Tamoxifen

We have had a couple of cycles now without taking fertility medication. I would say months but my cycles are longer than that! Last one was 7.5 weeks! sigh...

We wanted to give my body a chance to recover and be drug/hormone free after we miscarried baby #2. It does worry me occasionally that I am taking medication designed for women with breast cancer!

As you may remember, our fertility specialist wanted us to go to daily injections as our next step. We talked and talked about it and in the end I just am not ready for that step yet. It is costly (although not as much as an In Utero Insemination - IUI - or In Vitro Fertilisation - IVF). It also means taking regular trips up to the city to Hollywood Private Hospital here in Perth for testing and more injections. Nick would also have to undergo further testing.

So my Doctor decided that there was one more drug we could try before that step. It's called Tamoxifen. I take the tablets in a similar way to the Clomoid except twice a day - days 2-6. It works out to be 20mg a day. I have now finished taking the first course of medication and am very happy to say that I had NO SIDE EFFECTS!!! Wow! This is huge for me considering I ended up so sick with the Clomoid - especially that last round where I was on double dose.

I am also thrilled to report that I have now lost 12kg! What started as weight loss due to being so sick with the Clomoid and during the early pregnancy before the miscarriage (and lets face it - the 3-4 weeks afterwards that it took for my hormones to get back to non-pregnant levels), has continued and I am only 4kg now away from my goal! I had a goal of 16kg to lose. I am also excited that I am only 2kg away from being a BMI of 25! This is the recommended weight range for someone my age and height. Losing 4kg will put me in the middle of the recommended weight range.

I have managed to do this largely to eating smaller meals and eating healthier foods. When I say smaller meals, I don't mean starving myself! I realised while I was sick that my body didn't need to eat as much as I had been eating at meal times in order to be satisfied. I think I had been overeating by eating a large meal instead of having the smaller portions recommended. Now I eat about 1/2 - 2/3rds of the size meal I used to eat. It's still a decent sized meal and I find if I try to eat more I actually start to feel ill from overeating. I'm guessing perhaps my stomach has shrunken back to it's normal size from being stretched by larger meals? I have no idea if this is biologically correct but that's what it feels like :)

It has definitely been helpful to have our Thermomix. I have to give it a shout out - we are just eating so much more healthily than before. I cook from scratch making my own pasta sauces etc so we don't have the preservatives and other bad bits. It takes me as much time (or often less) as it would using a pre-packaged sauce/packet to cook and also uses all fresh ingredients which makes it taste just so much better! I'm so pleased to be able to get more fruit and vege's into James as well.

One final thing to note. I am feeling good. I mean REALLY good. Leading up to our miscarriage and dating back years now that I think about it, I was feeling so stressed, run down, depressed and anxious. All this fertility stuff really does impact your whole life. Since losing baby #2 (yet to be named) I have really focused on 3 things which have made all the difference in my life as so many of you have mentioned that you can see the difference.

1. Spending more time with God. Reading my Bible if not every day then very close. Praying. Meditating on His Word. I feel refreshed in my spirit and soul. It's truly been like living water to a thirsty person. I am so thankful that what started out as something I really needed to encourage myself to do is now becoming something I really look forward to and can't wait. I am getting such a hunger to read more of God's Word, even though I am working my way through from start to finish as part of a 30 by 30 goal and am currently in the "boring" books such as Leviticus and Numbers.
2. Gratitude. Thankfulness. Appreciation. I have been thinking about these things so often and most often in relation to Nick and James. I am so thankful to have a loving husband who cares for me, loves me unconditionally, looks after me when I'm sick, is romantic and passionate, loves our son to bits and will do anything for our family including working so so hard so I can stay at home with our boy these last few months before he starts school. I am so thankful for our amazing son James who has finally come out of the grumpy, angry, frustrated 4 year old stage where we were having mammoth tantrums 2-6 times a day and is the most caring, considerate, quick to say sorry and apologise for his behaviour, funny, energetic, compassionate, playful and just so huggable! Gratitude. Being thankful for what I do have and looking forward to the future.
3. Getting healthy. In body and mind. Spending time relaxing when I am worn out rather than piling more things on my plate. Eating better. Trying to be more active with James. Taking more care in the way I dress and look. Going to sleep earlier. Keeping house better.

