1.15.2014

The Medical Plan - Results

I saw Dr. D. yesterday for my follow-up appointment from all of my blood-work and the Follicular Maturation Series I had done in December. (This is long and full of details, feel free to skip it :)).

The Tests Themselves

Only a couple of my blood-draws were painful, but no major bruising, no bleeding, and no "I need to try agains", so I consider that success!

My FMS went very well, other than my lack of CM which just made things a bit dry and uncomfortable. (I switched from unscented to scented dryer sheets AND was just a bit stressed about this whole thing.) My poor lady parts were feeling a little abused, so much so that I said to The Man one night "I just need a break." BUT, the lady who did my scans. Her name was Rita and she was truly a gift from God. She was so kind, on the first day she said "I've never seen ultrasound orders like this, so I want to be sure I understand them and do the best I can because I know how much of your future depends on this." Um, yea, let's just say I had to resist the urge to give her a huge hug. Each day she let me see the screen and explained what she was seeing. I think she was more excited than I was the day we saw that I had ovulated. I had really prepared myself to hear that I had LUFs, so I was a little, or a lot, shocked that I ovulated. Anyway, I want to get her a thank-you gift for being so kind and sweet (she even squeezed me one day when I needed an earlier appointment than the scheduler could give me). Any suggestions?

I did have a little scare during my insulin/glucose fasting and 2-hour check. I could tell I was getting hungry toward the end, and when I left I was definitely planning what I would eat when I got home. But, it was New Year's Eve and I stopped at the grocery store to pick up a few things. As I got close to the check-out, I was feeling pretty light-headed and woozy. I even dropped my ID and debit card when I tried to get them out of my wallet. I grabbed a Payday and checked out, almost grabbing it when the lady asked if I wanted to keep it out. As I walked to the car, I got the cold sweats and tingly. I ate the Payday and just say there for a few minutes. I started to feel better and decided I could make it home, where I had leftovers to heat up and plenty of cookies if I needed something more. Well, when I got home, Dr. D's office called - to see if I was OK. Apparently my glucose had dropped to 48 at the 2-hour mark - no wonder I felt so bad, as it was probably another 20 minutes after that when I was at the store. I was so grateful they'd called to check on me, as I suspect if they hadn't reached me they would have called The Man and I wouldn't have been left in a bad state too long, had I passed out or anything like that. I was told to take it easy the rest of the day, drink lost of water and eat a good dinner. That was our exact plan for our New Years' celebration, so it worked out well :).

The Results

Follicular Maturation Series
Follicle size and maturation was healthy and "normal". Ovulation looked healthy and "normal."
Lining of endometrium was too thin, not drastically, but enough to be noted and discussed.

My estradiol looked mostly good. It rose and fell normally, with a little bit of concern regarding the post-peak levels. The reason for concern is this can affect implantation.

Numbers were:
CD 9 - 106.8
CD12 - 351.2
CD14 - 171.3 (which was actually P+1, I just didn't realize it at the time b/c of my awful CM and I had my blood drawn before my ultrasound. I suspected because I'd had a temp increase, but I knew I didn't have time for the blood draw after the ultrasound.)
P+3 - 74.2
P+5 - 100.6
P+7 - 112.7
P+9 - 129.2
P+11 - 134.6

My progesterone also looked good.

Numbers were:
P+3 - 6.1
P+5 - 13.9
P+7 - 18.8
P+9 - 15.2
P+11 - 12.5

I didn't ask Dr. D, but has anyone else ever taken femera/chlomid and HCG for a time and had their numbers get and stay better after being off the meds for a time? (That is what seems to have happened.)

LH and FSH were still out of ratio. Dr. D. said they like to see close to 1:1, mine was more like 3:1.

Numbers were:
LH - 14.2
FSH - 5.4

Ok, next up was my thyroid.  TSH was within normal range (.45 - 4.5), but high for the range they like to see when TTC (1 - 2.5).

Numbers were:
TSH: 4.02
Free T4: .95

Finally, insulin/glucose results.

I don't have numbers (it's hard to write as fast as Dr. D talks and I didn't get a written copy of them). But there was no concern with this - it seems going gluten-free and running/exercise are paying off!

