Hashimoto's Thyroiditis...

...I have it, for sure.

I finally visited with the local endocrinologist (not RE, just E) today and had an interesting experience. We'll call him Dr. Hippy due to his obvious hippy type nature, I mean, come on, he had shoulder length hair, Indian beads sewn around his stethoscope and he definitely had loafers on without socks. Regardless of his appearance, he gave me the info I needed straight up and with lots of detail, just like I like.


First of all, he and I had met before. About two years ago, I was invited to his office to do a seminar for him and his staff over lunch where I explained the correlation between diabetes and hearing loss and the fact that they should regularly screen their diabetic patients for hearing loss (and refer them to me for hearing aids of course). I remembered the prior meeting shortly after I first made the appointment and he recognized me right when he walked in the door. It was nice to have something to break the ice.
It was also nice when I was able to lay on the exam table fully clothed and without the use of stirrups. It was fantastic when he did the ultrasound and didn't have to put it in an uncomfortable place (you're thyroid is on your neck, not in your vagina, just fyi for those who weren't aware).

After the ultrasound and a mildly uncomfortable discussion about my food intake, exercise habits, overall disposition, hygiene and bowel movements, he was able to make a diagnosis:

Hashimoto's Thyroiditis based on hypothyroidism with bouts of hyperthroidism as well as the appearance of the thyroid on an ultrasound.

Results in infertility, early miscarriage and pre-term labor as well as lower IQ scores of offspring if left untreated.....great (said sarchastically).

He made some recommendations:

1. He recommended putting off TTC for 6 months until my thyroid is under control (this recommendation is still being taken into consideration)
2. He switched up my routine for pills (but not the dosage) including thyroid meds, vitamins, and other daily pills (done)
3. He recommended that I have my thyroid levels and antithyroid-antibodies checked immediately at a different lab in case the recent extreme values of 0 and 32 were incorrect (done)
4. He recommended I have things rechecked at 2 months and at 4 months (will do)
5. If the immediate labs are different, he will change his recommendations (OK...sounds like a plan!)

What I found most interesting is that he is willing to take some alternative possibilities for my infertility into consideration. He is willing to do a panel of auto-immune bloodwork testing including testing for NK cells. His exact words were "show me the evidence and I'll write the order".

So I guess that means I have some homework to do.

Still hanging around?...and an award

I'll freely admit that I have been testing. I just wanted to see if I could actually make a pee stick turn positive. I will say though that it's a little disappointing to see your first BFP and know that it's not real. That being said, it's not going away!!!

I can't believe my HCG trigger is still hanging around. I've googled it to death and I've read that the trigger will usually hang around for 1 day per every 1000 units, so that means 10 days for 10,000 units. I didn't believe it at first, but it does seem to be true.

I refuse to get my hopes up and believe that this could really be a positive. I'm only 9 dpo, but the last 4 days the second line has been the same faint pink color and doesn't seem to be going away completely.

Check out the photos: (Yes I post pictures of things I've peed on, but at least I crop the pee part out! Also, I do realize that there are extra sticks there, I did one the night after the trigger and two the day of ovulation, oldest at the top to today's at the bottom)

I've decided to combine posts too, so I just wanted to thank all of you who nominated me for the Liebster award. I really do appreciate it, I may not be witty, clever or all that entertaining, but I do feel loved, so again thanks!

Josey at My Cheap Version of Therapy
Jenn at The Chronicles of Violetta Margarita
New Year Mum at A year on: Our new beginning

As with most awards, there are rules, but these are ones I can abide by:

This Award is given to bloggers who have less than 200 followers, all in the spirit of fostering new connections. Leibster is German & means ‘dearest’ or ‘beloved’ but it can also mean ‘favorite’. The idea of the Leibster award is to bring attention to blogs with less than 200 followers.

Here are the rules:

1. Thank the giver and link back to the blogger who gave it to you. (see above)

2. Reveal your top five picks and let them know by leaving a comment on their blog. (see below)

3. Copy and paste the award on your blog. (see left hand column)

4. Hope that the people you’ve sent the award to forward it to their five favorite bloggers and keep it going!

My nominations go to:

Tracy at Just Let Go who suffers from RPL and is currently pursuing adoption both in Canada and the US.
Ducky at I'm just Ducky, Thanks who suffers from a heart condition and is having difficulty getting and staying pregnant, she lost her twin boys after her last IVF and is now on to the next round of IVF
Are you my moms at Are You My Moms? who is currently going through IUI's with her partner and has done three without success
Mag at Witty Infertility who is still trying to figure out why she doesn't get regular cycles
Cattiz at Colours of Cattiz who is newly pregnant after her second round of IVF

These women inspire me and I just think they're great, so if you haven't already, please follow the links and go say hi to them.

