a little different: looking at my life right now through the Four Elements. Intrigued?

The Four Elements of Me

Earth: What Grounds Me ~ Roots and Foundation
+ My husband, Larry: totally my rock, my love, my soulmate. We've been married for 2 and a half years. We were high school sweethearts from 1997... do the math. We've been together a long time and are still madly in love with one another.
+ My family: My mom, my papa, my sister Jasmine and her husband Neal - these are my core. Then Larry's mom, dad, and sister - just as much family as my own blood. And soon, probably sometime this week: Willow! My niece-to-be, the first grandchild, the little darling we've been waiting 9 months to meet. You can count on a post about her later this week since my sister will be induced on Friday :)
+ My faith: I'm Jewish. But I put an equal amount of faith in the goodness of humanity, the beauty that surrounds us daily we often take for granted, and in the sovereignty and power of the collective creativity of women. I ground myself by redefining the world around me, and walking forward with faithful steps in the world I've created.

Water: What Moves Me ~ Transition and Flow
+ My health: it's been in a varying state of flux. I have premature ovarian failure, diagnosed in April of 2009. I have Hashimoto's thyroiditis. I recently learned I've got degenerative arthritis in my lower spine. Oh yeah, I'm 28. Thankfully though, my thyroid appears to finally be stabilized after a year of ups and down, my my POF is being treated with HRT.
+ My job: Recently promoted.
+ My home: We are house-hunting, and hope to have a formal offer in to the seller by COB today.

Air: What Lifts Me ~ Joy and Celebration
+ Food, music, the arts, photography, flowers, Hell's Kitchen, Weeds, LOST, Radiohead, indie music, Vampire Weekend, MUSE, art house cinema, Bach Cello Suites, cooking, our trip Japan last year, camping, fishing, reading, writing, writing my book, RadioLab, The Moth, This American Life, taking the time to literally stop and smell the roses.

Fire: What Consumes Me ~ Passion and Perseverance
+ Having a family: The timeline has been pushed back significantly since we're buying a house, but we plan on adopting an infant domestically. We're skipping fertility treatments altogether.
+ My advocacy: I've recently decided that I am an health advocate, fighting for infertility treatment coverage and research. It all started with this video. The content of my blog has shifted slightly from mostly about me to more about the greater ALI blogosphere and what we can all do to be everyday advocates. I am also RESOLVE of New England's newest Board member on their Board of Directors!
+ My writing: I do it all the time. I've been keeping a journal in print or electronic form since I was in 7th grade. This blog is a continuation of that, but I'm starting to branch out to other places like Examiner.com and hopefully more paying opportunities. I'm also writing a book about my experience of converting to Judaism three years ago.

Looking forward to meeting new folks. Happy ICLW and happy commenting!

Image used with generous permission by the artist, Alida Saxon, copyright 2010.

Thyroid Update: The Butterfly in My Neck

Why the butterfly in my neck? The thyroid gland kind of looks like a little butterfly as it sits on your larynx. The butterfly is also the symbol of thyroid cancer survivors as well (no, I don't have cancer, but I like the transformational inspiration associated with the butterfly).

As you know, in addition to POI, I have Hashimoto's thyroiditis. Monday I had yet another followup appointment with my doctor. After my latest round of bloodwork, and for the first time in just over a year (by 2 weeks!) my TSH values would appear to be normalized and in optimal range. Triumph! I've made some definite progress since my last thyroid checkup in April. My numbers have come back the best ever, and not just my thyroid results.

My TSH is currently at 1.0. Free T3 is chillin' at 2.95, and free T4 is looking good at 1.17. These are all rather good numbers. The 137mcg of Levoxyl seems to be doing the trick, even while I'm on the pill. I thought for sure we'd have to double the dosage (the steroidal estrogen in the pill binds to the thyroid hormone in my medicine, zeroing out the actual amount of thyroid hormone I receive) but apparently the jump from 125mcg to 137mcg was enough to do the job. Symptomatically, I feel the best I have in a year. The brain fog is basically gone and I'm not walking around like a zombie. I still get fatigue, but I imagine it's likelier the result of diet, going to bed at 1am every night, and stress. My doc mentioned something about iron deficiency, so he's having my iron levels tested.

