Day 18

Well, CD18 has come and is almost gone. I didn't realize how many hopes I had hanging on ovulating by today until last night, when I accepted that it just was not going to happen this way. I really hoped that using progesterone to jump-start my cycle would be enough get me ovulating, but it's just not going to be. I called both my regular OB, Dr P, and my MFM OB, Dr W, who will be following my next pregnancy, to let them know what was going on. They both actually called back at times when I was able to answer my phone during my work day, which was basically a miracle. Dr W's nurse called first, and I updated her on the situation since I hadn't told them anything yet. I also told her that I am concerned about PCOS, but that Dr P wanted to treat with Clomid without looking into whether that is the issue or not. I'm not opposed to Clomid, but there is another medication, Metformin, that may be appropriate for PCOS that would help me cycle without (I think) increasing my chances of having multiples. In my mind, because I'm already considered high risk, I would rather try the medication that doesn't increase my risk of multiples, which is also considered high risk. If Clomid turns out to be the best option, then I'm ok with that, but I need to know that I've covered my options. Dr W's nurse said that "would be a great conversation to have with Dr W." I asked if a phone consult would be possible, since I live an hour away and would have to take off work, but she said he would want to see me in person. That's fine if the appointment is worth my time. Miraculously, she got me in next week Tuesday, so I'm pretty stoked. I really thought I would be waiting another month to get in there. Hooray!!
This afternoon, Dr P called me back himself. Although I felt uncertain about his plan before talking with him today, he answered all of my questions and I feel more confident. I do still want a second opinion from Dr W to address which medication is the best fit, but I feel more confident that Dr P is taking my concerns about PCOS seriously. He basically said that he would like to wait and see if I finish this cycle on my own, and if I don't start my period by day 32, he will do another round of progesterone to get me going again, then prescribe Clomid cycle days 5-9, starting with 50mg, then potentially 100mg, then 150mg in subsequent cycles progressively until I would ovulate. If I still don't ovulate on that highest dosage we would revisit the idea of FSH injections, which he said would "increase monitoring and cost significantly." Let's hope we don't have to go there. I told him of my understanding that Clomid is less likely to work if PCOS is the issue, and he confirmed that. I asked him about Metformin as an alternative, and he explained that typically, Metformin works best for women who are insulin resistant and over weight, neither of which I am (to my knowledge). It's possible that Metformin could still work, and I have a friend who doesn't fit the mold and has had great success (due in July :) ), so I'm not ruling it out yet, but that's good to know. I feel like he is considering that possibility, which I wasn't sure of before. Dr P also explained that research is still inconclusive as to whether or not Metformin produces any better results than Clomid. And later in the afternoon he actually emailed me a research article about a study that found that more live births occurred with the use of Clomid than with Metformin. I haven't made my way through it just yet, but I definitely will. So all in all, I feel much more like he is on my side after our conversation.

I realized something as I was lying in bed feeling frustrated last night. When M was born so early, I felt so disappointed in my body. I felt as though it had let me down. All my life, I have been able to just about anything I have wanted to do if I worked at it enough. But now, when it comes to the most important thing to me, my body has failed, and there is nothing I can do about it. I had worked through those feelings as much as possible, and since M is doing so well, it hasn't been staring me in the face for a long time. But once I realized that I am still not ovulating with the assistance of progesterone, I began feeling like my body is letting me down yet again. It's not as though this has been a long process thus far. I feel like I am more frustrated than can be accounted for by the last month and a half. But I think that what it comes down to is that the feeling of my body letting me down this time around is stirring feelings that I thought I had worked past. I can't tell you how sickening it is to know that your body has been unable to carry your baby to term, and to see that tiny baby struggling for life, and know that you are completely out of control. The feeling of wanting so desperately to protect her from every bright light, every loud beep, not to mention the invasive medical procedures, and being utterly unable to do so, is beyond words. It's sickening. Only another preemie mama could really know. The night I came home from the hospital, I just laid in bed, hugging my empty belly, and cried and cried. I don't ever want to feel that again. So the feeling of having no control over my body is a difficult one for me. I'm trying to embrace the body that God has given me and trust that he has entrusted me with this struggle for a reason, but I swing between that knowledge and the conclusion that my body is one selfish POS. It has always treated me just fine, but when it comes to growing another human being, it's just doesn't come easily. Hopefully I'll grow to be more graceful and lean more often towards the former. :)

In other news, part of my effort to embrace my body and know that I am fearfully and wonderfully made has been to sign up for my first 5K! I'm in week 2 of training and I'm actually really excited! I decided that it's time for me to force myself into some "me time" so pushing myself to do this is all about me. My mom, sisters, and a couple friends are also signed up, and I think it's going to be a lot of fun! August 18th- let the count down begin!!