She Says… No More Babies (For Now)

Disclaimer: This post discusses my ladyparts and is for those who are interested in TMI posts about fertility stuff. If you read for the cute baby pics, sit this one out.

I remember at my 6 week postpartum visit after Owen was born, my doctor asked me what I was planning for birth control. BIRTH CONTROL?! I scoffed. Thinking about sex was kind of the last thing on my mind. All I could think about were my nipples that burned and felt like someone was jabbing them with a knife whenever I dared put a shirt on them. Or how many minutes it had been since I last nursed and how many minutes I had to go pee before I had to nurse again. Or if I walked out the door in my pajama pants. Again. Birth control seemed like a lifetime away.

And yet, it’s vitally important, especially if you really aren’t ready for an oops baby.

So last time I was too paralyzed with new motherhood to make a decision about what kind of birth control I wanted to use. The comments on this post were extremely helpful, but I just couldn’t make myself make the appointment to get a sharp thing stuck in my vagina after that big slippery thing had just come out. As I said in that post, I am anti-hormone, given my infertility issues in the past, and I wasn’t ready for an IUD (mentally), so I chose not to choose.

This time, I was ready.

Even before I had Emmett, I talked with my midwife about ParaGard, the hormone-free IUD. I wanted to be held accountable so someone would make me do it. We had to reschedule the insertion date due to my extra-long postpartum recovery and then unexpected surgery a few weeks ago, but yesterday I put on my big girl pants and just did it. I had a lot of anxiety around this process, and I’m sure I’m not the only one. I couldn’t find very many candid blog posts about what it actually feels like. So, here you go internet, here’s the real deal about getting an IUD inserted (for me — everyone is different, obvs).

My doctor advised me to take a bunch of Motrin 30 minutes prior to the appointment to dull the pain. Umm, thanks. That made me about a million times more nervous than I would have been if they’d said, “It’s no big deal. Just come in”. Once I got there I saw piles of cotton balls and some brown goopy stuff and tools and those sealed bags of medical accoutrements sitting on the counter. Ew. I waited an uncharacteristically long amount of time for my doctor, which made the anticipation mount even more. Once she arrived and the pleasantries were out of the way, she had me spread ’em and put in the speculum. She prodded around figuring out where exactly my uterus was, which way it was tipping, etc. This was actually the surgeon who had just done my hysteroscopy, so she was intimately familiar with my uterus (score!). She swabbed the area with soap, which just felt like a dull pressure, not pain. Then she told me to take deep breaths while she inserted the little copper T. It was kind of like when you get a shot and they have to squeeze the medicine into your arm. The shot part is a quick sting, then the liquid going in doesn’t exactly hurt, but it feels all hot and weird and it gives me the willies to think about what they’re doing. So I felt a pinch, and then a hot, cramping feeling. Not terrible at all… just… strange. Like a really minor contraction or a medium-grade period cramp. It lasted maybe 30 seconds to a minute while she inserted it and positioned it. I yoga-breathed and stared at the ceiling. Then she cut the string to the right length (there is a string so it can be pulled out when I want), which I couldn’t feel at all, and we were done.

Not comfortable, but nothing compared to the other things my uterus has had done to it recently.

I mentioned in my other post that I had heard people say their partner could feel the string of their IUD during sex. Ew. She said that she has heard this complaint with Mirena (the hormone-releasing IUD), but never with ParaGard. Apparently the strings are made from different materials and the ParaGard one is preferable. Phew.

Since then I’ve had some minor cramping, like a period (not that I remember what THAT feels like!), but really nothing to complain about. The thing is good for up to 10 years if I want it, and the whole thing was covered entirely by my insurance. Hooray.

So glad it’s over, and it really wasn’t that bad. This was definitely the right contraception choice for us, and I look forward to condomless and baby-free sex.

 

P.S. If any friends or family members are still reading, I’m sorry. And I told you so.

She Says… Thinking Ahead, Looking Forward

I had my 6 week postpartum doctor’s visit a few weeks ago. I was kind of dreading it, since the thought of an internal exam while I was still healing from giving birth sounded more like cruel and unusual punishment than a doctor’s appointment. However, it really wasn’t that bad.