The numbers that surprised me the most were my lipid panel. My total cholesterol went down from 222 in January to 194 in June! No medication, no exercise... all just changes to my diet. (Speaking of- given the recent loss of my grandmother, we might have fallen off the good eating wagon a little hard.) My LDL and HDL numbers look good too; they've also decreased since January. I fully credit Dr. Organic with this progress. My triglycerides were high at 196; more indicative of insulin resistance than anything else. The doc recommends sticking with lifestyle change at this point, because it's clearly working, and triglycerides can be managed by lifestyle.

The only bad numbers I had were my vitamin D levels. I'm a bit low. Not in the "gonna get rickets" range, but I seriously need to start taking the supplements that my doc prescribed and I never got filled... oops.

These are the first positive set of numbers I've had all year, and I've got symptoms (or lack thereof) to back them up, which is vital to proper thyroid management. I just need to keep an eye out for my adrenal function. Basically, Hashi's is an autoimmune thyroid disease where my body just kind of eats my thyroid until it stops working. As my anti-thyroid antibodies are so high (over 1000), my POI is most likely caused by autoimmune disfunction as well. It is very possible that I could develop polyglandular autoimmune disorder where the next thing my body goes after is the adrenal gland. That would not be good at all, so I need to be on the lookout. The doc ordered that blood test as well.

Speaking of blood tests... It took one hour, three phlebotomists, and six- yes six attempts to draw just one vial of blood from me. I have awful, awful veins, and the two I can count on refused to cooperate Monday. I tried hydrating, hot compresses, pumping my fist, letting my arm hang down - you name it, I did it. I may look a wee bit like a junkie with bruises all over the insides of both arms and the back of my right hand.

Other testing: I'm getting a mammogram on Saturday. Not too thrilled about that; less upset about the discomfort and more about the fact that I'm 28 and now have to start regular mammograms. My doc wants this as a baseline but recommends that I have them done annually since I'm now on HRT. The test itself doesn't unnerve me, but the implications for what it could detect does. Cancer does run in my family (mostly bladder, colon, and skin) so yanno, in my paranoid mind I'm quietly freaking out. Oh, and I got my annual gyno exam and pap smear. Love the boob massage- I mean breast exam, hate the "wham bam thank you ma'am" tone of the pelvic exam.

Assuming my iron levels and anti-adrenal antibody tests come back normal, I don't need to see the good doctor for six months. It feels a little weird, I won't lie; I've been at his office every six weeks like clockwork and now to have this stretch into potentially the end of the year... Sometimes it's hard to let the idea that I'm actually getting better sink into my brain.

Other medical news: my back is doing leaps and bounds better. My x-rays revealed that yes, I have degenerative arthritis in my lower spine (AWESOME) and that it could flare up again. One (hopefully) last chiropractor appointment on Friday. I can now sleep through the night sans pillows around my legs and back and don't need to ice it as frequently. I've also stopped taking Advil like it's going out of fashion, so that's good. My stomach lining and liver are appreciative, I'm sure.

The healing that I've worked so hard on in my mind is finally starting to make an appearance in my physical body.

The butterfly has transformed.


Photo and original body art by Ally Averell via Flickr in honor of Thyroid Awareness Month 2010.

Who wants a ticket on the Thyroid Rollercoaster?

Stand in awe of my Mad MS Paint Skillz. You love 'em. Also, I'm pretty sure that roller coaster car is actually a hotdog with mustard and ketchup.

So I had my regular thyroid monitoring appointment this morning. Dr. G. seems to have forgotten the "I'm not your doctor" fiasco of early March, and we talked things like estrogen, swollen feet, and nausea. With topics like these, oh how I wish this could be an OB visit, but it was just GYN/RE. The swollen feet debacle last week was definitely a result of my body not only getting estrogen for the first time in over a year, but from a sudden drop in thyroid hormone (TH). PS- here's a handy thyroid function primer. The estrogen in the birth control binds to the proteins in my thyroid hormone, so hypothyroidic folks can double their current thyroid medication just to maintain the right level of hormones in their body while on the pill. It's pretty amazing stuff how intricately our bodies are designed to work.

So my TSH (thyroid stimulating hormone) has nearly tripled since my last visit in January. Higher TSH means my thyroid is functioning less. It's functioning less b/c it's not receiving enough TH, b/c the birth control is eating all of it. We're bumping up my dosage to 137mcg and I'll be back again in 8 weeks. If my feet start swelling again, cut the birth control for a couple of days.

