Baby #2 is on its' way!

Thanksgiving day seems like the perfect day to say that Baby Knowles is coming in May. Yep, the turkey isn't the only thing in the oven today.

We are so thankful for this addition to our family. I shared my struggles with infertility and being diagnosed with PCOS back in this post but will share some more information below since it's something a lot of people have had questions about. It's been a long journey, but I am now in my fourth month and ready to share with the world. If you aren't interested in all the talk about infertility treatments, and I don't blame you one bit, you can skip ahead to the pregnancy section below.

Fertility Treatments

(Please remember, this is just what I did and what worked for me. I'm not recommending this regimen or medication to anyone. My only advice would be to find a reproductive endocrinologist that you are comfortable with and that takes the time to listen to you and devises a plan that is customized to your specific goals and how far you are willing to go during treatment.)

We have been trying for a second child for about three years. Within those years, we have taken some breaks while dealing with career changes, emotional drain and other events that arise in a family that required our focus and energy.

My first step in seeking medical treatment was to see my regular OB in Hays. I was prescribed a drug called Clomid that is supposed to make your body ovulate. Due to my PCOS, I do not ovulate regularly, if at all. Unfortunately, my body did not respond to the Clomid. After trying various dose strengths, it was clear this drug was not working for me.

I was referred to the Center of Reproductive Medicine in Wichita, KS. This clinic is wonderful and I couldn't recommend Dr. Tjaden and his support staff more. His nurses took amazing care of me. However, going to Wichita was a draining experience. Wichita is about a four hour drive from Phillipsburg. With all the monitoring that needs to be done under fertility treatments, and at short notice, I was sometimes making the drive back and forth from Wichita every other day. Often my appointments would have to be first thing in the morning, which meant the additional expense of hotel accommodations on top of the gas, meals, etc.  Our insurance also didn't cover any fertility testing or treatments, so all appointments, lab work, ultrasounds, medications, etc. were out of pocket. It's impossible to put a price on the blessing of a baby, but boy, the price of getting pregnant with this one is staggering.

Under the care of the Center of Reproductive Medicine, we finally were able to find a combination of medications that worked for me and that my body responded to. It took a lot of different testing, trials and errors to find the right combination and regime and it wasn't a quick or easy process.

I took a drug called Femara, which is similar to Clomid, and is designed to make your body gear up to ovulate.

After about a week on the Femara, I started injections of Gonal-F. I had to give myself the injections into my stomach every night. During this entire time, I was being monitored in Wichita every other day with internal ultrasounds to see how many follicles were developing in my ovaries and how many looked like they would mature and release. I didn't want to become the next Octo-Mom!

Once I had enough mature follicles within the preferred size range, I took an injection of a medication called Ovidrel that would force my ovaries to release the mature egg(s). After the final injection, I took Prometrium during the two week wait to help optimize the conditions of my body for hopeful implantation.

I was very excited when test day came and I got a positive pregnancy test. After several years and too many negative tests to count, seeing a positive was almost unbelievable. I thought about telling Jim in some creative way, but I couldn't keep it a secret the moment I saw him. 

Pregnancy

This is from my first ultrasound, taken at 6 weeks. Doesn't it look like a profile of a gummy bear?

Morning sickness, or all day sickness, and exhaustion took their toll during the first trimester. I was actually in the hospital for dehydration at one point because I just couldn't keep anything down. I was also traveling all over the place for work during this time, like my trip to Savannah, and I'm sure I was a walking zombie during a lot of that time.

Glamourous bathroom self portrait of my belly at 8 weeks. A little bloat making its' appearance. 

We told Ethan he was going to be a big brother the day before Halloween. We waited to tell him until we felt we were in the clear and ready for everyone to know. We purchased the books below and explained to him that we bought them to help teach him about the new baby and that he was going to be a big brother.

 

 Ethan is very excited about being a big brother and is currently hoping it is a little sister.

Halloween Day

The second trimester brought with it more energy and less constant nausea and throwing up. I still get sick occasionally in the evenings, but nothing to complain about.  Here's a picture of my bump from yesterday in my office. 

I can't believe how much quicker I am showing the second time around - crazy!

Again, I have so much to be thankful for today. Plus, I get to wear elastic pants and have an excuse to "eat for two" today. Pass the pumpkin pie!

PCOS Awareness and My Story

September is PCOS Awareness month. Since I have been diagnosed with PCOS, and had no clue what is was before my diagnosis, I thought I would share it on my blog. Warning, things are going to get personal and probably TMI, so stop reading now if you are uneasy talking about womanly issues.

If you don't know what PCOS (Polycystic Ovarian Syndrome) is, here is a description:

Often called the “Thief of Womanhood”, Polycystic Ovarian Syndrome (PCOS) affects as many as 10% of women.  It can rob you of your fertility, cause irregular periods, lead to insulin resistance and obesity, as well as, depression. High levels of androgen hormones in women with PCOS can cause acne, excess facial and body hair growth and male-pattern hair loss. The long term risk factors for diabetes, heart disease and certain cancers are higher if PCOS is left untreated. (source: PCOS Diva)

 I have always had many of the symptoms, but never knew there was a root cause. I have had to battle heavy periods, 60-90 day cycles, and  work very hard to maintain my weight due to the insulin resistance and a low thyroid. The insulin resistance affects my blood sugar when eating and also makes me have uncontrollable sugar and carb cravings...all.the.time. 


The worst side effect for me has been dealing with adult acne. The older I get, the worse it seems to be getting. The other thing that has been getting worse is my PMS symptoms. Jim could testify to my extreme moodiness and irritability that can last weeks due to my long cycles. Not fun for me or anyone that has to put up with me. 


I found out that I had PCOS after I started seeing a Reproductive Endocrinologist when we decided to try for another child and found that we were having issues. 

It turns out that I do not ovulate...hence the very long cycles. My body will gear up to ovulate and then the follicles will turn into cysts instead of releasing an egg. The build up of these cysts in the ovaries can be pretty darn painful.


Some of the treatments for PCOS to reduce the symptoms include weight loss, low carb diets, Metformin (which has traditionally been used to treat diabetes), and birth control pills. Unfortunately, there is no cure for PCOS but these are things that can help with managing the symptoms. 


For myself, I have been through many, many rounds of oral medications to try and get my body to properly make mature follicles and then using a "trigger shot" to get the egg to release. Unfortunately, my body completely refuses to respond to oral stimulation medications.

The next step that I took was to give myself injections of Gonal-F. These injections of hormones do appear to be getting a better response from my body. Now we're at the point of trying to determine what dose works most effectively for my body. 


Being diagnosed with PCOS and infertility was heart breaking at first. I always imagined that I would have a handful of children. Now, I'm very thankful for Ethan and thankful for the team of specialists in Wichita that work with me and encourage me through the process of fertility treatments.


Alright...I warned you that it was going to get personal and TMI on here so no complaining.