Saturday, September 19, 2009

Contemplation


Lunartik in a cup of tea, originally uploaded by Kodamakitty.

I don't have a good photo to illustrate this post, but I am pretty pleased with this new toy, so there he is.

Ok, so since my last post I've finished my second round of 150 mgs of Clomid, which didn't do anything. It probably didn't help that I got a terrible head/chest cold right around the start of classes and was pretty much hopped up on Sudafed and Mucinex for the better part of a week. Still, sick or no, I kept my appointment for my day 12 ultrasound and we kept trying in case an egg decided to make a surprise entrance.

An ultrasound on day 12 and another on day 15 showed that nothing was really happening. My follicles were on the small side and a blood test showed that my estrogen and progesterone levels were not anywhere near what they would be if ovulation was imminent.

We met with Dr. Puschek on Thursday and we essentially have two options: Gonadotropic Injection Therapy or In Vitro Fertalization (IVF). Neither one is super cheap - I think the estimate for the injections are around $4000, and IVF is around $15,000. But, since I turn 35 next month, the odds of my having a viable pregnancy begin a very sharp decline.

So, if I do go with the injections, I would need to wait until I had a period at the end of October (we will be doing some extensive traveling and it just makes more sense to aim for November). Three days after my period begins Geoffrey or I give me a shot, usually in the abdomen. Starting on day seven, I would have to go in every day or every other day for a vaginal ultrasound and blood work to monitor my level of Estradiol, which measures egg maturity. Once it seems my follicles have matured and the Estradiol is at a specific level, I would then need an hCG shot to release the egg, followed by insemination. In order words, this is a lot like the Clomid regimen, but with injections, ultrasound and bloodwork every day for a week or so.

( source: http://www.ivf-indiana.com/gonadotropin-therapy.html)

According to the American Pregnancy Association, the steps for IVF as follows:
There are basically five steps in the IVF and embryo transfer process which include the following:

Monitor and stimulate the development of healthy egg(s) in the ovaries.
Collect the eggs.
Secure the sperm.
Combine the eggs and sperm together in the laboratory and provide the appropriate environment for fertilization and early embryo growth.
Transfer embryos into the uterus.

Step 1: Fertility medications are prescribed to control the timing of the egg ripening and to increase the chance of collecting multiple eggs during one of the woman's cycles. This is often referred to as ovulation induction. Multiple eggs are desired because some eggs will not develop or fertilize after retrieval. Egg development is monitored using ultrasound to examine the ovaries and urine or blood test samples to check hormone levels.

Step 2: Your eggs are retrieved through a minor surgical procedure which uses ultrasound imaging to guide a hollow needle through the pelvic cavity. Sedation and local anesthesia are provided to remove any discomfort that you might experience. The eggs are removed from the ovaries using the hollow needle, which is called follicular aspiration. Some women may experience cramping on the day of retrieval, which usually subsides the following day; however, a feeling of fullness or pressure may last for several weeks following the procedure.

Step 3: Sperm, usually obtained by ejaculation is prepared for combining with the eggs.

Step 4: In a process called insemination, the sperm and eggs are placed in incubators located in the laboratory which enables fertilization to occur. In some cases where fertilization is suspected to be low, intracytoplasmic sperm injection (ICSI) may be used. Through this procedure, a single sperm is injected directly into the egg in an attempt to achieve fertilization. The eggs are monitored to confirm that fertilization and cell division are taking place. Once this occurs, the fertilized eggs are considered embryos.

Step 5: The embryos are usually transferred into the woman's uterus anywhere from one to six days later, but most commonly it occurs between two to three days following egg retrieval. At this point, the fertilized egg has divided to become a two-to-four cell embryo. The transfer process involves a speculum which is inserted into the vagina to expose the cervix. A predetermined number of embryos are suspended in fluid and gently placed through a catheter into the womb. This process is often guided by ultrasound. The procedure is usually painless, but some women experience mild cramping.

These steps are followed by rest and watching for early pregnancy symptoms. A blood test and potentially an ultrasound will be used to determine if implantation and pregnancy has occurred.


( Source: http://www.americanpregnancy.org/infertility/ivf.html)

If money weren't an issue (and my mom generously continues to support the cause), I'm still not sure which way to go. Neither is assured.

Much much thinking and soul searching....

Geoffrey has found that our insurance will not cover IVF. And, at this point, it would seem that adoption would cost the same as IVF. So, we are going to try the injections first and go from there.

At least I get October off and then we start again.

^_^

Monday, August 31, 2009

Think Happy Thoughts


IMG_5457, originally uploaded by Kodamakitty.

Today was a long day. Not for any specific reason, other than that work is piling up and classes are imminent and I don't have nearly as much done from the summer as would like, and the house is a mess, and I have a sore throat from a post-nasal drip most likely exacerbated by my freezing cold office and and and... So, the usual.

