Monday, August 17, 2009

Doctor Appointment Update

Basically...

*Ultrasound = no pregnancy tissue left, which is good news.

*Bloodwork will come back tomorrow, hopefully reflecting hCG at zero.

*Doctor confirmed I have luteal phase defect.

*Doctor wants to wait 2 cycles before starting Clomid. She suggested Clomid or progesterone, but said Clomid was a better & more effective way to treat my issue as it actually corrects the corpus luteum rather than just supplementing it.

*She also suggested I use this time to lose a few pounds so that we have even better chances of a healthy pregnancy. I'm now excited to start a health kick since I have a good goal in mind and a good timeframe to work with.

Overall a good appointment, but a little sad I'll have to wait even longer to TTC again. She said we could start trying on our own after one cycle, but if we were wanting to do the fertility treatment, she requests 2 cycles before starting. I know it's for the best, but it still sucks. At least I have something I'm working toward in the time being.

D & I are already looking into a good weight loss system we're excited about. It will make our lives really easy and keep us focused and on track. He only needs to lose 10-15 lbs and I want to lose quite a bit more... but it'll be good we're both on the same page. :o)

Friday, August 14, 2009

So much better

I am feeling a lot better. The heavy m/c bleeding has stopped. I am now barely spotting and not having any cramps. Emotionally, I am feeling a lot better since it has passed. I did get a little emotional tonight in a department store at the mall... but that's because the lady was rude to me about not getting the shower gift sooner (they didn't have stuff in stock) and I got choked up thinking about WHY I didn't get the gift sooner (was going through the m/c & starting back work). So I cried for about 10 minutes in the store and got myself together.

Monday is my big appointment. Not sure if she's going to do an ultrasound to confirm that all the pregnancy tissue is gone or not. I am going to get another blood draw done so hopefully those numbers (on Tues or Weds) will reflect an hCG level of zero. I pray she doesn't change her mind on the Clomid & progesterone or want to wait to start it or something... she has been very understanding over the phone and very proactive, so I don't have any reason to believe she will "change her mind" on me or anything. I just hope it's as easy as her saying, "ok, let's start this your next cycle, here are the prescriptions..." but I honestly have no idea how it works. Some women are monitored on Clomid... others are not. If I'm not taking a big dose of it, I won't need to be. I guess a lot of my questions will be answered Monday afternoon!

I really feel like this could be our answer. I really feel like we could be pregnant before this year is over, with a healthy, sticky baby! I have no reason to feel this hope & optimism given my history... so I'm left with thinking it's God's way of comforting me and giving me hope that it will truly be the solution. I have prayed for peace day & night. Peace for our situation and peace for what's to come. Peace for all the uncertainty and I believe I have been granted that peace. We still have a long road ahead of us and if we do get pregnant, a stressful, nerved up 12+ weeks... (who am I kidding, 40 weeks!!!) but I feel like God is giving me this peace for a reason. That's all I can really say for now.

Wednesday, August 12, 2009

I iz on drugz.

:D

Today the miscarriage is in full swing. I had to change my pad 4 times in 6 hours today at work! Cramps have been god awful. I am happy the end is near. My doctor called me with my blood draw results... my numbers are down a little. I'm sure they're down EVEN more now. She called me in a prescription for Lortab and now I'm a happy camper. Well, physically.

I'm just going to relax on the couch the rest of the night & enjoy being doped up. LOL!

PS: Aside from a little crying last night on the phone with my sis-in-law, I haven't cried since Sunday!!!!

Monday, August 10, 2009

Blood Draw #4

Today I went for another blood draw. I also had to do a urine test which doesn't exactly make sense to me (isn't the blood test more important/informative?) My doctor wants to see my numbers going down. I PRAY they are going down so I don't need a D&C or medication to induce the miscarriage. This is my current worry. I'm still spotting heavily and today I had some more cramping while at work, but it was my own fault for forgetting to take Midol with me! :o( Tomorrow I'll hear from my doctor with those results. Next Monday I have a fertility appointment and D plans to go with me. I will appreciate that very much because I've realized how much I need his support through all this. Our friendship has grown even stronger in these last 2 weeks. My love for him has grown stronger, too. When I become weaker, he becomes stronger and I can depend on him to be my rock.

