Being a squeaky wheel sometimes actually helps...

I called my PCP's office today to ask if they could please, pretty please with sugar on top, prescribe me something to allow me to sleep without itching. (I may not have been that sweet; actually I was probably a cross between honey and vinegar, honestly. I'm that miserable.)

When the nurse called me back, she started asking a bunch of questions that led me to believe that NOTHING was documented in my chart. I stayed calm, believe it or not, and ran through the whole saga with her. Itching since July. Bloodwork and consult with dermatologist in the fall. Trials of three different antihistamines and steroid cream with no relief. Liver consult, ultrasound, fatty liver, CT scan, MRI. Two small lumps on right side of my neck.

Two things I'd have thought would have been asked previously but weren't were finally asked today:

• "On a scale of one to ten, with ten being the worst, how bad is the itching?" Umm, a five most of the time, ten when it's really bad.
  
• "Where exactly are the lumps located?" Back side of my neck, about two finger widths above my shoulder.

I have an appointment at 2:20 this afternoon.

Hurrah for someone who finally listened.

What's better, any answers or specific ones?

At least one part of my worry of yesterday may not be a big deal. Liver doctor's nurse was calling to tell me they wanted to schedule an MRI of my abdomen, because my CT scan showed something near my bile duct/portal vein that was either cysts or hamartomas (benign tumors), neither of which are apparently any big deal from my consultation with Dr. Google.

The good news about this is that it is not likely the cause of my itching.

The bad news about this is that it is not likely the cause of my itching. (!!!)

Gah! I want some results on that, and pronto. I've been sleeping horribly, kicking G out of bed on occasion (he's a light sleeper) and am generally miserable a good portion of the time.

The neck lumps, of course, are my next big worry, but I'll save that for another day. Get through one crisis (or non-crisis, as the case with my liver appears to be) at a time, right?

Will I make it to question two?

Liver doctor's office called. The nurse left a message Friday saying they want me to call them. No other details.

I hope it's just something stupid. I had a minor reaction to the IV contrast during the CT scan, so perhaps they're calling to check up on that.

Fingers crossed.

Another thing I haven't shared here or with some of my other friends is that within the past two weeks, I noticed a lump on the back right side of my neck. Well, I should say two lumps, as it now kind of feels like two distinct nodules of some sort rather than just one. I can't get an appointment with my PCP's office until February 27 because - surprise, surprise - the doctor that I see is leaving the practice. Apparently lumps on your neck combined with itching qualifies me for one of the "emergency" appointments; thank goodness, as the regular appointments aren't until June.

(Thank goodness? What am I saying???)

I'm trying not to think the worst. It's tough though. I remember saying in an entry recently that I hoped that whatever I was dealing with wasn't going to get in the way of trying to have a baby.

I'm now just hoping that I'm being paranoid about everything.

Question one

So, I got the report from the baseline ultrasound in the mail today. My 6-8 follicles were actually 2-3 on my left ovary, and 4-5 on my right. The left ovary is the one that's hiding behind my uterus, and it's slightly smaller than the right one. I assume the ovary size and the hiding bit corresponds with the smaller amount of follicles, as well? I've seen articles that say that as women go into menopause their ovaries shrink and fall behind the uterus, so I'm hoping that's not an indicator of anything.

Ok, so onto my real first question (the one in the paragraph above doesn't count): Will the FSH (theoretically) help me to produce more follicles, or better follicles? If I'm not a poor responder that is.

A man, a plan, a canal - Panama.

(Don't ask, I just love palindromes.)

So today was the RE visit. As G and I were sitting in the waiting room, my cell phone rang -- it was the nurse from the RE's office, calling about my bloodwork. "I'm in the waiting room," I said, "and will be seeing Dr. W in ten minutes."

"Oh, never mind then, he can talk to you about this." Talk to me about what??

Ends up it was (probably) nothing - my prolactin was slightly elevated, probably because I forgot and drank coffee that morning. Turns out though that I have a shy ovary -- my left one apparently likes to hide behind my uterus. The consequence of that being that while I know now that I had 6-8 antral follicles on my cd3 scan, I don't know if that's for one ovary, or both. At first, Dr. W said that the u/s might not matter since my FSH was 6.1. But then he read back through my notes and saw that it had been as high as 11.9 in the past, and got a semi-worrisome look on his face.