But today felt more wearying than usual. So, Geoffrey and I have agreed to blame it on the Clomid. I finished my fourth round last night and now it's a matter of waiting until Thursday to see how things go. Originally, my ob/gyn only wanted to do three rounds, given that Clomid can start to affect the quality of the uterine lining. However, based on the various tests and procedures, it looks as though my main issue is ovulation.

When I do ovulate, it seems to be a complete cycle most of the time, and my period begins on schedule, but whether or not I am releasing a viable egg and whether or not the sperm are getting to it seems to be another story. I'm not sure it's entirely logical to think that I would be more at peace with my current chaos if I were pregnant right now, so I'm going to blame the Clomid.

To counteract the sort of blue and down feelings, I'm posting this with a bright yellow flower - this was one of the bouquets from the Farmer's Market at WSU and they lasted a really long time, which was great.

And, in no particular order, here is an impromptu list of 10 happy things:

1) I love Geoffrey and he loves me
2) He's really been a trooper though all of this
3) We're living beyond our means, but it's temporary and we will sort all of this stuff soon
4) Bailey and Zookie (the dogs) love us, no matter what
5) We will soon have a new addition to the family, when Alex and Kara have their baby on September 22
6) I was able to take a walk outside, without discomfort or difficulty
7) Olga's is pretty good comfort food
8) This cooler weather is excellent sleeping weather
9) We live in interesting times
10) It could all be much, much worse

Be well, everyone! What's on your spontaneous list?

Sunday, August 23, 2009

It's only natural


It's only natural, originally uploaded by Kodamakitty.

And yet, I was really hopeful this time.

As I mentioned in my previous post, there appeared to be a candidate egg and poor Geoffrey had to learn to give me the hormone shot to stimulate its release. The following Monday (so almost two weeks ago) we went through insemination. We also found out the happy news that IUI is covered by our insurance (yet another instance where male procedures are covered, but I am sure someone else is blogging about that), so we didn't have to pay and we have since received a refund from the IUI in May.

All we could do was wait, since a pregnancy test would only pick up on the hormone from the shot and not give a true result. But today, alas, my period has started, thus the shot of feminine hygiene products (and a pretty Dunny for levity) and a crying jag from me...

Geoffrey is disappointed too, of course, but his gentle strength and reassuring love are the best balm to my bruised soul, and I'll readily admit, ego. These are not the sort of tests you can pass on merit alone. There is chance involved and Lady Luck is fickle. We can joke all we want to about women who have babies when they don't want them and how we spend all our time trying NOT to get pregnant until we do, but at the end of the day, my chances of conceiving are really about 20%. This is only really our third attempt. We may be able to get lucky on our next two tries or in our next seven tries.

I guess the important thing is to keep trying.

I may need to call in for a mental health day tomorrow. I'm okay, for the most part, just sad and I'm not sure I can truly deal with trying to be efficient and cognizant tomorrow. I may just stay in bed and watch "Truly, Madly, Deeply" while eating a bunch of chocolate and browsing on eBay.

Then on Tuesday, we will begin again.

Thanks for reading.

Sunday, August 9, 2009

Taking another shot


Taking another shot, originally uploaded by Kodamakitty.

So I went in for a day 12 ultrasound on Thursday (another $150, plus $100 for tests run the time before - yikes!) and my ovaries weren't ready yet. Which is kinda disappointing when you've taken a triple dose of a supposedly powerful and effective drug. Thankfully, this is the week I decided to use up some of my vacation time because I immediately went into sulking mode. Geoffrey was slammed at work, so he wasn't able to help me put things into better perspective until he got home. Which, of course, he did. My reaction to the Clomid could have been so much worse, I've lost a decent amount of weight, and I'm generally eating healthier (though my sleep hygiene does leave a bit of something to be desired).

I had to go back in on Saturday (you guessed it, another $150) and this time, it looks as though there is one "perfectly round... beautiful" follicle of the correct size to merit the shot to stimulate ovulation. Now, when we did this in May, we had to make a decision - inseminate before the shot so the sperm would be waiting, or inseminate after the shot so that the sperm would chase the egg. We decided to do the shot first. This led to a crazy race against the clock to get the injection, go home, have sex (because there shouldn't have been more than three days between ejaculations), come back 24 hours later, have Geoffrey, erm, produce, and then get inseminated two hours later. To say it was exhausting and chaotic was a bit of an understatement, followed by the disappointment of the egg and sperm not meeting up.

This time, the nurse suggested that if Geoffrey was comfortable giving me the shot in the evening at home, ovulation would occur within 36 - 48 hours, meaning that the insemination on Monday morning would have a better chance of coinciding with the release of the egg. My wonderful husband gamely walked through the procedure with the nurse, was handed everything in the photo above plus a square of gauze "in case she bleeds," and then we were ushered out the door with a reminder to have sex that day, none on Sunday and be ready to produce on Monday.

