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!

Love, Work: Treasure

It is Monday morning, 1 AM, the annoying alarm on my iPhone set to 5:45 AM, my adorable husband sleeping like a rock.

I can't sleep.

I could blame it on the relaxing Sunday spent with my family as Doug and I celebrated our 6th anniversary; he gave me some really sweet material gifts, but that afternoon nap was the best of all.

I could blame it on the hormonal craziness that is raging in my brain courtesy of the pills I am taking to ready my body for treatment for infertility.

I could blame on the action packed Monday coming my way. I would ordinarily be lying awake making a to-do list in my brain and looking forward to the challenges.

I could blame it on the late-afternoon coffee that followed my afternoon nap, but let's be real; I drink late-afternoon coffee on a fairly regular basis.

I think I will go ahead and blame it on the actual culprit. A four-day weekend is drawing to a close and I am not quite ready to get back to reality. We celebrated the 4th with cooking out, eating watermelon, watching fireworks and spending time together as a family.  I enjoyed a wonderful holiday weekend. In my pre-mommy days, these long weekends left me refreshed and ready to conquer the world.

I had a little taste of life at home, with leisurely summer days spent with Lily. We read books. We ate outside. I slammed this big ol' 34 year-old body down onto a slip 'n slide and possibly sustained internal injuries. I made delicious meals without any temptation to open a convenience food. It was everything working moms dream of in their stay-at-home fantasies.

Sure, I realize that staying at home full-time is VERY different from a long weekend spent playing, but I don't want to let go of the joy of those days. The beauty of it is that I don't have to let go of the joy. As my mind races with memories of a great long weekend, I am reminded of  scriptures that never took on their full meaning until I became a mother. I remember Mary, the mother of Jesus, and her memories of his childhood.

"But Mary treasured all these things, pondering them in her heart."

Luke 2:19

 

What would the joyful moments of life be without our memories? The smiles and giggles are always with me and I treasure them, pondering them in my heart.

 

And now I can sleep....

 

 

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.

Pray, Love: Finding Jesus

It was just after midnight and I was almost in bed when I heard Lily crying for her Baby Jesus. Lily names her babies after very important people in her life. We have babies named after her daddy, her great-uncle and her cousin. We have a baby bearing her first name, Lily and one bearing her middle name, Anna; not surprisingly, those are her prettiest babies. We also have a Baby Jonah and a doll who alternates between the names Doll and Jacy. The father to all these babies is a brown bear named Coco. For the record, there is no baby named Alison. Baby Jesus, however, has been a major player since her first birthday, when he simply went by the name "Da-Da".

It only took me a second to remember the last place I saw Baby Jesus. He was in the backyard, on the trampoline, next to her favorite pair of shoes. I put on my shoes, walked to the back door and flipped on the porch light. Nothing. The light was out. It is worth noting that Doug called me at work a few weeks ago to inform me that, during a sprinkler head repair, four (4!) snakes had been found in our backyard. I was so not excited about the trip to the trampoline, but my poor child was crying for her one and only Baby Jesus and I really wanted some sleep. I stood at the door, peered out at the trampoline and decided to make a run for it. Since I was a kid, I have had a theory that I don't let a lot of people in on; if you are running through a field of snakes, a high-knee sprint makes you practically invincible. On my trip out to the trampoline I nearly busted my chin with my right knee, but I am completely free of snake bites tonight. Baby Jesus was damp and cold, but Lily fell asleep the moment she curled up next to him.

I should not be surprised that my child can not keep up with her beloved babies. I had a similar problem. I was 5 years old when the Cabbage Patch dolls were a must-have item. By must-have, I mean that people were rioting in toy stores and waiting lists were put in place to control the crazy mommy mobs. My mom wanted me to have a Cabbage Patch Kid, so she went to great lengths to make sure I had one. It still had the "new smell" the day I took it outside to play (as any mother would) and ditched it in the backyard. The phone rang at our house and a kind neighbor on the next street over was calling to let us know her dog was using a Cabbage Patch Kid as a chew toy. I still have the doll. One of her arms is still hanging on by a single stitch, she has tooth marks on her eyes and some hair is missing. I wouldn't call her a collector's item by any means.

Should finding Baby Jesus on the trampoline at midnight really come as a surprise to me?

Because I tend to sit and think and procrastinate at bedtime, I could not help but think about the love of a parent. We love to give our children the things that make them happy. We will do almost anything for them, including running high-knee sprints through the backyard at midnight or going into a toy store war zone just to make sure they have a special toy. As I thought about this love, a scripture I have read my entire life took on a whole new meaning.

“So I say to you, ask, and it will be given to you; seek, and you will find; knock, and it will be opened to you. ¹⁰ For everyone who asks, receives; and he who seeks, finds; and to him who knocks, it will be opened. ¹¹ Now suppose one of you fathers is asked by his son for a fish; he will not give him a snake instead of a fish, will he? ¹² Or if he is asked for an egg, he will not give him a scorpion, will he? ¹³ If you then, being evil, know how to give good gifts to your children, how much more will your heavenly Father give the Holy Spirit to those who ask Him?”

Luke 11:9-13

 

The love we have for our children bigger than we can imagine, but it pales in comparison to the love God has for each of us. We should ask, seek and knock with this in mind, knowing that God's love is greater than anything we could ever imagine. Our heavenly Father wants to give us the greatest gifts, gifts that are far beyond trinkets to make us happy. He wants to give us the gifts that bring us joy, peace and eternal life. Ask. Seek. Knock.