Pretty standard stuff, and since I'm not pursuing ART, I don't need to work with him on protocols and IVF stuff. The rest, from here on out, is just maintanance. He wants to watch my adrenal function (anti-thyroid antibodies with POF almost always spell anti-adrenal antibodies) every other year or so. My hope is that once I find the right balance of TH with my birth control, I'll probably stop seeing Dr. G. I'm actually hoping to transfer my PCP to another doctor in the practice, one that's a) closer to where we live instead of schlepping a half hour to Wellesley for a 20 minute appointment and b) specialized in autoimmune thyroid and adrenal dysfunction.

Hashi's has nearly beaten me, but for the first time in over a year, I feel like I'm winning the war.

Other medical news: Ari and I have begun seeing a nutrionist. And they're not Diet Nazis! In fact, they don't even weigh you. We don't keep food journals. It's down-to-earth food and nutrition counseling with someone who appreciates food like we do. Our second appointment was last night, and while pounds are necessarily falling off of us, we're making real, positive steps to lifestyle changes.

A text I sent to Ari today: I'm fit as a fiddle and feelin' fine. Feelin' fine indeed. Edit: I forgot to add - this isn't sarcastic at all. I'm actually feeling the best I have in almost a year; I'm tired a lot, but I've got my mental acuity back, as the Hashi's had all but robbed me of when I was in a constant haze of brain fog. I'm also knee-deep in working on my entry for #ProjectIF. I'm hoping to post it next week. It's... involved. I'll just leave it at that. Still working on Iron Commenter status... happy commenting this week for ICLW!

Welcome to April's ICLW!

Hi there! If you're stopping by from ICLW, welcome and thanks for visiting. I think most of my pages and tags should be good places to get started to know a little bit more about this blog, but here's the quick and dirty reader's digest version with links to relevant blog posts to get you up to speed:

• Hi! I'm Miriam Keiko. The hubs is Ari Larry. We are so totally in love it's kind of ridiculous; we're high school sweethearts of 10+ years, only married for the last 2.5. We're Jewish, we love food, we love to travel. Oh, and we really want to be parents.
• I've got one ovary, and it's way busted (premature ovarian failure). My thyroid is also pretty busted (Hashimoto's thyroiditis). Our options, as I was told a year ago, is IVF with DE or adoption.
• Current treatments: birth control pills as hormone replacement therapy. I'm currently having my first "period" in over a year. I use the term loosely since it's really just withdrawal bleeding from skipping a couple of days of the pill. Also, I'm on Levoxyl for my thyroid. I've got a regular thyroid monitoring appointment on Thursday.
• After much ruminating, we've decided to pursue adoption! Like, literally finalized this decision a couple of weeks ago. We're still in the info gathering stages and have lots of questions. I'm definitely on the hunt for other adoption bloggers to follow.
• Next week is National Infertility Awareness Week. It's a cause near and dear to my heart.

I look forward to discovering new blogs and meeting new bloggers this week. I'm also going for Iron Commenter status, and working on What IF: Part Two, so I'm hoping to get in at least 2 posts this week, but it might be rough. Want to know more? Leave me a comment or shoot me at email (miriamshope AT gmail).

Happy commenting this week!

EDIT: In light of posting my What IF? video, I've put our real names up here and changed my "About Me" page.

Stroking ego in the name of medical care.

I call bullshit.

So I got a second opinion about my thyroid & POF last month, and it's basically the same. Next steps: birth control for hormone replacement therapy, up the thyroid meds. Pretty S.O.P. So I send Dr. G an email asking about whether I need to schedule an appt to get a scrip for said BP or can he just call it in. He then sends me a rather terse email back:

If I understand your recent correspondence correctly, you are no longer a patient of mine and will not be coming here for care any longer.  Under those circumstances, it would be inappropriate for me to prescribe a new medication for you  whose effects, positive or ill , i will not be able to monitor.  Your next care giver should do that.  But, in answer to the theoretical question, yes, birth control pills and adjustment of your thyroid rx is a good route to take.