Thanksgiving leftovers...

if you're doing it differently, then you're doing it wrong!

How to build the perfect sandwich from Thanksgiving leftovers. If you already ate all of your leftovers, well then better luck next year, bookmark this post...or maybe try after Christmas.

Ingredients:

Fresh:
King's Hawaii.an bread sandwich rolls (if you're really ambitious you can make your own hawaiian bread)
Lettuce
Tomato
Mayonnaise

Leftovers:
Turkey (of course)
Cornbread stuffing (aka dressing for you southerners)
Cranberry Sauce (I like mine from the can, although I know homemade is more enjoyable for some people)

Spread the mayo on one side of the roll, then add lettuce and tomato. Spread the cranberry sauce on the other roll (just like jelly on toast), heat the stuffing for 15 seconds or so, just enough that it's spreadable, and spread it on top of the cranberry sauce. Put cold slices/pieces of Turkey in the middle.

Smush (yes that's the technical cooking term) the two sides together and enjoy.

See, do as H does!

Hope everyone had a happy and healthy holiday and enjoyed the family and friend with whom they spent the day.

PS: Mary, sorry you missed out on leftovers, we couldn't wait for you.

PPS: Josey, I saw your post, thanks for the award! I'll post on it tomorrow.

PPPS: Still in the 2WW

Trigger time

Just finished at Lulu's office.

6 follicles on righty, 7 on lefty. 1 mature follicle on righty at 32 mm, yay! Go clomid! I'm a fan.

Triggering with 10,000 units of generic HCG, IUI tomorrow between 10-11 am.

Sent from my iPhone

Bullet point post

It's one of those days, where my brain can't process paragraphs, so bullet points will have to do.

• U/S is on Friday, I'm hoping for some good follicles and a nice lining and hoping that the changes I've made over the last week with taking my thyroid meds at 5:45 AM will even things out in time for this time to work
• On the fertility note, I noticed yesterday on CD 8 that I still had one clomid pill left (supposed to be taken CD 3-7). So I took it. I don't know if there were 6 pills instead of 5 or if I missed a previous day and I couldn't come up with a way to figure it out. I hope it doesn't affect anything. 
• I went with my friend Mary and her kids, and her friend Heather and her kids to a street fair on Saturday for Veteran's day, it was chilly and windy because it was up in one of the nearby mountain towns, but we all had fun. My feet, however, are killing me from walking around in a pair of shoes I specifically chose because I thought they'd be comfortable. 
• I have recently started watching Glee, sort of by accident. I like it though, and I found the first two seasons on Ne.tflix and could watch them all day...and did this weekend.
• We're not going anywhere for Thanksgiving, but H's parents are coming down for a few days. I've taken the whole week off work. This is the first time in the 3.5 years, that I've lived here and worked at this job, that when I've had more than 2 days off in a row we haven't gone anywhere. I will be enjoying the relaxing week at home (and probably watching some more Glee)
• Given that I will have the whole week off, I'm going to do some organizing around the house to include donating a bunch of books that I have been holding on to. At the very least, they are getting boxed up and moved into the attic. I love books and like to give my books to friends to read. However, it's gotten out of control. Our house is very limited on storage space and my books take up the entire closet of our guest bedroom, which will hopefully become a baby's room. There's no reason to wait to clean it out, so if I have the time, that will be the plan. 

I'm starting to plan for Thanksgiving so any good family recipes for side dishes would be greatly appreciated. In fact, I'd like to ask those who comment to leave their favorite Thanksgiving recipe in their comment or a link to it if it's already online somewhere. That way everyone will have some new ideas for Turkey day! Just an idea, if you'd prefer do a whole post on it on your blog and leave the link in the comment section below.

Thyroid woes

BAH!...back to square 1. 

My thyroid follow up results just came back.  Not good. Not good at all.