I was, unfortunately, still in the midst of “healing” at that point. Aka I hadn’t stopped bleeding yet. Most of the reading I’ve done say that a woman recovering from vaginal birth should expect to bleed for about 4 weeks (at the most) and then the bleeding should taper much like a period, and end by around 6 weeks. At my 6 week appointment, which was actually 7 weeks after I gave birth, I was still bleeding. A lot. I had called the doctor a few times prior to the appointment since I was nervous about the slow healing. I was walking a lot, so she suggested that the increased exercise might be to blame, but the longer the bleeding went on (and given the heavy amount), she actually became concerned about retained placenta or some other strange complication. She ordered an hCG test (which came back negative) to rule that out. Since I had issues with bloody noses during my pregnancy (and previously in my life), she considered the possibility of a clotting issue, but my bloodwork was within the normal range. She said my stitches healed beautifully and everything appeared normal upon examination. Finally, after several extra appointments and a lot of unnecessary Googling, it stopped. Just a few days ago, at 7 1/2 weeks. It stopped cold turkey… no tapering or changing colors or anything else that I had read would happen. Whatever, I’ll take it.

Now that I’m considering myself “healed”, I feel like it’s time to move toward increasing my activity level and embracing my new body and clothes that actually fit. Yesterday I spent all of Owen’s naptimes going through my closet and purging all of the maternity clothes, and the clothes that are ridiculously too small for me to fit into in the next few months (no one needs that kind of stress of trying on clothes that don’t fit all the time!). Now that my closet is cleared, I can buy a few new items for my fall wardrobe (hello, new jeans without elastic). I unearthed my pre-pregnancy workout clothes, and I intend to get some use out of them as I try to fit workouts into my new daily schedule. I’m also going to cut my hair. Chop it. It’s all part of the process. I’m totally excited.

At my doctor’s appointment, my OB asked me a question that forced me to think ahead, beyond new clothes and new hair. “What kind of birth control are you planning on using?”. Hahahahaha. The idea hadn’t even crossed my baby-filled brain. Birth control? Well, the form of birth control I’m using right now (ahem, abstinence), seems to be working quite well, thankyouverymuch! In all honesty, though, it’s a valid question. Although the old wives’ tale says that a woman can’t get preggo while nursing, we all know someone who proves that theory wrong. So birth control (for someday, when we actually have sex again) is something I need to consider.

As you know, we had a difficult time getting pregnant in the first place. In my personal opinion (after months of Googling and connecting with other women in situations eerily similar to my own), birth control pills are what caused my body to stop ovulating in the first place. Although I was diagnosed with Polycystic Ovarian Syndrome (PCOS), I don’t fit the classic PCOS profile. I don’t have wonky hormone levels or excessive hair growth or problems with weight gain. My reproductive endocrinologist called it “Lean PCOS”, but I honestly believe it was more a natural reaction to being on birth control for 10 years (and never missing a pill), wherein I effectively trained my body not to ovulate. Anyway, given this history, birth control and I are not friends. I feel very strongly about keeping my body free of added hormones at this point to see if it begins to ovulate on its own. Many women experience a sort of “resetting” of their systems after pregnancy, and issues that plagued them previously are gone. I’m really crossing my fingers that this happens for me, and someday down the line, I get my period like a normal person again.

So that rules out The Pill (even the mini-Pill), as well as any other birth control method that involves hormones. Which pretty much leaves condoms (since I am also opposed to a shot or device that eliminates my period for long stretches and/or inhibits pregnancy for a long time — we’d like to keep this family growing in the next few years!). Ugh, condoms. My hope is that someday I will have regular periods and will be able to use the Fertility Awareness Method (FAM), as described in my favorite book, Taking Charge of Your Fertility. But for now, I’m essentially just waiting for my period to return.

Or, you know, I guess I could just continue with our current method. But I’m not sure that bodes well for our intimate relationship 🙂

She Says… Working Out With Baby on Board

I have posted several times about the issue of working out while trying to conceive. It’s something a lot of women struggle with, as some doctors say “chill out on the cardio” and others say you don’t need to change a thing about your routine, and that exercise is a key part of making a healthy baby. When I first went off birth control pills back in February, I was the slimmest and most physically fit than I have been in my entire life. I had shifted my eating habits and lifestyle to be more conscious and health-focused about 2 years prior, and slowly but surely the extra pounds came off. I felt like I was at the top of my game. I worked out pretty hard about 5 days a week, and ate a balanced flexitarian diet of mostly veggies and whole grains, lots of low-fat dairy, and some meat (when it was high quality and hormone free).

