Monday, January 30, 2012

Inset Sensitivity and Starting Other Hormones Soon

Ahh Inset this is not something that I had not thought about when deciding to do IVF, but I should have! So last week I started the Ganirelix as I mentioned before. On these days, I noticed that I was having more Insulin Pump Inset sensitivity. But I didn't realize this until after I stopped taking the injections. On the 3 days that I was required to give myself these medicines, I had to change my inset injection site anywhere from 2-4 times (each day). The area was red more quickly and the insulin seemed to burn as it was administered into my body. Now I can't say that I haven't had this feeling before, but change it once and it was fine. Last Friday I had to change it 4 times! One of the times was at 4am because my stomach burned and stung so badly where the inset was, that it actually woke me up out of a sound sleep. Now if this is all coincidence, I don't know, but after stopping the Ganirelix, I haven't had as many issues.  I would say that overall I am noticing my inset sites getting more red and looking more irritated more quickly. Hormones do tend to make me more sensitive so this probably explains it. Just for example, if it's that time of the month or when I'm ovulating, Acupuncture is so much more uncomfortable for me! I'm much more sensitive when the needles go in.

I am still doing Acupuncture with herbs and taking the Estrace. I started my cycle last Saturday. I called into the doctors office as instructed and they let me know that my next appointment to come see them will be this Wednesday, Feb 1, 2012. I will then start all of my other injectable medications beginning Thursday Feb 2, 2012. This is also when I will start taking the Steroid Dexamethasone. Now I know this will cause me some insulin resistance, but I am not sure to what extent, so we will see!

I have been wearing my CGM since last week. (It's been driving me nuts sometimes!) It's still the issue of being outside the 20% variable. If the CGM says I'm 95 and my meter tells me 70, that is such a big difference in regards to how I would treat each one of those sugar levels! I am always double checking with my meter now, just to make sure I'm not over doing something one way or another.  I have seen some spikes in my sugars here and there over the past week, but nothing that I would 100% blame on the medications. I do think they have some effect, but not a great amount yet.

Ohhh exercise....*sigh* exercise has not been a close friend of mine over the past week either. I had planned to work out like a Mad Woman before I'm told that I can't exercise anymore. But let's face it, I'm trying to "live it up" before I lock myself down with all these medications and especially before I get pregnant:) Last social outings with cocktails or wine....last times where I'm not measuring out my foods or reading every single label before I put something in my mouth. When I was pregnant before I would carry a carbohydrate book around with me and or always look things up on my phone. Also, another reason I am not exercising is that I am tired. It may be the weather or it might be the fact that it was such a stressful decision to decide to do IVF, that now we are 100% in it, but body just said, "No More Right Now Brookie". I know I'll hit the gym at least one more time tomorrow or the day after though!

So as I have my appointments and I start my shots, I will keep track of how I feel and how my sugars are's almost time to start! Wish us luck! :)

Thursday, January 26, 2012

First Shots....

So I started my first shots yesterday of Ganirelix. This will be used to help control my ovulation. Between the Estrace and Ganirelix, I can honestly say that I haven't seen much, if any, insulin resistance. I know I said that a couple of days ago I was seeing some in the morning and I wasn't sure of the cause. Today after seeing the initial signs of my cycle starting, I'm pretty sure that is what has been causing my higher blood sugars. Since my sugars are usually higher in the morning, I had to raise my morning basals from 6am-11am. This has helped dramatically with keeping the sugars in good range.

How are the medicines making me feel? Initially the Estrace was making me a little shaky. It's hard to describe. But it's not too extreme. It has subsided since the first day I started taking it. I had difficulty falling asleep that first night though.  The Ganirelix hasn't given me any long term effects. The only issue that I am experiencing with this medication is a slight irritation at the injection site for about 5-10 minutes following the shot, followed by a mild burning sensation. (I have put my Insulin Pump insets in certain places and it has burned worse with the insulin going in)

Now that my cycle is on it's way, the big shots and the real fun begins! I guess the best part of being diabetic with all this is that I've had the past 27 years to practice giving myself injections, but I have to say that some of these big, new medicines can be quite intimidating! I am almost feeling that I'm learning how to do it all over again!