I'm significantly hypothyroid again. For those who care or can interpret it, my TSH is at 32.40

For those of you who don't speak TSH, that number should be below 5 for normal people, and below 3 for TTC, but not below about 0.35. (not that all of you TTCer's aren't normal or anything)

Last blood draw I was at <0.010, and now I'm at 32.40

Perhaps I should get another opinion on this...so I have decided to do just that. But...of course, they can't get me in until 11/29. I tried to pull the Dr. card but it just got me put on a cancellation list not actually moved up. And if they call me the day of, there is a very slim chance that I could actually come in anyway, so the 29th it is!

The ENT I work for placed the bloodwork order for me (or rather his PA did) so the results were delivered directly to me within 24 hours of the testing being done...which is pretty good for Nowhere, NM.  (hmmm...I wonder if this would work for beta testing should I ever get my BFP? I guess that the ordering Dr. would like the results first or too, so maybe not)This ENT had interest in endocrinology before deciding on ENT and was able to comment on the results.

He thinks I just need to be more consistent with the time that I take my medicine and make sure that it is on an empty stomach at least a half hour before eating, and recommended that I go back up to 75 micrograms.

Since I already wake up at 6:30 to take my temperature and have been waking up at 5:45 to go to the gym (yay, go me for getting my butt to the gym on a regular basis...or at lease just this week) I guess I could make that 5:45 wake up, take temp, take thyroid meds, go to the gym.

Wait...did I just say wake up, gym, and 5:45 in the same sentence...

Anyway, I guess I could make some changes to try to improve things, maybe H is right, maybe I'm just lazy...about the gym anyway.

As I was saying...

...I've decided that Lulu isn't that bad after all...but her staff is!

This went from crazy mess to borderline ridiculous in a matter of days.

When AF showed on Sunday, I tried calling the office first thing Monday morning. Something was weird with their phones and it kept ringing and ringing and ringing. I hung up and tried again later. When I did get through, I left a message with the receptionist for the MA to call me back later as I was trying to make an appointment. At 4 PM, I realized I hadn't heard back, I tried to call, but their system just went to voicemail, so I left a voicemail message this time.

On Tuesday morning, I still hadn't heard from them by 10 AM, so I called again, left a message again with the receptionist. When I hadn't heard back by the end of the day, I went to call back, I looked at my phone and I had a missed call and a voicemail, so I tried to call back...it was after 4 again...I had to leave a voicemail message again...damnit!

So now we are caught up to today. No call by 10 AM, so I call again...and left a message again with the receptionist, however it went more like this: "This is Michele C, this is my birthdate, I'm calling to speak with Monica to schedule my IUI." I could have just left it there as I had the previous two times, but since that hadn't worked yet, I added: "This is the 3rd day in a row that I have been unable to get a hold of her and haven't heard back. I'm starting to get frustrated and would really like to get this scheduled ASAP...Thanks for having her call me back at her earliest convenience!"

Now...it's possible...that my tone wasn't very nice.

But what do you know, in less than an hour, I'm getting a call from the clinic. It's Lulu!!!

She says "Michele, I was told there is some sort of emergency, what's going on?!?!!"

I reply (even toned this time) that I did not intend to get a call back from her, I was simply trying to schedule my next appointment and was frustrated that I couldn't get through to someone that could schedule it. She says she'll put me on hold and get Monica....Really??? Really!!!!

After several minutes on hold, guess who picks up...not Monica...

Danielle picks up, she tells me that Monica isn't available and that she would try to read Monica's notes and get me scheduled.

I had asked for a Friday afternoon appointment (easier for me to get out of work) but was told that it would mean a Saturday afternoon IUI and Lulu doesn't work Saturday afternoons. I say OK, lets just schedule it for the early morning and I'll figure a way to work it out. She gives me a 7 AM appt. Friday and a 10 AM appointment for Saturday.

I thank her...thinking the conversation was over of course...then she proceeds to tell me that "Lulu doesn't work Saturday afternoons because she doesn't get paid to come in on Saturdays" and just so I know "she is doing a favor by coming in on Saturday at all."

Wha...wha...what?!?!?!

What I should have said was: "I don't care if she's not directly getting paid, because I pay SOMEONE for these appointments. In fact, it's $300 directly out of my pocket each time we do one of these. She's salary and has signed up for a job that is 7 days a week. What do you mean she doesn't get paid?"

What I did say was "Well, I'm glad we could work out our schedules."