Recommendations/Prescriptions

Surgery to recheck tubes, to see if endometriosis has recurred, and to take cultures of endometrial lining.

Synthroid - 25 mcg/day

FertileCM and Muccinex to improve mucus quality. (And I will be switching back to unscented dryer sheets for the underwear load of laundry.)

Discussed use of va.g.i.nal estrogen to improve post-peak estradiol and endometrial thickness. Didn't prescribe it, I wonder if she's waiting until after surgery?

She took cultures of my cervix and around my urethra (I'm prone to UTIs) and discussed possibility of prescribing an antibiotic to take daily to prevent UTIs. No prescription yet, waiting for results of cultures.

How I feel about all of this is a whole other post. One I'm not sure I can write just yet, as The Man and I have to make a decision regarding the surgery. If you've made it this far, if you would please say a prayer that we are of one mind in whatever our decision is. I will also say that while I'm grateful for lots of good news, I am overwhelmed by what could potentially lie ahead and I'm trying to take it one day and one decision at a time.

30 comments:

  1. I enjoyed reading the post, I like informational posts like that. :) Anyway, I am really glad they are going to start treating your thyroid. I know there are a zillion different ways to treat the thyroid and people have a lot of different views, but at the end of the day, I am glad they are doing something. In talking with my Napro doctor, I realized how critically important the thyroid is as it really is a "master hormone" and getting in that 1-2:5 range is optimum.

    Also, I will pray for your intention about surgery and that is scary about your glucose test...glad you were able to eat something before you passed out. Ugh!!!

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  2. thyroid makes a huge difference for many people. I am "borderline" hypothyroid and will most likely hit hypothyroid at some point in my life. My mother and one of my sisters are both hypothyroid...they both crashed before anyone paid attention, so I'm glad they are doing something for you in that regard.

    Thanks for sharing...very interesting!

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  3. Prayers for you, The Man, and your doctors. It sounds like you got a lot of really great information.

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  4. Praying for your discernment!

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  5. Don't you love when you get actual numbers to put into the whole puzzle of IF? It's always reassuring to know that my body is doing something right ;-) Praying that you make the decision in accordance with God's plan -- I know you will.

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  6. Praying for peace in your and The Man'a discernment.
    Glad you were okay after your glucose testing; I had that happen to me after the 3 hour screen while pregnant with Lisbeth.

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  7. Wow so much going on! Go you for doing all those tests! I pray God guides you and the Man in discernment of next steps. =)

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  8. Praying for you and the Man!

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  9. That is a lot of information...and lots of decisions. I've been there..interesting numbers about the estrodial and progesterone numbers after stopping the meds...I didn't have mine checked when I quit the meds. Oh well...we are done trying ourselves anyways. Praying for you as you make decisions about your medical plan.

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  10. Wow! What a list. You're awesome for doing all that in one month. And those results *do* look encouraging! :)

    Praying for you as you discern your next steps!

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  11. That is a ton of information for one appointment! I don't blame you for be overwhelmed at all. Prayers that you and The Man are of one mind with all the decisions to be made. Sometimes I think that is one of the most difficult parts for me, trying to get and stay on the same page. Hugs!

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  12. That's a lot to take in! Praying for your both!

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  13. Dr. D has good luck with the vaginal estrodial. Good stuff. Maybe call and ask? I think she may have forgot. Those appts are long for her, too.

    Yay for treating your thyroid! I hope this helps that brown bleeding.

    yay for looking into the infection piece, you shouldn't have to worry about getting infections after doing the deed with your DH.

    This is all positive stuff! Yay!!

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  14. I will pray, sounds like you got lots of good info. I wrote a thank you card to the ladies who did my ultrasound series, they were so great as well. Wow, it sounds like a lot of the same things affect both our bodies with hormones, thyroid, etc. I'm reading this thinking maybe I should go back to FertileCM just to help, even though we are no longer doing HCG and synthroid. Hang in there, this is a tough road, hopefully you and The Man will find some peace in your next steps.

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  15. Good luck deciding about surgery. I feel for you, because I don't know what I'd do if my doctor wanted me to have another surgery. I'll be praying for you!

