And the MRI Results Are In....

When my doctor's office called on Thursday and told me my MRI results were in, I was beyond ready to find out what they were. They did not tell me the results over the phone, as they usually do when a result is completely normal, so I figured there must have been something found. On the other hand, they did not ask me to immediately come in for a consultation, so I figured my brain would not be exploding at any given moment. They scheduled me to come in the next Tuesday, which happened to be today, so I went home and began the feverishly searching Google for updates on my demise.

My doctor probably thought I was pretty smart, because today I was pretty much an expert in the pituitary gland and its role in the endocrine system. I have slept thousands and thousands of times since my last biology class, so the free Google refresher course was pretty helpful. Of course, Google has a way of leading a person to health message boards, which are notorious for people who thrive on sharing their peculiar medical conditions. Sure, I read about a few average cases, but who isn't intrigued by the pituitary tumor wrapped around the carotid artery or the woman who became blind when a pituitary tumor pressed on her optic nerve?

So anyway, on to the results. Today I found out that I have a 6x6x7mm tumor on my pituitary gland. It is an adenoma, benign, and there is no way to know how long it has been there. The gland itself is about 1 cm in diameter, the size of a pea, so my 6mm tumor is a little more than half the size of the gland. My tumor is not perfectly round, but it has what seems to be a very awesome tail to keep things more interesting. I am thinking of the tail as a mullet of sorts, just to keep a little party in the back. The symptoms associated with it have been with me for at least 15 years, but it seems it is medically impossible to conceive a child with a pituitary adenoma large enough to inhibit FSH and LH production. Since I did conceive a pretty awesome child 4.5 years ago, it would make perfect scientific sense for this tumor to have formed after Lily was conceived. We'll never really know, but I have dealt with amenorrhea and an annovulatory system since I was about 20 years old. Figuring that in, there is no "logical" explanation for how we got Lily, but I am so glad we did.

It might sound a little crazy to be thankful for a tumor diagnosis, but I am actually pretty pleased with it. No, I am not a hypochondriac. I generally have to be convinced I am sick. I have thrown up in some very public places in attempts to convince myself and those around me that I was perfectly well.

Really, though, finding what is actually going on is a wonderful thing, and here are a few of the reasons why:

1. I will not be having my ovaries drilled. As excited as I was about marching into the surgery center wearing a "Drill, Baby Drill!" t-shirt and carrying a "Let My People Drill" poster, I am pretty relieved that I will not be undergoing surgery. I am bummed that I won't be getting those days of relaxation that follow the surgery, but avoiding anesthesia and the pain of recovery is a pretty good trade off.
2. I found out this pituitary adenoma has affected my prolactin levels, making them very low. This might sound dramatic, but one of things that caused me the most anguish was breastfeeding. I had read hundreds of pages in books, spent an entire Saturday in a pricey breastfeeding class, went through three lactation consultants, rented a hospital grade pump and tried every home remedy known to man. I just did not produce much milk. Instead of sleeping while my baby slept, I was pumping away to no avail. To be honest, I had always been able to achieve pretty much everything in life I had worked for, and there had been few things in life I was willing to work as hard for as breastfeeding. I kept trying and trying and prayed that no soul would ask me how it was going. According to my medical records, my prolactin levels have been off for a long time. I am finally letting myself off the hook on my breastfeeding failure, and it is pretty cathartic.
3. The size of my tumor is pretty significant, but not so much that they will be cutting through any tissue to take it out. It is large enough to cause some major hormonal upheaval, but small enough that I won't need surgery. Every time I dodge the surgery bullet I am pretty happy camper.
4. I finally know why I don't ovulate. That is huge. Knowing the "why" provides a path to the "how." My physician has a laid out some great options for us. After I follow up with an endocrinologist (my genius doctor is a reproductive endocrinologist), I will receive injectable gonadotropins to induce ovulation. My condition is rare, but my doctor has a 100% success rate in dealing with it.  

