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

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

Love: Dr. Sears and his handy website

I spent the first thirty years of my life mostly free from worry. I had a stressful job, but I wouldn't go so far as to say that I worried. When I think of worry, I think of sleepless nights and stomach ulcers. I was way above any of that and prided myself on my ability to be cool, calm, collected and confident in even the most difficult situations. Occasionally I was a little stressed, but I'd just flip over to Matthew 6, read verses 26-34 and remember that God's providence was going to take care of the birds of the air, the flowers of field and my strong and capable self. 

Then one pretty spring morning I woke up with the urge to take a pregnancy test. It was positive, and I immediately found myself worrying. I was worried that I had a false positive due to protein in my urine after a meat feast the day before at a Brazilian steak house. I drank a gallon of water and an hour later tried again. It was still positive. I was so excited about being pregnant, but the worry had just begun. I didn't worry a bit about the finances of parenthood; I left that worry to the hubby, but I worried about everything else related to parenthood. I knew plenty of incompetent people who managed to keep their children alive and thriving, but the anxieties and insecurities hung around. 

I worried about what I was eating, so I went online and found 40 different conflicting lists about what not to eat while pregnant. I went nine months without a sandwich with deli meat and nearly killed myself (and everyone around me) when I quit the caffeine cold turkey. Unfortunately, enchiladas and Whataburger were not on the bad list, so I gained "baby" weight at a rapid pace. I researched medications and found myself nursing my springtime allergic reaction with nothing but a Neti Pot. Lucky for me there had been no reports of the Neti Pot brain eating amoeba at  that point in time. I gave up tennis because I had visions of a tennis ball flying into my abdomen and I stayed off my bicycle because I was pretty sure I would fall when I became the first person to ever forget how to ride a bike.  During the first trimester I found myself awake in the wee hours of the morning fretting about the seat belt in my car. Thanks to Google, I found diagrams for the correct way to wear a pregnant woman to wear a seat belt. 

The internet was my best friend and my worst enemy. Often it armed me with information that helped my fears subside. Other times I obsessed over the irrational advice freely dispensed on mommy forums and chat groups.  Before this pregnancy thing, I knew better than granting credibility to people who typed "2" instead of "to" and who disagreed with their pediatrician on every...single...point. Then came the epiphany. A midnight Google search for information on crib bumper pad safety brought me to the website that would soon become my best friend. 

If you have never checked out askdrsears.com, you, too will probably fall in love with my fried, Dr. Sears,. I found the answers to pretty much every question I had on one single website. There is information on every stage of pregnancy, childbirth, breastfeeding, nutrition, sleep safety, vaccines, childhood illnesses...you name it! This single website has answered so many questions for me at every stage: as the mother of a child still residing in my body, as the mother of an infant and as a mother of a toddler. The acetaminophen and ibuprofen dosage charts one of the greatest lifesavers. After all, the "up to 24 lbs." dosage on the bottle can't be terribly accurate. 

One of the greatest discoveries on Dr. Sears' website: Attachment Parenting. I have a feeling there will be an entire blog entry on this parenting style, but when I stumbled onto Dr. Sears's site I also stumbled onto a parenting style that has worked beautifully for my family. It empowered me to parent in the way I felt was best, but he gave it a name and research to back it up. Attachment parenting has given us permission to nurture our child in a natural and instinctive manner. 

We are blessed to have a FABULOUS pediatrician that we see for our well checks and sick visits, but Dr. Sears has done a fabulous job serving as our 2am pediatrician. Here are some of my favorite links from askdrsears.com:

http://www.askdrsears.com/topics/childhood-illnesses/medicine-cabinet

Check out the dosage guides for some commonly used medications!

http://www.askdrsears.com/topics/skin-care/rashes

If your child has sensitive skin, this chart can bring relief to the rash and give mom peace of mind. 

http://www.askdrsears.com/topics/attachment-parenting

If you are a new parent or a parent to be and are trying to decide exactly what your parenting philosophy looks like, take a look at attachment parenting. It's not for everyone, but I am a fan. 

-Alison