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  16. You took good notes! That sounds like a very full appointment. I'm glad for all the good news you got. Deciding to have another surgery is tough. Prayers coming your way!

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  17. Hi Rebecca, Thanks for always stopping over to my blog and your sweet comments. Praying for you as you make these next decisions, for your physical and emotional health in all of it. :)

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  18. I'm not sure I ever commented. But that thyroid looks awful.

    Synthroid will only lower you tsh by not actually improving your frees. So it makes your hypo worse rather then help it.

    Not that you would take advice from a stranger-but I'd definiteky look into armour and run like hell away from synthroid.

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  19. Praying for you as you continue to discern the next step!

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  20. Thanks for sharing your test results with us. And yay for actually ovulating! I'd love to someday have the FMS ultrasounds performed on me. My progesterone is so low the doc told me I probably wasn't ovulating, but I'd like to have that confirmed, you know?

    Glad to hear you're addressing the thyroid issues, too. I've come to discover how very much a messed up thyroid can mess up everything else in your body, that's for sure!

    I will continue to keep you and The Man in prayer as you discern what the best next step is for your journey.

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  21. Wow, yes, so much good news here! Praying for discernment on the next steps.

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  22. I've never met you and don't think we live anywhere near each other. I read your blog occasionally, but not religiously. Anyway, I had a dream that you were pregnant. I hope that encourages you.

    I had a year of unexplained infertility and a TSH that hovered around 2.5-3. I saw an RE at Yale -- I was living in Connecticut at the time. He was the first person to point out that my thyroid numbers, while technically okay, were higher than the preferred range for maximum fertility. He prescribed synthroid, and I conceived my son a week after I started taking it (the old-fashioned way) with no additional interventions. I could detect an immediate change in my cycle. I have taken a low dose of synthroid ever since and conceived my second child on the first try, no doctors involved. That's a way of saying I would ignore the poster above (Sew) who told you to run from synthroid and trust your doctor's opinion. Since you have a history of endo, I'm sure your situation is more complicated than mine. Prayers for you regardless of what you decide.

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    Replies
    1. Becky,

      You have to understand what synthroid actually does....It makes hypothyroid worse.

      All it does it gives your body a synthetic form of T4 which LOWERS your TSH. The only reason it lowers the TSH is because the body recognizes it as a thyroid hormone. It doesn't matter if in fact the body is utilizing it--which it doesn't. It will not raise your FREE T3 or FREE T4. Logically, FREES are what is available (free) for the body to use.

      The thought behind T4 is that the body is supposed to convert it to T3. A healthy thyroid makes more T4 (which is a storage hormone) and the body converts it to the life giving hormone T3. Does it make sense to put someone on a storage hormone only, assuming the body will convert it. Even a healthy thyroid makes more then just T4 only....

      Synthroid (T4 only) stops the pituitary gland from knocking on the thyroids door, which in turn makes your hypothyroid worse in the long run.

      Drinking the kool aid does not cure oneself of hypothyroidism. I'm sorry. I live a very active and healthy life without a thyroid. :) And I will continue to suggest that people find themselves better healthcare than synthroid. It does absolutely nothing and it's only through self education that one will understand why synthroid is worthless.

      I will go out and make it worse, I really think that synthroid is like the BCP. It does nothing to cure the disease. :) I'm not a doctor. I just self advocated and educated myself. I now at 34 years old can say that I feel better than I did when I was 18 years old.

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    2. And I'm not saying that you have a bad doctor at all....I actually think highly of your doctor. I just disagree with synthroid as a treatment for hypothyroidism.

      This information is not a secret. Natrual dessicated thyroid has been around since the 1800's. I could go on and on.... :)

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    3. My hypothyroidism is very mild. I presumed from your original post that Armour was some sort of supplement; I googled it and see that it is a prescription like synthroid, but with both hormones instead of just the one. Given that, I withdraw my reservations. I'm sure it works better for some people and really hope it works for her. In my case, I don't think it would be necessary, but I'll reconsider if I ever have difficulty conceiving in the future.

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  23. That's a lot of info! You must feel a little overwhelmed. You're in my prayers, as always!

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