When I didn’t get my period for a few months after stopping the pill, I began to wonder if I was working my body too hard in my workouts. Now, don’t get me wrong, I was certainly NOT training at the professional level, but I began to realize that maybe my body had a lower tolerance for extreme exercise than others, and maybe it was inhibiting my babymaking. So I called it quits on the really rough stuff — no more 4 mile runs a couple times a week, no more back-to-back weight lifting and cardio kickboxing classes, etc. I started practicing yoga at a studio near my house, and tried to get my kicks (pun intended) through power walking and shorter/easier stints on the stairmaster. While I realize now it was not my exercise that was keeping my period away (it was my PCOS), I still think this shift from gym rat to yogi was a really important one for me and my babymaking efforts.

So, I’m not gonna lie, I’ve gained a few pounds since changing my schedule. Nothing major, just about 5 pounds, and I’ve realized that this is probably my “happy weight”. I’m happy, healthy, I have a normal BMI (which I always did… I was never underwight) and I don’t have to push my heart rate out of my comfort zone 5 times a week to maintain it.

But I still enjoy going to the gym to feel like I’m keeping my body fit. So I took it VERY easy during the two weeks wait, just in case there was a little egg (or two!) trying to implant in my uterus. I did yoga a few times, and walked a lot, but skipped the gym for the most part. Then when I found out I was pregnant, I decided that plenty of women exercise while they are pregnant, so I probably could too. I have been trying to keep my heartrate around 140 bpm (which is recommended for pregnant women), but I’ve noticed that my body feels SO DIFFERENT while working out now.

• My resting heart rate is faster. Which means that my heart rate while working out is faster. Which means that I have to go very, very slowly or with very little resistance before my heart rate reaches 140 bpm.
• Almost as soon as I start exercising, I feel little dizzy spells. While this is a common pregnancy symptom, it is sort of scary if you’re on a stairmaster or treadmill.
• Pregnant women are supposed to avoid extreme twisting, stretching or tension of the stomach muscles. That means no deep twists in yoga, no ab work, etc.

Yesterday at the gym I was so exhausted after 30 minutes on the stairmaster that I was dreading coming home to walk the dog. That’s when I realized that maybe I should just be relaxing, at least for the 1st trimester. My body has a lot going on, and why test the limits of what I can withstand just because I want to workout? And while I am slightly nervous about gaining more weight than I need to for my baby to be healthy, I think I will be happier if I know that I’m resting as much as possible and not doing anything to stress little piccolini out while he/she/they are developing in these very important first three months.

If you’ve been pregnant, did you work out during your first trimester? Have you heard doctor’s opinions one way or another?

She Says… Trial and Error

The most frustrating thing about struggling with infertility for me is not knowing what’s going on in my body or how to make it do what I want it to. As a self-proclaimed control freak, this constant state of not knowing drives me batty. When I knew something wasn’t right when I didn’t get my period after going off birth control, I looked to doctors to use their magic to decipher the truth. But in the end, it’s really just a game of trial and error. The bottom line is that they don’t always know either, even though they are supposed to be “the experts”.

So, in an effort to gather as much information as possible, I turned to the internet, Googling the heck out of every search term I could think of. And I started this blog. And I joined Rubyfeather, a group of women in the Boston area going through some of the same issues. And I read other peoples’ blogs. Lots and lots of blogs. As I read them, there is this little ticker running in my mind all the time: She’s doing this, should I be doing that?… Her doctor said this, but my doctor says that… And on and on. And as more people have started reading this blog, I’ve started getting emails from readers doing the same thing. Comparing stories, asking for advice, offering advice, suggestions, comforting words. I love hearing from each and every one of you.

Over time I have received a few emails/comments that address the same issue: they question the level of care I am receiving from Dr. P. They asked why I wasn’t more closely monitored with bloodwork and follicle counts/measurements every few days throughout my cycle. They countered Dr. P’s decision to not give extra progesterone supplements with the Clomid. They expressed disapproval of the order of tests that he ran.

