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Life can surprise you sometimes.  The day after I wrote and posted the previous conclusion I got a positive home pregnancy test!  I had my blood test today and everything looks good.  Can I owe any of this wonderful news to this experiment?  There is no way to know for sure, but I would like to think so.  If you remember my story, I did two Femara cycles last summer after a few months of Metformin and I did not conceive on either one.  Flash forward 5-6 months and I am pregnant with only one round of Femara and no Metformin.  Perhaps I just needed a few more months for my body to recover from breast feeding.  There’s no telling.

So, the real conclusion to this experiment is ambiguous, but who the hell cares?  I am pregnant with minimal intervention and I did not have to take horrid Metformin to get this way.  I can’t see it any other way but a total and complete success!

I seriously cannot believe another month has passed since the last time I wrote a monthly report!  I’m not going to write a long report in the usual format since I am in the middle of a medicated fertility cycle and I cannot differentiate between actual progress and the possible effects of the medications.  What I will say is that I have remained true to the basic tenants of this experience –  I have eaten well, continued to exercise often, taken my daily supplements, and have seen my acupuncturist weekly with no changes or deviations.  My weight is slightly lower than last month and very stable.  I am not going to do body measurements because I am having some wavering abdominal bloating as I approach ovulation, but based on my appearance and how clothing fits, I would guess there has been very little change.  My acne is quite bad, but I am actively messing with my hormones by taking fertility drugs and this is a very common side effect for me while on them.  Emotionally, I am a little short of temper, but I have yet to feel any depression or major psychological upheaval, which is sometimes the case during a medicated fertility cycle.  My energy level has been a bit low the past week or so (again, normal for this point in a medicated cycle), and so I have started doing a Fertility Yoga DVD that I’ve owned for several years, but had only done a few times before.  Even though it’s a step down from the more ambitious exercise I usually do 3-4 times a week, I still feel like I get a decent strengthening and stretching work-out, and it’s better than simply doing nothing and letting my conditioning dissolve away.  I have also added a nightly abdominal and lower back massage using a blend of essential oils (mixed in apricot seed oil) that are beneficial for PCOS and infertility. The oils are Clary Sage, Geranium, and Rose – all with specific medicinal benefits for balancing hormones, increasing circulation and general stress reduction.  All in all, this has been the easiest medicated fertility cycle I have even gone through in terms of physical and emotional side effects.  I have also been able to achieve follicle growth without the use of Metformin, and that is a first for me.  All of this speaks volumes for what I have achieved in doing this PCOS experiment.  The proof is in the pudding though, as they say, and the proof for me will be to conceive a healthy baby.  I won’t know if I ovulated for a few days still and won’t know about pregnancy or not for two weeks after that, so lots of watching, waiting, and testing with baited breath to go, but I feel very positive about it all and that’s the best I can hope for.

I realized that a lot of the anxiety I was having, just in general, and in regards to jumping on the TTC bandwagon again was about the great unknown.  Would my doc insist that I be on Metformin again?  Would my new insurance cover treatment again?  Can I continue my experiment while I undergo conventional fertility treatments?  Will I be able to stay sane enough to be functional and “present” for my 21 month old toddler?  I started this experiment because I was really having a hard time with the fertility medications and being a good Mom through it all.  I’m turning 34 next month and that only leaves one year between me and “AMA” or Advanced Maternal Age.  To make a long story short, the anxiety of not actively TTC is starting to override the anxiety of going through a medicated fertility cycle.

I decided to put a call in to my insurance company and it looks like they will pay for some monitored cycles.  I then called my fertility doctor’s office and told them that I wanted to do another Femara cycle, this time monitored.  I’m now taking Provera to induce a period so I can take the Femara.  There was no mention on Metformin, whether I was still taking it or if I should be, so that’s one worrisome question answered.  I see my acupuncturist tomorrow and we will form a new game plan for using acupuncture/herbs/supplements to compliment conventional fertility treatments.  This is my acupuncturist’s specialty.  What I am hoping is that all of my hard work with this experiment has created a hormonal profile that is mediated enough from PCOS that I won’t need Metformin.  I’m willing to take it again if absolutely necessary, but it will definitely be a last ditch effort.  Obviously I will continue with my eating plan and will exercise every other day, or 3-4 times a week.  I plan on taking all of my supplements and herbs until a pregnancy is confirmed (unless explicitly contraindicated while TTC or in the luteal phase of a TTC cycle)

Four months of this experiment have now come and gone!  This has seemed like the fastest month by far, probably because this lifestyle change has become a habit that I don’t think about it as much as I did in the beginning.  I just keep a general framework in my mind and try my best every single day to work within it.  I am spot on for a few days and then I may not get the chance to exercise for 2-3 days in a row.  Instead of trashing the whole endeavor, I just start right back up and make up for lost time.  It’s making good choices most of the time that makes the difference.

