Vitamin D Deficient

I finally got a call back from my doctor about the blood tests they ran on Monday. She said everything looked normal except my Vitamin D levels. Now, I had a problem with my vit. d levels a few years ago too. It was the leading cause of some serious fatigue issues. To put it in perspective, the optimal range is anywhere from 50-80 on the blood test. (Don't ask me 50 what, because I have no idea what the measurement is, haha. I just know the numbers.) Anyway, 50 is the minimum optimal level. My level was somewhere around 11. Not good.

My doctor told me to start spending more time out in the sun and to start taking Vitamin D supplements, something like 1,000 IU's a day. I did that. Went back in a few months to test and the level had only gone up to about 13. Ugh. I was tired all the time and it sucked. They ended up putting me on a prescription of 50,000 IU's a week. It made a huge difference in my energy levels, but (genius), they never came back to check my levels after that again. I guess they assumed those major levels were enough.

I kept taking the 1,000 IU regular pills, the kind you can get at any pharmacy or drug store, but lately, just like with the metformin I talked about earlier this month, I stopped taking my pills. I started having some serious fatigue issues again lately and was wondering what was up. I was hoping this month maybe it was a pregnancy symptom, but it seems that my Vitamin D levels are back down to below 20. I have no idea how it got that bad again! It's not like I stopped taking all my vitamins for months and months. It's just been a short period of time. I'm guessing the prescription they gave me way back when never really even brought me up to a normal level. I think it probably just got me to a decent, not tired all the time level. Then, when I stopped taking the vitamins like I was supposed to, it dipped down really low again.

From doing some online research, it seems like women with PCOS are quite often deficient in Vitamin D. I wonder why that is? Is there something inside that's not working right to allow our bodies to absorb the vitamin correctly? I want to look into this more. One study out there also claimed that something like 93% of women with infertility problems are Vitamin D deficient. I mean, it's the internet, so not everything is true. BUT if it is true, wouldn't it also make sense that a vitamin d deficiency is a possible cause of infertility? It makes sense to me. So why aren't RE's checking our vitamin d levels and making sure we have a normal level before resorting to all these injections and clomid and things that really mess with our bodies?? (Thank you Clomid for an extra 15 pounds I still haven't been able to shrug since May). I just wonder if it's a real issue or not. Deep thoughts by Sarra, lol.

Anyway, now I'm back on the 50,000 IU prescription and have to go back in 3 months to check my vitamin d levels again. Ironically, my appointment to check is right smack dab in the middle of the time when I'll probably be going through the end stages of injections for IVF and getting ready for my ER. (egg retrieval) I figure I'll be getting sticked with so many needles that month, what's one more, right? /sigh. Hopefully the new scrip will get me back on track with my energy levels and help get rid of some of this fatigue. And if it helps me get pregnant? That would be amazing!

Feeling Better'ish

I'm still having some dizzy spells. I feel like I've been asleep for almost all of the past twenty-four hours, haha. Sudafed is definitely knocking me down, not to mention the heat outside that makes me want to stay in and curl up in the air conditioning.

On a good note, my temperature is still up this morning. I have been so incredibly bad about keeping my chart updated this month. Between our trip to Vegas and a lot of late nights working, I just wasn't able to take a consistent temperature reading. My chart looks all wonky this month. I wasn't sure I would ovulate, but somewhere around CD 18, I got a positive OPK. Now, my temperature has been up over 98 for the past few days, so I'm pretty sure I ovulated. Unfortunately, I am still not sure when to expect AF to show her ugly face, but hopefully it won't be too much longer. I'm anxious to get in for my saline u/s next cycle to get the IVF ball rolling.

Of course, I would be fine if AF didn't come at all for the next, say, nine months. :) In the meantime, I think I've got about five or six more days to wait and see. Hopefully by then, this inner ear infection will be gone and I'll be back to normal.

Sudafed

Ugh. I have medicine head.

