'My Lemon of a Body'

I promise, my goal is to someday write a happy, positive, cheery post again. I used to be an optimist, I swear.

Today is not one of my optimistic days, though.

I had my follow-up to the Bad Blood Pressure appointment today. It was still high (144 over I-have-no-idea), but not as bad as before (150-something over 100-something). So at least I'm moving in the right direction, but obviously still a long ways to go.

And now there are other issues. One, my fasting glucose was in the pre-diabetic range at 110, even though I'm on Metformin. Another bad sign, and another huge motivation to exercise and eat better.

But the bigger news was that my TSH level came back at a measly 0.092. Apparently, I have hyperthyroidism. Hyperthyroidism can cause high blood pressure. (Although I probably can't blame all of my blood pressue on that, as much as I would like to.) And it can cause miscarriage. (Again, can't blame it for all of my m/c's - I've had my TSH tested a few times during the past 5 years, and it's never been this low before.)

So it needs to be addressed, which may mean postponing the cycle we were planning to do in October. Since we're only planning the retrieval for October (a transfer would probably be February at the earliest, assuming there is anything to transfer), maybe there's still a chance we can do that - I'm waiting to hear back from the RE.

I also have a list of appointments to go to now, starting with a thyroid ultrasound next week. (I'm so used to trans-vag ultrasounds, let's hope I remember to keep my pants on for that one. Imagine the ultrasound tech's shock if I suddenly start to undress...) And then there's a lovely 3-part nuclear medicine "uptake" test and scan of some sort that involves me swallowing a radioactive substance while the tech who gave it to me flees the room. (It's never a good sign when the FAQs include "Why Do Medical Personnel Run For the Door After They Give Me RAI?")

And because I haven't whined enough, let me add that on top of all of this lovely news, one of my best friends confided to me this afternoon that she is pregnant again. Of course I'm happy for her, and she's the most supportive IRL friend I have because her first child and this baby are both IVF babies, so she knows what it's like. But still, it hurts a bit to think that she is now well on her way to having her second child, and here I am probably postponing a cycle for at least a few months and don't even have a first kid.

One more thing I feel compelled to whine about: Everything I read says hyperthyroidism causes weight loss. If I'm going to have to deal with this darn problem, the least I could have is that symptom! I mean, really, is it so much to ask for? Fat cells, fleeing my body. Running far, far away. With everything else I have to deal with, I at least deserve that! But noooo, they're all still here, stubbornly clinging to me, mostly in places that make me look like I'm pregnant when really I'm not. When I pointed this out to the physician assistant who was delivering the news to me this morning, ("What do you mean, hyPERthyroidism? Have you SEEN the number written down for my weight on that chart?") she said no such luck. Apparently, it's actually a rather rare symptom. It would figure that would be one of the few things where I actually didn't fall on the rare side of the odds.

All of this reminds me of a conversation I had with a friend of mine when we went to go see a movie earlier this month. She has had several health problems, including infertility, MS, and ironically enough, a thyroid issue. Now she's facing knee replacement (at age 36) for an old knee injury. During our conversation, she said, "I'm doing okay, but some days I wish I could trade in my lemon of a body for a different one!" I know how she feels.

On the bright side (see, this is me working to try to dig up at least a little bit of my formerly sunny, optimistic self), my cholesterol was shockingly normal at 181. It's been in the 210-230 range for the past couple of years, so this was a very nice surprise. I have no idea what improved it, but I'll just be glad about it. And try very hard to resist the urge to go out and have a steak for dinner to celebrate it.

The Moment of Truth

There are rare moments in life when something happens, when something you've known all along but have chosen to shove aside and ignore in hopes that it will go away, can no longer be ignored. Instead, in that moment - the moment of truth - the whole ugly reality is suddenly so in-your-face that it's impossible to not change.

My moment came at about 11:30 a.m. this morning.

I was in my family physician's office, because I've been suffering from a cold all week. I figured there's not much they can give me since it seemed like a cold, but today I was miserable enough to make an appointment anyway.

The nurse's assistant weighed me, took my blood pressure and clipped a device to my finger to check my blood oxygen level. Then she escorted me to an exam room, where I sat clutching the Kleenex box and coughing loudly.

It wasn't long before the physician assistant who I was scheduled to see walked in. She shut the door very deliberately, stood in front of it with her feet braced apart as if I was likely to rush the door in a tackle, looked at me as directly as any person ever has in my entire life and said, "YOU have high blood pressure."

I'm sure it sounds like I'm overdramatizing this, but it is a seismic moment for me.

I know I've gained weight (55 pounds since we started infertility stuff 5 1/2 years ago), I know my blood pressure isn't great. But I kept telling myself that it was just temporary, that eventually I would bring it back under control.