‘Tis the season for all manner of diet blunders, but I have been successful in resisting the temptation to fall off the wagon.  I enjoyed Thanksgiving without so much as an added pound, which I did, not by turning down the delicious meal, but by remaining moderate in my food choices and continuing to work-out, even when out of town.  I used to be fairly frustrated about the fact that I have not lost many actual pounds, despite lots of effort, but I now know that each pound lost is backed up by lean muscle gain and is stable, meaning the scale does not fluctuate wildly anymore.  When I lose a pound now, I’ve really lost it.  Because of this, I no longer feel like a slave to the scale or a rigid diet that cannot include an occasional treat (within reason).  I trust myself and my body.

My supplements have changed quite a bit this month with the addition of D-Chiro-Inositol, myo-inositol, and a weekly prescription of Chinese herbs.  I have not been taking any of them long enough to report much change yet, but I am very hopeful.  I sincerely wish that I could report today that I have recorded an ovulation, or even gotten a spontaneous period, but more time is needed it seems to get those kind of results.  Here’s a link that details my supplements and all of the changes that have been made along the way.

Despite feeling impatient at times in regards to my progress this month, I generally feel such gratitude for the positive changes this experiment has made in my life and for my husband and baby as well.  I look great, but better than that, I feel great too.  My interest in life is filled to the brim and I feel my creative juices flowing again.  I periodically catch myself smiling, almost giddy with happiness and excitement for the year ahead of us.  I am feeling more confident about being able to handle the responsibility of having two children.   I am actually just starting to feel ready to be pregnant again. This goal, I am confident, will be met in 2011.

So, I guess we should take a look back at the original success criteria for this 6 month experiment, noting my progress since last month:

1) Ovulation and Menstruation – It had been a while since my last period, and I began experiencing some signs of Estrogen Dominance (constant fertile cervical fluid, ferning on ovulation microscope every day).  I started an oral natural progesterone supplement called Progon B, and 8 days later I started spotting and got a very light period lasting about 4 days.  I have since started Chinese herbs and acupuncture to stimulate ovulation, but no rise in basal body temps. yet.  This goal is still a work in progress, but I have never felt closer to this goal than now since it was with Chinese herbs that I was able to regain my cycle back in 2006. Very hopeful to see what the next few weeks bring.

2) Stable weight and body measurements –  I am wearing clothing that I have not been able to in many years.  I once had a pretty remarkable wardrobe from my fashion design days in NYC, and thankfully I kept some of my more timeless pieces.  The clothes not only fit, but they look really good.  This thrills me to no end!  The big news is that I now have a waist!  I have not been able to wear anything that accentuated it in many years.  I actually pulled out a belt and wore it over a dress for the first time in as long as I can remember.  I have been fighting a puffy Insulin Resistance belly since childhood.  I still weigh myself most days and I hover around 112-113.5 lbs with very little fluctuation.  This goal has been met and exceeded!  See my body measurements below.  Despite not losing many more pounds, my measurements keep going down.  YES!

3) Little or no acne – Similarly to last month, I have had some success and failures this month in regards to my acne.  Myo-Inositol has helped me fight the urge to pick at and scrutinize my pores, but I have since screwed with the dosing too much and so the jury is still out as to if it can help my OCD-type preoccupation with my skin/acne for the long haul, enough to make a lasting difference in my face.  I was hoping that I would know something more by the time I wrote this, but I’m still not sure enough to make any grand declarations.  Hopefully the picture, and my face, will become clear enough to make an accurate report.  This goal is still a work in progress.

