Mira helps with dishes.

Mira peek-a-boos

Good news.

On Tuesday I went in for my blood tests. (In case you don't know what I'm talking about, the back story is here.) On Thursday my doctor called me back with the results. In addition to testing FSH, I was also tested for LH, estrogen, and prolactin blood levels. My FSH and LH were both in normal ranges for a woman who is at the pre-menstrual stage of her cycle, so that's good. My estrogen was low and my prolactin was high. But both of those results are explained by the fact that I'm breastfeeding. When you are breastfeeding, your body can send hormonal signals to the reproductive system, basically trying to prevent another pregnancy, and it appears that is what's going on with me. (The evolutionary purpose of this is that if a mother already has an infant to care for, another pregnancy too soon may overtax her body. Also, the infant has the greatest chance of survival if the mother's efforts can be focused on it rather than diverted into another pregnancy. For all my fellow evolutionary biologists out there...or anyone else who cares. Prolactin, by the way, is also referred to as the "mothering hormone". It's thought to be the primary ingredient in the hormone cocktail that causes a mother's intense emotional response to her baby. When I explained all this to Brian, he said, "So your tests say you are uber-mom." Yep, pretty much.)

So the doctor thinks that my estrogen levels have been pretty low ever since Mira was born (aka, for as long as I've been breastfeeding). But despite that I was still having normal periods. And then, he suspects, I missed an ovulation. The missed ovulation in combination with my low estrogen has caused my body to have a "reproductive hiccup".

However, aside from the missed ovulation (which is actually pretty common and can be caused by anything down to simply stress), my body is behaving perfectly normally considering that I gave birth 10 months ago and have been breastfeeding since then. So my doctor wants me to keep an eye on my cycles over the next few months to make sure that the missed ovulation was an anomaly rather than something that will be recurring.

Really, the only bad news (and it's not even really so bad) is that, because of the hormone levels caused by breastfeeding, my reproductive system is not really primed to conceive another child. That doesn't mean I'm completely infertile or that I shouldn't try to get pregnant. It just means that it might not happen right away, as I'm less fertile than I normally would be if I weren't breastfeeding. And the worst case scenario (again, it's really not so bad) is that I might not be able to conceive again until after Mira is weaned. But even that is unlikely.

Brian and I have decided to stop contraception and just... let it happen, if it does. We'd still like to have another baby, but after this little scare, I'm not feeling any sort of rush. So I'm feeling pretty freed by this. As if to reinforce my newfound tranquility, I heard a segment on the Dr. Laura show today that seemed to speak to me. It was a call about a woman whose friend was struggling with fertility issues while the caller herself was newly pregnant. She was concerned about her friend's response and wanted Dr. Laura's advice on how to break it to her. Part of Dr. Laura's response was addressed more to the general listeners than to the caller herself: she said that sometimes it feels like the universe has done us a disservice, has reached out and struck us down for no reason we can imagine. And sometimes when that happens it is easy to take out your aggression about the perceived wrong-doing on those around you. She said that in instances like that we should stop and think about what we have rather than focus on the things that we can not have. Take a second to list and really think about the things and people you cherish in your life and you may realize that you are hurting those people you love by pouting about the one thing you can't have, an act which is selfish at its core. And if you find yourself doing this, then you should say to yourself, "Self, we have to stop doing this. Let's just be sweet and gracious from here on out and 'hug what we have' rather than dwell on what we can't." So I'm taking that message to heart and "hugging what I have". Now excuse me, I have to go give my husband a big kiss. :D

Houston, we have a problem....

I'm sure most of you remember this post, where I said that Brian and I (well, me specifically) were having fertility issues and that I was starting a 10-day hormone treatment prescribed by my doctor. Well, here's the update.

I finished the last day of the hormone treatment yesterday. The treatment (progestin, a progesterone analog) was supposed to trigger me to have a period. It didn't. So I talked to my doctor today.

Normally, the combination of progesterone and estrogen trigger women to menstruate. So because adding progesterone to my hormone palate didn't stimulate a period, the problem is likely with my estrogen levels (aka, I'm making too little or no estrogen). There are two likely culprits for this problem: the ovaries or the pituitary gland. Normally the pituitary gland releases FSH (follicle stimulating hormone) which stimulates the ovaries to produce estrogen. So the problem is that either my pituitary gland is not producing FSH (not telling the ovaries what to do) or that the ovaries are not responding to the FSH (in which case FSH levels build up as the pituitary gland basically "yells" at the "deaf" ovaries).

So my doctor wants me to come in early next week to get my FSH blood levels tested. This should at least tell us whether the problem is with the ovaries (if FSH is high) or some other problem further up the hormone pathway (if FSH is low, that points to the pituitary gland or the hypothalamus region of the brain which regulates the pituitary gland).

