Book Review

I have read a few books pertaining to infertility/ adoption, so I think I am going to post my reviews on them.


The first one is this "Managing PCOS For Dummies"  by Gaynor Bussell RD


After accepting PCOS, I wanted to know what to do.  Some life decisions needed to be made and such.  The amazon description of this book looked hopeful. I was hoping for things like "how to find a doctor that is specific for this syndrome" "how to tell your family"  "what to tell your friends when they ask why you have been married for 6 years and have no children"...  I have read other "for dummies" books and liked the style of them and their information has always been valuable and instructable.

First impressions of the book were ok.  But I quickly came to realize that this is not the book i had bargained for.  I should have known what I was getting into when the main author was an RD (registered dietitian)

Ladies.. this is a diet book.  It basically says through the whole book that your PCOS is fixable by a low carb diet, exercise and diet diet diet. Also there is some holistic herb crap thrown in threw the pages.  Thanks.. not really that helpful.  I know my mid section is hefty and if I wanted a "how to diet book" I would have bought one.  I read it in 3 days hoping it would get better and have some life advice.. but it didnt.. I sold the book.

I went back to the amazon website to copy the picture of for this post and now the description is appropriate for what the book is... a way to handle pcos threw starving yourself.

Overall I give this a rating of 1 out of 5.. very poor.

Our Plan

Rich and I sat down a little while ago and hashed out what our plan of attack was going to be for this baby business   That talk resulted in the following plan, which i have neurotically laid out in a baby flow chart. This is a very paired down version of what will be going on.  We will of course be charting temperature and cycles, so that may make moving on down the chart quicker or slower.. ie if we are ovulating at one point on the chart but not getting pregnant, we might stay there longer to give nature some more time, conversely if we are not ovulating at certain points of the chart, we are more likely to move to the next option faster.  Last time I was off birth control I did not cycle at all, so I have a strong feeling that his is going to be a long uphill battle that will lead us down the adoption road, which is just fine with me.. but we still want to give the old fashioned way a shot.



Options


Venus von Willendorf (fertility goddess figurine) 

After coming to terms with my PCOS, I started looking at options.  Now let me restate that I am a graduate student in the sciences, and have a very high capacity for learning a new subject quickly and understanding all the medical research jargon.   So once again, I went to the original research articles to see what treatments were working, the risks..  the cost analysis I had to do more by using google than research papers.  The options as I saw them were slim...  here is a list of viable treatments that I found, in the order of how they should be tried, plus a little statement of what I feel the literature says about my situation in particular as it pertains to this option

Metformin-  Doesnt really do anything involving fertility, but helps with some metabolic symptoms that may result in a slight enough change to get an egg to drop...  this does not really work for most people, it really only works for those who cycle frequently anyway, which is not me. But it is the first try for many doctors, so the chances are that if you have PCOS, this will be the first drug given.

Clomid-  this can be given at several different doses, with low risk to the womans health.. just some really annoying side effects like crazy dreams, night sweats, nausea, headaches.  Its efficacy in a lady should be seen right away with ovulation.. the chances of this working in people like me with no ovulation is said to be around 5-10%.. not very high, but worth a shot because it is non-invasive, low risk and relatively low cost compared to the next steps.  Oh let me also mention.. a women with PCOS always has a higher risk ratio for multiples, because of the way your eggs are built up.. so be aware.. if you ovulate with this drug .. it could be more than one egg.

Injectables with IUI (inter-uterine insemination)- This is a valid therapy, but now we are getting into high risk, high cost, with still a low efficacy.  The risk here is so high of uncontroled multiples for women with PCOS that many fertility clinics will not perform this procedure and suggest you go straight from clomid to IVF.   The cost here is very high.. thousands and thousands.., it is invasive, painful.. can result in hyperstimulation for women with PCOS which has very severe side effects including loss of ovaries and in some cases death. All that to say that this option is not really done on PCOS women that frequently anymore. (as a side note, Kate Gosslin has PCOS and did this option.. now she has 8 kids)

IVF- Again, because of the injectable hormones you have pain, invasiveness, expensive expensive plus an extreme risk for hyperstimulation.  The one plus with this is that they harvest the eggs, fertilize them then only put a certain number back in.. so you have way less of a risk for extreme multiples.  However, the outcomes are still really low for women in my shoes only 15-20% chance of pregnancy per cycle tried.. and each cycle is upwards of 25k without the unforeseen costs of hyperstimulation.