Flashback: when I was in high school, my dad became ill with non-Hodgkin's Disease lymphoma and so he couldn't control his type II Diabetes and his hypertension just with diet and exercise. For a short while, my aunts would come by and administer the insulin he needed. But one night, no one could come, so it fell to me. Why my dad hadn't learned to inject himself is a mystery to me now, but I got my first lesson on giving a shot over the telephone. Up until my junior year, I had thought I would become a nurse, like my mom and most of her family, so I suppose it seem like as good a time as any to learn how to use a hypodermic needle. Thing is, I hate needles. Totally freaked out and scared of them.

This meant that my hands and presence of mind were not too steady giving this shot to my dad. It was not pleasant, and I botched it terribly (the insulin formed a bubble beneath his skin, so it didn't get delivered into the muscle). I cried my eyes out, because my dad was also expressing how much I was hurting him at the same time (I did eventually get proficient at administering insulin and using lancets to check blood sugar - in fact, most nights I would have to be home by 11 in order to help with that). Did I mention I hate, hate, hate needles? Definitely one of the major factors in deciding to major in Psychology instead of Nursing.

So, my brave, brave husband and I discussed the fact that he had never given a shot before. Thankfully, my mom was off this weekend and agreed to supervise. Thankfully, too, the shot is administered to the top outside quandrant of the buttock (either side) and so I cannot see it and it doesn't hurt as much as you might think, especially when my mom, the uber-nurse, looked at it and said, "wow, that's a long one - they really mean for it to be IM" (intra-muscular), and starts measuring it with her thumb. Not reassuring, except that I knew it wasn't that bad once the needle was in.

I am happy to report that Geoffrey did just fine and the shot was administered successfully. My mom talked him through it (I can see why she's a good teacher on the unit) and also had extra alcohol wipes in the house since the nurse only gave us one pad (I mean, really - you have to wipe the bottles AND my butt. One is not enough. But I digress).

Tomorrow we go in for another "deposit" - insemination (another $350). Keep your fingers crossed!

Wednesday, August 5, 2009

Reflections

Me Then: October 23, 2008 (which was my birthday)
San Antonio Riverwalk

Me Now: August 2, 2009
IMG_4734

I was using the "Faces" feature in iPhoto and suddenly wanted to see photographic evidence that I was actually managing to lose weight. I know my clothes have been fitting better and I am enjoying smaller portions of things, but I really think these two shots hammer home that I am making progress and that I need to keep going. Sooner or later, I'm sure I'll be taken off of the metformin and I need to be ready.

In other news, I finished a triple dose round of Clomid (150 mgs per day) last week so tomorrow morning I go in for yet another ultrasound. If all goes well, we'll attempt insemination again on Friday. It's been frustrating, especially as I start to sort through all of the stuff in the house and begin to realize just how mortgaged to the hilt we really are. But I am sure that we would be able to handle a baby, right? We'd just have to make do and cut back on stuff and sell stuff and borrow stuff and make it work :)

Thanks as always to everyone for their loving support - especially Geoffrey.

Sunday, July 19, 2009

Update


My favorite shot of the day, originally uploaded by Kodamakitty.

July is a bit of a break from the fertility regimen. The pregnancy test came back negative, so no ectopic pregnancy to worry about, but the "leftovers" in my uterine lining and follicles mean that the clomid would most likely not be effective this month. I am to come in for another 3rd day ultrasound when my next cycle begins.

I could have used this month to chart my basal temperature, or continue to pee on sticks to figure out when I was ovulating, but to tell the truth, it is actually a relief to not do anything at all. I am continuing to take metformin and try to exercise at least every other day, but to not have to mark time by the days in my cycle is a bit of a luxury. The summer is already going by so fast!

Classes are over for now and I am trying to get the house a bit more organized and de-cluttered for the fall. I am sure that as I find ways to manage my time and stress better that will only help on the baby-making front. I continue to take pictures, such as the one above, that help bring a smile to my face hopefully to others too. This picture did come at a bit of a cost, as it was taken at the private home of a colleague who then had to request that I take some of the pics down. A bit embarrassing for me, but a good lesson that not everyone wants to have their pictures taken or shared, no matter how lovely or becoming I think my humble pics might be. I am always learning!

Monday, July 13, 2009

Surviving the summer

Wow - I can't believe how fast the summer has been flying by! As I mentioned in my last post, the end of my spring session classes were close at hand. They are now officially over and the grades are posted (I did better than I expected, but according to Geoffrey, that's fairly normal, as I seem to always expect one grade lower than I actullay earn, lol). I am sure these delightful kitty highlighters, sent by one of my Flickr contacts, were part of my success. Thanks, Nicole'!