But the reality is that I'm 5'7" tall and I weigh 220 pounds. I'm 15 pounds heavier than my husband, who is 4 inches taller than me. Until this year, I've never been heavier than him. Yes, a lot of that is due to infertility and a lot of that is due to an anti-depressant I take that has weight gain as a side effect. And it's also due to genes - both of my parents are obese, have high blood pressure, high cholesterol, etc. And I have metabolic syndrome, which includes all of those things. But the truth is that it has much, much more to do with the fact that I don't exercise, we rarely cook, and I eat a ton of junk.

As a result, I'm 34 and at significant risk for a stroke. And, it's rather difficult to carry a pregnancy to term if your blood pressure is through the roof. My blood pressure has been on the high side for a couple of years now, but I've just chosen to pretend it wasn't an issue. But I'm new to this doctor, and she (and apparently her physician assistant) isn't the kind of person to take any crap.

I kept telling myself that "tomorrow" I would stop drinking soda, stop eating so much ice cream, start sticking to a diet. But of course "tomorrow" never comes.

That moment when the physician assistant looked at me and uttered those words was a turning point. I have a long way to go to get to where I need to be, but I have to do it. Reality is now too much in my face for me to be able to ignore it. Plus, I have to go back in two weeks to get it checked again.

I don't yet know what this will mean for our upcoming IVF cycle. But around here it means a major lifestyle change not only for R and I, but also for my mom, since she lives with us. She grew up immediately after the Great Depression, and that has profoundly impacted her life. She is a food hoarder - we have two refrigerators in our house and a large walk-in pantry, and one entire refrigerator is hers, and she also takes up half of the other one. The pantry is about 90 percent her food.

She buys three half gallons of ice cream at a time. There are four or five pie crusts in the refrigerator, a dozen boxes of cake mix and eight boxes of lemon bar mix in the pantry. There is an entire drawer of chocolate in one of the refrigerators - chocolate bars, chocolate bark, chocolate chips, a chocolate Easter bunny, Reese's peanut butter cups, etc.

I sat down and talked with her today. She is willing to stop buying the ice cream, but she's not willing to toss out or stop buying the cake mixes and other stuff. She says she will relocate them to a place where I won't have to see them. (I'm guessing that will mean in her closet.) I'm not sure what she plans to do with the stuff when she makes it, but I will need it to be out of sight.

Right now I don't feel well from the cold, which has turned into a sinus infection, and from a migraine that was triggered by some of the medications I got today. So it was pretty easy to eat healthy - or really, not eat much at all - today. But once I start feeling better, I know this is going to get a whole lot harder.

Still Plugging Along

First of all, thanks to all of you who commented about R and his heart issue.

R had the EP study done last month, and he got the defibrillator. The way the EP study was done, his cardiologist injected a medication to see how easy it would be to trigger cardiac arrest. The cardiologist had only injected about 20 percent of the medication he was planning to inject when R arrested, so the doctor felt it was clear that R needed the defibrillator, and he implanted it right then.

Thankfully, R's recovery has gone very well. The pain is almost all gone, and the bruising is gone. This particular doctor implants the device as if it was a pectoral implant, so R now looks very buff on his left side. The doctor (and the rest of us) have teased him that he will need to focus on working out his right side now so that he is even.

The biggest change for him has been mental - adjusting to the idea of being a "cardiac patient." The morning after his procedure, while I was down in the hospital cafeteria getting myself breakfast, a cardiac rehabilitation specialist came by to talk to him. When I got back, he said, "But it's not like I'm a 60-year-old with a pot belly who just had a heart attack!" During his follow-up appointment at the cardiologist's, we were the only people in the entire waiting room under the age of 65, except for one guy about our age who was there as his grandmother's ride. All the other patients kept looking at us, no doubt wondering what we were doing there.

His restrictions (no driving, no lifting more than 10 pounds) will end on Oct. 1, and we'll likely be out of state at our clinic later that month for the next cycle. Right now I'm just waiting for CD1 to show up so that I can start the BCPs. It should happen toward the end of next week, but I had some spotting last week, so I don't know if it will happen next week or if my body is on another wildly irregular cycle. If it doesn't happen by CD35, I'll do a round of progesterone withdrawal to induce it.

Our new RE is cutting my stim meds in half - I'll be starting with 75 units of Gonal F and 75 units of Menopur per day. I know that sounds insanely low to most cyclers, but during our last cycle I started out on 300 per day and wound up with 32 eggs. (And 17 embryos and 0 babies.)

Given that I am R's chauffer for the next month and that I really want to focus on the cycle, I began taking steps last week to scale back my second job (real estate). I'm hoping that by the end of this week, I will have reduced my load in that area by at least 50 percent. I'm also hoping that means I will have more time to blog again. I've needed the space from it - and really, from all things infertility - but it's time to step back in again.

Here's hoping for a relatively uneventful autumn.