Adoption-  Expensive (depending on which avenue you chose), emotionally invasive, but not so much physically.. but has 100% outcome of having a child

In the next post, you will see what our plan is...  but as you probably can tell from my explanation that i really dont like the injectables and IVF options.. these options we will not be perusing because of all the research I have done, I do not feel comfortable using these options for us.  Do they work.. sure sometimes.. but with the risk analysis I did for our situation... we do not want to go down this road.  I think this is a very personal decision for each couple, and I would never be judgmental towards those that chose this path.. I would just hope that you do not go into it hastily and really really do your research to make sure this decision is right for you.

Baby Name of The Month: Lorelei

Lorelei ( Lor-eh-lie)


Why Lorelei-
This name originally comes form a German legend.  Rhine Maidens were legendary water-dwelling creatures (mermaids) responsible for luring sailors to their death on treacherous rocks with their irresistible song.  Much like sirens in the Odyssey.  The head water sprite (mermaid) gave her name to a boulder located on the Rhine river which is there today.   The spelling of the rock is Loreley but the name is always Lorelei.


So you might be thinking, why would you consider a name with such a wicked story.  Well, it is just a story.  Rich and I really love mythology and the fact that this stems from Germany, (Rich is German decent) is a plus.  I love the frilly-ness of Lorelei, she just sounds so girly.  
In the social security administration numbers released this year she ranked 531 out of the top thousand, which is great from my stand point.  This means that roughly only 536 babies were named this in 2010.. as compared to the number one name Isabella where 22731 girls were named this.  I much prefer non-popular names so they dont always have to be referred to as a secondary trait .. like Amy T. or Amy with the curly hair or fat Amy.  Naming her Lorelei, i am sure she will just be Lorelei to her friends.


Also, Marilyn Monroe played Lorelei in Gentlemen Prefer Blondes.. and how can you not love a Marilyn Monroe reference.


Downsides to Lorelei-
I hate hate hate nicknames.  I love pet names like pumpkin, or cupcake, or anything like that.  I hate nicknames, where you name your child Melissa only to call her Missy for the rest of her life.. why in the world didnt you just name her Missy?  I will never understand this.  So Lorelei lends herself to being called Loren or Lorel or there is that awful one from gilmore girls Rory.  


All in all, Lorelei is very girly, with a cool history and not too popular..  but with the slight possibility of being called something other than Lorelei.   With this one draw back, she is still on the long list of possible future baby T's!




Baby Name of the Month

This is a series I would like to start.  I love names.. and love considering future names for my child/children. This will be something happy to post on my blog, as some of them can be rather depressing when considering my situation.  But even though i have PCOS, I will have a child!!!! So I think I am going to start profiling the names I/we like.  I am going to be honest.. we have a top girls name and a top boys name.. I will not be relieving these.  I also have a list of 50 other names, so I think we will have plenty to talk about here.  It also is good to look to the future, that someday I will have a child to name, this child may or may not be from my own womb, but that doesnt matter, he or she will be mine, they will be ours and one of the things I am most looking forward to is naming them!!!  Come back later today to see the first baby name profile.

Pink cupcakes

Well in the last post I talked about my denial phase.. this one is where it gets real.  When it all finally hit me.

So around fall of 2008 we were settled into our new city, I threw a big halloween party, school was hard.  We started the hunt for a new dog (severus) so our little schatzi would have a friend.  Things were tough but totally fine.  I think this is when I started my PCOS research.

I started googling.. reading the normal sites.. wikipedia, web md..  stuff like that.  Now keep in mind, I am a scientist.. getting a PhD.  I have the know how to read the real research.. to read PubMed.  I would say that 95% of my research was reading primary source science articles about PCOS, about Fertility treatments and that's when it got real.

I remember discussing it slightly with Rich.  Telling him things like you know most of these women are not getting pregnant and are having severe side effects from the fertility treatments.. then they dont even get pregnant.  He listened and commented.. I still dont remember what exactly was said, but I remember my science mind turning on and just searching and searching for an answer.. a bright light.  There are none.

