My 'What's Next' Appointment

I had my appointment yesterday with my doctor to discuss whether the Lupron has worked or if I need three more months. I had already told the nurse twice (once before I got the third injection and then again yesterday) that I will not do three more months of this medication. The nurse asked why and I gave her a list of complaints (mood swings being number 1, cramps-can't stand for more than 5-10 minutes before I need to sit down, fatigue, I could go on and on but I won't).

I was very excited and nervous to tell the doctor I was through with the medication. When he walked into the examination room, he jokingly was teasing me about how I wanted to quit Lupron. He did the exam and told me that I was much better than I was when I first came in to see him and he seemed very excited and hopeful, which makes me VERY excited and hopeful. He then told me that even if I loved Lupron, he would take me off because there is no need for me to be on it any longer. I was THRILLED! He told me that the Lupron would still take another six weeks to work out of my system and to expect my next "friend" mid March. It has been 6 months since I've had my little "friend" and was one of the good things about Lupron, so I'm dreading it as my "friend" starts up the endometriosis and is one of the problems with my infertility. Doctor told me that I probably won't have a normal cycle until mid April and not to worry with this first one. But once I get my second one, we have to get pregnant soon before my endo gets worse again. No pressure.

I have my consult appointment March 5th to discuss what medications to go on to help getting pregnant, as I have issues ovulating on my own. So there was talk about inducing ovulation/carefully monitoring if I ovulate and going back on Metformin-which was the medication I took the month I became pregnant with Evie.

We are very excited by this news as when the doctor first told us of Lupron he had mentioned that I would go on it then go on birth control for a few months afterward, but when I mentioned birth control he told me that was not necessary and wanted to try to get us pregnant very quickly. We are thrilled and hopefully we will have BIG news to share by the end of the year...or sooner. :-)

Injection #2

I received my second shot on Monday and so far do not have any new side-effects. According to the nurse, the worst should be over and I shouldn't have any new side-effects. I did mention how bad my mood swings have been, and she told me it was normal and not to go killing anyone-haha. I also mentioned the pain in my foot and told me she had never heard that being a side-effect before. She told me to keep an eye on it and if it got worse, she would direct me to a specialist. I still from time to time get nasty cramps due to endo and I should mention I haven't had my little friend since Sept, thanks to good ol' hormone therapy treatment and menopause. I do get hot flashes from time to time, but it's not too big of a deal. When I get hot, I ask people around me if they are hot and 99.9 percent of the time it's just myself who is hot. I've learned to dress in layers, that way if I do get really hot, I can shed one of the layers.

Well that's the gist of treatment so far. Not very exciting, but I am so looking forward to being myself again when this is all over and hopefully not seeing the doctor so often.

Week 1

It's been 9 days since my injection. I didn't think I would be getting as many of the side-effects this early, but I've got 'em.

The first effect that I got from the shot was pain, this happened almost immediately. A day or two after I received the injection, I started noticing more frequent and intense pain. It has gotten worse over the last week. Last night was the worst. I had been in pain all afternoon and by 6 in the evening, I couldn't walk. I was in so much pain from the neck down. I felt awful that I wasn't able to make dinner or play with my daughter or even help Doug put our daughter to bed. All I could do was cry (mostly because of the pain, but also have been having extreme mood swings). My husband has been so good. I had blown up about something silly last night and he had every reason to be angry, but instead he cooked dinner, put Evie to bed and then helped me to bed. I truly am so very blessed that I married such a good man.

So I already mentioned the mood swings. It gets pretty bad. I'm usually angry all the time now, but have a few moments when I'm depressed and just feel the urge to cry-which I try my best not to do. Usually when I start crying, I can't get myself to stop plus I really don't have the time to cry.

Hot flashes. It's not too bad yet but it definitely disrupts my day and night. I was shopping earlier today and all of a sudden felt so hot. I was sweating, and I should mention that it was pretty chilly out. Once I got to the car, I turned the AC on full blast. At night, I will wake up sweating and will pull the sheets off of me and a couple hours later will wake up again freezing and pull the sheets over myself and this goes on all night. When I wake in the morning, I'm tired. Of course, I'm exhausted all the time now regardless of getting 4 hrs of sleep or 8 hrs.

I get headaches and migraines more frequently. It doesn't help that some days I am so nauseous I don't eat.

From everything the doctor told me before receiving the injection and from what women have said about the side-effects, this is all normal. Pain is at its worse in the first 14-30 days, but sadly the rest of the side-effects will probably be with me for 8 more months.

I'm so very thankful for my husband who has really been doing his best to care for me. I am also very thankful for my support groups who listen to me rant and offer understanding, support and advice. It has been so hard going through this when most of my family and friends have no idea what this is like. I know when I get to hold my second child in my arms, it will all be worth it, but I hate the process we have to go through to get there.