Most importantly, I have answers and I am so thankful for them. I have spent a lot of time in prayer during this time of trying to conceive a second child, and prayer naturally leads me to scripture. I have had the "barren" women of the Bible on my mind and heart and have found such empathy with them. Even as a child, reading their stories gave me a heavy heart, but during this time in my life I have begun identifying with them in even greater ways. I can feel their sadness, but most of all I can understand their unanswered questions. Even when I was vaguely diagnosed with PCOS, I knew there were some answers to be found in modern science. I could see my ovaries on an ultrasound screen. I could hope to benefit from modern medicine. I had answers and understanding of the complex reproductive system, while women like Sarah and Rachel and Hannah had to rely solely on the unseen. Because I have the blessing of modern medical science, I suppose I will never know how I would have handled my infertility journey without it. Of course, I do know one thing; my faith has made all the difference in my outlook and for that I am eternally grateful. I don't know what the future holds, but I know God's will is perfect. Tonight I take comfort in knowing that and in reflecting on a scripture that has led me through the best and worst of times.

"For I know the plans that I have for you,’ declares the Lord, ‘plans for welfare and not for calamity to give you a future and a hope."

Jeremiah 29:11

Pray, Love: If I were an MRI, where would I be?

I learned a few new things on Monday.

1) I can be still for 30 minutes.

2) I am not claustrophobic.

3) The MRI machine was not quite relaxing enough for that nap I've been wanting.

I went in on Monday morning for the MRI of my pituitary gland. Depending on the results, I will either undergo my ovarian drilling (most likely outcome) or treat the pituitary issue before the ovarian drilling. All in all, it was the normal medical procedure experience.  I had the eccentric waiting room people, the daytime TV exposure and had to go to the bathroom several times despite fasting.

There was a guy listening to various covers of "Seven Spanish Angels" at a very high volume in the waiting area. I still prefer Willie and Ray to anyone else. I did make eye contact with the wrong person during the Elvis Presley version and we did, indeed, laugh out loud. As would be expected, the guy with the music was oblivious.

Everyone was so friendly, but each reminder that this was a brain MRI was a lite disturbing. It sounds much better when you say we are "scanning the pituitary gland". They all worked very efficiently, so much so that I only caught part of The Price Is Right in the final waiting area. I don't see a lot of daytime TV because my job does not really allow that so this might not be news to anyone, but Drew Carey is skinny! 

Before I went in for the MRI, I had to run to the restroom. It would seem like having no food or drink that morning would have kept me from needing that potty trip, but I am thinking the gallons of water I consumed the night before was catching up to me. They directed me to the restroom and, seriously, give a girl a warning that when she turns the corner there will be 3 completely sedated people on gurneys in the hallway. I almost didn't need the restroom. Freeeeaaaky.

The gentleman doing my MRI was awesome, so much that I took down his name so I could pass along the compliment. It was not a bad experience at all and I never pressed the panic button. Most importantly, I was completely still for 30 minutes. This is a huge accomplishment.

I waited 24 hours for the results, then 48 before calling for results.

Oh, wait, they can't find my MRI. 

I am guessing this huge brain of mine completely baffled the machine. The other possibility is that someone was using the computer to  play on social media and deleted my MRI to make room for some of those dirty bathroom mirror self portraits. There is also the possibility that they will find it tomorrow. 

Tomorrow we shall see. If they don't find it, I will schedule a new on ASAP. Once we have results, I can go in for my surgery and get the ball rolling. Let's get to that ovarian drilling!

All in all, it comes down to the perfect will and timing of God, and perfect works for me.

"Wait for the Lord; Be strong and let your heart take courage; Yes, wait for the Lord." 

Psalms 27:14 NASB

Pray, Love: Slight Change of Plans

What a change a day can make! I will still be undergoing in the ovarian diathermy, but it looks like we will be waiting 2 weeks.

I have always worked to be a bit of an overachiever, but sometimes I really outdo myself. I met with my OB/GYN/RE today and he had spent a lot of time studying my labs. He found that my luteinizing hormone (LH) and my follicle stimulating hormone (FSH) are very low and based on these findings, it seems that we will be taking a slightly different approach.