The first breakdown came in January 2009 ( about 9 months after diagnosis).  One of my classmates was celebrating her birthday, a princess party, and I made the most perfect pink cupcakes.  These are the darling cupcakes that sent me over the edge...


Rich ran to the store while I was putting the finishing touches on them.. he was gone maybe 15 min.  As I was finishing the cupcakes I started crying like a baby..  big ugly crying.  The thought hit me that I may never be making cupcakes for a princess party for my little girl.. i may never have one.  I just couldnt stand it.. I went and curled up in a ball on the couch and broke down.  Rich got home shortly and found me.. I think he was in shock, he thought I was hurt .. i was, but not physically .. emotionally.  I had never let the actual reality of infertility hit me until these darn pink cupcakes sat on my counter in the kitchen.

I sat and cried in his arms.. and he was perfect.. just being there, and loving me.  Thats all he had to do.

Who knew pink cupcakes could carry the weight of the world

Infertility


Always gets me choked up.

Denial ... Not Just a River in Egypt

Well after diagnosis of PCOS life went haywire.  Not because of the diagnosis, but because my husband and I had decided on a school to get our PhD's at, and it was 3000 miles away.  A 5 year commitment to be payed in beans while we slaved away trying to study and do research in our fields.   So this meant moving cross country to a place we had only seen for 3 days, and being poor students again.  We sold everything, packed up the toyota corolla and our only fur baby schatzi. He drove, I flew.  And we arrived in the south on July 1st.  The humidity was shocking, the bugs were the biggest I had ever seen.. and what the hell were boiled peanuts?

I remember planning our next 5 years out and discussions of trying to start a family while in graduate school.  No mention of the fact that I was infertile.. just discussions of getting pregnant possibly towards the end of all this madness.  I remember looking into the schools policy of maternity leave.. yes they have one.. which was a bonus. I remember interviewing at the school and asking current students if they had any friends with children in graduate school.. and could it be done.

3.5 years later, looking back on this time of my life I can safely say I was in big denial.  I thought it would all work out.  We would be the best students, have awesome bosses that supported family, and all Rich and I had to do was get to our 4th year and we could start thinking about baby. It would be easy.. throw the pills away, have a margarita, some lace panties... voila a baby.  I would have a beautiful baby shower, and be the envy of all the girls.  Big Big Big denial.  We talked about parenting, childcare, cute science onsies.. but never about the big factor PCOS.  I dont know what Rich was thinking.. maybe in the back of his head he was saying " wait a minute .. didnt she just tell me about problems having a baby, should I bring it up?"  maybe he was thinking "man I could really go for some tacos right now" ... who knows.  But I can tell you what I was thinking... " I have everything I have always wanted, everything else I want in life will fall into place just as I had always planned.. degree, baby, job, house.. no problem."

Denial.. Until about 6 months later, thats when things started to hit me.

Looking back, I dont regret this phase... it kept me sane through one of the most craziest times.  I dont know what would of happened had I been an emotional wreck at this point.. would we have even gone to graduate school? I have no clue.. all I know is that I was focused on the future.. and my future was bright and shiny.

PCOS a path to diagnosis

Warning: this post is all about menstruation and can be "real" at times.. be warned.

PCOS... What is it? to be exact it is...
 Polycystic ovary syndrome is one of the most common endocrine disorders. It is a genetic disorder that can be inherited from either parent.  PCOS produces symptoms in approximately 5% to 10% of women of reproductive age and is thought to be  the leading causes of female infertility.


The principal features are anovulation, resulting in irregular menstruation, amenorrhea, ovulation-related infertility, and polycystic ovaries; excessive amounts or effects of androgenic (masculinizing) hormones, resulting in acne and hirsutism; and insulin resistance, often associated with obesity, Type 2 diabetes, and high cholesterol levels.


In lighter terms.. you have hormone imbalances that causes your eggs to not release, giving you little to no cycles and little to no fertility.  The hormone imbalances also cause those other symptoms which vary from person to person but can be acne, hair growth, obesity, diabetes and high cholesterol. This hormone imbalance also makes it severely hard to loose weight and correct or avoid obesity diabetes and high cholesterol. 

This is the story of me and my dark passenger (dexter reference). 

I was officially diagnosed with PCOS in March of 2008.  I had been married for 1 1/2 years, and we were NOT trying to get pregnant.  This is how my story differs from many PCOSers out there.  Most people do not find out about infertility until they give baby making a try.  I consider myself one of the lucky ones.. we were not trying and would not be trying for quite a while.