4) Stable and positive emotions – I’ve had some resumption of some roving anxiety that I have suffered with in the past on several occasions this month (likely low blood sugar from new supplements), but for the most part I have felt very even keeled and happy.  I feel confident and much more take-charge than maybe ever before.  I’m not shying away from things that used to intimidate or scare me.  I’m ready to take on more responsibility in my life.  This goal has been accomplished yet again!

Body Measurements:

1) Natural waist:
a- 27″ on 10/7
b- 26″ on 10/23
c- 25″ on 11/23
d- 24″ on 12/22

2) Lower abdomen (around fattest part of tummy):
a- 32″on 10/7
b- 29 1/2″ on 10/23
c – 28 1/2″ on 11/23
d- 27 1/2″ on 12/22

3) Lower hips (around largest part of butt):
a- 35 3/4″ on 10/7
b- 35″ on 10/23
c- 33 3/4″ on 11/23
d- 33 1/4″ on 12/22

4) Individual thigh circumference (around thickest part of one thigh):
a – 20 3/4″ on 10/7
b – 19 3/4″ on 10/23
c – 18 3/4″ on 11/23
d – 18 1/2″ on 12/22

Three months are now completed in this PCOS Experiment!  This month the experiment went from a highly regimented plan to a sustainable way of life.  I’ve been so self-disciplined since this experiment began that I no longer felt the need to record my progress daily, and so I ditched my daily format.  I was feeling stressed until I could stop and type out everything I had eaten for the day, and with a toddler, finding the time was getting tough.  The new, free-form blogging is much better suited to where I am in my progress.

I decided to take my exercise requirements down just a slight notch, from 5-6 days a week to working out every other day, alternating cardio and strength/resistance training.  I also started adding in a little bit more complex carbohydrates in the form of gluten free rolled oats a few mornings a week.  I made these changes in the hopes that I will be able to not only finish this six month experiment, but to keep it going for the rest of my life.  I’ve been afraid of burning out as things in my life become more complicated and prevent me from adhering to a strict lifestyle.  I have only seen the scale go down since I made these amendments to the original plan.  I started the month a solid 115 lbs and now I’m seeing the scale hover around 113 lbs most mornings.   I’ve continued to find my clothing slowly getting looser and more comfortable.   I just did my body measurements since the last monthly report and I have dropped more inches (see below).  Wow, that is satisfying to see!

Since last month I’ve noticed my weight being less vulnerable to restaurant meals and changes in my diet.  This weight stability gives me a lot of confidence when we do have a family dinner out or I want a glass of wine or a square of dark chocolate as a treat.  I might have seen the damage to the scale a few months back, but I have come far enough now that it’s no longer a problem.  I’m assuming it’s because I have raised my metabolism and healed a fair amount of insulin resistance.  The other more noticeable change since last month is the appearance of my face.  I have a quite naturally fleshy/full type face and even at times of being thin, it looked chubby, especially in photos.  I can see the reduction in puffiness and fullness in the mirror and can see it in photos too.  What an awesome and unexpected side effect of this experiment!

Since I am not reporting on my diet and lifestyle daily anymore, I want to give a synopsis of the things I am still currently doing on a weekly basis to help control my PCOS symptoms and to help my body heal.  I continue to add a splash of apple cider vinegar to every glass of water I drink.  I have half a grapefruit several days a week.  I drink green and spearmint tea once or twice a day.  I work out every other day, doing both cardio and strength training.  I go to acupuncture once a week.  I try to reserve a few minutes a day for a relaxing bath, usually with Epsom salts and essential oils.  I’m still eating very cleanly, with an emphasis on low carbohydrates and whole foods.  I eat small snacks that contain protein in between meals to keep my blood sugar stable.  I take a wide range of daily supplements prescribed by my acupuncturist to help my body heal my PCOS.  I record all info about my supplements here, including changes as they occur, and there is lots of change monthly.

So, I guess we should take a look back at the success criteria for this 6 month experiment, noting my progress since last month:

1) Ovulation and Menstruation – This month I started having almost daily fertile signs and symptoms which has lead both my acupuncturist and myself to believe that I am now experiencing some Estrogen Dominance (a build up of estrogen that is never balanced by progesterone because of the lack of ovulation).  I started experimenting with a saliva microscope and it shows that I am in the presence of increased estrogen every time I use it.  A week ago, I started back on Symplex F for two weeks to try to stimulate ovulation.  I had my first high temperature this morning, so this is not proof of ovulation, but a girl can hope.  Suffice it to say, this goal is an ever evolving work in progress.

