Tuesday, September 28, 2010

Polycystic Ovary Syndrome (PCOS)

Brace yourself, this is a long one.


Between one in ten and one in 20 women have PCOS. It is the most common cause of female infertility. I happen to have a lot of friends who have it.

I think of it as the "ugly" syndrome.

Common symptoms include:
  • Acne
  • Excessive and uncontrollable weight gain
  • Abnormal and excessive hair growth (in male patterns: on the face, neck, belly, etc.)
  • Irregular periods

I have every symptom except for weight gain.

Typical women ovulate regularly (an average of every 28 days). Women with PCOS may not ovulate at all, and when they do, they tend to get cysts, or fluid-filled sacs, on their ovaries. It hurts. A lot. It often requires surgical removal. I had a cyst literally for my entire pregnancy. The Kid kicked it all of the time.

"The ovaries, where a woman’s eggs are produced, have tiny fluid-filled sacs called follicles or cysts. As the egg grows, the follicle builds up fluid. When the egg matures, the follicle breaks open, the egg is released, and the egg travels through the fallopian tube to the uterus (womb) for fertilization. This is called ovulation.

"In women with PCOS, the ovary doesn't make all of the hormones it needs for an egg to fully mature. The follicles may start to grow and build up fluid but ovulation does not occur. Instead, some follicles may remain as cysts. For these reasons, ovulation does not occur and the hormone progesterone is not made. Without progesterone, a woman's menstrual cycle is irregular or absent. Plus, the ovaries make male hormones, which also prevent ovulation."

Blood tests will show higher levels of male hormones, such as testosterone.

I was diagnosed with PCOS around the age of 18. My doctor prescribed oral contraceptives and spironolactone, a drug typically used to treat high blood pressure. After a few months, every symptom of PCOS disappeared. It was wonderful.

When I got married, I knew that it would take a long time to conceive. Many doctors won't prescribe assistive reproductive medication until a woman is diagnosed with infertility (the inability to conceive after one year of regular intercourse without contraception). Within less than one month of stopping my birth control and spironolactone, I sprouted manly hairs, broke out, and gained almost ten pounds. Lovely.

Since I already had a PCOS diagnosis, after 7.5 months of "trying" I went to a fertility specialist. It's a good thing I did. He agreed to give me clomid, a drug meant to increase ovulation, and metformin, a drug typically used to treat type II diabetes but that has been shown to make clomid more effective. Oddly enough, women with PCOS have a MUCH higher chance of developing type II diabetes. In fact, "more than 50 percent of women with PCOS will have diabetes or pre-diabetes (impaired glucose tolerance) before the age of 40." Once again, lovely.

Clomid works by blocking the estrogen sensors in your brain. When your body doesn't think it's producing enough estrogen, it produces more. Estrogen is the hormone that causes ovulation.

To reduce the chances of ovulating more than one egg and having multiples, doctors start you on the smallest dose of clomid, 50 mg. You take one 50 mg pill per day for five consecutive days some time in the first eight or so days of your cycle (usually days 3-8). There are all sorts of tricks to know exactly when you ovulate, but I won't get into that now.

If you don't ovulate after that first cycle, most doctors will increase your dose by 50 mg. I was on clomid for 9 months. Here is how my cycles went:

50 mg: no ovulation
100 mg: no ovulation
150 mg: ovulation, no pregnancy
150 mg again: no ovulation
200 mg: WIN! Six months later, I'm a momma.

According to my doctor, the "vast majority" of women ovulate with 150 mg or before. I guess my body is really messed up.

Out of curiosity, I called and asked my doctor what would happen when The Boy and I wanted to have another baby (don't freak out--it's still in the distant future). He said that since I needed "high doses" of clomid for my first pregnancy, they would just start me out on high doses next time. It's good to know that it won't take 16 months to get pregnant every time we want to have another baby, but it sure is scary to think that I could have twins. Let's just hope I don't have any more micro-preemies. Ever. Let's shoot for seven-pounders. Although, I'd settle for a four-pounder.

Anyway, if you know anyone who has PCOS, has the symptoms of PCOS, or has been struggling with infertility, direct them to the link at the beginning of this long post (sorry). It can be a rough thing to deal with, but it can be dealt with.

Wednesday, September 22, 2010

Saturday, September 18, 2010

A healthy dose of irony.