So I've had to stroke his ego a bit and confirm that no, I just went for a second opinion and that yes, I'd still like to be his patient. This is probably the most ingratiating thing I've ever had to do: my doctor thinks I've broken up with him and now I need to come crawling back to him. It's highly likely there was a miscommunication b/t our practice's office staff and Dr. G (it wouldn't be the first time) and that when I had my medical records sent over to second opinion doc, it was construed as seeking another provider... even though I explicitly told them I was seeking a second opinion.

I shouldn't have to grovel to receive appropriate and timely medical care.

Second verse, same as the first.

Got a second opinion re: thyroid and ovarian function yesterday. This doc basically confirmed everything, and actually told me I was right to trust my instincts about not taking the new 137mcg dose of Synthroid back in December. My sticking to the 125 mcg Levoxyl has paid off, as my numbers already show; he said it just didn't make sense that when my TSH was in the basement, Dr. G increased my dose. He should have either lowered it, or left it the same, according to 2nd opinion doc.

He did state that Dr. G's rather periphery test of my adrenal antibodies should be monitored more closely. With widespread autoimmune dysfunction (thyroid and ovarian), there's a good chance I could develop anti-adrenal antibodies. Which, quite plainly, would suck. A lot. So I just need to be mindful of sudden weight loss, loss of  appetite, and dizziness - key indicators. I might never never develop anti-adrenal antibodies. Or it could happen a month from now. Either way, he said I seem pretty in tune with myself, so I just need to remain vigilant. His suggestion was to move to hormone replacement therapy as soon as possible, and to not be surprised if my thyroid med is nearly doubled in dosage. (The estrogen binds to chemicals in the Levoxyl formula, so I need to take a ton more so my body can actually absorb the thyroid hormone.)

So, I suppose the next step is making an appt with Dr. G to get a birth control scrip.

Other news as of late... Ari got a job! This is big, big news, as of yesterday. He's negotiated the final number and everyone is happy with it, so there you go :) After almost a year of unemployment (March 30th would have been a year), Ari's got a job with a company that he thinks he'll be very happy with. I'm really excited for him. He starts on March 15.

What the hell happned to January?

This happens every year. I work in higher ed, so January just vanishes. November is also notorious for just disappearing. Work has been crazy. I hate my job, I hate the people I work with... it's just a challenge to get out of bed every morning, which is extra hard when you live where you work. What's worse is I hate the field I'm in now, and I don't really know what else to be when I grow up.

Things occupying my time as of late: work. More work. Here, have a few extra hours of work tonight. Cooking, cleaning, and watching epic amounts of LOST. I'm 3/4's of the way through Season 3. Thank goodness seasons 4 & 5 are shorter. Final season premiere in less than 2 weeks. I'm so excited I could just piddle.

Latest round of bloodwork has come back. TSH is up to1.06 from 0.029 just 4 weeks ago. Free T3 is still steadily climbing. No clue if this is good or bad. Free T4 still rocking out in normal town. I am most excited about the TSH. I basically told my doctor I wasn't upping my dose (which he recommended at the end of December). I stayed on the 125 of Le.voxyl and it seems my body just needed more time to adjust to the dose. Symptomatically, I'm feeling pretty darn good.

Here's the most interesting lab that came back: my estradiol is up from 20 to 27. This is interesting b/c in the last 2 weeks, up until about 2 days ago, my boobs were sore, I've been crazy moody, and holy shit - my libido came back to nigh high school and college levels, much to Ari's happiness. I've also had intermittent discomfort in my right ovary region. It lasted about 2 days, on and off. There's a chance I could have some kind of cyst.

Or maybe *strokes imaginary beard inquisitively*... maybe the Big O happened?


...

Ahahahaha! Man, that would be crazy. Theoretically, my estradiol was in the right range, as was my LH, but my FSH is through the freakin roof (63! Highest yet, I believe.)

But we didn't take any chances, and course corrected appropriately (refer to the libido comment above.) Things I am promising myself right the hell now: no pee sticks, unless I'm hurling chunks for a few days in a row. Who knows what's going on down there. It's weird to feel all PMS-y again. I haven't really had PMS in a year... actually, about this time almost exactly a year ago. Huge PMS buildup and then... nothing. This moodiness has taken me by surprise really- I've forgotten how weird it feels. I'm bitchy, emotional, bloated... I lament about missing it for over a year and then forgot just how icky the whole menstrual cycle can be sometimes.