I look forward to seeing if we will have a baby to announce at New Years!

International Pregnancy and Child Loss Month

We lost our first precious bundle at 9 weeks pregnant. We lost our third baby at 6 weeks. It was a traumatic and horrible experience. Unless you have been there yourself, it is hard to really grasp the depth of feeling and trauma.

This is a song I found written by Pink about her miscarriage. Stay strong everyone.

Have you tried...?

"If you stop thinking about it, it will happen."

"Just relax and don't stress"

"You need to pray about it more"

"You need to trust God more"

" You need to ......"


For someone who suffers from infertility, you sure do get a lot of advice handed out by (usually) well meaning people. I came across a funny picture today which made me laugh and I thought I would share it with you all so you know what we have tried!

We have tried:

1. Vaginal Ultrasound
2. HSG/Hysteroscopy
3. Blood tests - 16 viles in two days!
4. Laparoscopy
5. 2-hour Glucose
6. PCOS Panel
7. Semen Analysis
8. Pelvic ultrasound
9. Hormone Testing
10. Clomid
11. Metformin
12. Temperature recording
13. Intercourse recording
14. Saliva ferning recording
15. Low fat diet
16. Chia seeds
17. Low-cholesterol diet
18. Pre-natal vitamins
19. Vitamin B
20. Nurse practitioner
21. Midwife
22. Family GP
23. OB-GYN
24. Fertility Specialist
25. Radiologist
26. Exercise
27. Prayer
28. Meditation
29. Visualization
30. Promises
31. Bible reading
32. Fasting
33. Crying...

• at church
• at baby showers
• at grocery stores
• in hospitals
• everywhere
• in the car
• in the bathroom (after negative pregnancy tests) CONSTANTLY
• in Hubby's arms
• hugging our son
• storing away James' baby clothes
• dismantling the cot
• giving away baby items

34. Different positions

35. Just relaxing

36. More sex

37. Less sex

38. Thinking about adoption

39. Thinking (and applying for) Foster Caring

40. Not thinking

41. Researching options

42. Giving it time

43. Hoping more

44. Hoping less

45. Getting a pet (Hello Mr Darcy!)

46. Worrying less

47. Worrying more

48. Being happier

49. Being thankful for James

50. Being thankful in general

51. Being less selfish

52. Trying to be a better mother to deserve another child

53. Elevating my hips

54. Taking a holiday

55. Stop trying for a month

56. Denial

57. Grief

58. Bargaining

59. Depression

60. Considering just having one child...

So there you have it - 60 things we have tried. I don't mean this post in anger or bitterness. It is just meant to be an enlightening of what couples with infertility can go through. So support your friends and family who may being going through this. It is a long and hard journey to travel through. Be kind to us :)

Round 1 of Clomid

I made it! I'm through!

I have just finished my first round of 5 pills of clomid. I had to take the Clomid once a day for 5 days from CD2-6. This little pill will help my system produce more of the hormones it needs in order to mature eggs to ovulate.

I had a fairly smooth ride with the Clomid thankfully. I have read of people having shocking headaches, nausea, hot flushes... Thankfully I only really experienced one symptom - nausea.

I didn't start to experience the nausea until CD4 (2 days into taking the Clomid). I then experienced it each day after that until the day after I finished the meds. It got worse each day culminating with the 5th day of taking the pill. I ended up with my head over a public toilet while shopping at Harbourtown! Eww! Thankfully I wasn't sick in the end but yuck it wasn't nice! I drove home with an empty shopping bag in the centre console of the car ready just in case.