2) Stable weight and body measurements – Overwhelmingly, this goal has been met and exceeded!  I started this experiment at 117 lbs, went down to 115 lbs for a while, and I’m now around 113 lbs consistently.  My abdomen is pretty darn flat and not reactive to eating.  See my reduction in body measurements below.

3) Little or no acne – I’ve experienced both total clarity and an upsurge in acne at different points this month.  I had not experienced a completely clear face at any point in the months prior, so I would say that I have had at least some success in this department.  When I don’t fuss about and pick or squeeze on my face and keep it clean and doctored up with my various acne preparations, I can now have relatively clear skin.  Even with that though, I still had some breakthrough pimples that surfaced no matter what I did to prevent them.  This goal, while I’ve seen moderate improvement, is still a work in progress.

4) Stable and positive emotions – Like my acne progress I spoke about above, my emotional health has been both very good and wavering at times as well.  I’ve had some mild depression and reduction in motivation in regards to this experiment during this month, but I really think I solved this problem by changing the parameters of this experiment as I mentioned earlier.  My self-assurance and confidence has been quite good and I have felt more like reaching out to people and less introverted.  I am going to call this goal accomplished for now, especially since I’m no longer dealing with rocky emotions on a daily basis, just in isolated drips and drabs.

Body Measurements:

1) Natural waist:
a- 27″ on 10/7
b- 26″ on 10/23
c- 25″ on 11/23

2) Lower abdomen (around fattest part of tummy):
a- 32″on 10/7
b- 29 1/2″ on 10/23
c – 28 1/2″ on 11/23

3) Lower hips (around largest part of butt):
a- 35 3/4″ on 10/7
b- 35″ on 10/23
c- 33 3/4″ on 11/23

4) Individual thigh circumference (around thickest part of one thigh):
a- 20 3/4″ on 10/7
b- 19 3/4″ on 10/23
c – 18 3/4″ on 11/23

Jude is having a very hard time getting down for a nap lately and I am not getting the time I need to relax, exercise, and prepare a thoughtful lunch every day without fail.  This makes me feel really stressed out.  I’m definitely NOT just throwing in the towel, but I think I need to loosen the reigns a little with this experiment so I don’t feel such a sense of failure when life gets in the way.  A good friend once reminded me that a watched pot never boils and so I think I need to change the format of my daily status reports to something more informal.   I am ready to just have this become a way of life without constant monitoring.  I will continue to make notes along the way as necessary and do my monthly progress reports, but I don’t need the added stress of reporting everyday anymore.  I feel confident that I can stay of track without it.

I had one of those days where I felt impatient regarding my PCOS progress, and when this happens I always spend a bunch of time online, looking for the next thing to add to my PCOS plan.  I have taken D-Chiro-Inositol before, but only for a month.  You see it mentioned in so many articles and blogs about PCOS that I just feel like I need to give it another try.  I asked my acupuncturist yesterday about it and she hates for me to add yet another supplement to my already long list because DCI is expensive and it takes a while to see results.  I agree with her, but I feel like I need to give it a try.  I found a slightly cheaper place to order it in Australia, so while I’m waiting on it to get here my acupuncturist started me on regular, and cheaper, inositol.    I’ll update that info on my PCOS Supplement Regimen page.

Even since the time change a few days ago, I’ve felt like a chicken running with it’s head cut off.  I was so tired from the weekend that I almost talked myself out of exercise today, but I had some green tea instead and got my butt moving anyway.  I am really going to have to work on my motivation to get through the rest of this experiment.  My routine has really been trying to run off course lately and I keep nudging it back, trying to salvage it.  Jude is requiring more and more from me – I feel like I’m running in circles most of the day just to keep up.

Had a tiny more bit of spotting and felt bloated after dinner for the first time in months.

Exercise – did about 3/4 of Crunch: Burn and Firm Pilates DVD with 3 lb. weights

Mind/Body – Had a very brief few minutes to soak in the tub and read while Jude watched a video.  He did end up joining me within a few minutes to splash his arms in my bathwater, so my time-out was shortly over.  Good while it lasted.