Basically, PCOS can originate from two different factors. In the end, you have much of the same result as far as the effect on the ovaries and reproductive system. Because the factors causing the PCOS differ, the ways of treating the two types will differ also. About 95% of women with PCOS have peripheral factor PCOS, where the syndrome is ovarian in origin. The other 5% have central PCOS, where the amenorrhea originates from a central endocrine problem triggered by the hypothalamus and/or pituitary gland. My labs reflect a central origin and I will need to have an MRI to take a look at my hypothalamus and pituitary gland before I have the ovarian diathermy.

We will still move forward with the diathermy and injections in two weeks unless something really crazy shows up on the MRI. It will set things back a couple of weeks, but all in all it does not have a huge effect on our timeline.

Here are a few things I learned today:

1. Although the central factor PCOS is much more rare, my doctor actually has a higher success rate in helping couples dealing with this type of infertility.
2. I won't be getting that nap.  
3. I am a little resentful that I had to do a pre-op phone call and tell someone how much I weigh. I have to do the call again in two weeks and will have to utter my weight again. Not cool.
4. People in waiting rooms are annoying. I was sitting in the waiting room with a couple obnoxiously speaking in a high volume whisper tone. My very loud 3 year-old's inside voice is quieter than the whispers these people were letting out and I had to work hard to maintain my composure. Suppressing your laughter for 30 minutes is very difficult. They got up and were replaced by gum popping couple. It was sort of like a SNL sketch, but much, much longer.
5. My new injection regimen will consist of FSH and LH, increasing the chance of multiples. Fortunately, my doctor will scan me daily during the injections to make sure we aren't getting too productive.
6. With the new likely diagnosis, my doctor is even more baffled that we have Lily. I am not sure how it can be scientifically explained that I ovulated for what might have been the only time in a 15 year period. I do know that I was earnestly praying and that she came at a time when we had significant loss in our family and she was a perfectly bright spot. What a special girl!

Thanks again to everyone for the prayers. That means more than you can ever know! I really struggled with the idea of making our infertility struggles public because I have never been the type to freely share my burdens with others. I had a couple of reasons for sharing. First of all, people naturally want to know if you are wanting another child or trying to have another child. I don't find it offensive when people ask, but when you reply by telling them you are struggling with infertility they naturally feel like they inserted their foot in their mouth. By being more up front and open about our struggles, I can save people that awkward feeling. The second reason I decided to share this struggle was to ask for prayers, because "the effective prayer of a righteous man can accomplish much." (James 5:16) Thanks so much for taking the time to pray for us!

Pray, Love: And We Are Drillin'

Drilling.

Ovarian Drilling.

Whoa.

I remember when I first started researching PCOS and infertility and I came across a thread on a message board covering the topic of ovarian drilling. I cringed, mainly because that is what I do when I give any thought to medical procedures. The cringing only increases when that procedure has a barbaric word like "drilling" in the name. It sounded like an archaic procedure and one I would never have to worry about. After all, we are in the 21st century and have so many less invasive techniques available. Drilling. Why on earth would I let someone drill holes in my ovaries?

So anyway, I am having it done on Friday. By Friday, I mean the day after tomorrow.

About a month ago, I was sitting across from my incredibly intelligent reproductive endocrinologist discussing my pregnancy with Lily, from the ease of conception to the ease of being pregnant. We then began discussing the much bigger picture. I had ovulated one time in six years. I gave Femara a shot and only ended up with a whole lot of little follicles. I am not getting any younger. He sensed that I love information and he began sharing the history of PCOS diagnosis and let me watch really cool slide shows about FSH and LH production. He began telling me about an old procedure used 80 years ago where a doctor would take out a piece of the ovary of a woman with PCOS for diagnostic purposes and the woman would end up having regular ovulation. Over time, the surgery has become much more sophisticated but still has very desirable effects, particularly for women who have dealt with PCOS since the onset of puberty and for women who have not responded to drugs such as Clomid or Femara. The procedure is now done as an outpatient procedure, it is laproscopic and they use lasers to drill the holes. They also call it ovarian diathermy now, which sounds a lot better than drilling. In the end, there are still holes, but I sure do prefer the word diathermy. The success rate, when combined with some FSH injections, is high. I'm in.