So now it's on to the tests to see if I am likely to ovulate this month! Today being Monday (CD7), This is what's in store for me this week:

• Tuesday CD8 - Blood test. This is to check my hormone levels which will indicate if I am likely to ovulate and also whether it looks like I will release more than one egg. If my levels are greater than 2000 then we will be advised against trying to conceive this month as the chance of multiple pregnancy will be greater.
• Thursday CD10 - Ultrasound. This is to measure any eggs (follicles) that are present. If there are greater than 3 eggs measuring 16mm or more, then again we will be advised to avoid trying to conceive due to the risk of multiples. 

So that's what I'm doing this week. What is happening in your world?

PCOS

PCOS. What on earth does that mean?

My diagnosis of Polycystic Ovarian Syndrome makes a ton of sense. After all these years I can finally put a name to what is wrong with me.

Ever since I began my monthlies I have been irregular. I never settled down to the 4 week cycle and it bugged me to no end. With cycles anywhere between 3 weeks to 11 weeks, I always knew something wasn't right. I saw a gynecologist when I was 17 who performed a laparoscopy but had no findings.

The Encyclopedia defines PCOS as:

Endocrine (hormonal) disorder in women, characterized by high levels of male hormones (androgens) and infrequent or absent ovulation. It causes a high proportion of female infertility cases. Symptoms vary but often include increased serum concentrations of androgens,insulin resistance, hirsutism, acne, and obesity. Menstruation may be irregular, absent, or excessive. The ovaries are usually enlarged and contain cysts.
Encyclopedia

Source: womens health

It wasn't until I went back and read the symptoms of PCOS when the light bulb went off in my head and the last 13 years of my life made more sense!

SYMPTOMS:

The symptoms of PCOS can vary from woman to woman. Some of the symptoms of PCOS include:

• Infertility (not able to get pregnant) because of not ovulating. In fact, PCOS is the most common cause of female infertility. Check!
• Infrequent, absent, and/or irregular menstrual periods Check!
• Hirsutism (HER-suh-tiz-um) — increased hair growth on the face, chest, stomach, back, thumbs, or toes Thankfully no!
• Cysts on the ovaries Check!
• Acne, oily skin, or dandruff Sigh. Check.
• Weight gain or obesity, usually with extra weight around the waist *looks at latest photos of self* Check.
• Male-pattern baldness or thinning hair I don't think so?
• Patches of skin on the neck, arms, breasts, or thighs that are thick and dark brown or black  check.
• Skin tags — excess flaps of skin in the armpits or neck area a couple - check.
• Pelvic pain check.
• Anxiety or depression check - at times. I had bad Post-natal Depression with James but not sure that comes under this diagnosis.
• Sleep apnea — when breathing stops for short periods of time while asleep Hmmm will have to ask Nick if he's noticed anything...
  womenshealth.gov

I also found out that many women with PCOS go on to have a higher risk of miscarriage and pre-eclampsia (high blood pressure during pregnancy) - both of which I have had. James had to be born a couple of weeks early due to my blood pressure levels being at dangerous levels and platelet count dropping (I'd bleed out). 

Everything just makes sense now. All these things I thought weren't connected actually came from the same problem! Finally I can move on and start to work towards treating (there is no cure) what I have and working towards another baby. No wonder we weren't getting pregnant if I wasn't ovulating!

If you or someone you know has many of these symptoms, I would encourage you to catch up with your Doctor. PCOS is not just a problem if you are trying to get pregnant but can also lead to some serious problems such as diabetes, high cholesterol, heart attack, endometrial and ovarian cancer. Treatment is available and a healthy lifestyle can help. 

If you suffer from PCOS I would love to hear from you!

Trying to get some answers

James was growing and becoming a fun loving little boy. We were enjoying (almost) every minute of it! Sure there were hard nights when he wouldn't sleep, breastfeeding didn't work after 12 weeks of trying and expressing full time, and we had some hard times with reflux - but all in all it was awesome!