The other parts of my success, of course, include the support of all of my friends and family, and Geoff in particular. Many thanks to those of you who read this blog and who ask about how things are going. I know I do not always have the most gracious response, but I am working on it and I appreciate everyone's care and concern.

Unfortunately, this last round of Clomid did not help me ovulate with any great predictability, and the ultrasound this morning seems to indicate that I have some "leftovers" and that my uterine lining is a bit thicker than to be expected. I had to have a blood draw (never fun, as I am opaque and one of my veins is, as the nurse said, "a bit crooked") to confirm that I do not have an ectopic pregnancy.

If things are in the clear, then I have a prescription for a triple dose of Clomid and around day 20 of my cycle I will need to start testing my urine daily to see when I will be ovulating. Having done that last month, with not a lot of precision or therefore, success, I am not looking forward to it. But, it's way cheaper than going to Southfield every two to three days for an ultrasound.

So now I am trying to get caught up at work, trying to get organized at home, and trying to have a bit of fun over the summer too. Geoffrey and I have been walking the dogs ever increasing distances and I know we're all the better for it. I went to the fruit market over the weekend and came home with some lovely veggies that I will hopefully cook and not allow to turn into petrie dishes in my crisper. Even if I don't get pregnant, I can at least get healthy!

More soon.

Sunday, June 21, 2009

Walking it off


Zookie glamour shots, originally uploaded by Kodamakitty.

Well, the SIS (see last entry below) looked good, but the Clomid did not appear to be making my ovaries develop any faster than usual, despite the double dose. So, rather than having an ultrasound on cycle day 11, I went in on day 13. Still no major developments. To me, the most ominous phrase must be, "I'll talk with the doctor and call you to let you know what to do next."

The verdict is that Geoffrey and I will need to purchase an over the counter ovulation predictor kit. The kit comes with test strips to try and identify a surge in LH, which tells you that ovulation is imminent in the next 72 hours. Unlike a pregnancy test, you have to take the test in the afternoon, preferably around 2 pm (that should be fun at work) and it takes about 10 minutes. Once there's a surge, then we are supposed to have intercourse three days in a row in order to try and intercept the egg.

As my coworker Craig observed, "normally the most fun thing about having kids is making them, but that doesn't sound like the case here." LOL! It's true - this feels a bit more like a science experiment than anything else. Thank goodness Geoffrey and I have a long history with each other, I am quite sure that is helping reduce some of the awkwardness that could come from having sex on schedule. We're both fairly silly and playful, and that definitely helps to alleviate some of the tension.

In the meantime, with the nicer weather and cool mornings, I've been trying to take my girl Zookie (see picture above) out for more walks. I don't mind the treadmill, but it gets a bit boring. Early in the morning the day is fresh, there aren't as many distractions and Zookie is a joy to walk (unless there's a squirrel, then all bets are off. She's getting better). I don't sweat as obviously as I do on the treadmill, but I've been taking longer and longer walks, so hopefully that compensates a bit. I would much rather walk outside - winter will be here soon enough and force me on there every day.

If Geoffrey and I do not get pregnant this month, then I'm back on the Clomid at 150 mgs. I am quite sure that at that level I am bound to have to suffer through more of the side effects I mentioned in an earlier post (dizziness, bloating, etc. ). Thankfully, my eight week spring classes will be over and it should be relatively easier to call in, if necessary.

That's the scoop. I'm trying not to get too stressed out about it, and to be honest, I'm actually too tired at the moment (work, classes, home, unbalanced checkbook, daily performances for Orientation Wednesday - Thursday) to be too jittery. I just have to keep walking it off!

Tuesday, June 9, 2009

Take two


DSCF1434, originally uploaded by Kodamakitty.

Literally - this will be our second attempt to get pregnant using Clomid, and I'm starting a double dose, 100 mg, tonight. I am trying to keep on schedule with working out a tiny bit each day. Today was an exception since I had to be out to Southfield before 8:15 am for an ultrasound.

The next step will be having an SIS (Saline Infusion Sonogram) or Sonohysterography this upcoming Monday. Essentially, they want to see if the fallopian tubes are, well, open for business.

Here's the explanation from University Women's Healthcare.com:


Saline Infusion Sonogram (SIS)
The saline infusion sonogram (SIS), also call sonohysterography, is an ultrasound test done after a saline solution has been infused into the uterus. The saline solution distends the uterus and acts as a contrast to the internal structure. This procedure provides more detail than a conventional ultrasound.

The Procedure
The SIS is performed early in the menstrual cycle, preferably between days 4 and 9, when the menstrual period has stopped or almost stopped but before ovulation occurs.