At first when I read these emails and comments, they made me angry. I trust Dr. P; I chose him because he is a well-respected doctor at one of the best infertility clinics in the country. I’m putting my body and my future in his hands. So I ignored them. But then I started questioning why I blindly put so much trust in him just because he is a doctor. Maybe I was wrong to just do what I was told and not question him? Maybe I should be pushing for more aggressive treatment or certain medicine?

So today I called Dr. P’s nurse coordinator (the one who knows me and answers all of my questions), and I told her I had been talking with some other people going through this process and that they were being monitored more carefully (bloodwork and ultrasound prior to each Clomid cycle, more bloodwork and ultrasound once the Clomid was finished, still more bloodwork and ultrasound around the expected date of ovulation, hcg injections, post-injection check-ups, etc.), and I asked her why I wasn’t getting these daily check-ups. She said that Dr. P was following normal protocol. That he is an extremely cautious doctor who doesn’t like to disrupt his patient’s lives with daily doctor’s appointments. Given my young age (26), overall health (excellent), fertility history (only been off birth control since March, borderline “Lean PCOS” diagnosis), and timeline (only on second cycle of Clomid, still having “relations”, as they call it, not IUI or IVF), he likes to take things slowly. And since I am starting with the lowest dosage of Clomid and working my way up, there is only a very small chance that I’ll be overstimulated. Given the fact that there’s no evidence that I have even ovulated at all yet, and my almost-normal antral follicle count from my previous ultrasound, he does not see a reason to overwhelm me with monitoring appointments and bills at this point. And for that, I thank him.

The nurse’s answer assuaged my fears, but still leaves me with that icky not knowing feeling. I don’t know what the right course of action is. Why aren’t there hard and fast rules about these things? The answer, of course, is that no two bodies are exactly the same. What your doctor says about you may not be true about me, and vice versa. So I appreciate hearing from everyone, but please know that I am a firm believer in individualized care. What works for me may not work for you. And what your doctor recommends for you might not be good for me. And as much as we’re all searching for answers in each others’ stories, we have to realize that we have no idea. It’s all a game of trial and error.

What about you? For those of you on Clomid/IUI cycles, are you monitored every few days? Does it add stress to your life and schedule? How do you know if your doctor is taking the right course of action?

She Says… Movin’ on Up

First things first… we’re doing fine. Thank you all so much for your support and comments yesterday. It was disappointing to hear the news that I was not pregnant, but in some small way it was a relief. At least now I can stop obsessing! As if out of spite, yesterday my temperature spiked to 98.4. If I hadn’t just had the negative blood test, I would have been SURE that was a sign that I was preggo. So much for temps being a reliable indicator (at least mine!).

I drowned my sorrows in a few beers and some deliciously cheesy Mexican food, which helped 🙂 And now it’s time to move on. Onwards and upwards, I say. I am so thankful and happy that I ovulated last month on the lowest dosage of Clomid. It seems like that little bit of medicine was just the jolt my body needed to get back in working order. Ovulating is half the battle, right? So I feel confident that now it’s just a matter of time before we make a baby.

Even though we don’t know exactly what the bleeding was that I experienced about a week ago, I also feel like that was a good sign. It’s at least an indicator that something is going on in there that wasn’t going on before.

So now I wait again. Wait for my period.  I’ve been waiting for my period since March when I went off birth control, so I’m getting a little impatient. The nurse at Boston IVF assures me that I’ll get it this time, though, since I ovulated. Well, we assume I ovulated based on the positive OPK I got. If I don’t get it in a few days, I’ll call her back and see what she suggests. But in the meantime: Get it together, body! It’s time to start a new cycle so we can try again!

She Says… What now?

Thank you all SO MUCH for your encouragement, support and advice over the past few days. Who knew this babymaking thing could be so complicated?!