Around James' first birthday we decided that we were ready to start to give him a baby brother or sister. The waiting game started all over again. When we had been trying for number 2 for just over a year we went to the GP to ask for some help. I had an ultrasound done. It came back showing several cysts - 5 on one ovary and 7 on the other. I was told that I didn't have "enough" cysts (at least 10 on one ovary) to be able to be diagnosed with Polycystic Ovarian Syndrome - PCOS. We were referred to a fertility specialist in our area. I rang to make the appointment and when I was told that it was $260 for the first appointment, we decided to try to wait a bit longer. We just didn't have the money like that at the time. 

So we waited... and tried... and negative tests... and waited... and tried... and more negative tests... You can see the pattern.

We got down. We got upset. I cried many months when the tests came back negative. Nick had to pick me up again and again. When were we going to get pregnant?! Lord why are we not having another baby yet? What is wrong with me?! I can't do what a woman is meant to be able to do!

James' 2nd birthday went by. No baby. His 3rd birthday went by. No baby. It's time we have to suck it up, save money, and see the specialist. 

This was absolutely me!

September 2012 we visited the GP again who did some blood tests. They came back with Insulin Resistance and higher levels than normal of testosterone. The Dr perscribed Metformin - a drug that manages and treats insulin resistance and is often used with diabetic and PCOS patients. I was on that for a couple of months until she gave me a referral to the specialist. 

In Jan 2013 after waiting two months for an appointment we finally saw the fertility specialist. At this stage we had been trying for number 2 for 2 years and 5 months. I was so nervous about what they would find out. The specialist was so nice and put me at ease - even though he was a male looking up there! He took a couple of swabs and ordered a full slate of blood tests, an ultrasound and a test nicknamed HSG - Hysterosalpingogram. 

I had to do the blood tests in two lots as they needed to take so many different viles! I also had to do a glucose fasting test which meant no eating from the night before - get a blood test taken when I arrived at the pathology lab before drinking a horrible yucky sugar drink - sit there waiting for 1 hour and do another blood test - sit for another hour and do another blood test! My arms were aching at the end of that! I ended up with a big bruise on one arm from the sympathetic nurse taking blood in the same spot twice!

I had to do my ultrasound on CD4 (calendar day 4 of my cycle eg 4 days after I started my period). It came back with several cysts again on each ovary. The same mostly as my ultrasound a year and a half earlier. The HSG test was something I was nervous about!! I had been told by the specialist to take 3 codeine before I had the test done. A radiologist inserts a spectrum (the duck lips they use on you to open your vagina up when you have a pap smear). Then they clamp your cervix and open it in order to insert a tube into your uterus. Once the tube is in they blow up a little balloon inside to hold the tube in place and prevent it from slipping out or moving. Once everything is in place they insert a dye. If your tubes are clear the dye will show up on the xrays as filling your uterus, down through your tubes and then spill out in a cloud into your abdomen. If you have any blockages then the dye will not show up spilling out of the end of the tube.

I expected pain and yes there was some. I think perhaps there had been a small blockage as the pain occured when they pushed the dye through. I had clear tubes but the radiologist said that the pain may have been pushing some debris out of the way before it cleared the tube. This test was done on CD 8 (needs to be done between CD7-CD10). 

Last week - 18th of April 2013 - I went back to the specialist to get my results. Yes I have cysts but again not quite "enough" to be diagnosed with PCOS. The HSG showed clear tubes. The blood tests however showed more than enough data to diagnose PCOS and so the diagnosis was made. I have high levels of insulin resistance and high levels of testosterone because of it. 

I have been put on a medication called Clomid or Clomiphene. It is a common fertility drug used with PCOS patients. I will be starting this today - Tuesday 23rd of April 2013. I will detail more about this later this week and will follow through with posts about my experiences. 