Maybe this is just my ovary's way of saying, "Happy New Year!" before flipping me off every time I think about trying to have my own children.

And if I really do actually get a period- a for reals, honest to goodness, no this isn't withdrawal bleeding from being the on the pill period- I'll be devastated. That could have been THE last egg.

Or maybe... maybe there's a fucking chance. Maybe my body is slowly recovering itself, having a lil Bionic Woman peptalk between thyroid and ovary, saying things like, "We can rebuild her."

Next time I meet with the doc I'll make sure to get an u/s done, just to check for cysts. It's been 6 months since my last u/s, which came back normal. But for now, I'm going to ride out these PMS-like symptoms and see where they're taking me. I hope they're takin' me to Mom Town, or at least Holy Shit You're Ovulating Ville, by way of This Would Be a Fucking Miracle Airways.

For now, I'm just flyin' standby.

Dear Thyroid: You suck.

My appointment with Dr. G was a disaster. Despite the dosage increase, symptomatically, I've felt the worst I've felt so far (horrendous brain fog, lethargy, sleepiness, coldness in hands and feet - the usual). And yet the numbers say the inverse: my TSH was 0.024 - well in the hyperthyroid range. This is apparently common for folks with Hashi's - they can yo-yo between hypo- and hyperthyroid. Given the random spurts of racing heart rates and palpitations over the last month, and the recent crazy bouts of insomnia I'm dealing with, I knew this was going to happen. I have all the classic signs of a "thyroiditis flare up."

Basically, my thyroid is losing its damn mind, as indicated by the graph below. My TSH levels are in blue:

Dr. G has again prescribed a dosage increase (up to 137 mcg now) and has moved me to Synthroid instead of Levoxyl. The difference between the drugs is minimal, but perhaps my body might prefer one over another. It's like the difference between a Honda and a Toyota - they're both good Japanese cars, but some people just like one over the other (for the record, I'm a Honda girl and Ari is a Toyota boy).

My T3 has also been steadily climbing with each dosage adjustment. I need to go back and do some basic primer reading on T3 and T4 levels and what the hell they mean, b/c I just can't remember. This thyroid stuff is complicated and confusing.

I thought that perhaps Dr. G is moving a bit too conservatively, so I thought by telling a little white lie I might move things along more aggressively. I mentioned that Ari and I were earnestly moving forward with DE/IVF in the next six months (really, prolly not for another year), so let's get my body in shape to make that happen. The most aggressive thing he did was send me to the lab for 5 vials of blood and tons of bloodwork: vitamin D, folic acid, estrogen & progesterone (I think), cholesterol, hemoglobin A1C (glucose over time), and a host of other tests. I spent a half hour in the lab, b/c once again, my notorious thin/spongey/rolling veins played their little games and it took 3 sticks, 2 cups of water, and lots of fist pumping and overly tight tourniquets to be able to actually fill any of the 5 vials needed. It didn't help that the phlebotomist slipped when undoing the tourniquet and pulling out the needle and missed hitting the puncture wound with the gauze, sending a spurt of blood high into the air and almost all over my shirt (it did get all over my arm, her glove, and the tourniquet itself). I almost hit the floor - I just don't do blood, my own or otherwise.

It's been 8 months and I have little to show for it - I'm the heaviest I've ever been in my life, I feel miserable, and oh yeah, can't have my own kids. I hate feeling like a prisoner in my own body. I hate knowing that I used to be 118 lbs just 9 years ago, could do a two-hour performance singing and dancing with only a minor asthma attack afterward, and I looked good. I looked healthy. My periods were regular, albeit artificial with birth control, and my sex drive was almost criminal.

Cut to me now: 186 lbs (I only gained a pound since my last appointment, but I just feel a lot heavier), wheezing just going up a flight of stairs, not to mention the joint pain in my knees (another side effect of Hashi's - joint paint), and the worst acne of my life, a generally puffy face in addition to my double chin (another Hashi's side effect), premature ovarian failure, and a sex drive that comes and goes, and never with any great fanfare. It's practically a passing thought that I try to actually respond to once in a while.

