Let's Cheer for the 100th Day of School!

Ahh, the 100th day of school. In the 80s, there was nothing especially exciting about the 100th day of school. We celebrated the first day and the 180th (last) day, but everything else was a day of school. Fast forward to 2016 and it is a really big deal. Like, a big enough deal that every kid at school is supposed to make and wear a shirt with 100 items on it.

We started out by going to Pinterest because my creative space in my brain has been smothered by the overflow from the responsibility space in my brain. At least with Pinterest I can look like a mom who wanted to put some creative effort into this little project. Mistake #1? I let this kid hang out with me while I Pinterested. Browsed Pinterest. There really should be a word for that. Anyway, I let this kid help me, and she obviously loves extravagance and thinks she is a very fancy girl. 

We searched and searched and we both had our favorites. I wanted to do the gumball machine design that kept popping up while Lily was set on 100 hearts with a message about loving school. We set out to buy materials and then had yet another creative disagreement. Do we cut felt hearts, use sparkly heart stones, or use some other little object to form a heart? There was some eye rolling from both sides and  then a new idea popped into my brain. Lily liked it, so we moved ahead with our new idea. Lily loves the idea of cheerleading, so we decided to use 100 little pom-poms to make...you guessed it, pom-poms.

Execution was easy enough. We started with a white shirt, 100 little pom-pom balls (1/2 inch), a tiny bow, a glue gun, iron and some of those handy t-shirt transfers that run through an ink jet printer. 

We printed a cheerleader on the transfer as well as some verbiage about the 100th day. Next, we ironed on the cheerleader and words.

Once the transfer cooled and the backing was peeled off, we added heated up the glue gun our embellishments. We glued the bow on top of the head of our cheerleader since bows are our thing. Then we added 25 blue poms and 25 red poms on each of the two pom-poms for a grand total of 100! 

Once the hot glue was dry we sat back and looked at our creation. Lily loved it, so I call it success! 

I sat and looked at our masterpiece for a few more minutes, while Lily used the remaining 150 pom-poms to let it snow on her toys.

Nice.

And here we are, ready for day 100! 

Pray, Love: We're still working on #2, but hopefully not #2, #3, #4, #5, #6...you get the point.

It has been about 7 months since I blogged about infertility or urine in my fridge or pituitary tumors, but here we are, ready to start working on making baby #2 happen.  Back in August I had finally received some real answers about the amenorrhea I have experienced for 15 years and a reason for the difficulty we have had in trying to conceive a second child. Then things got busy. We decided to take a little break from all the appointments and decisions and let the craziness of the fall and winter holidays and birthdays take us over. Even with the break from the decisions and the appointments, we did not get to take a break from the reality of secondary infertility. You never forget that, more than almost anything in the world at this moment, you want another child. People won’t let you forget, either.

“So do you not want more children?”

“You better hurry up and have another baby or your little girl is going to be a brat!” (That ship has sailed, my friend)

“So good to see you! So you still haven’t had another baby? You better hurry up before you have too much space between your kids.”

Lily and the naked, filthy, brilliant Baby Rowie

Whew! No pressure or anything. I think Lily just got tired of waiting. She has invented a huge family of brothers and sisters and likes them come along with us. Her favorite imaginary older brother is named Belie or B’lai or Buh-lie. She has never actually spelled it for me. He goes lots of places; he went to Chuck E. Cheese with Lily and her grandparents and they actually had to use tokens for him to ride the rides. Alone. While they stood and watched an empty ride move for 90 seconds. Sometimes she prefers a smaller family, but no matter what she has her Baby Rowie. She tells people all about her baby brother named Rowie and right now she is working on teaching him how to say talk and walk. His first words were a full sentence. He said, according to Lily, “I just said my first words.” He’s a remarkable child. Very dirty and usually naked, but remarkable.

We had decided to take a break from infertility treatment options until my second pituitary gland MRI drew closer. We didn’t want to be in the middle of fertility treatments if the MRI happened to show growth, which is, by the way, extremely unlikely. The MRI is coming up in the next couple of weeks, so last week I went to see my reproductive endocrinologist (RE). He is the one who diagnosed my pituitary adenoma just from studying my labs.  Last week we sat down to discuss our course of action.

I went in with some knowledge of what he felt would work from out discussions in August. Basically, my reproductive system seems to be perfectly healthy and ready to go. My follicle count is higher than normal for a “woman my age”, as hitting 35 puts you in the “a woman your age” bracket. Everything is ready to go, but my pituitary gland sends absolutely no signal to my reproductive organs. Since we are only missing the signal, my RE initially suggested we do injectable gonadotropins. Basically we would be injecting the hormone that would normally be sent by my pituitary gland. His only concern for me was over-stimulation of the ovaries, leading to an over-production of eggs. That was 7 months ago.