Although, Doug and I still have a lot of thinking and talking to do, I am really thinking that right after I have our next child (if we are blessed to have another bio baby), I am getting a hysterectomy. It's not set in stone yet and again, we have a lot of talking to do, but all I hear from women who have had severe endo, it's the best decision they made. I know it will put my body through menopause, but I'm already starting to go through some of that and will most likely be put back on some type of hormone therapy that will cause side-effects. I much rather (as of now), get it over with and be done with the pain and surgeries.

So this is what I have had to deal with during week 1 and 2. My purpose for this blog is to maybe help who ever is going through the same issues and to record my journey through infertility and maybe in a few years through adoption, if we are lead to doing that in the future. Although it has been rough, I try my best to count my blessings. I have a wonderful family. I love my husband and daughter more than life itself and count myself very blessed to have such an amazing family. The more we find out about my infertility issues, we really do thank God for our daughter as we feel she truly is a miracle.

Lupron Depot with Add-On

I had my post-op yesterday and was given my first round of Lupron. I am very thankful and lucky that insurance covers the add-on pill, which is suppose to lower side-effects.

After surgery, Doug supposedly told me that the doctor wanted me to go on this therapy-but of course anything you tell anyone after surgery usually doesn't work since the person who just had surgery is still very out of it. So when the nurse called me the following day, after surgery, to tell me how everything went and how the doctor wanted me to go on this injection for the next 3 months, I was overwhelmed. The nurse said I would have to talk with insurance since they have to verify I want to go on this therapy, and every month I will have to verify to send the medicine to the doctor. I did my research and joined a support group, most women who have gone through this didn't end up liking it very much, but I still haven't found someone (from the support group) who has done this therapy with the add-on pill. From what I gathered from research, what the doctor told me, and from other women is this-the medicine has these side-effects: bone loss (will have to take calcium supplements), mood-swings, depression, hot flashes, won't be able to sleep (like tonight), and makes women angry (advice was to go to the gym and often).

The reason for this route, is because since my endometriosis is at a level/stage 3 (with level 1, being not severe/easily treated and level 4, being very severe/hard to treat), this medicine will stop my cycles and lower my levels of estrogen. Endometriosis is when endometrial tissues that lines the uterus, grows outside the uterus, this irritates the body, causing pain. Because the lining grows outside the uterus, on the ovaries, fallopian tubes, etc; the bleeding produced by the growths (same as menstruation), causes the body to react and surrounds the blood and tissue with scar tissue, causing more pain and infertility. By lowering my levels of estrogen, it should stop the tissues from forming/growing and will stop my ovaries, why it will "trick" my body into a menopause state.

When I went in to my post-op, I wasn't sure if they would have gotten the Lupron, since I talked to insurance about 4 days prior to my appointment-but sure enough, they had it (and I was very glad, since I hate having to make multiple appointments a month at their office since they don't allow children-due to respect towards couples who are having issues with conceiving). I had a million questions for the nurse and doctor and was pleasantly surprised that the nurse knew almost everything about this injection and gave me a few brochures about Lupron therapy and the side-effects. When the doctor came in to do the post-op examination, he seemed very (happily) shocked I had agreed to do this since the side-effects scare women off of doing this drug. But because I trust this doctor and I truly believe he is looking out for me and believes this will help me in the long-run, I agreed. I can't say enough how much I love this doctor. After the experience I went through with my last doctor, who was always too eager to open me up and not tell me anything-especially annoying when I was pregnant, I am so thankful for this doctor who tells me like it is, talks me through my issues and gives me options. Dr. Alfred Rodriguez is amazing. Anyway, after my exam, he talked with me about the medicine and told me that women under his care (who take the pills along with the injection), usually don't have severe side-effects, so that makes me hopeful. He told me that since I just had surgery and he took out as much of the endometriosis as possible, he strongly believes that I only need 3 months of this medicine-but the effects of the medicine will last 6-7 months and not to expect to TTC for 8 months. So what will happen is I will go in every month, for 3 months to get the injection. Two weeks after my third injection, he will do another exam and figure out if I will need 3 more months (6 months is usually the rule with women like me, but again just had surgery and am pretty cleaned up on the inside). Because endometriosis can occur quickly, we have no clue if I will need 3 extra months of this therapy. After the doctor left, the nurse had me turn around, as she didn't want to scare me with the size of the needle, and although the injection hurt just a tad, I joked with her saying it couldn't be worse than the epidural and we both laughed.

After reading the booklet the nurse gave to me it seems that the first 2 weeks will be hard. Pain might be severe and the symptoms of endometriosis might increase. After that, it is a guessing game when the side-effects and pseudo-menopause will kick in. Nurse said it could happen immediately or it could take as long as the third injection to appear.

My next scheduled injection is for Dec. 19.

Update

I just received the call from the doctor's office. She told me that my endometriosis is really bad and ranking it between level 1-4, she said I was at a level 3. So the doctor wants me to come in every month to take a Lupron Depot shot for the next 3 months. This means that I will be going through menopause (since it shuts down my ovaries) for the next 7 months and cannot TTC at the earliest until June of next year. On the bright side, the doctor believes if I go through this, that it does have long term benefits. However, I'm nervous about having to go through pseudo menopause at 26, but everyone seems to say that it will make my life pain-free and more enjoyable. So I might start the first shot on the 21st of the month.