Saturday, I started having these crazy dizzy spells. Moments where I felt off-kilter and the world seemed to be spinning. Of course, I had a friend who said it was an early pregnancy symptom and part of me got excited. Technically, I'm in the 2WW right now, so it's definitely possible. On the other hand, I know it's such a slim chance, so I hate that it got my hopes up even a little bit.

The dizziness continued yesterday and this morning, so my husband drove me to the doctor this morning. I have fluid built up behind my ear drum, so the doctor thinks this must be the cause of the dizzy spells. Boooo. Lol. She told me to pick up some pure sudafed, 30 mg, and take small doses for the next couple of days until the dizziness goes away. Apparently sudafed is on the approved list of medications for pregnant women (just in case). She also ordered some bloodwork done. Since I've also been feeling tired, she's checking my Vitamin D levels for one thing. I used to be severely Vitamin D defficient and had to go on super pills of 50,000 IU's to get it back to normal.

The check-out sheet also says she ordered a comprehensive chem panel and something called CBC w/Plts. Not sure what that is. I know the Vitamin D test takes like 10 days to get back, so I don't know how long it will be before I hear from her. Anyway, I was a little disappointed that there was such an easy explanation for the dizziness. I was so hoping it was an early pregnancy symptom! Instead, I'm stuck taking sudafed, which I hate. It's supposed to be non-drowsy, but this stuff knocks me on my butt. I just got up from a 2 hour nap in which time seemed to fly by. I seriously thought I'd only laid down a couple minutes ago, and boom, it was already five in the afternoon. Crazy!

On the bright side, I'm going to get some really good rest over the next couple days!

Getting Back on Medication

I've been a bad girl long enough. The time has come to get serious about my health. I wrote earlier last week about my terrible Metformin habits, but it hasnt' just been a problem with the Met. It's also with all my other drugs. My vitamins, everything. Tonight, I officially started back on all the medications and vitamins I'm supposed to be taking. If I can be really good and take them every single day, I'll have just over 2 months of getting used to the drugs and getting in shape before we do IVF. Hopefully that's plenty of time to get myself in tip-top health before we start going through the hard stuff.

As much as I feel bad and regret going off my medication for selfish reasons (I felt awful ALL the time), I know that my doctor has my best interest in mind. I know these are medicines I need to be on to give myself the best chance of getting pregnant. So isn't it worth feeling bad and having digestive issues for a few months? Yes, I would say it is. In the grand scheme of things, there are much worse things I could be taking. Metformin is just a temporary sickness as long as I keep my nutrition under control. So as of tonight, I'm back on a plan and determined to stick with it.

Here's what I take on a daily basis:

• Glumetza, 1000 mg (This is the metformin. My doctor prescribed 2000mg, but I have to work up to it since it makes me so sick. I'm going to start on half dose first, then work back up to the 2000 in a couple of weeks. Yikes!)
• Vitamin D3, 1000 IUs
• New Chapter Organics Prenatal Vitamins, 3/day
• Fish Oil, 800mg EPA twice a day (I take Carlton's Finest Fish Oil from Whole Foods. It's a liquid but it tastes like lemon. I used to take pills, but then I always had this fishy taste in my mouth that I HATED. This fish oil is actually quite nice and has no real aftertaste issues. Plus, it's pure.)

It doesn't sound like a lot. Especially not compared to what I'll go through with an IVF cycle. It's definitely manageable, and I know in the long run, it's best for my body. I'm going to get back in the habit of taking them and hopefully with a new plan for diet and nutrition, the metformin won't bother my stomach quite as much.

As a side note, PCOS bites. I sometimes wish I could be like a normal woman who could just take the vitamins and be fine. End of self-pity moment.

Wedding Today

George and I are going to a friend's wedding today! I always look forward to happy events like this where everyone is smiling and in a good mood and there is so much joy in the air. And of course, there will be wedding cake.The only down-side is that lately, I feel like I'm always looking around and seeing pregnant women everywhere. I'm sure today will be no different. I am betting I will see at least four or five pregnant women. Is it just me? Or are there more pregnant women in the world right now than ever before?