Sunday, August 9, 2009

Depression

It's safe to say I have felt depression this past week. To me, depression is not a state of being that one can control or talk their way out of. It's not just feeling sad or down in the dumps. It's like a reflex that cannot be controlled and consumes you.

I hate that I have been feeling depressed for more than just the obvious of it SUCKS. I hate it because I am able to separate my mind from the situation right now and try to look on the brighter side... what's to come. But my body doesn't give a rat's a$$ that my mind is moving forward at all.

I start crying at random times, many times unprovoked. I do tend to get the crying urge more when I'm alone or feeling lonely. However, other times I just start crying in the middle of being busy or even with other people. And it's not even when I see babies or something like that. It's just a reflex. I have a permanent knot in my throat and at any given moment, I am liable to burst into tears.

I have had a really hard time picking myself up. I have tried really hard, too. I have tried to keep myself busy. I've tried to surround myself with friends/family. I've gone out to eat a few times and tried to maintain a normal life. D even took me shopping yesterday and I got some great new clothes for work, new shoes, and went to a nice dinner. I have not been just sitting around moping all day... but inside, I am miserable. No matter what I'm doing, I am feeling terrible. I'm exhausted, emotionally, mentally and it's taken a physical toll, too. My mind is not all there in whatever I'm doing. I do not feel like myself.

I know that it takes time to grieve and I need to take it one day at a time. Believe me, I know. I've been through this before. Even though my mind is feeling more optimistic this time around, my emotions are way worse than the first miscarriage I had (and that's pretty hard to beat). I don't know if it's because I've realized there is a problem with my body and yes, there is a CHANCE that I may never be able to carry a child. I have hope that I will, but that is always in the back of my mind.

People have told me I have the "good problem." Apparently, it's good that I can GET pregnant, but can't carry the baby? Really? This is the GOOD problem? Sorry, but to me it seems like a *slightly* better alternative to have problems getting pregnant but can carry the baby when you do get pregnant. There are so many possibilities out there that can help a woman conceive, but there are not nearly as many opportunities to help a woman carry that child. And both problems suck, if you ask me. I don't have the "good problem."

I just wanted to write out my feelings because I had hope that it might help me in some way. I'm not sure if it did... I guess we will see. It has been a miserable week and the weekend has been pretty sucktastic, too, for more reasons than just this.

Friday, August 7, 2009

Doctor Called

I really like her. I have to say, after my first miscarriage, I thought she was a bit "cold." Perhaps I was just overly sensitive at the time, but I really think now that she's had a baby of her own, she has really turned into a much more caring and personable doctor. She happily answered all of my questions and we set up a game plan.

I am going on Monday for another blood draw. She would like to see my numbers coming down. I am spotting/bleeding now. It has definitely not gotten heavy yet (even though this morning I thought for sure it was here....) and I haven't had any cramping yet either. So I imagine if my numbers don't come back less, she will want to do something to help the miscarriage along. I just hope it happens over the weekend on its own.

Then, a week from Monday (the 17th) I have an appointment with her to discuss our plan of action. I'm going to present her with my charts (both online and hard copy) and our phone discussion consisted of discussing Clomid and progesterone.

She said we can begin TTC again after my first normal period. This current bleeding does not count as a period. So it'll be over a month before we are TTC again. I'm okay with that because honestly it'll take me a little time to be emotionally ready again. Right now I'm crying unexpectedly. I think it's because the miscarriage is looming ahead of me and I'd just like it to be DONE and behind me. You know?

So I believe the plan will be Clomid & progesterone. I also want to start taking Vitamin B6 as an additional supplement to the pre-natals I'm already taking. B6 can help lengthen luteal phase. I actually feel an ounce of hope for this coming medicated cycle. I feel like it really could be the answer to the recurrent early miscarriages. I feel really thankful that modern medicine has allowed for this issue to be corrected... what a blessing.

Not much else to say other than I'll update as updates come. Please continue to pray for us that this miscarriage hurries up & passes without too much additional heartache and stress! I appreciate it greatly.