Here’s a recap on where we stand:

• First round of Clomid (50mg) started on September 9th (if I had a cycle, that would have been on cycle day 3… since I don’t have a cycle, it was the day I got the drugs in the mail!)
• Started using an ovulation predictor kit (OPK) on September 16th (pseudo cycle day 10)
• I got clear negatives the first few days, and then got somewhat confusing almost-positives on September 19th & 20th
• Then I got the real deal — definitely positive on September 21st (pseudo cycle day 15)
• My willing husband and I “bumped it”, as he jokingly says, every night from September 18th to the 23rd (ok, I guess you all know that the last one was in the afternoon by necessity)
• Then Benjamin left for NYC for work and won’t be back until Saturday night

If the OPK reading was correct, we totally nailed it in terms of timing. In addition to the OPK, I definitely had some physical symptoms that indicate that ovulation occurred on the 21st, including the elusive mittelschmerz (which sounds to me like some sort of Yiddish insult… but is really the term for “middle pain” or cramping from ovulation). Not so comfy. Literally haven’t felt that in, umm, a least a decade… possibly ever! One can never be sure what was going on inside my body pre-birth control. There were a few other symptoms as well, but, in an effort to maintain some sort of personal boundaries, I won’t discuss the details of my cervical mucus on the blog. Ooops, I guess I just did.

So, one would imagine that I’m feeling pretty good right now. Except that I’m not. I’m nervous. And impatient. See, my trusty guide through this process, Taking Charge of Your Fertility, tells me that my temperature should shoot up 12-36 hours after ovulation. The author says a couple trying to conceive should have sex up to and including the morning of the temp shift. If I ovulated on the 21st, then my temp should have shifted this morning. And it didnt. Well, it did a TINY bit (for instance, my normal temps are usually between 97.6 and 98.0 and this morning was 98.2). I was expecting a more dramatic shift. I’ve literally been taking my temperature all day long (and before you respond to this post saying “your temp will shift throughout the day”, “you’re supposed to take it the same time very morning”, blah blah… I know. It’s not rational. But I can’t stop.). So now I’m beginning to doubt my mittelschmerz and the OPK and all the signs that pointed to ovulation a few days ago.

And the real bummer of it all is that I won’t be able to confirm or deny any of these things until October 6th. I have an appointment at Dr. P’s office for a pregnancy test. DID YOU HEAR ME?! MY VERY FIRST PREGNANCY TEST THAT COULD BE POSITIVE! Could someone please fast forward to then? Please?

Anyone out there in the blogosphere have experience with temp charting after ovulation? How much does it really go up? Is it possible that it won’t go up, but I still ovulated? How’s a girl to know?

She Says… 13 Again

I’m 26 years old… I thought I was done with acne.

During my adolescent years I was blessed with very clear skin. Sure, I got a pimple here and there, but nothing major. The last few months, however, have brought more blemishes than all of my middle school years combined. I’m guessing that it’s a result of the hormone roller coaster I’ve been on — on birth control, off birth control, on Provera (see?!), off Provera, etc. Unfortunately for me (and my husband, who has to look at me every day), I’m wearing my hormonal imbalance on my face. And we’re not talking tiny little pink marks here, folks; we’re talking gigantic, painful, under-the-skin, emerging-like-a-volcano kinds of pimples. Totally gross and surprisingly uncomfortable. Currently I am rocking a hard, bright red, cyst-like mound on my chin, and I can feel a new one surfacing inside my nose. Seriously. Inside my nose.

Normally I would head to the dermatologist about now for a prescription to tame these beasts. But, as I’m getting closer and closer to getting preggo (we hope!), I’m hesitant about pumping more chemicals into my body than I need to. So I guess I’ll just have to deal.

In other news, I FINALLY got the insurance company squared away, and my Clomid is en route to me right now. As soon as it arrives, we can get going! Maybe that will make me forget the little red volcanoes on my face…

She Says… Finally!

Ok, the title may have given it away… but I FINALLY had a “period” for the first time since February! Wahoo! But let’s start at the beginning, shall we?

I went off birth control at the end of February after a perfectly normal period (and a decade of perfectly normal periods before that, thanks to the wonders of birth control). Benjamin and I tried our best to make a baby. When I didn’t get my period 4 weeks later, I absolutely thought I was preggo. I entertained daydreams that I was one of those deliciously fertile women who get pregnant their first month trying. Not so. A few weeks later I thought I was knocked up again. I convinced myself I had miscalculated my cycle, and now I was really pregnant. Not so. Month #3, same deal (although, admittedly, by this time I had caught on to the fact that I wasn’t ovulating, and even though the chance was slim that I was miraculously pregnant, I considered it). So then my wonderfully proactive doctor did some blood tests (all normal) and prescribed Provera as a little “physical challenge”, so to speak.