Diet – 114 lbs

Breakfast – large iced green tea with milk, 2 fried eggs, 2 chicken breakfast sausages, 1 scoop of cottage cheese

Lunch – leftover butternut squash bisque, collards with black eyed peas, braised red cabbage,  and about 1/2 cup cottage cheese for protein

Dinner – Half a grilled NY strip, half a roasted acorn squash with butter/honey/cinnamon, leftover braised red cabbage, and a wedge of iceberg with homemade blue cheese vinaigrette dressing

Snacks – green tea with milk, half a grapefruit and a handful of raw almonds

Feeling a bit sluggish on the second day of no exercise.  With everyone in town, plus trying to stick to this experiment, plus getting things done on a usually busy weekend, and I’m running in circles all day.  Started spotting a tiny bit again and boy, oh boy, my acne is HORRID!  What the hell is going on with my hormones??  A period, ovulation, or just plain screwed up??  I wish I knew.

Exercise – took the day off

Mind/Body – Got to hang out more with my friends from out of town and see their miracle babies.  Due to the time change, I got a few extra minutes at the end of the day for a relaxing bath and some reading time.

Diet – did not weigh

Breakfast – black/green/spearmint tea with milk, 2 fried eggs, 2 chicken breakfast sausages, 1 scoop of cottage cheese

Lunch – leftover butternut squash bisque and about 1/2 cup cottage cheese for protein

Dinner – Chicken Parmesan cutlet topped with marinara sauce and mozzarella cheese with sauteed portobello mushrooms/thyme/butter/sugar snap peas, and lima beans on the side. very small glass of red wine

Snacks – green tea with milk, red grapes and a handful of raw almonds

When we began in earnest to try to conceive Jude with fertility treatments (early 2008), I became part of an internet support group for thin women with PCOS who were also trying to get pregnant.  Over the years most of us have remained friends and have shared the ups and downs of our pregnancies, births, and our adventures in mommy-hood together.  We arranged a little get together this weekend in Austin for four of us and our babies (plus 3 husbands).  It was so weird and wonderful to finally get to meet everyone after sharing so much online.  What a miracle to see all of the babies after some of us had such a hard time getting them here.  I know I will eventually meet everyone in the group in real life because these women are my true friends – friends that were really there for me through some of the hardest times in my life, and continue to be there during the happiest.

Exercise – took the day off

Mind/Body – I had such a good time getting to meet and visit all of my friends and their babies.  It was good for the heart and soul.  Also got a badly needed date with my husband where we were able to talk, laugh, and have fun.

Diet – 114 lbs.

Breakfast – small latte and one black bean, bacon, cheese, and avocado breakfast taco on a corn tortilla

Lunch – did not feel great so only had an almond Bumble Bar

Dinner – date night out – tortilla chips and salsa, 3 mini al pastor tacos, and a few bites of refried black beans. One top shelf margarita on the rocks!!

Snacks – iced tea

I forgot to mention that at my visit this past week, my acupuncturist wanted me to try halving my Gymnema dose to only one tablet, 3 times a day rather than 2 tablets, 3 times a day.  I wrote about Gymnema in depth here, but in a nutshell it helps regulate sugar metabolism and makes me have virtually no sugar cravings despite eating low carb and almost no sugar, except for in fruit.  I started feeling sugar cravings by the end of the first day with the reduced dose (11/2/10).  I tried to fight the urge the next day, but I decided that I needed to up my dose again and just modify it a little.  Since I eat almost no carbs at breakfast, I will not take any after that meal.  I will take 2 after both lunch and dinner.  So far this seems to be working.

Exercise – Crunch: Super Slim Down DVD

Mind/Body – Got a quick and very hot bath where I was able to lay back and meditate for a short while.  It really helped to both relax and invigorate me at the same time.

Diet – 114 lbs.

Breakfast – black/green/spearmint tea with milk, 2 fried eggs, 2 chicken breakfast sausages, 1 scoop cottage cheese (which Jude ate most of)

Lunch – leftover red cabbage, collards/black eyed peas, and a scoop of cottage cheese for a little protein.

Dinner – Roasted butternut squash/veggie soup (pureed) topped with cheese and cilantro chicken sausage

Snacks – half an apple and a handful of raw almonds, green tea with milk, small juice glass of raw milk