Seriously though, I am very tempted to write a letter, but who do I give it to, Lulu? She work's under another Dr., do i give it to him? Do I attempt to contact their HR department? Should I just ignore it for now as I got what I needed in the end anyway?

I don't expected to be treated better than other patients, but I expect to be treated at least the same as other patients. But if they are treating all their patient's this way, how do they stay in business????

Decisions...decisions

Dangit! Blogger ate my post, so I'm sorry if this is all over the place and a little wordy, but I already had the whole thing typed out.

So after a few days of falling temperatures, and a handful of negative HPTs, AF showed up yesterday. I've come to expect her, I was prepared.

But...

It was the first time that H really seemed disappointed. I believe that he thinks (just like everyone else) that it will just happen. This month opened his eyes to the fact that we are going to have to make this happen, it's not just going to happen on it's own. When I told him AF was here, he just kept wandering around shaking his head saying "Really?...Really?!" It was cute and frustrating all at the same time.

Later in the day, we got into an argument about what we should do for this next cycle.

I think we should stick with Lulu. Although I do complain about her, she does seem to be doing what is appropriate and what I ask of her, even if I'm a little frustrated with her sometimes. I believe that she is by-the-book because she knows know other way. She wants me on clo.mid, a CD13 US, an in office HCG trigger, and a CD14 IUI. To be honest, we have yet to do it exactly that way. This cycle I can make that work though. I can get Friday, Nov. 18 off work in the afternoon, then I can go in on Saturday the 19th for an IUI. I have taken the entire following week off work so I can relax afterwards. I have already called the office and am waiting on a call back to schedule the appointment. Watch and see, I bet she has taken that weekend and week off too.

H however, wants to go to local Dr. Creepy this month. Dr. Creepy will prescribe clom.id, but does not do any monitoring or a trigger, but rather waits for the LH surge and then does the  IUI 24 hours later. He is simply an OB/GYN and therefore is cheaper for the IUI which is out of pocket for us. I feel like this would be a repeat of last cycle and we know how that one turned out. I feel like I need to try something different each time, rather than repeating the same thing over and over and expecting different results (that's the definition of insanity...right?) However, he is convenient and I think we will save this for December simply for this convenience if November doesn't work for us.
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On a separate, but related note:

I've gotten several comments/e-mails from you guys about why I don't get a second/third opinion. Honestly, I'm just not ready for it, but here are my other excuses.

Lulu is already an hours drive away, there is no one else in my city or that city.

El Paso, TX is the next closest city, it is about 80 miles directly south, and there is a Dr. there that I have heard is pretty good, but hard to get into and I've heard he is kind of an ass. Also, I would have to go back to my regular OB/GYN or Dr. Creepy to get a referral to Dr. El Paso. I'm not ready to go back to Dr. Creepy, and I don't want to go to my regular Doc to tell him that I went behind his back and have been having IUIs. I could go around the system and get the PA that works at my practice to make a referral, but I don't really feel comfortable doing that, nor do I believe that insurance would honor that referral.

I could also potentially go to Albuquerque (which someone on here suggested, and I really appreciate the information) but that is about 215 miles north of here.

I know everyone can appreciate how hard it is to get out of work for repeated Dr's appointments, but it is really hard for me to take off last minute and for extended periods of time. I see patients and I supervise students so if I take an afternoon off, 25-30 people need to be rescheduled. If I take a full day off it's double. I'm typically booked full out about 3-4 weeks. We don't have enough places to put those rescheduled people. Also, it's hard for me to take Fridays off because I work in remote office an hour in the opposite direction of Lulu's office, which makes it a 2 hour trip to get to her office if I leave in the middle of the day. Plus, we are only there one day a week so there really is no place else to put those people. I lose sales and the office loses money and because I work on commission, I miss out on money. The fact that we may have to pay out of pocket for IVF eventually makes me want to miss out on these appointments and commission even less.

This coming appointment time on Friday the 18th, I'm lucky that Boss Lady can cover for me and no one needs to be rescheduled. I did have to tell her I'm on my period and that I will be taking crazy clomi.d pills again though (really it wasn't that bad).
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Side note: I'm not in a woah is me/feel sorry for me type of place this month about any of the above information. Shit happens/it's not my time/it just didn't work, I know.

Your opinions on Lulu vs. Dr. Creepy and repeating the same things over again would be greatly appreciated though.

Need a laugh?

Just try eating all of your kids halloween candy!

Thanks Jimmy Kimmel!

Michele