I was planning to have it done later in the month of August, but at an appointment on Tuesday I found out there was an opening for Friday, 8/2. I took the opening and am hopeful and prayerful that this will help us complete our family.

To break it down without the use of acronyms like PCOS and FSH and LH, here are the key reasons I am doing ovarian drilling:

1. Doug and I desperately want another baby and my doctor feels like this is a great opportunity for success.
2. Lily needs a sibling. She is constantly bringing imaginary siblings into our lives and they have names like "Buh-LIE" and "Lore".  She has chosen one of her baby dolls to be her baby brother and from time to time she tries to get him in trouble. She also attempts to make us feel guilty for neglecting our plastic baby. She will make a great big sister some day.
3. I need a nap. The way I understand it, I get to rest for like 3 days following this procedure.
4. I've always been a little curious about general anesthesia and how it would feel to be under. If I end up on YouTube while coming off the anesthesia, anyone responsible will not get to hold the baby I am hoping this surgery helps produce.
5. Ovarian diathermy has other medical purposes for me as well, so unlike most fertility treatment, this procedure is covered under insurance as an outpatient surgery.
6. I hear you get pictures from the surgery and, although my child is adorable, my Facebook needs something more exciting on the wall.
7. I have always avoided surgery like the plague, but the prospect of this helping us conceive a child makes it to great to pass up. Hannah was willing to promise God she would take her little boy and let him serve in the tabernacle, away from her, for the opportunity to bear a child (I Sam. 1 &2). What's a little drilling in comparison to that huge sacrifice?

I am going in on Friday and hope to have a smooth procedure, a speedy recovery and the positive outcome we so desperately want. Please keep us in your prayers as we take our next step in our journey to completing our family!

Pray, Love: Just One More...

I was blessed with an idyllic childhood in a Christian home in a small town with a wonderful family. One of the greatest blessings of time spent growing up was my brother, Kyle. I was three weeks shy of my second birthday when Kyle was born and, since he was walking at 9 months, he was part of nearly every childhood adventure in my memory. We were siblings, but best of all we were friends. Our personalities were as different as night and day, but we loved being together. We fought a lot and could argue about almost anything, but we never stayed mad at one another for more than a few minutes. He helped me be a tomboy and I helped him be kind and sensitive. We were (and still are) quite a pair.

When I visualized the family I would someday have, I always visualized a kind, caring husband and two children just close enough in age to be close friends. I hit the jackpot in the husband department (oh, yeah!) and I have an amazing little girl who keeps me on my toes and rolling on the floor in laughter. The only problem? I just want one more.

Doug and I had been married almost a year and a half when we decided we wanted a baby. A few months later we were pregnant and so excited about being parents. We fell in love with Lily the moment we found out she was on her way and feel blessed every day to have such a happy, healthy child. We also knew we wanted at least one more and, not long after Lily’s first birthday, we decided we were ready for another child whenever God felt like we needed one. We hoped we could have our children two or three years apart so they could be close in age and play together. Time passed, and we realized we were not going have children two years apart. We tried to look on the bright side; maybe our kids would be three years apart and Lily would be old enough to be a helper and understand more about having a sibling. More time has passed, and now is Lily is three and a half. We are still looking on the bright side; it looks like we won’t be paying college tuition for two kids at once.