So that's where we stand. I'm pretty upset about it. I'm not sure what this means for my health, if I'll have to be on artificial hormones for the rest of my life, if there's some other more serious problem in my brain (that's where the pituitary gland is located), if Brian and I will be able to have another baby at all, if we do whether we'll require fertility assistance, what the hormone levels mean for my breastfeeding Mira, and on and on. On the bright side, this whole experience has made me appreciate Mira that much more, to think that we got so lucky to have her before all this started.

Following directions

Mira has learned quite a few different tricks. She now knows:

"Come here" -when accompanied by holding your hands out to her

"Give a kiss" -though she is discerning about when she will do that one, and I say right on for not letting anyone pressure her into kisses ;-P

"Wave hi/bye" -She'll do this one to anyone at anytime; she loves to wave. She'll even sometimes wave unbidden if I say Hi or Bye to her.

"Clap" -This one she will do when someone says Clap or Yay or when someone else claps or even when she hears an applause.

"Pretty smile" -as you can see in the video. This one is pretty new.

Those are the ones that I feel she knows really well, but there is so much more that I tell her to do and she just does it. Things like, at bath time I'll say "Let's go upstairs" and she heads for the stairs. Or "Where's Daddy" and she'll look around for him. Then other things that aren't common for me to say but she responds anyway, like "The toy belongs in the basket" and she'll put it there. It's really amazing to me to think of how much she not only is understanding at this age, but also is *responding* to. She's like a little person or something. ;-P

I think she's also working on saying "cat". Every time she sees a fuzzy animal, she makes a "kkkkkkk" sound. Sometimes she makes it as far as "kkkkkka". At this point she's not discriminating: all furry animals are cats.

So much for that plan...

My regular readers may remember this post in which I said that Brian and I wanted to start trying for kid #2 around November. Well... about that. My body has apparently gone on strike.

I started by last menstrual cycle on 10/23/09. I was thinking that I'd let myself have one more cycle (due on 11/21) and then we'd start trying to conceive. Well the 21st came and went and no cycle. At that point I was thinking that either I was just a little late or it was possible that we had a contraception failure and I was already pregnant (in which case, wow, we didn't even have to "try" on that one). So I waited on it. When I was 4 days late I took an at-home pregnancy test. It was negative. So I was thinking, "Ok well then I'm sure I'll start my period soon, so no worries." At that point I still wasn't really worried, just wondering "Umm, what happened to my period?" (I'm normally quite regular.)

Fast forward 4 more days. I woke up on Saturday morning and I was having abdominal pain, but not cramping or anything that felt normal. In my mind I started thinking about all the things that could be wrong and with the abdominal pain plus the missed period I started to worry that I had an extra-uterine pregnancy. If that was the case, then I would need an ultrasound to diagnose it. So I called around several after hours clinics, but none of them had ultrasound equipment available on site. Finally, I relented and gave in to the idea that I was just going to have to go to the hospital (normally I'd have gone to my OB, but remember it was a Saturday, so nothing was open).

At the hospital they gave me a pregnancy test and it was also negative. The doctor there explained to me that even an unhealthy ectopic pregnancy would still register on their test, since it is so sensitive. She also told me that they had no way of determining why my period was 8 days late and that I should check into that with my OB on Monday. She then explained that they could put me through a battery of tests to try to find the source of the abdominal pain, but at that point my fears about an ectopic pregnancy had been allayed and the pain was already starting to fade so I decided to forgo any further tests.

As of today, I'm 11 days late and I had an appointment with my OB. He said that when women miss their cycle it is usually due to one of two reasons: either they are pregnant or they have a hormone imbalance. With the hospital pregnancy test, he was fairly certain that I'm not pregnant. So he said that likely I have a hormone imbalance. There are multiple things that can cause that, commonly an ovarian cyst or a failure to ovulate. Either way, he said it would be relatively simple to prescribe for me progesterone, the hormone that would naturally signal my cycle to begin. He said that I should get my period within 10 days of starting the hormone treatment.

So today I'm starting the progesterone. In the mean time, I'm not fertile. So there goes my plan to try to conceive another baby. Now, my next cycle could go back to normal, in which case it would be likely that I could conceive at that point. But there's also the chance that this hormone imbalance is due to some bigger issue that will continue to effect my fertility. Hopefully that is not the case.

I have to admit that I'm a little disappointed. I know that I should feel lucky that I conceived my first child as easily as I did. And I do. But I guess I was hoping that it would be just as easy the second time around. I'm not as stressed out about it as I could be, since I already have one beautiful healthy child, even if I never regain fertility (unlikely, but possible), I'll still have her. But, dangit, I just really wanted things to go according to plan. Oh well...