I hate knowing that I could do so much more if I just had the energy, if I just had a body that would cooperate with me for more than a couple of weeks at a time. I hate getting stuck with needle after needle, praying that maybe this time- this time-  my TSH will be in the optimal range and I can stick with one dosage for more than 6 weeks at a time. I hate feeling physically a lot older than 27. I hate looking in the mirror at myself and thinking, Miriam, what the fuck happened to you in the last decade? Where did that spunky spry go-get-em girl disappear to?

While I'm still coping with infertility, realistically, my bigger issue right now is my thyroid. I desperately need to find some Hashimoto's or Hashi's w/POF blogs out there. If anyone has any recommendations, I'd love them. It's so frustrating to know that I can't even begin to address any of the infertility until my thyroid chills the fuck out... I told Ari at lunch today, it almost seems like we should just start the adoption process now b/c I'm sure that will move faster than trying to get my body ready for IVF.

I'm tired of feeling like everything in my life is perpetually on hold right now.

CD365

You read that right: tonight marks Cycle Day 365... it's officially been a year since the start of my last period. I can't believe it's been a whole year already. CDs 1-4 were regular heavy flow and then... nothing. I thought for sure on CD15 I was ovulating - mittelschmerz and everything but alas, the end of January came and went... nothing. February... nothing. By mid-March I figured maybe I should have the doc take a look. Dr. E (aka, Dr. Skinny Bitch) assured me it was stress. Oh, and being overweight. Something about excess estrogen being stored in my fat cells. "But if you're really worried, go see Dr. G (my current RE) b/c I don't really see anything wrong. It's perfectly normal for periods not to return for several months following the cessation of birth control."

So I met with Dr. G and he ordered 7 vials of blood to be drawn. We both thought it was PCOS and a nasty hypothyroid problem. Turns out it was POF and Hashi's. March 18 of next year will be a year since my diagnosis. I'm not sure how I feel about that. Right now, I'm mostly buzzed, from 2 beers and a Snickers-tini from a bar downtown.

. . .

Tonight we celebrated Ari's 28th birthday. It's actually tomorrow (my lil Solstice baby) but he has a Mason's meeting and I have Red Tent Temple, so we braved the foot or so of snow downtown and went out for drinks and wings. A lot of people bailed, but understandably so - the snow and freezing temps nearly kept us at home.

We spent a night this weekend in Stockbridge, MA, at the Red Lion Inn. A picturesque little town, home of Norman Rockwell... it was a nice one-night getaway just to take us away from everything. We spent time visiting family friends of Ari's (they go to the Red Lion every Christmas) and they got us a room. We had a lovely dinner (I had the maple braised pork lion, Ari had the elk tenderloin), and enjoyed an evening of experimental jazz funk in the bar downstairs. (Surprisingly, the band was actually really neat.) We slept in the most comfortable bed ever, and managed to avoid even a single flake fall on the town of Stockbridge - a narrow strip of western MA managed to avoid this entire nor'easter. By the time we got home today, we didn't hit any snow falling and the roads were all cleared.

. . .

On the eve of the new moon, Rosh Chodesh, and more importantly, the Winter Solstice... I'm left contemplative.

Brief Updates on Life

Sitting in the BWI airport, waiting to fly home. Ari's great-aunt passed away Tuesday and we drove down from MA to NJ Wednesday night and then from NJ to MD for the funeral. I have to be at work tomorrow, so I'm flying back tonight and he's driving back in the late morning tomorrow. Aunt B's funeral was really just... hauntingly beautiful and serene. My heart breaks every time I think of Uncle N: 61 beautiful years of marriage. Ari and I lived near them when we lived in MD and made it a point to visit when we could. It was not unexpected; she was given a year to live six years ago, but she declined sharply in the last 6 months. It's just very sad, and another thing I can add to the "Things That Sucked in 2009" List. It's a long list.

On a lighter note: my sister's 2nd ultrasound went well. Things are going swimmingly for Otter and her Spud. I am excited to see her at Christmas. So far, no need for an amniocentisis, and that's wonderful news given her age.

Work is... work. It's a paycheck, housing and health insurance at this point. I have come to the firm decision I will no longer be a doormat to my bully of a supervisor, and quite frankly, I'm a better person than my supervisor and will not let my supervisor win. Bullying is not a management style- it's a personality flaw, and I'm simply not going to take the passive-aggressive bullshit anymore. I'm digging in my heels and ready to fight the fight, if need be.