Even though we were taking a break from decisions, treatments and appointments, my mind never did take a break. Instead, I found myself obsessively googling fertility treatment in the wee hours of the morning when I should have been sleeping. I didn’t do it every night over 7 months, but I lost plenty of sleep. As my RE appointment drew nearer, I lost sleep every night for a couple of weeks. My heart and mind were in a tailspin because, although I know without a doubt that we want a baby more than almost anything, we were entering a realm where our beliefs about life would be challenged. 

There is a word in the infertility world that is used often by many of the experts. The word is “reduction”, as in selective reduction of embryos. I went in to my appointment late this past week with a list of questions, all relating back to our firm stance that reduction is not an option for us. I presented that to our RE in our meeting and tried to do so without seeming preachy or judgmental. He had already casually mentioned reduction as a way to ensure we didn’t carry too many babies. Basically, without leaving reduction on the table, he would not do the injectables with us. Instead, he would want us to make the leap to in vitro fertilization (IVF). He feels the IVF process would give him a little more control over the number of embryos, but that prompted more discussion about our stance on extra embryos and frozen embryos and what would be done with them. He presented a plan that would allow us to pursue IVF while only creating embryos that would be transferred. No life would be left behind, but he made a huge leap (and cost increase) to IVF in a matter of seconds.

For now, we have decided to seek a second opinion. I will be meeting with a physician from a different fertility center here in town to discuss the injectables and some methods for controlling the number of mature follicles. I have done a lot of research on methods such as follicle reduction, and that was not something the RE I have been seeing was willing to discuss.

We are prayerful about the next step in our journey. We don’t want six babies and a reality show, but we do want to have another child and we want Lily to have a brother or sister.  We know we want to take advantage of medical advances that our Creator has given us the opportunity to explore, but we want to do so with respect for life and His creation. We don’t know if our next child will grow in my body or in the body of a woman we may never know, but we know we want to shower another child with love and attention. We want to bring up a second child in the nurture and admonition of the Lord. Oh, and we think some soul deserves to have Lily as their big sister, because she will totally rock it!

“Before I formed you in the womb I knew you…”

Jeremiah 1:5

Pray, Love: Birthdays, Control Issues and Dogs

As of the stroke of midnight, we are two months away from Lily’s 4^th birthday. She is chomping at the bit, I am excited about planning and Doug is looking forward to a cute little party while praying we don’t get too carried away. I come from a family of birthday people, where we make a big deal every year and sit around and comment on each gift as we open them all one by one. Birthdays are a big deal whether you are eight or 88, but there is a special kind of excitement in those single digit years. 

For the past three birthdays, I have had the luxury of controlling Lily’s birthdays. 

The first year, of course, she had no opinion. She was just pleasantly surprised when she had new toys wrapped up in paper and completely ecstatic when we plopped a giant hunk of cake in front of her face. 

The second year she had preferences, but at almost two her concept of time was not unlike that of an armadillo. I wanted to celebrate her love for Minnie Mouse and make it fun for me, too. She showed up for the party and, for the most part, she liked it. Always a bit eccentric, she hated opening gifts, but was totally on board for the cake.  

The third birthday brought a little more of her involvement, but I was still making the big decisions. I knew I wanted a circus theme, so I spent lots of time playing up the circus we attended and crafting a party around the thing she had been trained to love. I spent the months leading up to these birthdays making one-of-a-kind invitations and decorations, having more fun planning the parties than an adult really deserves.

Four is different. Four is really different. I spent the latter part of the summer up to my old tricks, working on convincing my very strong-willed child that her favorite things just happened to match the things I had pinned on my Pinterest board. Some may call it manipulation and I am really okay with that. I had a great idea for a train birthday party after she fell in love with the trackless train ride at her end of school party. I had grand dreams of train whistle favors tied with pretty ribbon, a little bit tomboy with a touch of femininity, little sandwiches shaped like trains and birthday pictures on an old caboose. I even spent time in the hot Texas summer riding around with her on local trains and she loved them, but not enough to trump her idea of a dream birthday party.