A patient who has had an infection in the uterus or fallopian tubes (sometimes called Pill, pelvic inflammatory disease, or salpingitis) at any time in the past should take antibiotic pills before the test is done. Most women will feel more comfortable during the procedure if they take about 600 mg of ibuprofen (3 Advil 200mg tablets) about 30 minutes before this ultrasound is done.

The patient lies on her back with her feet in stirrups (as on a gynecology examining table). A speculum is placed in the vagina and a small tube is used to insert a saline solution into the uterus. A vaginal ultrasound probe is used to make images of the saline filling the endometrial cavity. An evaluation of the cul de sac (open abdominal space behind the uterus) is done with the vaginal ultrasound probe still in place. If either fallopian tube is open, some of the saline should be seen in this space.

Reasons for SIS
SIS is used to evaluate the inner cavity of the uterus (endometrial cavity). It can also be used to discover whether either of the fallopian tubes is open. This test does not reveal any abnormalities on the outside of the uterus or on the ovaries, such as adhesions or endometriosis.

Recovery
The test may cause some discomfort, such as pelvic or lower abdominal cramping. Most women can drive and return to work within two hours after the SIS. There are no specific restrictions on activity after the SIS has been done.

Contact the nursing staff or a physician after the procedure if any of the following symptoms develop:
• Persistent pelvic or abdominal pain
• Difficult or painful urination
• Temperature over 100 degrees


Sounds like more fun than you can shake a stick at, huh? Well, it should at least give us more information about how to best optimize our chances of getting pregnant with this round of treatment.

Speaking of treatment, thank you to everyone who has stopped to ask how I've been, or to express positive thoughts and prayers for our success. Geoffrey and I are very lucky to have such supportive family and friends, and when we do have a little one, he or she will be loved beyond measure not just by us, but by the amazing people in our lives.

Onward!

Sunday, June 7, 2009

Bleeding Heart


Bleeding Heart, originally uploaded by Kodamakitty.

Bleeding me. Sorry to be graphic, but that's the update. Last night my period started, meaning that the Provera-Clomid-IUI procedure from two weeks ago did not take and I am not pregnant.

I had a good cry last night and poor Geoffrey was his reassuring best. I can't deny that I'm disappointed, even though the probability of having everything work out perfectly was relatively small (about 10 - 20%). And, to be fair, I have not had the majority of the terrible side effects many women have to suffer through to be able to conceive.

My initial thought was, "Oh God, I don't want to do this again," but after a good night's sleep, beignets and coffee this morning, and sitting down after a long absence from the blog, my guess is I'll be getting back in line and back on the roller coaster for another round trip. My guess is that my Ob/Gyn will up the Clomid dosage. My commitment is to actually get on the treadmill at least 5 days a week in order to start dropping more weight (I've been holding steady at 10 pounds lost since this journey began - time to push off the plateau).

Anyway, that's the update. Thank you for keeping me in your thoughts and prayers. I will try to update more often and to keep moving forward.

Monday, May 18, 2009

If only it were this easy!


Fat smackdown, originally uploaded by Kodamakitty.

Looking at my food log, which admittedly has a couple of "lost" days on it, I have not been putting the smackdown on fat as much as I could or should. I'm still allowing myself to award dispensations based on stress or special occasions, though to my credit, I do think I'm eating somewhat smaller portions.

I'll have to go back at some point in the near future to get more pics of this exhibit, but I was really tickled by these "whack a mole" machines at our local science center. Geoff played this one and thought it was a little silly, but I could imagine working out a few ice cream cravings by taking a whack at this machine. For example, I forgot to log that big serving of ice cream from the other night. Drat! Clearly, I need one of these for home.

On the baby-making front, I finished my five days of Clomid and went in for an 11th day ultrasound. I do have a candidate follicle that looks promising, but it's not quite large enough for me to be given a shot to instigate ovulation. I have to go back on Thursday. I know that eating, sleeping and exercising better will help make this process a success, so I am letting that be my motivation for today.

Sunday, May 10, 2009

Here goes hoping


Here goes hoping, originally uploaded by Kodamakitty.

This morning Geoffrey drove me to the Ob/Gyn's office for another ultrasound and blood draw (ick!). I've been given the go-ahead to start a round of Clomid, which will last five days, followed by another ultrasound, and if all goes well, a shot (ick) to stimulate egg release and hopefully, ultimately, conception.

All of this while I begin an intensive eight-week spring class from May - June, Monday through Wednesday, with New Student Orientation beginning in June. And did I mention that I have an all-day conference in East Lansing tomorrow before rushing back to Detroit for class? I have clearly lost my mind. Perhaps it's hanging out with my truant eggs.