I know it's just because my mind is fixated on it, but it stills seems like a lot more than normal. A pregnant belly or a new baby always used to make me smile and just light up inside. Now, even though I still get that sweet, happy feeling when I see someone about to have a baby or holding their newborn, there's also a twinge of sadness. I catch myself wondering if that will ever be me? It doesn't make me depressed or anything, there's just this moment of pause, you know? In truth, we really haven't been trying that long compared to some couples, but in my heart, I've been waiting for this for a very very long time. Yesterday was the due date of one of my friends and another actually did give birth to her new baby. They both got pregnant after George and I started trying. It's hard to think so much time has gone by already.

Today, I'm not going to wallow in some kind of self-pity when I see all these happy pregnant women and this new bride. I'm going to smile and think about how wonderful it will be this Christmas to go visit my family and be  more than two months pregnant already. I'm going to think about how I'll be pregnant on my 35th birthday and how next year, someone will throw me a baby shower and everyone will come to visit us in the hospital this time next summer to meet the new Bittmann baby(ies?).

Zumba!

Part of my plan to get ready for IVF and be the best I can be is to work on my fitness. This has been a sore subject with me for a very long time. I was active as a child growing up in Georgia. I loved to jump on the trampoline, ride my bike, play out in the woods, and take long walks. But when it comes to anything sports-related, I'm just not at my best. As I got older, my fitness level flatlined. I tried going to the gym a few times in college. I played some racquetball, but for the most part, I just hated working out. I felt so self-conscious, like everyone was looking at me and thinking I didn't belong there.

I joined Jazzercise a few years ago and spent about six months working out there. I loved it. I really enjoyed the dancing, but I didn't see much weight loss, and it was pretty much always the same work out. Plus, the group I was going to felt like they already had a little clique of friends and again, I just didn't feel 100% comfortable. With a few months to go before IVF, I know it's my time now to work on my fitness. To manage PCOS, I have to exercise. I just HAVE TO.

So George and I joined the gym closest to our house. Lifestyle Family Fitness. I signed up for 3 sessions a week with a personal trainer. Yes, it's expensive, but right now, it's one of the most important things in my life. Included in my gym membership are daily classes of all types, including yoga, body pump, step classes, and my personal new favorite - ZUMBA!

I've heard people talking about it for a long time, and I even bought the DVD workout set, but I didn't fall in love with Zumba until I started going to the classes at my gym. OMG, it's so much fun!! Yes, I'm the overweight girl trying desperately to get my hips to move right, but I don't care. Everyone there is so accepting and fun. Right now, I'm going twice a week, Wed. and Fri. mornings. It's an hour long class, and on average, I'm burning at least 500 calories that hour! Combined with the 30 minute personal training right before, I'm burning probably close to 800 calories three times a week. (I go to beginner yoga on Mondays after training.) I would like to step it up and go to a few more of the weekly Zumba classes. There's one on Saturdays I might start trying and one on Tuesday afternoons. It's fun and it's fitness. Who knew?

Exercise is key for me right now. It's helping me manage my stress. It's helping me manage my PCOS. And it's giving me energy to get through my week with a smile on my face. I don't know how my exercise routine will be affected once the injections begin. From what I've heard, most people have to stop doing anything that really raises your heartrate while on the meds, so we'll see. Obviously, after the embryo transfer, I'll be on bedrest and wanting to take it easy for a week or so. But for now, full steam ahead. Zumba, personal training and walking in the evenings. I'm feeling really good about these changes, and I really feel like I'm going to stick with it this time.

Now, if I could just get my nutrition under control...

Building My Sanctuary

Our bedroom is awful. When I first moved in with my husband, his house was pretty much not decorated at all. I spent some time a few years ago painting and trying to make this more of a home, but I'm not the most talented interior decorator, haha. (To say the least!) The downstairs, the bathroom, and the office got some love, but our bedroom got ignored. It was partly about money and partly about time.

Now, however, I want to make our bedroom a sanctuary. I want it to be a place I can relax and destress and feel good. I know that throughout most IVF cycles, there are at least a few days of bed rest, and I want our bedroom to be an awesome place to do that.