He only looked slightly worried while reading G's SA results, but didn't seem as bothered about that -- his plan is to have G do a repeat SA -- at the office this time, no rushing through traffic to make it to the lab in under an hour since there is a chance that could have contributed to the motility issue.

Then I told him about the liver/skin issues. He told me that, given my u/s and FSH, his next step is to try injectibles (Follistim or Menopur, possibly) -- but I will need to get that cleared with my PCP and my liver doctor. I don't know if there could be any danger to me from those, but I'll admit I am slightly worried about my liver/skin issues pushing back our ability to move forward with treatment. I guess I should be more worried about having a serious illness than about whether we'll be able to keep trying to get pregnant, but I never said my priorities were completely worked out.

Oh yeah, one more thing -- I get one try with the injectibles. If it doesn't work, we move on to IVF I assume -- with motility issues there's no need to consider IUI, and with poor response to FSH there's no point in continuing with the injectibles.

I just said on someone else's blog that I wish I had bookmarked all those blogs that deal with these things I never knew I'd need to know...

I have so many questions.

2007: year of the caduceus?

Is it too soon to be tired of doctors for 2007?

Probably, considering that I have five medical-related appointments/checks in the next six weeks -- luckily, they're spaced out fairly well. (I'm betting that by the end of the year, I will wish that we'd had the foresight to create a flexible spending account for medical expenses, though.)

I had my liver consult on Monday, and I like the approach the doctor suggested: he drew some more labs to re-check the antimitochondrial antibody test with a slightly more sensitive assay; he ordered a CT scan of my liver, scheduled for 1/22, which apparently gives a clearer picture than an ultrasound; and we're meeting again in a month to see how the results look. I'm also supposed to try to lose some weight, since that could be contributing to my fatty liver and elevating my alkaline phosphatase. If that doesn't lower the levels by April, he will schedule a liver biopsy. He can't do anything about the itching just yet, as he can't treat me as though I have PBC until he confirms it or rules it out. I have another appointment with my dermatologist mid-February, though, so perhaps they can figure out something else that will help.

Back to fertility or lack thereof -- in preparation for my RE visit on 1/17, tomorrow I get to go for cd3 bloodwork and my very first baseline ultrasound. I am trying not to think about it too much because my past borderline FSH level a year ago makes me slightly nervous.

Stopping myself from thinking more about it right. now.

Whatever I had to say...

...seems inconsequential when compared to what Jill has on her plate right now. Please give her some support or at least a prayer.

A new year, finally

Happy 2007 to anyone reading out there. I said a little prayer at midnight that things would improve for us, but am not as hopeful as I'd like to be. Time will tell.

Kathy McC tagged me for "Six Weird Things About Me"... part of me thinks that anyone who's read here at all for the past year or so knows far more than six weird things about me. :) But here goes:

1) I do not like the feeling of things between my toes. (I've never worn a pair of traditional flip-flops for more than a few seconds in a store.)

2) I have a weird gag reflex that is triggered by pasta without enough sauce (or sometimes just reheated mac and cheese, pasta alfredo, etc.) and egg whites. Sometimes scrambled eggs, but that's usually only if I don't put enough salt on them. When it happens I cannot finish what I'm eating even if it's the first bite that caused it.

3) I sleep with a very well-worn G.und bear that I've had since I was twelve.

4) Kathy said she was afraid of driving... I used to be afraid to call people on the phone. Even when I started this temp job and I had to call references, a small amount of terror spread through my chest. I got over it, obviously, but even with time I've still found it to be difficult.

5) I am a compulsive skin picker. Hangnails, fingernails, scabs, blemishes etc., I just can't seem to resist. It's embarrassing and I'm trying harder not to do so, but the itchiness isn't making it easier.

6) I am slightly freaked out about admitting my weird things to the blogisphere because I am an "approval seeker" and want to be liked. :) Therefore, and because just about everyone who knows me well enough to be tagged has already done this, I will just say farewell to 2006 (thank goodness).