Well, at least I'll be too busy to be bogged down by the potential side effects of Clomid, which thankfully are not experienced by the majority of women who take the drug, but they don't sound like fun. Essentially, it sounds like a really baaaaaaaaad bout of PMS:
*Stomach upset
*bloating
*abdominal/pelvic fullness
*flushing ("hot flashes")
*breast tenderness
*headache
*dizziness
Source: Web MD

Wheeee! About.com has an excellent write up by Rachel Gurevich, who notes that many of the women she spoke to also experience mood swings:

Mood swings are another side effect of Clomid that in clinical studies didn’t appear as often as I’d imagine (less than 1% of women). But that’s difficult to believe, given how many women have told me the mood swings were the worst side effect of taking Clomid. Mood swings may mean feeling more emotionally sensitive, tearful, or even depressed or anxious, though infertility itself can bring on these feelings without drugs. It helps to be forgiving and gentle with yourself, and to practice good self-care, during treatment cycles.

So, we're in for a bumpy ride, possibly, but if this might be a relatively painless (ick, and double ick, as noted above) way for us to start a family, it's not a bad start. Here's hoping!

Tuesday, May 5, 2009

Capturing calm


IMG_1840, originally uploaded by Kodamakitty.

I haven't had a chance to post lately, but I have been taking photos, so I wanted to share one of the ones I was really pleased with. I love photos because they can capture a moment, a mood, or a view of how we wish life really is. This picture to me is vibrant, soothing, and calm.

Which right now, despite the relative lack of traffic in my office, I have a long laundry list of things to do that make life anything but calm.

It's time like this that my dubious powers of rationalization lead me to eat that one extra serving, or to crave things that I know will show up on the scale the next day. I say that it's because I'm under stress, knowing full well that if I am truly under stress, my body will be on full-alert mode to hold on to every extra ounce in order to survive whatever ordeal I am supposedly preparing for. Batten down the hatches! Every fat cell for itself!

I need to teach my body to crave healthy things and to hit the treadmill or go for a walk when I'm bored or fidgety. I also need to get a bit more organized so that I'm not drowning in a sea of paper and projects. I keep waiting for a good time to do it all in one lump sum, but that never really happens.

So, much like I took some time out to take advantage of a sunny window and a free bunch of sunflowers, I will try to take advantage of smaller moments to sort little piles, rather than letting them pile up. And I will take advantage of small moments to gain a sense of calm, rather than letting everything build up into a morass of frustration and inertia.

I will be calm. I will get organized. I will not let the munchies get me!

Thursday, April 16, 2009

Keeping track


Keeping track, originally uploaded by Kodamakitty.

I meant to update sooner, but things have been super busy between work, classes (one more week, yay!) and just general laziness. I have though, still been keeping up with my morning weigh-ins and food logging. I slipped a bit at Easter, and today, which included a consult with my Ob/Gyn and a preview of the hard work to come, lunch at a groovy diner with my friend, Patti, as well as a banquet with the most amazing food, sigh.

I bought this notebook from Michael's when I was out with my friend, Sonia. It turns out to be the perfect amount of room to contain a day's menu, I know I've gone too far if I have to start writing sideways in the margin or consider not skipping a line between each mealtime. I am also using the log to track the amount of sleep I'm getting each night and how much medication I am taking.

So far, I have found that days where I can list simple meals are usually also the days where I lose the most weight the next day and I feel better. Common sense, right? Sure, but it really hits home when I can see it on paper and see it on the scale, and feel it within my body. A day where I go up by two or three pounds usually means that I can look and see that, yup, I didn't drink enough water and/or ate stuff I know I shouldn't (or at least not as much of).

I am also finding that I do start to feel full three or four bites before I'm done, but i push on anyway to finish my meal. I think there are a few reasons for this:

1) I've bought into the hype, as I suspect we all have, to blame our parents for making us clean our plates (though I honestly don't remember ever really having to be told to do this)

2) I tend to save the best bite for the last bite. I know, it's odd - but I'll save that last crispy crust for the end, or I'll eat things on my plate while trying to decide which flavor I want to have in my mouth last (will it be a meaty taste, or a starchy taste? It's very rarely ever a salad taste). If I stop early, then I'll miss out. Which really means, I need to start eating the best parts first!

3) I'm sometimes afraid that if I don't enough at dinner, I'll be hungry for a snack later. But that doesn't make a lot of sense, really. I mean, if I'm hungry, then I'll just snack on something healthy. It doesn't mean I need to feel full to the gills every time I eat. And, if I keep my meals small enough, sooner or later it won't take nearly as much for me to feel as full.

I could feel myself beginning to get a little lazy, so I thought blog post was in order. This weekend I'll work on taking pics of the books I want to review here, and I have a couple of 100 calorie snacks to review as well. I also have to start adding more exercise to my routine (an hour a day, yikes!) so I am sure that will come up here as well.

Be well!

Sunday, April 5, 2009

Slimming down


Sew cute!, originally uploaded by Kodamakitty.