Surgery

I had my third laparoscopy and first hysteroscopy yesterday. We dropped off our daughter at a very good friend's house (since she was SO nice and thoughtful to offer that to us) yesterday morning. After hanging out for awhile, we made the trek to the hospital. At around noon, they called us back to get everything started. I was extremely nervous over this surgery since I had to sign a form saying if something went wrong, the doctor would have to remove the ovaries (luckily it didn't come to that-Thank God!) They got my IV going and gave me anti-nausea medicine. All the nurses asked me a few questions and before I knew it, they were ready to take me to the OR. At about 1:15 I was completely out and stayed out until 4. They brought Doug into my room where he told me what the doctor had told him (and how badly the doctor felt that he had to do this surgery). Since I was still pretty out of it, I kept dozing off. The nicest nurse came into my room and said that when I felt ready to get up, to let her know. I actually have to say that these group of doctors and nurses were the nicest ones I have met thus far. Anyway, the nurse comes back in at around 6 and I'm feeling alright enough to stand, but only for a minute. Since I cannot leave the hospital until after I urinate (sorry), I was really wanting to go so we could leave. After 5 attempts of trying (because I am so dehydrated from the fasting), I finally told her I had gone and I was discharged at 8 p.m.

I have to say that this has been a much easier surgery than my other laparoscopies. The nurses and doctors took care of all my issues I have had to deal with in the past. Because I get nauseous so easily, I am still wearing a anti-nausea patch and before I can take any pain meds (again, makes me really sick), they gave me a bottle of anti-nausea pills. So for the majority, I have been feeling normal. No nausea (or very little) and just in a little bit of pain-nothing to complain about. The best part, is that I feel hungry enough to eat and have been eating a little every so often. I really am blessed to have a good doctor that actually listens to me, it feels so nice.

According to the doctor, to keep the cysts and other fertility issues at bay, I am going to start hormone therapy (low dosage birth control pills) either today or at the end of the week. I'm hoping that within a month or two we can start TTC.

I am extremely blessed to have so many family and friends who have been praying and helping us through this challenging time, I love you all and appreciate all that you have done for us. You all are amazing! Thank you!

Big Appointment

Doug and I had our big doctor appointment this morning. We were blessed to have one of our good friends watch Evelyn, so we both could go to this appointment. And she had a ball playing with her pal, Mitch.

Once arriving at the hospital, we were almost immediately led into the doctor's office. The nurse gave us a brief overview of their findings and that the doctor would probably want to perform surgery. After she left the office, the doctor came in and spent a good hour with us explaining everything that was wrong. He told us how torn up he is about my case, because I am only 26 and have already had 4 surgeries. He informed us that I had a couple of conditions (Endometriosis, ovulatory dysfunction and PCOS). My uterine lining is very thick, on one ovary I have a very large functional cyst and the other ovary is polycystic and has many follicles. With all of this in action, I am not ovulating. The doctor isn't sure why this happens, but told us that there is no cure and I will battle this until I have a hysterectomy-which I will probably have done after our second child is born, although I would like to wait until I'm in my 30's.

This time around we were actually given a choice. I could go through another surgery (it's really a 2 for 1 since the doctor wants to do a laparoscopy and a hysteroscopy) or I could start hormone therapy. The pros to another surgery is that it would be a quick-fix and make me feel better. I should mention, that because of all of my infertility issues, I'm usually in pain all the time. I get sharp stabbing pains that seem like they come out of nowhere and cramp often. Don't get me started on how bad my menstrual cycles are, and I have other issues tied into this as well. The other pro to surgery is that after I recover, we can start TTC immediately. The cons to surgery is that Doug would have to stay home to care for our daughter while I recover. Recovery time is about 5 days and because I cannot take pain medications (very weak stomach), those 5 days are extremely rough (I have had a laparoscopy twice already and this will be my fifth surgery in the last 3 years).

With hormone therapy, the pro is that I may not have to have surgery. The cons are it would take 2 months of being on this before we could TTC. Another con is that I would most likely be sick 24/7 from the medication. And once I have been on it for two months and the cyst isn't gone (meaning it's a tumor), I would need surgery. Worst case scenario would be that we couldn't even start TTC until Feb. (at the earliest) and we basically would have wasted both time and money.

Both of us decided that surgery was the best route at this time and we pray we are making the right decision. My surgery is scheduled for November 9th and will have a few appointments before then (one a pre-op and another to place an instrument in the cervix). However, if we are blessed to get pregnant after this surgery, once the child is born I will have to start hormone therapy to control the cysts/PCOS until I decide to have a hysterectomy.

I want to thank everyone who have been praying for us and have welcomed Evelyn to stay at your home while I go to my appointments. You all are amazing blessings to us and we appreciate your kindness immensely.