How did the diagnosis come about?  Well lets start from the beginning with a full menstrual and symptom history.

Age 11 1/2. 6th grade - first aunt flow visit
Age 12-14  7th-9th grade-  Very irregular periods some light and spotty, some like a gore horror movie something in the vane of Carrie at the prom.  But the key here was irregular.. I got my cycle maybe 3-4 times a year.. I was not worried about pregnancies or nor was I anxious to have this event every month.. so no doctor visits for me.
Age 15-17 10th-12th grade- Still same symptoms as above, but now a little weight gain around the middle, I was also very active, swimming, softball, volleyball, plus lots of academic clubs and teams so as most young girls hear from people, your period can be irregular when very active.. so this is what I thought was going on.
Age 18-21 College- Enter birth control (bc).. my first cycle was horrible, i thought I was giving birth and there was enough blood to be the truth.. actually now looking back I just hadnt had a cycle in so long I must of had lots of stuff built up. But then the regularity came.. a period every 28 days, I could even predict it down to the time of day and it was very light and only lasted 3 days.. ahhh all was right in the world.  However, I was in college for a science degree.. lots of bad habits formed in the way of eating and not being active, so the weight gain started to become more and more. Also, major migraines which i had all my life, but durring college they were frequent and terrible, lots of vomiting from pain during this time of my life.
Age 21- Prepping for marriage. I started having skin issues, darkening around my neck and my underarms. I hoped I could get a cream and it would go away before the wedding. I went to the college nurse practitioner and she mentioned PCOS and said I should go to a gyno. But that it was not fixable by a cream.  Well at this point in my life, with no health insurance, a senior in college planning a wedding.. i really didnt care nor had the motivation, nor did I even know what PCOS was.. so I didnt go.  She also did not explain PCOS and I did not do any research on my own.
Age 21-23 Marriage-  Remember those migraines?  well they got even worse.. but now I was done with the all nighters in college and had a husband with health insurance.. so off to the doc I went.  Many lifestyle changes had to be made for the migraines (which i still to this day do and they help). One change that was made was to take me off oral birth control.. i actually dont remember the science behind this.. but we did it, and this was important to my future PCOS diagnosis.  So a whole year went by.. we used alternative forms of bc.. but during that year I did not have one cycle.. not one.  So off to the doc (who is just a family doc not a gyno).. he sends me to a gyno..  and of course with my history of skin coloration, weight gain, very irregular to no cycles.. she doesnt even have to blink before she says... PCOS.  She then actually gives me the whole explanation of what it is and suddenly my whole medical history makes sense, and I agree that I fit the bill.  But to confirm she sends me back to my family doctor for blood tests and then a tech place for ultrasounds to look at the ovaries.  Well I am sure you know by now, they came out positive .. and so here I am 23 years old .. still slightly newly wed, not even trying for a baby.. and I get told I have PCOS and my chances are slim now because I do not even cycle on my own anymore.  She tells me if we are not into trying for a baby for a while, I should go back on bc to control my cycles and other symptoms, so we do a very low dose bc , I get a pat on the butt and get to go home and tell Rich.

So I tell him.. I really cant remember the reaction.  Honestly I dont remember my reaction.  Frankly we were not in the position to be thinking about children, but I knew I wanted them someday.  So I think this is when I moved into my denial phase.

The next phase in this story will be the subject of another post.  I wanted this one to be just about the diagnosis and initial reactions.






It all starts here

Funny how things work in life, I feel like this blog has been writing itself for years but I have not yet put it down on to actual print media.  I ask myself why, and it is probably the acceptance factor.. once I start writing it down I have to accept that this is happening.. and its happening to me, to us, to we. What am I beating around the bush about... BABIES.  Thats right babies, not just babies, but making babies or adopting babies.

So here is where we start.Stats on myself:

Name: Nicole T.
Age:   27
Marital status:  Happily Married 5.5 years (if you are doing the math I was 21 when we got married)
Fertility status: PCOS diagnosed
Mental status: anxious
Job status: Graduate student, PhD in Immunology
Kids: two fur kids


And we are off.. to start documenting the goings on in our life revolving around bringing home a baby.