December 09, 2008

2nd Opinion: Kind of Different, Kind of Not

You'd think after nearly six years of infertility that I would have learned my lesson: Ask two doctors to look at the same test results and information, and you'll get three different answers.

2nd Opinion Endo isn't convinced that the thyroid issues mean it will be impossible for me to carry a successful pregnancy. But, he doesn't really have any data to back that up, either; he's just going on experience - he said he's had some patients have very high TSH levels (translation: extremely hypothyroid) who still were able to get pregnant and stay pregnant with those abnormal levels.

I received my Thanksgiving week blood results from 1st Endo last week, and my TSH has continued to climb. That wasn't a surprise to me, because I can barely stay awake during the day, and fatigue is one of the main symptoms associated with high TSH. But what's odd is that the hormone levels that are usually low when TSH is high were not low - they, too, are continuing to climb and are now abnormally high.

2nd Opinion Endo thinks what I'm experiencing is intermittent thyroiditis, meaning occasionally my thyroid suddenly goes into overdrive, causing me to become hyperthyroid, and then when it tires itself out, it hits bottom and bounces in the opposite direction, making me hypothyroid until it settles back down to normal. I asked if pregnancy could trigger it to go into overdrive, and he said yes, absolutely. So I guess that would explain my high blood pressure during pregnancy, since it starts to happen pretty much immediately, whereas pregnancy-induced hypertension usually doesn't begin until sometime in the second trimester.

All of that said, he doesn't think that my levels are a cause for concern, even though they are climbing. He says they're "close enough" to normal that nothing needs to be done other than just continuing to monitor them at this point. Like 1st Endo, he also said he doesn't think the levels are abnormal enough that they would be creating any of my symptoms.

All of which leads me to wonder, what the heck is the point of a "normal range" if you're just going to look at people outside of that range and say, "eh, close enough..."?

So, I'm going back to my PCP tomorrow to share all of this information with her and see what she recommends. She's a DO rather than an MD, so she tends to have a more holistic approach. I think she's my best shot at getting someone to address my health based not just on numbers on a piece of paper, but also on symptoms and how I actually feel.

December 02, 2008

Second Opinion Next Week

All of you are the best! Thanks so much for your support and solidarity.

I should have mentioned in my last post that I do have a second opinion scheduled, kind of by accident, for Monday.

How does one wind up with an "accidentally scheduled" second opinion, you ask? Second Opinion Endo was actually my first choice when I looked into making an Endo appointment a couple of months ago, because I had seen him a few years back and he seemed supportive of our IF issues and concerned about my mom's thyroid issues being passed along to me. (But all my numbers came back normal at that time when he tested me, so nothing came of it.)

Anyway, Second Opinion Endo's first available appointment when I called in October was Dec. 8. So I scheduled that, but called around to see if I could get in anywhere else sooner, and Endo (who deals exclusively with thyroid issues) had appointments available two days after I called in October, so I went there. But because I've learned to never cancel a doctor's appointment until the very last minute (especially with someone like an endo, which can be a 6-month wait in our city), I still have Monday's appointment scheduled.

I also called Endo today to get last Tuesday's test results, and his office is supposed to call me back tomorrow with those and fax them to me. So we'll see what those show.

In the meantime, being one not inclined to let grass grow under my feet, I've already been thinking about various options. We may look into IVIg, but I've done intralipids before, and I'm hesitant about lowering my NK levels too much (intralipids brought them down to 3%). I have to think those little suckers are important for things like fighting cancer cells, and I'd hate to trade one heartbreaking problem for another, potentially deadly problem.

(Please understand that I don't know for sure that the use of IVIg or intralipids could make someone more susceptible to cancer, so if you've taken intralipids like I have or IVIg, I'm NOT saying you will get cancer. But to me it seems that if NK cells protect against cancer, and you reduce the number of NK cells that are functioning in your body, that by extension you're also increasing your risk for cancer.)

I'd like to consider gestational surrogacy, but if we don't have someone step forward who is willing to do it for us, I don't know that we have the emotional or financial strength to go through the process of finding a surrogate.

And because I'm a crazy person, I've also (with enormous reluctance and distrust) started researching adoption again. We really, really wanted to start at the beginning with a newborn, but after all we've been through, I think we're to the point where we would be willing to give up the newborn requirement if it means we could actually have a living, breathing child in our house.

I looked at Ethiopia and really liked that option, because it is possible to adopt a baby under the age of 1, the cost is (relatively speaking, of course) lower than some other programs, and you aren't required to travel. However, I did some checking around, and R and I wouldn't qualify, because Ethiopia has a no-anti-depressant policy, and after 6 miscarriages, 3 failed adoptions and everything else we've dealt with these last six years, I need anti-depressants the way a fish needs water. Even R, who before this nightmare was the textbook definition of an eternal optimist, had to start taking them this summer because it all just got to be too much.

So, Ethiopia is out. But apparently Lyberia and Uganda are still options for us, and I've also started looking at places like Nepal and Brazil. If you would have told me six years ago that at some point in the future I'd be considering going to NEPAL (I'm not even quite sure where that is!) to have a kid, I'd have told you that you were the crazy one. But I think the claim on crazy is all mine at this point. :-)