Had my appointment this past Wednesday with the RE. First off, I have to say I really, really liked him! He's got just the right attitude for me - not too forceful, but not a pushover either.
The first part of the visit went as expected. We did a baseline ultrasound, which showed a cyst on my left ovary. He was unsure if this cyst is a "workable" cyst (i.e. it will dissolve on its own either in ovulation or just a normal cyst some women get in cycles) or a "non-workable" cyst, such as the one I had removed 3 years ago. He said we would definitely monitor and see what is happening with it. He measured my endometrium and said it was of a good thickness, but it looked cloudy/snowy on the u/s as if I were on CD21 rather than CD11 as I actually was on. He ordered a progesterone draw to see where I actually was in my cycle since I had taken Pro.vera to bring this cycle on.
Now, onto his recommendations. He approached things a little differently than I had thought, but still covered most of the same items. He stated that his first agenda was to get me healthy. Right now, he's concerned that I wouldn't be healthy enough to carry a baby. He said there would likely be problems for me and for the baby as well. Therefore, his first order of business was to refer me to a pulmonologist for an evaluation for asthma and sleep apnea (as suspected). That was what I expected, so nothing unusual there. My appointment with the pulmonologist will be on June 9.
The next thing he discussed was my chronic headaches/migraines. I had thought he would send me for an MRI, but instead he told me that recent research had suggested that women who suffered from migraines often had a magnesium deficiency, so his recommendation was to start a special supplement of magnesium (it has some other things in it and they gave it to me in the office as it can only be ordered online and is not available in stores). I'm to take one in the morning with food and one in the evening with food for two weeks, then one in the morning with food and two in the evening with food. I'm also to keep a record of any headaches I have.
Next, he told me he wanted me to stop taking Met.formin for six weeks and monitor my blood sugar very closely so he could diagnose insulin resistance or diabetes himself. So far my sugar has been running very slightly high, but nothing scary. I'm also to monitor my blood pressure closely, as he will probably be sending me to my regular GP to start blood pressure medication. He suspects I have hyper.tension and he doesn't want to risk that getting worse with a pregnancy. That, sadly, is running pretty high.
The next order of business was to discuss all the bloodwork he wanted me to have done. On Wednesday, I had two large vials of blood drawn, then on Thursday I had four more of the large vials and three medium-sized vials drawn. I still have another lab to be drawn - the one testing for MTHFR - but I had to be sure my insurance would pay for it because it is an extremely expensive lab! I'll be having that one drawn sometime this week, hopefully. Some of the bloodwork has already come back (the benefits of working in a hospital - I checked for the labs that were already back) and my triglycerides are high (surprise, surprise), my white blood count is slightly elevated, my red blood count is slightly low and my uric acid levels are elevated (I feel a gout attack is probably coming soon - I truly had that!). Once I find out more, I'll let you know those.
Our other discussions were about doing an HSG after all the bloodwork came back and he was satisfied with that, as well as another endometrial biopsy. He has already given me a prescription for a drug pack to get me throught he biopsy, which is definitely an improvement over the first time I had it done (Dr. Bashful told me it wouldn't hurt at all and there was no need for me to take anything - not even any Tyl.enol or Ale.ve), so I'm not dreading it too much. The Hubs will be having another SA done. Again, we aren't too worried about that as his first one had a count of 76 million, motility of 70% the first 3 hours and morphology of 80%. Our RE said he was dubious of a morphology of 80% because the "normal" man only had a morphology of 7 to 8%, so not really sure about that (he did say his research was more experimental than some in this area). After The Hubs is added to my insurance in July, he will also be seeing a pulmonologist to check his lungs as well as, when he had his physical for immigrating from England, his lung x-ray showed some nodules on his lung and he was sent to a specialist before they could okay his visa. Fortunately, it was only scar tissue from having bronchitis when he was younger.
There was also the mention of weight loss (although, to his credit, of the two and a half our appointment less than five minutes was spent on discussing weight loss and he said he knew it was very difficult for those with insulin resistance). We talked about diet and exercise and he also mentioned that lap band surgery was an option. The Hubs and I decided that for now I would try diet and exercise again. I'm really not enthused about the idea of surgery for weight loss. I've heard some good things about it, but I've heard more bad, so that will be a last resort. The Hubs and I are going to try the Sou.th Bea.ch Diet and see how that works for us.
I think I've remembered everything from the appointment. If I remember anything else, I'll post about it. It certainly is a lot to take in in a short period of time!
Now for the fun stuff. I have tried three times previously to complete a project of taking a self-portrait of myself every day for a year. I have failed this task three times, lol. So, I decided I would try once more and, maybe with your help, I can complete it. I thought this would be a great year to complete the project and hopefully I'll get the opportunity to take some pregnancy photos of myself. I would appreciate any comments you make and definitely any suggestions of photo ideas! You can view my year in photos at Wistfulgirl in 365-D. Hope you enjoy it!