Journal entry from 10 November 2009:

"Tonight Nate and I started painting the baby's room. I just want the next three months to go by fast so that I can see my son. I'm so excited to have him. I wonder all of the time how big he'll be and what he'll look like. I hope he has my eyes, Nate's nose, my lips, and Nate's smile. I wonder if he'll have hair or not, and what color it will be. I wonder if it'll be curly. I know that he'll be handsome and have my heart no matter what. He already does."

Yes, I was huge for 27 weeks.

If I only knew.

Two days later I found out that my baby was 2 pounds 7 ounces, had my eyes, my nose, and Nate's lips and smile. He had lots of dark, wavy hair. I was right; he was handsome. And he had my heart even more than I thought possible.

He was pretty big for 27 weeks, too.

Thursday, September 16, 2010

I'm glad it worked out the way it did.

Sometimes the thought crosses my mind that maybe I was never meant to have babies. I mean, it took almost a year and a half to get pregnant and then I could only stay pregnant for 27 weeks. I'm just not good at having kids.

Then I feel guilty for wanting more.

But then I think of how important it was that The Kid made it to this earth. There were so many opportunities for him to just not exist. That's how important he is. I just hope that I am now worthy and capable of helping this special baby to reach his full, amazing potential.

I'm so glad that I don't have to take that huge responsibility on my shoulders alone. I have The Boy, and the Lord.

It most certainly is not an accident that it worked out how it did. It is nothing short of miraculous.

Sunday, September 12, 2010

Has it really been 10 months?

Yes, my child is a whopping ten months old. It's been a bit of a big month, too!

At 10 months, The Kid:
  • FINALLY wears size two diapers. (He wore size one for about seven months!)
His first diaper, the pre-pre-preemie size, and a size two.
  • Is barely starting to outgrow size 0-3 month clothes.
  • Is somewhere in the 13-pound range.
  • Is very good at rolling around to get what he wants.
  • Can sit up unassisted rather well (and reach for toys) for about one minute at most.
  • Consumes about 20 ounces of milk, one stage two jar of baby food, many crackers and cheerios, and 8-10 tablespoons of cereal per day.
  • Nurses for 10-15 minutes every morning, but not at any other time during the day.
  • Sips water from a big-boy cup (but doesn't like it much).
  • Can use his thumb and pointer finger to pick up small items, such as cheerios. This, apparently, is a very advanced skill for such a young baby (not 10 months, though...7 months). I'm fairly certain that he doesn't have cerebral palsy. Truly amazing.
  • No longer wants to take a bottle for anyone but me. I know it hurts The Boy's feelings, but I think I get the short end of the stick. I hope it's just this week's phase.
  • Loves it most when his mommy sings and his daddy whistles.
  • Sleeps on his knees with his bum up in the air and his arms under him.
  • Is bored with all of his toys.
  • No longer qualifies for early intervention services!!! He is completely caught up to where a 7-month-old should be. The therapist said that they hardly ever see that in a baby as young a The Kid who was born so early. Hopefully he never needs them again, but I won't count on that when he starts school.
  • Is getting hard to photograph. He just wants to roll around.



Thursday, September 9, 2010

It's gotta end some day...

Yesterday I told myself that it's coming to an end. I decided that today I would only pump twice. My supply is steadily decreasing and it's time. I've come to terms with it, and it's OK. Next month The Kid and I will fly to The Northwoods, and by then the whole lactating thing will all be over. And it'll be so nice.

But now...it's my regular pumping time...and I feel like an addict. I can't just not do it. I think I'll just pump for 20 minutes, instead of my regular 30.

After all, providing milk for my baby is a good thing, but spending day in and day out pumping (at this point) is a bad thing.

And All Bad Things Must End.

Friday, September 3, 2010

Thursday, September 2, 2010

Pictures of our Wonderful Life

The Kid eats like a horse. Here he is, all happy to be in his high chair:
And showing off his teeth (all the better to eat cheerios with):
And The Dog, where she keeps post while The Kid eats. You never know when a stray cheerio might fall to the ground, requiring her to clean up. It's a rough job, but thank goodness The Dog is willing to do it:This is how The Kid sits up on his own these days:
"See? I worked hard and now I have four BIG teeth!":
We went to the zoo the other day. As you can see, The Kid's Mommy-proclaimed favorites are monkeys:
I fear he may be too big for the bouncy chair (if you can't tell, he has rolled completely over to his belly, despite being strapped tightly in):
Lots of play requires lots of sleep:

We love our life.