Long Overdue Update

It's been ages since I've blogged! I'm now almost 28 weeks pregnant and doing well. My only complaints are that I am having trouble sleeping and am tired all of the time. I still take a nap every afternoon, which means I don't get much done around the house, but it's become the new normal around here. Being pregnant while chasing after a toddler hasn't been too bad. Some days I feel like I am just dragging myself around, but it's totally manageable. I am so thankful that Lily still naps.

I've also been having some hip pain. I also had it with Lily, so I decided to see a chiropractor this time, and it has really helped! I don't need 800,000 pillows or an extra mattress topper this time, so that is nice.

I am gaining too much weight (although, in the CF world, that is not really a complaint) - I'm already over 25 lbs. I gained over 40lbs with Lily, and I was hoping to gain less this time, but I guess my body just likes to gain extra weight during pregnancy. I will admit that I am not eating perfectly, but my diet isn't horrible. I am just starving all the time! Oh well, I guess I will just go back on Weight Watchers after this one is born.

CF-wise, I am doing great, for which I am so thankful. However, I am very nervous about how things are going to go once the baby arrives. February through April seem to be my sick times of the year, so it should be "interesting" to see how I do with a new baby and a toddler bringing germs home. I know, whatever happens, we will get through it, but it may suck, especially if I end up needing IVs.

I am planning to look into Kalydeco once this baby arrives, but I am not very optimistic. I am extremely confident that it will work for my mutation, based on the in-vitro data, the fact that Vertex is currently doing clinical trials on my mutation, and the results one woman (who has my mutation) experienced. But, my doctor hasn't seem to keen on the idea. Before I got pregnant, he didn't seem to really want to write the script because it's so expensive, but he said he would because my insurance would cover it and he "didn't want to the be roadblock". However, now my insurance is requiring pre-authorization, so I think my doctor will have to fight to get me on it, and I'm not sure he will be willing to do that. And, even if he is, I'm not sure insurance will cover it.

And, I can't believe I forgot to mention that it is a GIRL!!!! I am so excited to have two girls. I grew up in a family of two girls, and I just love having a girl, so I am really excited to have another. Now we just need to decide on a name!

12 Week NT Scan

Today I am 12 weeks and I had the NT scan. Everything looked good! The baby was very chill - just laying on its side, not wanting to be bothered. I still can't believe everything is going well!

One thing I forgot to mention about the second time around is how I am so distracted by Lily that I almost forget that I have a baby in my belly :)

I'm still very tired and feeling nauseous, but I'm hoping it will get better soon. My hips started aching last week, so I decided to visit a chiropractor. I had my first visit on Monday and I really liked the chiro.  I can't say yet if it helped (my hips felt better when I left, but they ached last night). I'm going to see her again tomorrow so we can talk about my treatment plan.

The Second Time Around

So, can I just say that the second time around has been hard? The first trimester exhaustion has been kicking my butt! I'm not sure if it's actually worse, or if it just feels that way because I have am now a SAHM to a toddler, which means I can't sleep in, sit at a desk all day, or leave work to rest. Lily doesn't go to bed until 9:00, so I rarely get to bed before 10:00. And then I've had insomnia, and I keep waking up to pee. And the sun usually wakes me up at 6:30. On the plus side, I do get to take a nap while Lily does every afternoon, so I'm usually EXHAUSTED until 2:00, but then I feel better until I go to bed (although I still feel very lazy).

I also can't work out like I want to. It's too hot to go for a run (bad for the baby), and I'm too tired to workout while Lily is napping. So we make it to they gym about two days a week. The other days we either have errands or doctor appointments. And, once in a while, I like to do something fun with Lily. I'm also feeling guilty about not being able to do as many fun activities as we usually do.

To top things off, Greg has been traveling for work like crazy.  That just sucks and I hope it gets better by the time the baby gets here.

I've been counting down the weeks until my energy may come back! I'm hoping I'll be feeling better by 14 weeks (although my fingers are crossed for 12 weeks). I'm 11 weeks today, so hopefully there are only three more weeks to go!