Here's My Problem

This is why charting is so valuable. Without charting my cycles, I would have had NO idea that my luteal phase was too short to carry a baby. I wish I had known before conceiving this time, but I'm comforted in knowing that going forward, we have a plan of action to correct this problem and hopefully, God willing, we will have success next time. I will be starting Clomid and Progesterone my next cycle. Feel free to real below what my problem is with my cycles. Of course, miscarriage can happen for outside reasons as well. My doctor and I believe this is why I've had 2 very early miscarriages.

What is a Luteal Phase Defect or LPD?
Luteal Phase Defect

A luteal phase is the time in a woman’s cycle between ovulation and menstruation. In a pregnant woman, during the luteal phase the fertilized egg will travel from the fallopian tube and into the uterus for implantation. The luteal phase is normally 14 days long and on an average it can be anywhere from 10 to 17 days long. If your luteal phase lasts anything under 10 days it is considered a luteal phase defect. But some doctors believe that if the luteal phase falls under 12 days, then it is a problem. If you conceive and you have a luteal phase defect, you will have an early miscarriage.

A luteal phase defect cannot sustain a pregnancy because the uterine lining in these women begins to break down, bringing on the menstrual bleeding and causing an early miscarriage. There could be more than one reason for the luteal phase defect which can be found out after medical analysis. Going by statistics, the number one reason for a luteal phase defect is low progesterone levels. Your doctor can do a progesterone test on you 7 days past ovulation to determine exactly how deficient you are. Once you know that there are several ways of correcting this defect.

Causes of Luteal Phase Defect
The three main causes of luteal phase defect include poor follicle production, premature demise of the corpus luteum, and failure of the uterine lining to respond to normal levels of progesterone. These problems occur at different times during the cycle but can also be found in conjunction with each other.

Poor follicle production occurs in the first half of the cycle. In this case, the woman may not produce a normal level of FSH, or her ovaries do not respond strongly to the FSH, leading to inadequate follicle development. Because the follicle ultimately becomes the corpus luteum, poor follicle formation leads to poor corpus luteum quality. In turn, a poor corpus luteum will produce inadequate progesterone, causing the uterine lining to be adequately prepared for the implantation of a fertilized embryo. Ultimately progesterone levels may drop early and menses will arrive sooner than expected resulting in luteal phase defect.

Premature failure of the corpus luteum can occur even when the initial quality of the follicle/corpus luteum is adequate. In some women the corpus luteum sometimes does not persist as long as it should. Here, initial progesterone levels at five to seven days past ovulation may be low; even if they are adequate, the levels drop precipitously soon thereafter, again leading to early onset of menses and hence a luteal phase defect.

Failure of the uterine lining to respond can occur even in the presence of adequate follicle development and a corpus luteum that persists for the appropriate length of time. In this condition, the uterine lining does not respond to normal levels of progesterone. Therefore, if an embryo arrives and tries to implant in the uterus, the uterine lining will not be adequately prepared, and the implantation will most likely fail.

Correction of Luteal Phase Defect
Fertility charting is an easy way of detecting whether you have luteal phase defect. If you do, don’t worry because luteal phase defect can be easily corrected. Immediately seek the advice of your physician first before starting any treatments to correct it. In most case, luteal phase defect can be corrected through over-the-counter remedies and/or with prescription drugs.

1. Over the counter remedies for luteal phase defect:The two main over the counter remedies for luteal phase defect are vitamin B6 and progesterone cream. Vitamin B6 is perfectly safe and can be taken daily in dosages from 50 mg to 200 mg. Taking vitamin B6 every day during the entire month will help to lengthen the luteal phase.

A progesterone cream is usually targeted for menopausal women; however this cream is also useful in lengthening the luteal phase. A cream with natural progesterone works best. Use about 1/4 to 1/2 a teaspoon of progesterone cream spread on the inner arm, inner thigh, neck, and chest - alternating places - twice a day from ovulation to menstruation or until the 10th week of pregnancy.

2. Prescription drugs for luteal phase defect:The most common prescription drugs for luteal phase defect patients are Clomid or progesterone suppositories. Clomid is taken orally as prescribed by the doctor. The suppositories are taken through the vagina after ovulation has occurred and until either day 14 post ovulation or at some point weeks later during a pregnancy, if pregnancy occurred.