It's getting late and I am getting sleepy, but I wanted to post a quick note about how things are going. This morning it looks as though I've lost 10 pounds since I began taking the metformin. Yay, me! Tonight I had a bit of a heavier dinner out with my mom, but it felt good to see such a large difference between my starting weight and today.

I found this adorable tape measure at Target for $1, along with one shaped like a dinosaur and one shaped like an elephant. I guess kids must love the measure stuff, since it was in the party favors aisle.

I haven't measured myself yet, but my clothes seem a bit looser and Geoffrey commented on my slightly shrinking stomach. I like having these as a sort of talisman - it's a reminder that I only need to "measure up" to my standards, as long as I am healthy and able to do what I want to do.

I hope to post a couple of book reviews in the next couple of weeks - the end of the semester is fast approaching, and there's a lot to get done at work and here around the house. My system seems to have adjusted to the meds once again - tonight's dinner was prime rib from the Texas Roadhouse and that's a fairly fatty (and therefore DELICIOUS) cut of meat but so far, no major stomach rumblings.

Once side effect I do notice is that I am sleeping more soundly and that I fall asleep quickly, and that sounds very good right now. I hope you have a good week.

Monday, March 30, 2009

Mmmmm...sleep good


Warm and cozy bed, originally uploaded by Kodamakitty.

To begin bringing down my blood sugar levels, my doctor prescribed metformin, also known as Glucophage. Apparently, one of the most common causes of PCOS is high levels of insulin reducing the amount of estrogen and progesterone in the system and prohibiting ovulation. Also, half of the women diagnosed with PCOS are overweight. One of the benefits of metformin is that women who take it often lose weight, which has been my experience so far (mostly water weight, but at least its moving!)

I started my first dose almost two weeks ago and had sufficiently recovered enough to up my dose a few days early so I could adjust over the weekend. Common side effects include nausea, diarrhea and upset stomach, which is really not something I want to have to deal with when I have appointments every half hour on the half hour.

The funny thing about lists of side effects is that is very easy to become a hypochondriac and identify with every symptom. On the other hand, I don't want to discount a reaction if it means something is seriously wrong. I know I'm on a serious medication, so I am trying to be observant. For now, none of my symptoms have lasted longer than a few days or been uncomfortable to the point of being unbearable, so I am pushing onward.

My first week, I had some stomach rumblings and I was in the bathroom pretty soon after taking the pill, but nothing terribly awful. There was a day that week (roughly two or three days later) I stayed home to work on e-mail and slept almost the entire day. Clearly, I will need to plan for a day like that each time I up the dosage (ultimately, I'm supposed to take four doses a day).

I moved up to two doses last week Friday and wound up straining something in my right shoulder blade area. I was working on getting through a lot of e-mail and didn't move from my desk for a long time. It felt like a nerve pinch and I'm still a bit tender, though now it's moved to the front of my rib cage. And of course, since it's now two to three days since I began the increased dose, I'm feeling pretty sleepy (or at least sleepy enough that whenever I lay down, I fall asleep).

To make matters worse, there was quite a bit of snow around here yesterday, so my sinuses are also draining, which makes me sleepy as well.

Why the concern about sleep and shoulder strain? I have to make sure I'm not exhibiting Lactic Acidosis, a very rare reaction that occurs in about 1 out of 33,000 people taking metformin.

Symptoms include:
• feeling very weak, tired, or uncomfortable
• unusual muscle pain
• trouble breathing
• unusual or unexpected stomach discomfort
• feeling cold
• feeling dizzy or lightheaded
• suddenly developing a slow or irregular heartbeat
source: Diabetes Monitor.com

It will be interesting to see what happens when I increase to three pills two weeks from now. I want to be able to stick with this medication, especially since it seems to be working, but I promise that if this pain persists, I'll contact my doctor.

Sunday, March 29, 2009

Caffeine and Blood Sugar


Dinner at Ruby Tuesday's, originally uploaded by Kodamakitty.

I wouldn't say I've done a ton of research about losing weight, but one of the more recent news items I've come across regarding insulin and blood sugar is the connection between caffeine intake and blood sugar.

For the past two weeks, I've cut back on my caffeine - drinking caffeine-free Diet Pepsi, mixing half sugar-free caffeine-free International Foods Café Mocha with half coffee for my daily cup at work, and only having one cup of coffee on the weekends at home. I'm not actually tracking my blood sugar at this point, but I figured every bit helps, right?

In thinking about this blog, I've been meaning to post this once I had a chance to find a reputable summary. So, on researching it this morning, I've found this happy (for me, at least) news:

From Mayo Clinic.com

Question
Does caffeine affect blood sugar?

Answer
Short-term studies indicate that caffeine impairs insulin action but not necessarily blood sugar (glucose) levels in young, healthy adults.