First OB Appointment

Today was my first OB appointment. It was also my first appointment with this OB because my previous one moved. This OB was a sweetheart and I'm glad I picked him.  I am going to get a lot of ultrasounds, which is nice! I even got one today, and the baby was measuring 9w0d, which is only one day off based on ovulation and exactly right based on my last u/s. The baby's heartbeat was 174 bpm and everything looked good! He said the risk of miscarriage low enough (5%) that we could start sharing the news, but I am still nervous and will probably wait until after my 12 week appointment.

I am still in awe that the baby is doing well - I just can't get over how easy it was this time around. :::fingers crossed it continues to go this way:::

6w2d Ultrasound

We saw a heartbeat! The ultrasound went great. The little bean was measuring 6w3d and had a heart rate of 124 bpm. I'm finally starting to relax a little and actually believe we might be taking home a new baby in February :)

The coolest part of the ultrasound was when the tech said to Lily, "You're gonna be big sister." And Lily looked a bit confused and said, "Big Sister...."

The RE gave each of us a hug and said we were ready to move on to the OB, but we could have another u/s in a few weeks if we wanted one. I am on the fence about that, mostly because I already have enough doctor appointments. But, I may schedule it just for the peace of mind.

I can't believe I may never see my RE again. That seems just crazy (and a little sad).

Ultrasound Today

I ended up having a "surprise" ultrasound today. This morning I called the RE's office because I've had a pain in my left upper back for three days, and I had read shoulder pain could be a sign of an ectopic pregnancy. My RE was glad I called and told me to come in right away.

I was fairly confident that it wasn't ectopic because I hadn't had any other symptoms, but I was so glad he told me to come in because I wanted the extra piece of mind! I just can't get over the disbelief that it could happen so easily this time around, and I was feeling nervous because some of my symptoms had disappeared.

We saw a gestational sac with a yolk sac, in my uterus, which was perfect for 5w1d. No signs of ectopic. Yay! I feel much more relaxed now!

As far as symptoms go, I had been experiencing some mild morning sickness, but that went away a few days ago. I had a few days where I felt nothing other than bloat. But the past two days I have been so sleepy, and I've been hungry!

As far as the back pain goes, I also called CF clinic because I thought it could be lung related. Because I'm not having any other symptoms of a chest infection, they think it's probably just a sore muscle and suggested I get a massage ;) I'll take that diagnosis!

Beta #2

175! I am loving these good, strong numbers. Before I was always a bit below average, and now I'm a bit above average, which would make sense with my early BFP.

I'm already having some pregnancy symptoms, which is reassuring - mostly a raging appetite, cramping, and a little nausea.

My RE's office also checked my TSH and upped my Synthroid dose. My TSH was 3.3 before the dosage increase.

In other fun news, Lily turned two yesterday! It all does go by so fast.

In CF news, clinic called yesterday because I cultured "a little bit of pseudomonas." Which means that, if I get sick while PG, I will have to go on IVs because there are no oral antibiotics I can take that are safe for pregnancy. So that sucks. Hopefully Cayston will keep the pseudomonas at bay. I'm also thinking I am going to stay on Azithromycin...originally I planned to go off it because I didn't really notice it helped me, but it's only a pregnancy category B, and I think it would be good to include anything I can that might help to fight the pseudomonas.

Beta #1

70 at 13 dpo! (Average is 63). I've been very nervous because my symptoms aren't as prominent as they were with Lily, so that made me feel a lot better.

I had my beta drawn yesterday at 12:30, and the lab said the results wouldn't be in until 4:30, so I assumed I wouldn't find out until this morning. Instead, my RE called me himself at 9:00 last night because he "didn't want me waiting on pins and needles any longer." How awesome is that?

He told me to call this morning to schedule another beta for tomorrow and an u/s for two weeks from now.

I am still in disbelief and am taking this one step at a time, but I feel more relaxed now!

It Got Darker!!!

Here is a photo to compare today's test to yesterday's. I don't think the camera picked up the faint line from yesterday, but you can definitely see it on today's test (which is on top).

Soooooo....I think I am pregnant! I am giddy with excitement. The timing would be perfect - our kids would be just under three years apart, so Lily will be more independent, (and hopefully potty trained), but they'd be close enough in age to play together. And I'd be due in the winter (February), when my mom wouldn't be working.