Right now, our bedroom has zero artwork, a plain white down comforter (no duvet), no headboard, no curtains, an old dresser from when George was still in high school, and a rack of computers, LOL. No exactly romantic or relaxing! There is definitely a lot of room for improvement. Unfortunately, there's so much that needs to be done, it could get pretty expensive. With the expense of IVF already climbing, we don't want to spend too much money on the room.

Here's my idea so far for the room. I just ordered the prettiest 10 piece bedding set (on sale!) from JC Penney. It's called Serenade, and I love it.

Instead of the current off-white walls, we're going to paint this gorgeous blue called Twin Cities from Valspar paint. I think it's going to be perfect! I think the blue will be very relaxing and beautiful and calming. On the beautiful dark wood nightstands my dad built us last year for Christmas, I want to put vases with beautiful silk white flowers. I also hope to put some nice artwork on the wall that brings in the nature theme and brings some life into the room. A good friend of mine that I met on the Baby Center forums is a designer. She's the one who suggested the paint color (with a nod to the fact that we might have twins, hehe) and also this branch wall art.

Design-wise, I think those are some good starting elements. I love the earthy theme and the calming colors, and I really think this is going to be a great place to meditate and unwind while we go through the rollercoaster of IVF. We are also going to try to put a new headboard and a new dresser in the room, as well as some nice off-white or dark brown/green curtains that match the leaves in the bedding. I'll try to post pictures when we're finished. My hope is that our bedroom becomes a sanctuary while we are TTC and also a great place to call our own when we begin to share our home with a new baby (or two :).

Metformin Misstep

Metformin sucks. For those of you who have never heard of this medication, you'll just have to take my word for it. It's a diabetes medication that reduces blood sugar levels. I don't have diabetes, but with the Poly-cystic Ovarian Syndrome, I am insulin resistant. Metformin is prescribed for a lot of women with PCOS to manage blood sugar levels. Researching up on it, I know that it has some amazing benefits for dealing with the symptoms of PCOS. The problem is, as I said earlier, Metformin SUCKS.

I was first prescribed it by my regular general doctor a few years ago. She put me on 250 mg a day and it made me so sick, I was miserable for weeks. Almost 3 months, honestly. Then, she bumped it up to 500 mg a day and the hell started all over again. You can imagine my shock and dread when I went to see the doctor at the fertility clinic and he prescribed 2,000 mg a day of Glumetza, which is another, nongeneric form of Metformin. I almost died. 2,000 mg? You've got to be kidding me!

If you just google "Metformin side-effects", you would probably get pages and pages about what this drug does to your body. It's extremely unpleasant. I'm about to get a little graphic, so if you get disgusted easily, just skip over the next part, haha. Here's what metformin does to me. First of all, it gives me a terrible stomach ache. It puts me in a constant state of feeling nauseated. I have only thrown up a few times, but it's just miserable feeling like I could throw up at any moment. Then, there's the diarrhea. Literally, I have had days where I cannot leave the house because I'm on the toilet all day. It's disgusting and miserable and totally steals my dignity. I get awful headaches, have to drink a ton of water to stay hydrated, and am pretty much miserable all day every day.

Now, even after saying all that, I will admit that it does get better. After a few months, it gets better. At least until I eat a few bites of sugar. Then, it all starts over again. All it takes is a single cookie or even too much ketchup and I'm in the bathroom for hours with awful stomach cramps and misery.

So, after going through months of getting used to it, why would someone ever stop taking it? I have no idea, but that's exactly what I did. Multiple times. It seems like every time I get through the worst of it and start to get used to it, I just stop taking it. It's like a part of me just gets so tired of not being able to eat anything I want and not knowing when I'm going to wake up feeling awful. I just can't take it anymore and I rebel. I stop taking it. I binge on sweets and fried foods. Then, I reach a point where I know I have to start taking it again and the hell starts all over.