I was supposed to take the Provera for 7 days, and then wait and see what happened. At Day 7, I wasn’t feeling any terrble symptoms (I had read the symptoms could be pretty nasty), and I was optimistic. On Day 8 I started to feel a bit crampy, irritable and fatigued… but, not one to blame things on medicine, I assumed it was just a long week at work. Day 9 assured me that the symptoms were definitely hormonal, and were definitely a result of the meds (as I hadn’t felt that tearful and agitated in, umm, 3 months!). This big, red beauty also appeared around this time:

I felt a little sorry for myself, until IT happened. And all ill-will towards that little pimple went out the window — it was all worth it. Yes! I got my period! Well, I’m not sure if you can actually call it that because (without going into too much detail), it only lasted a day and didn’t exactly present itself like my period. However, the doc herself said, “that counts”, so I passed the test. I won the Provera Challenge 🙂  That means that a) I love Provera, b) I am producing enough estrogen to cycle on my own, but my body just hadn’t gotten there yet, and c) now I have to wait it out and see what happens next month to see if I start cycling normally.

So, the hubs and I are cleared to keep “trying” this month, and it’s quite possible that I could start ovulating/cycling normally. So, we’re back in the (proverbial?) saddle, folks! Doc says to call her in 6 weeks if I haven’t gotten another period, and we’ll discuss a cycle of drugs (Provera, and possible Clomid to stimulate ovulation) to get things going. We’re going to make a baby one way or another!

She Says… Bit the Bullet

It has now been 71 days since I last got my period and went off birth control. That is two and a half cycles. In that time I have, on two separate occasions, thought I was preggo, identifying and overanalyzing “symptoms” that may or may not have really existed (not to mention spending time and money on unneeded pregnancy tests!). The whole process has opened my eyes to the reality that I actually have no idea what’s going on with my body. As a well-educated, intelligent person with a passion for living a healthy life, that bothers me. And it’s a little hard to admit.

My insatiable appetite for Googling has led me to countless discussion boards and websites for women trying to conceive. And the #1 response to almost every single one of these women is: Buy Taking Charge of Your Fertility by Toni Weschler. When my primary care physician mentioned this same book, I felt like I was being hit over the head. Why hadn’t I bought the book yet? I was getting information from all kinds of different sources, but neglecting the one source that hundreds of women endorse (and have for many years… this is not a new book). I think one reason I didn’t want to buy the book is that I didn’t want to admit how much I don’t know. Obviously that is a ridiculous reason, as the ignorance may be costing me valuable time “trying” to conceive.

So I bit the bullet. And bought the book.

I cracked it open last night, highlighter and pen in hand, ready for my first lesson. I could not put it down. I’m only on page 55 and already I have learned a few things reminiscent of fifth grade Health class that I did not know before (!), and am excited to begin putting this knowledge into practice by paying close attention to my own body. Weschler’s entire theory (though I am already quite convinced it is not just a theory… it is undeniable, scientific truth) is predicated on the idea that the commonly held belief that the average woman’s cycle is 28 days is a myth. For me, the bottom line is that even though I haven’t gotten my period in 71 days, that doesn’t necessarily mean I’ve “failed” at two cycles; I could be on a completely different calendar from the average woman. I can’t wait until I have time to read more. (Although I read on the subway on my way home from work everyday, I think I’ll be leaving this book at home… I may be an emancipated woman, but I still don’t feel comfortable reading a fertility book with images of cervical fluid on every other page in public!).

In the meantime, I also called my gynecologist to see when it would be appropriate for me to come back in to see her. She said I should call back and make an appointment in two weeks (a full 3 cycles since I went off birth control with no period), and she’d run some tests. So, the wheels are in motion! I’ll get this thing figured out in no time.

She Says… Ugh

Headache and fatigue like whoa. Is this how my new, non-caffeinated life will be? Could it be hormone withdrawal from birth control already? I’ve only been off it one day! I’m trying to tell myself it’s just exhaustion from a long weekend… that way it will be fixed with a good night’s sleep. But I made the mistake of Googling to see if these symptoms had anything to do with going off birth control and found countless posts from women complaining that they suffered headaches, cramps, nausea, weird bleeding and all kinds of crazy stuff when they went off birth control. Hm.