However, in individuals with type 2 diabetes, the impact of caffeine on insulin action may be associated with a small but detectable rise in blood sugar levels, particularly after meals. The amount of caffeine noted to have caused this effect was about 500 milligrams (or the equivalent of five cups of plain, brewed coffee) a day.

For individuals with type 2 diabetes who are struggling to control their blood sugar levels, limiting your caffeine intake may provide a benefit.




Even on a regular basis, it is very rare for me to drink more than two cups of coffee a day, so this is a bit of a relief. I love coffee (it would be my profession if it were more lucrative than higher education, to be perfectly honest). I thankfully don't have withdrawal symptoms if I don't have coffee, but I am one of those seeming few who actually LIKE the taste of the stuff (Geoff likes it more, he takes his black - I rarely drink mine straight).

Granted, I will probably still continue with my usual routine because it helps me cut down on the amount of cream and sugar I use with my coffee. I like diet soda just fine, but I find that sugar substitutes are just too sweet in anything else.

Saturday, March 28, 2009

My fondest wish


My fondest wish, originally uploaded by Kodamakitty.

I asked a palmist once, if I was ever going to be recognized for my talents and abilities, and she said yes. And then, many months later, I receive this fortune. Kooky!

Do I even need this kind of recognition? I would argue that everyone wants to be recognized - for their opinion, their thoughts, their talents. It's about respect and appreciation.

What does this have to do with being good enough? Isn't it enough for me to know that I'm doing my best? Well, yes, to a great extent, but I think without recognition or feedback from others one could become narcissistic or convinced of one's worthlessness.

One of the many reasons I haven't really put forth the effort to lose weight has been an odd need to prove myself beyond looks or what I have previously dismissed as "swimming in the shallow end with floaties" - buying into the idea that one could be pretty or smart, and I was clearly destined to be smart. Which of course, is total bullshit. I am blessed to have friends who are both beautiful and brainy and I wouldn't put up with this kind of thinking from them, either.

So, now that my health is on the line, and now that I've accepted that I do want to look my absolute best and see what my best weight is where I can still eat what I like in moderation without having to spend hours in the gym, I want one of my talents to be that I can truly take care of myself and my health. It is a talent I have underutilized thus far and I plan to develop it.

As for recognition, in starting this journey I've received a lot of amazing support. Quiet, steadfast, stand-by-you support. For which I thank you (you know who YOU are) with all my heart.

And a special thanks to Geoffrey, who posted this on my Fiickr photo with which I created this blog:

galfridus73 says:
You've always been more than good enough, Sweetie, no matter what. I love you!
I love you, too, Geoff!

Awwwwww... :)

^_^

Thursday, March 26, 2009

REPOST: A New Start


A new start
Originally uploaded by Kodamakitty.

I will most likely be blogging about my trials and tribulations with trying to lose weight on a joint venture with my cousin Joann, but for now, I wanted to jot down a few thoughts before I forgot them all. At least I can blame the medication if I do!

On Monday, March 16, I had a second visit to my new ob/gyn. Pre-Med students, take note - bedside manner extends beyond the bedside and it can be the difference between a patient who listens to what you have to say, not to mention one who actually decides to return to your office and one who either disregards what you suggest or doesn't come back. Suffice it to say, I haven't seen my old ob/gyn for at least 4 years.

Old ob/gyn (which sounds like one of the background nicknames for the dancer on the left in CATS) clearly missed tons of clues about why after three years of not not trying, I still wasn't pregnant. Now, I fully disclose that I have been overweight since, like, the fourth grade, but still, this new doctor got it in one and I am now have a tentative diagnosis of PCOS - Polycystic Ovary Syndrome. I'll spare you the gory details (or at least save them for the new blog, lol), but at least now I feel like I have more of the bigger picture to work with.

It's funny, my parents both have/had type II diabetes, and I know how I'm supposed to be eating, sleeping, and moving, but until the reality of needing to lose weight becomes more concrete, it's easier to put things off until tomorrow and just have another slice of pizza. I still plan to be able to have that piece of pizza, only it will now be a bit smaller and accompanied by a large salad.

One thing I noticed about today - it's Saturday, and obviously, my weekends are less structured than my normal Monday - Friday routine. Today was a bit difficult because I was more in tune with my urges to munch on something - was I actually hungry? And what if I was, what was a good snack? Today's answer? A slice of whole wheat toast with exactly one serving of marmelade and some raspberry leaf tea. Not a lot, but just enough.

I'm not following any actual diets, and I'm looking at the Nutrition Panel primarily to work out proper portions and to avoid excessive fat/salt/nasty stuff. I don't want this to be a diet, I want it to be a lifestyle change. So this pic is of my new food sleep/food/water log. My plan is to become more aware of what I am eating and hopefully not become so aware as to be obsessed. Wish me luck!

^_^