Ari's been applying for some more full-time work since he knows how unhappy I am at my job. He's got two apps out right now, so if you can put the good vibes out there in the universe for him, it would be much appreciated. Also... his birthday is Monday! It'll be the 12th birthday of his I've spent with him... nuts. I have some serious shopping I need to do before then :)

On the IF front... I've been much more open to the idea of adoption rather spontaneously in the last few days. Not sure why, but maybe I'm not meant to be pg. I really worry about whether or not I could successfully carry a pregnancy to term - just a weird gut feeling I've had in the last couple of weeks. As much as it would be a healing process for me, I just don't know if it's a realistic goal. DE/IVF is scary, just in terms of what you have to go through medically, and I don't know if physically, I'm really up for that. And if it failed, or worse yet, I miscarried... the emotional and financial damage could be irreparable.

I have a regular 6-week thyroid  checkup on Monday with my RE. I'm not looking forward to it. Despite the dosage increase over the last 6 weeks, symptomatically, I feel worse. I had my b/w done yesterday (with a juicy lookin bruise on my hand... I look like a junkie) and I'm not confident that the numbers will be what I hope they will (in the 2-3 range). I'm betting they'll be over 5 again. I haven't hit my sweet spot TSH level yet, and honestly, after 9 months of treatment and yo-yo-ing on Levoxyl dosages and TSH values, I'm starting to get pretty fucking impatient. Add to the fact that my doctor basically said it's useless to try and take care of anything related to my weight right now b/c of my thyroid being unstable, and well, I'm not feeling to great about my health. I'm a terribly impatient person and I might need to seek a second opinion to see if I can't move this on a faster track. At the very least, I might need to seriously reconsider again supplementing this with some TCM and acupuncture.

Well, this wasn't brief at all. I'll write more in the coming days... I've got some interesting initial thoughts and observations on the donor selection process now that we've registered with a couple of databases online. Weird stuff, man, weird.

For now, time to board. I can't wait to sleep in my own bed tonight.

Makin' a list and checking it twice.

So, if we want to get this "having a baby" party started, I'll need to have a few things in order. It is astounding everything we need to consider in the grand scope of things. And when I look back on it? I want to throttle my high school health teacher for spreading this notion that getting pregnant consists of merely glancing at a member of the opposite sex, let alone actual contact. In a way, I'm thankful I was diagnosed before we started trying, b/c I've probably only spent about $75 in my lifetime on pg tests, back when I missed a pill here or there or my period was randomly late. Man, if only I knew!

DE/IVF affords us the rare opportunity to time things in a way that natural conception can't. And this might not be the best thing for us, since we (like to) get a little caught up in the planning stages of things. (Case in point- the nearly 2 years we had to plan our wedding. We had everything planned to the smallest detail.)

So here's what we need to have sorted out before we can begin this journey:

1. Insurance. This is pretty self-explanatory, but having an insurance plan written in the state of MA is a biggie, b/c MA has some of the most comprehensive infertility treatment laws in the nation. In a lot of ways, it really binds us locationally to this state (which is great, b/c I love it here). The other option is NJ, which is where Ari and I are from originally, but like I said, we love it up here and MA is where all of our friends are.
   
2. Income. Also pretty self-explanatory. Right now, we're working on 1.5 incomes as Ari gets the new business up and running. Seeing as we need to sack away upwards of $15k for one DE/IVF cycle, this is also a biggie.
   
3. Housing. I'm in the unique position of having free housing with my job. It's been a lifesaver for the past 9 months. However, there are also unique challenges with my job as a result of said free housing and how it relates to maternity leave.
   
4. Well-managed thyroid. Have another monitoring appointment on 12/21. I'm hoping I'm in a better TSH range, but my suspicion is that it has crept back up, as symptomatically, I've felt like poo since I upped dosages. I think I may have had another ATA attack, and I'm dumping TSH right now. My RE is a little slow on protocol, and I'm seriously considering getting a second opinion/more aggressive RE after the new year.
   
5. Lose weight. I've got about 50lbs I need to lose to get my BMI where it needs to. And losing weight will be next to impossible until I have a well-managed thyroid.
6. Adopt healthy lifestyles. Regular exercise, eating better, and getting everything squared away with my teeth, because oral health is directly linked to instances of miscarriage.