I'm getting excited and focusing on being positive throughout all this. I notice myself getting back into a very focused state of mind when it comes to my sugars and what I am eating. Not to say that I'm not always aware, but when it comes to pregnancy, or potential pregnancy, I suppose it's that maternal instinct that kicks into overdrive:)

My first appointment as a part of Plan Calendar #2 will be within the next few days most likely. The other meds may start even sooner...I'm not sure yet? We'll see what happens next soon!

Tuesday, January 24, 2012

Estrace Medication Started....

So I started my Estrace today. It's basically an Estrogen hormone from my understanding. So has it affected my mood or sugars??? It's really hard to say! So I woke up with a normal blood sugar of about 115 at 7am. (One of my daughters early mornings...she's usually a good sleeper!) Within about an hour I looked at my CGM and it said I was over 200! I hadn't even eaten a thing yet nor did I take any medicine.....which makes me wonder Why is this happening?? The same thing happened yesterday in the AM, but I didn't have my CGM on yet so I didn't notice. It took more than 2 times the amount of insulin to bring the sugars down. Why is this 2 days in a row...and then I thought about I got a little teary too with my husband this AM (I'm not a sappy one)....Oh Yeah! My Period is coming!! It's not due until the end of the week...but maybe it's going to be early and this will explain the rise in numbers? (I don't get high numbers before my period every month....just sometimes) I guess I'll just have to wait and see.

As for how the medicine made me feel....there was nothing right away or shortly after taking it. About 6-8 hours after I started feeling anxious and a little shaky. Now if this is a result of the medicine or just that I'm a little anxious about the whole process, I don't I continue to take it we'll see what happens. As for my blood sugars, it took a little bit more insulin than normal today to bring my sugars down...but once they got there I was good, even experiencing a couple of lows.

I should note, that especially when necessary, I am Very diligent about checking my sugars. If I feel a little off, the first thing I do is check. Wearing the CGM, I get an idea of how things are, but I always do a glucose check for verification. When pregnant before I would check up to 15 times a day, and now I usually check about 7-10 times a day.

Well tomorrow I begin my first shots...Ganirelix....We'll see how the Estrace continues to make me feel and if this makes me feel any different.

Monday, January 23, 2012

Pump, CGM and First Meds! enjoyable weekend, full of good company and some last good cocktails!! Even though the doctors office said I can have a couple of glasses of wine until the retrival, that most likely won't be the case. And I'm hoping that the no cocktail thing will be what's happening for the next 10 months at least! :)

My Animas Insulin pump I wear all the time so it's ready to go. I'm charging my Dexcom CGM (Continuous Glucose Monitor) and will set that up for myself this evening. And the meds are all ready to go. I have to be honest...I'm not so excited about putting on the CGM quite yet. The inaccuracies with the numbers are sometimes so frustrating (outside of the standard 20% variable), that I'd just rather not wear it. But with the "Trend" arrows that it has, that makes it worth wearing. I can see if my sugars are consistent, on a slight increase or decline, or on a rapid increase or decline. I can also set high and low alarms so I know when I'm going out of a certain range. For this reason, I will definitely wear it. I did not have this advantage in my first pregnancy.

I'm starting my first medications tomorrow! So the main stimulation medications do not begin until next week. Right now I am in Calendar #1 of my plan. This means I start certain medications before my monthly cycle. The first medication I begin with tomorrow is Estrace. (orally 2x per day) Now I have to be honest....each medicine that they will have me taking I will be having to look up in some sort of Dictionary or Encyclopedia....(do those still exist!?) Or let's face;) Now how it is going to help me, I have NO CLUE....cause everything I read online says it has something to do with Menopause or Vaginal dryness....ummm....definitely not in either category! I'm only 33 and don't have the other issue:) I guess the main purpose is to help maintain the endometrial lining? (I am NOT a I don't know for sure)....But this is where I don't know if the medicine will start effecting my blood sugars or no? The day after i start the Estrace I begin Ganirelix. This is medication that will be shots in the AM for 3 days before my cycle...and then 3 more later. What I know about this is that it has something to do with Ovarian stimulation. Once again...I'm not sure if this will effect my sugars or not? I will keep close track of this over the next few days. We're keeping positive thoughts as we know this is the right and best next steps in our attempt to have another child!:)

Tuesday, January 17, 2012

Preparing myself Physically, Mentally and Financially!

