Tests. And more tests. Yay!

So, my progesterone is normal, and I have to say, I'm a little surprised. 

Let me backtrack:  I visited my RE a few weeks ago, complaining of a very spotty, light period.  Of course the return of my AS was a primary concern, but then my RE took a look at my ovaries via ultrasound and of course gets me completely freaked the fuck out about how one of them is "puny," perhaps I am facing Diminished Ovarian Reserve (DOR) and I could be in a "fertility crisis" (note to RE:  please, I implore you, never use the word CRISIS with me.  Ever).  She sent me home with a fair degree of nail-biting paranoia, insomnia and scripts for more blood tests, a Progesterone check on calendar day (CD) 21 of my Cycle and the FSH/Estradiol/AMH combo on CD 3 (which will fall next week) - this one to assess just how many good eggs I could have left in me.

Low progesterone is common cause of premenstrual spotting in women my age, so I was sure that I would get a call saying I needed to go on a hormone supplement.  Instead, I got a call saying my progesterone is fine, asking that I come in for a sonohysterogram to take another look-see at my uterus.

First, the sonohysterogram: This is a test where a catheter is inserted into your uterus, which is also being monitored by ultrasound.  The catheter is hooked to a line of saline, which then fills your uterus, so that a doctor can get a visual image on any potential abnormalities, such as polyps, or fibroids, or other anatomical issues. This test is reportedly painful as all fuck.

And yet, as is par for the course for me, I am THRILLED to be getting this done next week.  My guess is that my RE is looking for a polyp or fibroid near my ovary causing spotting.  But I have had a nagging fear that my cervical scar tissue has returned, so if a catheter can get in there, it means that there is at least some passage way.  Likewise, the catheter could break away any tissue present.  Or, alternatively, if the catheter doesn't get in, I at least know to hop a plane to Boston for a fun in-office hysteroscopy with my miracle doctor.

And pain, well, I figure if I could have scar tissue cut from my cervix without anesthesia I can get through this right?  And I don't have to fly into Logan (yet).

What my current RE lacks in the warm and fuzzies, she more than makes up for in competence, I think. 

What a difference an injury makes

Wow, can I just note really quickly that I can honestly go more than two hours straight without thinking of babies, or fertility, or scarring, or miscarriages or diminished ovarian reserve now that I am hobbling around on crutches and my leg is in a considerable amount of pain?  AWESOME!

Down the Rabbit Hole

Today I saw my RE to discuss my wonky periods.  Needless to say, I'm headed down an incredibly dreary path that will be recognizable to other women my age.  The good news:  a "beautiful" uterus (not something us AS gals hear too often) and one decent ovary that likely has an appropriate number of eggs for a gal my age. 

The bad news:  one "puny" ovary that is very likely putting me on the path of Diminished Ovarian Reserve (DOR).  I get to look forward to progesterone testing in exactly 2 weeks, and then more detailed hormonal testing two weeks after that to determine just how realistic is for my aging ovaries to knock a healthy egg out.  Depending on the outcomes of that testing, there could be some highly uncomfortable conversations in my future about what lengths I want to take medically to conceive.

I never imagined I would be in this position, hell, few women do.  About 18 months ago we formally started down the road to giving niblet a much wanted sibling.  While I certainly rationalized that a miscarriage could result from a pregnancy, I never imagined that I would lose over a year of my fertility in the process.  I certainly could never envision two medically complicated miscarriages, one with an instruction to stall trying to conceive for over 6 months of time.  That time I lost could have well turned out to be crucial. 

And it's hitting me that both internally and out, I have a very different body from the one I started out with those 18 months ago.  My obsessive exercising has done little to shed the weight of my last pregnancy, and it's not lost on me that I am walking on crutches right now, without any clear idea of how long my recovery will be.

Whoa.  This is a total bummer.

With that, I am off to my first acupuncture session.

Another PSA

Well, things are looking up.  Sure, I'm on crutches, and I'll need physical therapy, and it's raining so hard that we're all walking around looking like pathetic drenched kittens, but it's a torn muscle behind my knee, not a ligament, and I won't need surgery, so I'll take it! 

But the better news is that my RE can actually squeeze me in this coming Monday to start investigating my wonky period, including setting me up with progesterone tests.  What a difference a new doctor makes.

So here's my public service announcement for the week, the one I will never stop repeating:  PLEASE, press your doctors if you feel that something is wrong.  YOU know your body better than anyone (and if you don't, YOU have the power to learn it's rhythms and cycles).  If your doctor is dismissive of your concerns, seek out a second opinion. 

Every day I check the support boards and read the post of some poor soul who is spotting, or whose period is lighter or maybe she has a weird cramp, and her doctor is all "ehhh, you're worrying too much, a woman's body isn't always like a clock, sometimes things are a little out of whack, it's probably nothing."  Ughhhh, this is often times a seriously wrong answer.  Because how many of us just know our bodies tweaks and quirks when something appears or feels off?  I bet a whole lot of us. 

Good god, it's hard enough for so many of us to get pregnant, or maintain a healthy pregnancy once we get that BFP.  Adding on the weight of a doctor who won't listen or help when we believe something is wrong is time and energy that none of us have to waste.

A brief interruption from our usually scheduled fertility thoughts

So you know how I do all of that dancing to keep my spirits up and my head together and boost endorphins to stave off depression?

Yeah, well, I am waiting on an MRI today because friends, I cannot walk, and I am fairly sure I popped a ligament in my knee last night during what was an otherwise tremendously fun and challenging ballet class.

Which is kind of funny, because I was all depressed about my wonky period this week, and wanted to dance in order focus my thoughts on something that didn't involve my uterus.

And now I get to wonder whether I need arthroscopic knee surgery. 