I want to say a quick thank you to those of you who have written to me to express how reading our journey so far has encouraged you or someone you know who is going through fertility issues. I really hope and pray that you will get some answers for yourselves soon! I love reading your feedback and stories so please - keep them coming!

The waiting game

We left New Zealand with heavy hearts. Heavy because we were leaving friends and family behind but also heavy because we were leaving after losing our first baby. Things got a lot harder on us with two of my sister's announcing their pregnancies in close succession as we arrived in Perth - babies that would have been less than two months younger than our baby would have been. It took me a long time to be able to walk into a shop and buy them a baby gift, knowing that it would have been us needing the baby items had things been different.

We started trying again after waiting the recommended 2 months after a miscarriage and the waiting game commenced again. Nothing happened. We endured the endless questions from well meaning people "when are you going to have a baby?" responding with "We're trying!" My Mum made the joke that we should have shares in the pregnancy test business - the amount of tests we went through! It got to the point where I just didn't expect to see two little pink lines on the tests anymore.

At one year of trying after our miscarriage, we went to see the Doctor to see what was happening. He was so unhelpful and gave us our second lot of "oh you're so young, keep trying and come back in a year". Thanks. That helps.

December 2008 - we decided that we were going to really commit ourselves to praying about a baby and ... uh.... trying - A LOT. We prayed over my body that it would do what it needs to do and be able to maintain a pregnancy. We prayed over timing. We prayed over Nick's body. We prayed over the baby we were believing for - over each part of his or her body that it would be healthy and perfect. WE PRAYED!

I was due to begin my next cycle on the 23rd of December - just before Christmas. I prayed with everything in me that we would get a positive test that day. The 23rd came. Nick and I spent the day doing some last minute Christmas shopping and returned home that evening at about 8.30pm. I popped into the bathroom to do the test with such an expectant heart, inside cringing for the letdown that I had come to expect each testing time. Before the liquid had even finished covering the whole test result area we had two pink lines! I raced out of the bathroom and stopped frozen in the lounge room staring at Nick sitting on the couch.

"I'M PREGNANT!?!"

We both were shocked and kept checking over and over again the test result. I raced back in and did another one (I bought a pack of 3) and sure enough - two pink lines!! Again they were like the tests I did with our first pregnancy - a lighter pink line and a darker one. I had done so much research by this time that I knew it didn't matter how dark the lines were - just that there were two! I couldn't believe it. A baby. Finally. A BABY!

We got to share with our family our news in a way that was so memorable and special to us. We asked to be put on speaker phone when we called Nick's family in New Zealand on Christmas Day. Everyone let out excitement and it was so fun to give them a Christmas present - the news of their first grandchild / niece / nephew / great-grandchild on the way.

With my family here in Perth we shared the news while opening presents. When everyone had done with opening the presents in my parents lounge just before a big Christmas lunch, I said to my Mum "oh! I forgot! I have a card that goes with your present". I feigned disinterest in watching her read it while talking with my sister across the room. I waited and waited holding Nick's hand until she got to the end of the card

"Dear Mum and Dad,
We just wanted to thank you for everything you have done for us since we moved to Perth. You've been such a great help and we appreciate it more than you know. We wanted to give you a present to say thanks but couldn't think of a better one than to give you another grandchild - due September.
Love Ali and Nick xx"

My Mum let out a squeal and looked up at me and said "Really??!!!" I started crying and said "YES!" and we jumped up and started hugging. Everyone else in the room started asking questions about what was going on and Dad read the card and pretty soon everyone understood what was happening. It was the most perfect way I could think of to announce our news to my family and I cherish the memories.

James was born 2 weeks early via C-Section due to some complications with Pre-eclampsia. We were in shock as we had been lead to believe we were having a girl at our 20 week scan! We were overjoyed with our surprise little boy and quickly worked to replace the pink with blue. He has been such a joy for us and we love him to bits! He is now a happy, healthy, bouncing, almost 4 year old boy who makes us laugh daily. He was well worth the wait!