Sometimes it makes us sad, but in ways that are a bit unexpected. I find myself very sad as I long for a family of four, but I don’t find myself sharing that with others. I feel guilty for feeling sad. Every time I begin to dwell on our secondary infertility (the term for infertility experienced by couples who already have a child), I feel like I should count my blessings and treasure the extraordinary child I have. I think of friends who are still struggling to become parents for the first time and I think of Hannah, the mother of Samuel, who pleaded with God for just one child. I find my sadness is mixed with twinges of guilt, as if I am not fully appreciating the gift I have been given with the child I am watching grow before my eyes. I find myself on the verge of grief, but do not feel I deserve the right to grieve. After all, I have one really awesome kid.

Secondary infertility is fairly common, but still not well understood by most folks.  Many people just assume that if you have been able to have one child, then it makes sense that you would be able to have another. Some people assume you only had a desire for a single child. A few people make snide comments about parenting a single child, insinuating that you really don’t know what real parenting is about until you have two. Everyone seems to want to know when we are going to have another one. We’d like to know the answer to that question, too.

I managed to bury the sadness deep inside for a long time. I would tell myself how blessed we were to have Lily and that someday, when the time was right, we would blessed with #2. The defining moment when I recognized my own sadness over the situation occurred when I was reading Lily her bedtime stories and, out of nowhere, she said, “Mommy, I want a sister!” She thought about it a second and said, “Or I want a brother.” It was obvious she didn’t care which; she just wanted a sibling and I, more than anything, wanted to be able to provide her with that.

Until recently, I had once again managed to bury the sadness and the desire. We still had that desire to have a second child, but had only dabbled in fertility treatment. We decided to put our house on the market, forcing us to make the third bedroom an appealing space. Until that point, it was the storage room for all things baby. When Lily would outgrow something, it would go in that room. We had her nursery furniture, clothing, toys and everything else a couple would need to completely spoil their baby. I insisted we set the room up as a nursery to show the house so it would showcase the size of the bedroom. Somewhere inside, though, I made that decision because I could not bear the thought of moving the nursery furniture to storage. The crib and changing table and rocking chair mean so much more to me than showcasing a spacious room; to me, they represent a hope and a dream that we pray for daily. They represent just one more.

Eat: Low Carb-friendly Taco Soup

There is so much conflicting information out there about PCOS, but one thing most everyone can agree with is that a diet low in simple carbohydrates can be helpful. This is a favorite low-carb recipe for our family! It doesn't hurt that it is one of the simplest recipes in my collection.

 

Taco Soup

• 1 lb lean ground beef or ground turkey
• 1 onion, chopped
• 1 tsp minced garlic
• 3/4 cup water + water as needed
• 1 Taco Seasoning packet or 3 TBSP of your favorite taco seasoning (Here's my favorite!)
• 2 cans Ro*tel tomatoes
• 2 cans black beans
• 1 (16oz.) package of frozen green beans (or fresh if you have them on hand)
• Shredded Cheese (optional)
• Diced Avocado (optional)

1. Brown meat with onion and garlic until meat is brown and onion is translucent.








2.Drain, if needed, then add taco seasoning and 3/4 cup water and cook over medium heat until water is nearly evaporated.








3.Pour the meat mixture into a large pot, then add the tomatoes and beans. If needed, add a little water to cover. Cover and cook on medium heat for 20-25 minutes, stirring occasionally.










4. Top with cheese and avocados, then enjoy!

This soup freezes well and reheats well. If carbs are of no concern to you, adding corn and tortilla strips or chips to the soup will make it extra tasty!

PCOS: Polycystic Pinterest Board

I have started a Pinterest board with various PCOS educational items, nutritional tips and other articles of interest. I would love for you to follow my board!
Alison's PCOS Pinterest Board

PCOS: Let's do this!

Hi, my name is Alison and I have Polycystic Ovary Syndrome (PCOS). There, I said it.  I have PCOS.