A couple months ago, I went home to Georgia. I knew we were going to the beach and I wanted to be able to eat when we went to dinner. I wanted to drink and have fun. So I stopped taking the Metformin and haven't taken it since. I don't know why, but food is a huge part of my happiness. It's so hard for me to live without it. I know that sounds awful and shallow, but it's the honest truth. On the other hand, taking the metformin means a healthier body. It means a better chance of getting pregnant, and more importantly, it greatly reduces the chance of miscarriage in women with PCOS. It's a medicine I HAVE to be on. Plain and simple. I'm just not looking forward to going through the side-effects all over again.

I know this has been a total whiny post today, but I just needed to get this off my chest. I wish there was some other way to get healthy besides taking this drug, but I trust my doctor and he firmly believes I need to be on it. I'm planning to start back tomorrow with 1,000 mg a day for a few weeks until (hopefully), my stomach starts to get used to it again. Then, I'll go back up to the 2,000 mgs and stay on it until I'm 12 weeks pregnant. I can only hope that in the end, it makes a real difference.

Our Plan Moving Forward

I thought I would take a post to organize my own thoughts on our current TTC plan. After talking with our doctor at NCCRM in April after several failed IUI's and Clomid cycles, we decided to move forward with IVF. Rather than just rush into it and start right away, we decided to take several months to prepare, save money, and try to get into a better place for IVF. Somewhere in the back of my mind, I kept thinking we might get pregnant on our own before it came to that, but after four cycles without fertility meds, we still are not pregnant, so we are looking on toward the upcoming IVF and setting our sites on success.

At first, we planned to start IVF in August, but as most of you know, I'm a writer. I just released the fourth book in my YA series. There is one final book left in this series and rather than go through the emotional roller coaster of IVF (and possibly morning sickness soon after, hehe) while I'm still writing this series, I thought it would be better for me to write and publish the final book before we begin IVF. I am just starting book 5 now and hope that it can be finished and published by mid-September. (fingers crossed!) In the meantime, we are going to get all our little ducks in a row so that when the book is published, we are 100% ready to move forward.

Here are the major things that we need to do before we can start meds:

• Saline Ultrasound - this has to be done during CD 5-9. I've already had one of these done, but that was back in November and my clinic's policy is to do another one right before IVF to guarantee that there are no tumors or fibroids in my uterus that would prevent an embryo from implanting. Also, I've asked my doctor to check my tubes just to see for sure if they are blocked. Instead of performing a painful HSG, he said he can add bubbles to the saline and see the tubes clearly. I plan to go in for this u/s during this next cycle.
• IVF Labs - George and I both will need to get blood tests done to check for infectious diseases (I think this is a federal requirement for IVF). I'm not sure yet if I will need to also get another check of my FSH and AMH and all that good stuff since I had those tests done less than a year ago, but we'll see.
• Acupuncture Initial Evaluation - I know that acupuncture isn't a necessity when it comes to IVF, but I'd like to go for it and do everything I can to give IVF its best chance for success. Some studies say that acupuncture can increase implantation rates, so I'm going to go for it. We have a couple's evaluation already scheduled for August 1st.
• S/A and Freeze - This is all George, haha. He's had a semen analysis done several times before and everything has been awesome with his results (above average which is great), but the fertility clinic requires him to do another and they also require a sample to be frozen ahead of time just in case there is something that prevents him from giving a sample on the day of retrieval. That way, there's always a backup if anything happens. The freeze is one thing insurance does not cover, so that's $200 out of pocket, but totally worth it.
• Weight Loss - My doctor says that he doesn't believe my current weight will cause any problems with IVF, but he did say that any amount of weight I can lose before the procedure will only help the maturity and quality of the eggs retrieved. I am very disappointed to say that since this time last year, I've gained nearly 20 pounds. Ugh. How does that happen? Well, I know how it happened. I gained nearly all 20 pounds during the clomid rounds and it totally sucks! It scares me about the drugs for IVF and how my body will handle it. Am I going to gain a bunch of weight? I hope not. I definitely need to drop some of this weight. I am working with a personal trainer 3 times a week, going to Zumba classes, Yoga classes, and walking a lot with George. I also have a new diet plan, so I am confident I can drop that 20 pounds before we start meds. However, I am also happy to know that my doctor doesn't think my current weight is going to be an issue.