This is totally doable.


..right?

Yes, I'm still here

I've just been trying to regain steam to post- I don't want to let this journal fall to the wayside (like I've basically let my personal LJ just kind of putter around for the last 3 years). Anywho... here's what's new in life:

2 weeks ago: Japan was amazing. 2 weeks, 7 cities, 1,300 pictures.

Yesterday: b/w for thyroid panel.

Saturday: RESOLVE Bay State Chapter Conference . Actually really looking forward to it.

Monday: Appt w/Dr. G. to go over b/w results. Here's hoping the 100mcg is doing it, but I'm not so sure with a week of jet lag and daylight savings time.

Tuesday: Appt w/Dr. S. to talk about all the crap that's been rattling around in my head since we got back from Japan. Also, a good chance to process some of the things Ari and I will have encountered this weekend at the conference. I'm finding that therapy has been quite helpful... it's nice to talk to a third party who understands, but isn't my husband or someone connected to me. I'm still working up the nerve to write that letter to the child of my genes that I won't have. I've got a good opener in my head, but not much else beyond that.

Ongoing: The unemployment checks have run out, but Ari just started his own business, so we're navigating the land of the small business owner right now. Much of my time has been spent working on his website. I've always had a good eye for design - it's just a challenge when I'm using 2 programs I've never worked with before and I'm basically teaching myself the platforms as I go along (iWeb and WordPress).

Looking at things in numbers

So my latest round of thyroid function tests have come back. And once again, my TSH has shot up, so now we're up to 100mcg. I was quite frustrated the other day when I actually went back through this blog and plotted my TSH levels over the last 6 months on a graph. And here they are:


What's particularly frustrating is how much this resembles my BBT chart that I started keeping almost a year ago: peaks, valleys, and no biphasic pattern. Not that my TSH should resemble a biphasic menstrual cycle, but it should appear stabilized.

*sigh*

This has been a rough week for some reason. Nothing in particular has triggered this emotional onslaught, but I am very frustrated with my thyroid, and I've just been very sad this week. What didn't help was calculating exactly how many days it's been since my last period: 281 days. 9 months, 1 week. 40 weeks rounded down. If I had conceived instead of getting a period on 12/20/08, I would be exactly full term today. But we weren't trying, we had no idea about my Dx... it just wasn't in the cards then.

But damn is it hard to realize it's been that long. I really do miss having my period, even the mood swings, the tampons, the cramps - all of it. It marked my sense of time. I'm lucky that I meet with a lovely group of women for a Red Tent Temple at each new moon, and that's helped immensely.

Like I said, it's been a hard week with regard to my IF headsphere. Tomorrow: Yom Kippur. The Days of Awe come to a close, and our fates are sealed for another year. I've sent up my prayers louder than ever this year, so we'll see. On Rosh HaShanah it is Written, and on Yom Kippur it is Sealed.

Good shabbos all.

Thyroid & General IF Updates

Dr. G sent over my latest results, with more thoughts on Ari's SA. While the numbers may be borderline, they're ok for IVF, but he wants to boost Ari's count when we eventually go that route. Most likely will involve a modified diet and some vitamins.

Latest thyroid panel: TSH is down from 5.69 to 2.93. T3 and T4 are still mid-range normal. Dr. G wants to up my Levoxyl to 100 mcg. I've felt a noticeable difference since re-upping my dose. We're almost there, but not yet. I'll be so glad when my levels are where they should be.

As for IVF, donor eggs... That's all up in the air. The finances just aren't in place, our current housing arrangements are less than ideal, and really... are we ready to be parents yet? I seem to think I am, but there are moments where I wonder if I'm just blinded by a biological imperative. Ari has a clear timeline in mind, so it looks like it's going to wait for a couple of years yet. It's frustrating, confusing... I'm hanging in, I suppose. I am seriously doubting the viability of even trying to use birth control to stim my ovary anytime in the future. 2 reasons: 1) disappointment. 2) I'd have to complete readjust my thyroid meds again, and lord knows, I am not about to redo the last 7 months of work.

So, we wait.

Until then: get my thyroid in shape, get me in shape.

And wait.

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.

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.

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.