YOU WIN UNIVERSE.  You fucking win.

Thinking about Postpartum Depression

When niblet was born I was sad.  Very sad.

My OB, in hindsight, didn't ask me many questions about how I was feeling.  I am fairly sure I filled out some sort of standardized questionnaire about my feelings at my 6 week visit, but I am pretty confident I would have checked off all of the boxes that said "nothing to see here, kids, all's honky-dory."

Niblet's pediatrician showed a few signs of concern at her early well-baby visits, given that I was a quivering teary-mess.  She had colic, you see, and cried for about 8 hours straight every day, from about 3-11pm  (no, really, I promise you, I am not exaggerating.  I wish I was).  He explained the "baby blues" and noted that once niblet started adjusting to the world better, in a few weeks I would feel better too, my hormones would regulate, things would look up.

Unfortunately, they didn't.  I was still pretty fucking sad well after the normal two-week period of baby-blues had passed.  And with the sadness came guilt.  How could I be depressed?  What kind of ingrate was I?  I had given birth to this incredibly beautiful, stunning life.  Relatives came to stay, friends came to visit, we were literally immersed in love, we were truly a lucky little family.  But it didn't matter, I just felt awful and powerless.  And very afraid.

It's difficult for me to conjure the memories of the many months that I felt on the verge of breaking during niblet's infancy.  But while many friends expressed concerns about my well-being and stability, I never actually sought additional medical help.

My hormones started regulating - or at least, my depression abated -  after about 5 months of what I consider "phoning in" my mothering.  Don't get me wrong, Niblet was nursed and hugged and carried and cooed at and given all of the attention plus some during those early months, but I often felt like I was having an out of body experience while devoting that attention.  Anyone looking at me would see an ordinary mom enjoying her newborn, and not the reality of a scared mother who spent many hours feeling disconnected and dead inside. 

I was obviously driven to write this post by the recent capitol hill shooting.  It got me thinking about my own circumstances, how even with great access to medical care and an extensive support network of friends and family (including a husband who is incredibly "hands-on" about fathering), my less-than-picture perfect reaction to childbirth was incredibly frightening.  It also got me thinking about the only other times I ever felt this deep, dark weight - after my two miscarriages (though more acutely with the first one, characterized by through the roof HCG levels, when I had carried my doomed cancer baby for nearly three months).

Women who suffer miscarriage are often told to just go home, rest a day, stay out of swimming pools and warm baths if they've had a D&C, and refrain from sex for a few weeks. My own OB actually told me I would be physically "just fine" one day after my first D&C.  I don't know about you, but no one ever explained to me that I would feel awful, not just from existential grief, but from the rapid hormone drop I would experience.  In a way, I was lucky to know my body so well from my past experience, I could anticipate what I knew would also be a dreadfully painful physical reaction to my miscarriage, let alone the emotional one.  And lo and behold I anticipated correctly, because the depression that came on was a doozy. 

I wonder how many women out there are suffering very real physical hormonal after-effects of miscarriage and told to basically suck it up and get on with their day?  How many women who carry babies and lose them in their second and third trimester are being monitored?  Yes, some people expect them to be sad, but how many doctors are really watching for the potential after-effects of very real chemical crashes they are experiencing?

Beating back the doldrums

As I head down the final stretch of yet another two-week-wait I am really trying to do a better job of keeping my wits about me.  Last month's emotional meltdowns were, well, really fucking exhausting. 

Also, as many babycenter lurkers know, October 15th is National Infant Loss Awareness Day.  Many virtual friends will be wearing ribbons, lighting candles, attending walks and vigils.... I just learned that I will be getting my yearly employee evaluation that day.  Nice timing universe, the last thing that will be on my mind will be my fertility.  So really (!) nice timing universe.  I now acutely understand the mixed emotions that come with a day of recognition.  On the one hand, I am heartened that people have a public forum to acknowledge the real losses they have experienced.  On the other hand, my miscarriages are carried with me on a daily basis. 

This month I am trying to be physically proactive about beating back the depression that will inevitably creep in when I pee on sticks and get big fat negatives (BFNs for any random readers unfamiliar with fertility speak).  I'm taking a ballet class this week, because you can't possibly think about your shriveling old eggs and the weight of your own mortality when you're trying to execute pirouettes, I promise you.

And next week I have an interesting new addition to the justonemorebaby wellness regime, acupuncture.  There's reams of (virtual) literature out there about the benefits of needles directing blood flow to your uterus, unblock your chi, stimulating hidden superpowers (can mine involve vacuuming?) and whatever the fuck else they do.*  I mean, it can't hurt, and I am one of the lucky few in the US whose employer covers it, so cost isn't an excuse.  Why the hell not, right?  I have heard that quite simply, it makes you feel good, and that's as good a reason as any for anything in my book.

For those who are wondering, other elements of the justonemorebaby wellness plan include a daily dose of (VERY EXPESNIVE) Co-Q 10 supplements and prenatals.  Co-Q 10, for the uninitiated, is like, the magical wonder vitamin, so if Co-Q 10 can't help me, nothing can.  Oh, and I have also significantly scaled back my caffeine intake.  I haven't completely eliminated it, mind you, because I would like to have a few friends and family members want to take care of me in my old age.  I'm sort of like the Hulk while operating sans tasty stimulant (albeit shorter and not green) in this respect - "Please don't make me angry.  You wouldn't like me when I'm angry."

*I say this will all due respect to practitioners and believers in Eastern Medicine.  No really, I'm not being facetious here, my Dad is - no shit - a tai chi master - and I will take the advice of an experienced acupuncturist, over the advice of dipwads who couldn't figure out that my cervix was sealed shut, ANY day.