So that's our list. Once the book is finished and the list is done, we'll start the official process. I don't know all the details of the meds I'll be taking yet, but I do know a few things. Here is a rough outline of what our IVF plan will be:

• Birth control pills for 10 days to restart my cycle.
• Clomid starting cycle day 2.
• Injectables (not sure which ones yet) for 10-12 days.
• U/S every 2 or 3 days throughout injection period and E2 check.
• When follicles are ready, trigger shot.
• 36 hours later - Egg Retrieval (not looking forward to anethesia here, but going to stay calm).
• 3-5 days Later - Embryo Transfer (My doctor plans to transfer two embryos as long as there are two near-perfect ones to transfer. I'm very hopeful we can get at least two great embryos.) Any remaining embryos will be frozen for a possible FET round (Frozen Embryo Transfer) if IVF is not successful. 

Our chance of success is between 50-60% with IVF at this clinic, and I'm feeling really good about it. An FET round has a 30-40% success rate, so as long as we can get at least 4 healthy embryos, we have a really good shot of being pregnant within the next six months. I'm so nervous, but also excited about the future. I'm so glad we have a plan now and are moving forward with IVF. Even though the actual retrieval and transfer are probably still three months away, I know that time is going to fly by and it will be here before we know it.

Las Vegas, a New Blog Design, and a Focus Shift

George and I are home from Las Vegas! We had the most amazing 9 days in the city. For us, this was both a celebration (his birthday) and a time for relaxation before we start our journey toward IVF. We both really needed an amazing week to let go of all the stress of the past year of failed fertility assistance. We needed some time to reconnect and just enjoy being together. It's my hope that our Vegas trip will also end up being our last vacation before we're pregnant! Here's a picture we took. Don't we just look so happy?

(Note: Yes, I do have blue hair, lol. My Dr. at NCCRM says no more hair dye once we get started, so I'll have to go back to plain brown soon, but for now, it's still blue and expressive, hehe.)

While I was away, I was also working with Faith of A Design of Faith to do a complete redesign of my blog, and I couldn't be happier with the results!! Thank you so much, Faith. You did an amazing job and I am so incredibly grateful. This was something I really wanted to do for myself so that I can have a beautiful place online to share my feelings throughout this roller coaster ride of TTC. As of today, I am going to make a pledge to blog every day. I think it will definitely be therapeutic for me to be open about my feelings. IVF is feeling so real right now even though it's been pushed back a few times. We're really at the beginning stages right now, so this is the perfect time to rededicate myself to my own blog and opening myself up to what's about to happen in our lives.

Now that our vacation is over, I feel a major focus shift deep inside. I've been wanting to have a baby for so long, but there have always been obstacles in my way. Now that my life is finally in a good place and I have finally found the most amazing man to raise a family with, we're having trouble getting pregnant. With the PCOS, I always knew this was a possibility. Still, there was a part of me deep down that hoped when the time was right, I wouldn't have trouble getting pregnant. It's heartbreaking to see that all those fears are coming true. I always thought IVF was a last-chance scenario, so to find ourselves in a place where it's the next step has been really hard to swallow.

When we first talked to our doctor about IVF this past Spring, I kept thinking we might still get pregnant in the meantime and not even need it. Month after month has gone by with no BFP. My chart is showing that I'm ovulating, so what's the problem? It's just heartbreaking and so frustrating. I feel like now I have to just let it go of all those fears and frustrations and just know that this is our path. IVF is going to be our miracle. I'll write more about our upcoming timeline tomorrow, but for now, I'm just focusing on getting healthy, working out to try to lose a little bit of weight before we begin meds and doing my best to relieve any stress. This is our time, and I'm going to embrace it and do everything I can to contribute to a successful first (and only! I hope!) round of IVF.