So thinking about all of the hormones I am about to pump into my body, I am trying to start thinking about how my sugars might act and how I'm going to feel. My last A1C was 5.1, so I feel I'm starting off in a great place with that. I finally got back into the rhythm of exercising in 2011, which has helped me to drop my total daily basal levels and the overall amount of insulin I take which has been great! (I'm on an Animas Insulin Pump and I absolutely love it!) But I know I'm needing to exercise at least a minimum of 2-3 times a week...and what is coming up with IVF....Exercise Restriction! As soon as I start month 2 of the IVF cycle plan, it's no bouncing or lifting over 20 lbs....(good thing my daughter knows how to walk!) They say you can do some light walking...but for me and my diabetes, it doesn't help me to maintain the lower levels of insulin.

Let's just say I've been working out like a mad woman since we decided to do IVF! Just to try and prepare myself physically with the hopeful pregnancy to come. 30 min of hardcore cardio, strength training and weight lifting. I figure I should do as much as I can before I have to completely stop. BUT...I have also been trying to get in my last min foods that I know I won't eat if I am pregnant, like the good carb loaded stuff! So though I wanted to lose 5 lbs before it started....I'm just playing a balancing act:) I'm not saying I'll cut out carbs if IVF works...but it won't be as many burritos and pizza.

So no exercise and having to take Steroids throughout the process of IVF....I'm a little freaked out how my body is going to react to everything.  I got them to put me on the lowest dose of steroids, but I went on steroids before when I had my allergic reaction to a medicine Dec 2010, and I could not get my sugars out of the mid 200's and low 300's at times. With that experience, deciding to do IVF has been a bit of an emotional experience. Even though you 100% want and are ready to do this, it can still make you feel stress, worry, anxiety. Am I ready? Can my sugars handle this? Is the stress it's starting to bring effecting my sugars now? Will the meds effect me? Can I handle the stress if IVF doesn't work? Can I handle the stress if we try naturally and it doesn't work again? What has given me some sense of peace is that 1) We've tried naturally for a long time over the past years 2) We tried other things such as Clomid, Acupuncture, Herbs, IUI and HCG shots without maybe it's time for this next step and I should just embrace it....but still there is there impending fear And excitement.

And lastly....the financial preparation. Oy vey! A call from the fertility clinic today...I must seriously be in the wrong profession if I'd like to be making a healthy living!! "Would you like Plan Option #1, #2 or #3?" Plan #1 A Pay For Service can submit Only this one to insurance. Plan #2 is a Shared plan...where if it doesn't work and depending on the age range you fall in, you can get a certain percentage of money back. The doctors office "Shares" the responsibility with you. And Plan #3 The option plan...where you can do up to 2 full rounds of IVF for the same cost. It seems so easy to choose Plan #2, but if you don't meet certain criteria, you don't qualify and I am out of range for my FSH. You have to be under 10 and I am 10.7. So I can enter on a "provisional" basis...and if I produce over a certain amount of follicles, I can switch to this plan. Plans #2 and #3 you can't submit to insurance and mind you....they cost a Lot more! So which to choose? We have until the end of the month to decide. Cost is a big decision maker in choosing to do IVF as well. We'll have to figure out what works best for us!

Monday, January 16, 2012

The Journey Begins....Why We Are Chosing IVF

This is a blog about being a Type 1 diabetic, getting pregnant and trying to get pregnant again...and hopefully it will be about being type 1 diabetic throughout pregnancy...everyone's story is a little different and this is me chronicling mine.

When I was diagnosed with Type 1 Diabetes almost 27 years ago, I didn't at the time quite realize how diabetes would change my life, nor did I think about getting married, or even having children in the future. I just always assumed that because I had Type 1 diabetes, that I probably wouldn't have kids. Way back in the "olden" days, that's what you heard about Type 1 diabetics. I am happy to say that is one of the furthest things from the truth. It IS possible....but it doesn't mean that the path to get there was not and is not frustrating, and the whole process...sheesh! You think pregnancy is tough...add on being pre-gestational diabetic! It's a whole other world of frustration and worry....but it is possible to get through it!