My daughter, you see, has fallen madly in love with “Tangled”, the Disney movie telling the story of a very tough Rapunzel who knocks people out with a frying pan and swings through the air using her hair. What little girl wouldn’t love that? She wants a princess castle moonwalk, a tower cake and lots of friends there to help her celebrate. She also wants to release floating lanterns into the sky and, although I am reasonably sure my explanation of drought conditions and the danger of setting the town on fire are above her head, she seems to understand that the lantern release is not part of the plan.  I think it’s going to be a great party and I guess it’s now time that I get on board with what Lily wants; it is her birthday, after all. I mean, I did the hard part of actually giving birth, but I have no 19-hour labor story to use for leverage. Easy C-sections don’t count.

Letting go of party planning is not easy for a control freak like me. Thinking about the control I will be relinquishing over the rest of her childhood and adolescence is even more overwhelming. I love being a mom and I love having things just so, but I have to remind myself that the object of this whole raising kids thing is to have a mature child who can leave the nest as a confident, independent adult. It’s a daunting task, but I will just keep relinquishing a little control at a time and setting the boundaries where they matter.

I can let her have a Tangled birthday party while drawing the line at releasing lanterns containing actual fire into the skies of drought-stricken Central Texas.

I can let her choose her clothing while teaching her it is entirely inappropriate to wear pajamas and cleats to church or school. Note: I do reserve the right to drop certain pieces of clothing off at Goodwill at 3 am if the teaching becomes too challenging.

I can let her choose her favorite flavors of juice at the store while teaching her that the artificially fruit-flavored drinks are a waste of calories.

I look back at the best memories of my childhood, and many of them involved my parents setting boundaries while allowing me to make decisions and feel independent and strong. Quite honestly, it was a lot like the invisible fence where the dog wears the special collar and won’t go past the invisible boundary while not fully understanding why. Then one day I did not need my special collar anymore. I knew the boundaries and I appreciated them. Sure, I forgot my training a few times and nearly was hit by a car or two, but the training was always there. I hope I can do the same for Lily.

And only after midnight can we jump from birthdays to control issues to the numerous ways humans are like dogs. You’re welcome.

Testing, testing, 1-2-tee-tee

I went in to this weekend with no firm plans, but the intent to go and do whatever in the world I pleased. I now have plans, and I am planning to be at home. 

Today I went to en endocrinologist for a follow up from my pituitary adenoma diagnosis earlier in the week. I saw an endocrinologist I had previously seen for PCOS follow up and he is a really great doctor. My reproductive endocrinologist had checked labs on the pituitary hormones that fall under his scope of care and that included FSH, LH and prolactin. My medical endocrinologist needs to check my Adrenocorticotropic hormone, which we will call ACTH from this point on because typing it out hurts my fingers.

I know I have probably complained in the past about fasting labs. I abhor fasting labs. I can deal with not having food in the morning; it's the coffee deprivation that makes me cranky. Anyway, the positive thing about the blood draw for ACTH is that it does not have to be done while fasting. The negative? It is preceded by a 2 day urine collection. The neutral? I will also be doing a saliva sample as part of the testing.

Lily is pretty excited about the urine collection. As soon as she walked in the door, she began going through my urine collecting swag bags. The shovel is her left hand is not in any way connected to this urine collection.

Despite Lily's excitement about the supplies, there are a couple of drawbacks for me.

1) The urine must stay cold. I repeat, the urine must stay cold. I will be storing the urine in my refrigerator. Now, I am not perfect housekeeper. There is actually a cake in a Pyrex dish in my refrigerator right now that has been growing the next miracle drug/mold for longer than I would like to admit. That being said, there is something about storing urine in my refrigerator that really grosses me out. I am that person who flushes the commode with my foot and touches no fixtures in a public restroom. My grandmother taught me to cover toilet seats with paper when I was 3. I am going to have urine in my fridge, right next to the coconut milk. Yuck.

2) I can't really go anywhere. I will be doing two separate urine collections, each for 24 hours. I am planning to pack a cooler for church so I can bring my urine with me. That sounds so sick and wrong. I do want to note that my cooler will be in the car, not sitting next to my purse and Bible. Anyway, being confined to my house for a weekend is huge for me. In case anyone has not met me, I am an extrovert. The last time I did a personality test, I was considered an extreme extrovert. I will do my best to stay home, but if you see me walking through the outlet mall carrying a little igloo cooler, don't judge.

Did I mention that I don't have to fast for the blood draw? 

I am looking forward to knowing more about my pituitary function and am thankful for amazing doctors! If nothing too crazy shows up in these tests, it looks like we will be able to start injectable FSH and LH next month in hopes of giving Lily a sibling who can share in her excitement of urine collection jugs.

I will leave myself with one last thought:

"Be anxious for nothing, but in everything by prayer and supplication with thanksgiving let your requests be made known to God."

Philippians 4:6 

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!