Until recently, only my husband, mother and maybe 2 close friends had any idea that I struggled with PCOS. It's not that I am ashamed to have PCOS, but stories of cyst-covered ovaries and infertility elicit sympathy and I have a serious complex about sympathy directed toward me. Perhaps I have a psychological problem or some childhood trauma buried deep inside, but I doubt it; it feels more like good, old-fashioned pride. I hate for someone to feel sorry for me. Oh, sure I like to feel sorry for others. After all, I grew up in a little corner of the world where Texas and the South collide head-on and I love to feel sorry for other people. "Oh, bless her heart," and "I sure do hate to hear that" roll off my tongue with such ease. I just don't want to have any heart blessing directed at me. My life is, for the most part, an open book, but only a handful of people know about my struggle with PCOS.

I started my period at age 13 and vividly remember the mixed emotions that came along with that. On one hand, I was excited to grow up. On another hand, I was moody and did not yet understand why. On yet another hand (I get as many hands as I want because I am talking about female hormonal issues), I was pretty upset because the night before my womanhood began I had talked my mom into this really cute Guess skirt and had plans to wear it church the next morning and I was extremely paranoid about this whole period thing. Everything seemed to go by the book, but 28 days later I was without a period. My periods came when they pleased, but I don't think I ever had more 4 in a year. I was in great shape, very athletic, but not so lean and muscular that amenorrhea should be a problem.

At 16 I took my first trip to the OB/GYN. Before long I was having ultrasounds and labs done to see just what was causing the irregular periods. I remember hearing something about polycystic ovaries, but I was not particularly worried. After all, I was not sexually active and only having to deal with periods and all that comes with them only a few times a year seemed like a winning idea. When I went to college, I began gaining weight. Along with the weight came a new PCOS symptom. I suddenly had acne, a problem I had managed to avoid in my high school years. I went on birth control pills throughout my 20s to trick my body and keep these symptoms in check and did not think much about it at all. My OB/GYN made it sound so simple. He told me to take the pills to keep things going, then some day when I was ready for a baby he could give me another handful of pills and we would be good.

I married my husband, Doug, when I was 28 on 07.07.07 and we did not want a child right away. I went on birth control for nearly a year and a half and stopped taking the pill in October 2008. I had my "period" from the last pack of pills during the first week of November and then waited for another period to creep up. By early February, I had still not started and decided to see my OB/GYN to ask for an injection or pills to induce a period. She told me we would need to wait 6 months following the last course of birth control to induce a period and sent me on my way.

On the morning of March 20, 2009, I rolled over in bed and my breasts were very sore. I decided to take a home pregnancy test and received a positive result. I drank about a gallon of water and took another test an hour later. It was still positive. I remember calling my doctor's office to get in for a blood test and answering that awkward question about my last period. Um, November? I was about six weeks along when we found out and on November 18, after a very uneventful pregnancy, I gave birth to Lily.

I packed on weight VERY easily when pregnant. I was unable to produce much milk (another PCOS symptom I later found) and was not able to exclusively breastfeed, so I hoped I would manage to have a period. I did not so we induced one with pills when Lily was 4 months old. I dieted, exercised and couldn't see to shed any weight.  When Lily was a little over a year, I stopped the pill and continued to try to lose weight with no success. I am writing this blog post two years later and I have not had a natural period since giving birth. In fact, in the 5 1/2 years I have been married, I have only ovulated once. On the positive side, our success rate on fertilization is 100%!

After about 6 months of dealing with infertility after Lily, I found a fabulous new doctor who helped me work on getting to the bottom of my problem. He showed me ultrasounds of my ovaries covered in "string of pearl" cysts and studied my labs carefully.  He referred me to an endocrinologist and I have learned so much about PCOS since then. I was prescribed Metformin, a drug generally used to treat diabetes and spent about a year and a half on Metformin and was actually able to drop a little weight with the help of that drug. Just recently, I started more in depth research about PCOS, hormonal imbalance and the processes of the body and have decided to take a more natural approach. This is where I will share my journey.

Doug and I would like to add another child to our family and I would like to do so as naturally as possible. I will combining exercise, nutrition and natural supplements in an attempt gently coerce my body to have a regular ovulatory cycle. If you are reading this, I hope it can help you in some way. All I ask of you is to pray with me as I embark on this journey!