So some people might look at this and think "IVF, that means you must deal with Infertility". In my case, no. My husband and I were diagnosed with "Sub Fertility". Almost 2 years ago I gave birth to a beautiful baby girl. But that was after over a year of trying and going through surgery to remove endometriosis from my ovaries and slightly blocked tubes. After the surgery and another 4 months of trying we conceived naturally our beautiful baby girl.  3-4 months after having her we decided to go for the next one. Since that time we had 1 miscarriage (at 9 weeks), which was completely heartbreaking. No, it was devastating to me.

It's been just about a year now with no luck on conceiving again. This is where the doctors tell us that the "Sub Fertility" comes in. Thank goodness for decent medical insurance right now because we have gone through thousands of dollars worth of blood tests, immunology tests and fertility drugs. My FSH is over 10 (10.7 to be exact...and this was tested more than once), my 21 day progesterone is a little low (so they say it would make it hard to sustain a pregnancy) and some of my immunology tests were Mildly off (which means, potentially, that if I am getting pregnant naturally, it's possible that my body might be fighting off the pregnancy....seeing it as a forigen object) And oh yes! To top it blood type is O negative....Rogam here I come! And fertility drugs....*sigh*. Those were even frustrating before I took them! Scared on what they were going to be doing to my insides, how they would make me act, wondering if this is too far out of the relm of not "natural"...and I haven't even gotten to the IVF drugs yet! We started with Clomid...and clomid alone. No success. Then we did another couple of rounds of Clomid with the HCG Trigger shot. (Watch out hormones! My poor husband....I was definitely not "non-emotional" throughout all of these processes). But once again, no success. So after multiple OBGYN's, blood tests, sperm tests and different opinions left and right we have decided to do IVF. Before coming to this decision for sure, we got the opinion of 2 different IVF doctors as well. They both agreed that I have Sub Fertility and that my Follicle count was lower than it should be for somebody my age.  Here is a little time line of how things have gone:

  • July 2008- Started tying for a baby
  • May 2009- Surgery for Endometriosis
  • September 2009- Pregnant!!!!!
  • May 2010- Delivered Healthy Baby Girl
  • October 2010- Started Acupuncture with herbs
  • December 2010-Pregnant
  • December 2010- Severe allergic reaction to Medicine after conception
  • Feb 2011- Miscarriage at 9 weeks
  • August 2011- Begin Clomid 100mg- still doing Acupuncture and herbs throughout all
  • September 2011-Tons of blood work. FSH 10.7
  • September 2011- up Clomid to 150mg with IUI and HCG Trigger Shot and Progesterone Supplement
  • September 2011- OBGYN suggests IVF after we get blood work back
  • October 2011- Clomid again with 2 IUI's and 3 HCG trigger shots and Progesterone, Acupuncture and herbs
  • October 2011-OBGYN suggests IVF again- have phone consult with IVF doctor
  • November 2011- still not pregnant, Obgyn suggest IVF Again
  • December 2011- FSH 10.7...Again
  • Jan 2012- Still not pregnant...Starting Plan 1 of the IVF process. Still doing Acupuncture and herbs.

Deciding to put myself through the process of IVF, especially because I'm a Type 1 Diabetic, definitely has me freaked out! Hormones, fluctuating sugars, this all what is going to happen to me?! Most importantly, how will this all effect my sugars? Also I wonder, am I just not being patient enough? Because we can get pregnant...we've proved that, but the docs say that with certain blood tests results that came back, failed IUI's, having had surgery for endometriosis, along with having diabetes for so long, that I should just go for it!

So OK, I'm going for it!! I've looked online and have tried to find websites/blogs with more info about being Type 1 diabetic and doing Invitro Fertilization. There are some, but I want to share how these drugs seem to effect me because of my diabetes! They may do nothing at all! But my purpose is to chronicle my fertility journey. I remember some things from before, but this will be a whole new adventure...and like they say, "no two pregnancies are ever the same!". So wish us luck, we start the first shots in about 8 days.... and here we go!!