I can't bring myself to talk like it is truly real yet. I just can't believe the IUIs worked that fast! I was sure I was going to have to get back to that depressed "will I ever get pregnant?" state that I was in when we were TTC#1. So, I'm probably going to be very nervous for a while. Right now, I'm almost expecting this is going to be a chemical pregnancy or something. It amazes me that Greg and I can have sex on our own 10,000 times (actually, it's more like 20-25 times) and never get pregnant, and then, every single time we've done a clomid IUI - BAM! Pregnant!

BUUUT, I'm still very excited and happy!

Eeeek

So, I have been testing out the trigger, and yesterday I got my first BFN. Then, this morning, I decided to test again just for additional piece of mind that the trigger is gone, and I got a very, very faint second line. Now I am going crazy wondering if it's the trigger or the beginning of a BFP. I was wondering if maybe my urine was more concentrated this morning, so I took another test after lunch, and the line is still there.

The last time we did IUIs, it took, at most, 9.5 days for the trigger to get out of my system. Now I am  9dpiui and 10.5 days past trigger, so it could go either way. :::trying not to get my hopes up:::

In other news, I recovered from my illness without antibiotics! Whoohoo! I bought a home PFT monitor, and I absolutely love having it because it provided me with assurance that I didn't need to call my doctor.

IUI #5 Complete

It was a piece of cake! I was nervous it would hurt (because it did last time), but I didn't feel a thing. And Greg's numbers were fabulous - his postwash count was 112 million :O and 98% motility.

Now I just need to kick this illness. So far, I don't seem to be getting any worse, which is good, but I'm also not really feeling any better. I don't feel too bad, but I have a junky cough, some lung pain, and my voice is SO hoarse. I keep waiting for CF clinic to call with news about my x-ray or culture (although I know the culture results take a few days). I am counting down the days until I start Cayston next Friday.

119%!!!!

That was my FEV1 today. It hasn't been that high in almost 10 years! Between adding pulmozyme, NAC, fish oil, and allergy shots, something is definitely helping. My doctor said I made his day.

It's funny because I didn't even know I had CF clinic today until I got the appointment reminder yesterday afternoon. Perfect timing considering I am sick. My doctor thinks it's just a virus, but he may put me on something if my sputum culture comes back showing psuedomonas (I did not culture it at my last appointment three months ago).

(And to the commenter who asked if I've tried hypertonic saline - I do take that twice a day and have been for years. I love it and think it's had a big impact on my health.)

CD13 u/s and CF stuff

This morning's ultrasound showed that my 12mm follie is catching up - now I have 16.5 and 18mm follies - two! The plan is to trigger tonight and do the IUI Wednesday morning. I'm scared about having two, but my RE said the risk of twins is only 10%. And this is very similar to the cycle I got PG with Lily - I had 16 and 20mm follies when we triggered that cycle.

And, unfortunately I have to give an update in CF-land. I have bronchitis, blech. Last week I caught a cold from Lily, and now I've lost most of my voice and have a junky cough and lots of nasal congestion. I've heard this is going around right now, so I'm guessing it's viral and hoping to stay off antibiotics. So far I don't feel too bad, just tired and a little junky. This is the first time I've been sick since I've started pulmozyme, so I'm hoping that will be a big help.

CD12 Ultrasound

One 16.4mm follie on my left side. The RE wants me to come back tomorrow for another u/s - he thinks I will be ready to trigger, and then we will do the IUI on Tuesday (CD14). I'm so glad I pushed for an earlier u/s!

Bring on IUI #1 (Part 2)

I don't know what you call it when it's your fifth IUI, but your first IUI TTC #2, LOL. Anyway, I am very excited to begin this process! I was so nervous for so long, but now everything feels right.

I got AF on Wednesday, so my RE called in Clomid and Ovidrel. This time around, I have insurance coverage, which means a little more work because my insurance has its own requirements. Like CD 3 blood work every six months. I had that done this morning, and I got a call this afternoon that the insurance has authorized this IUI.

The plan is for me to take 50mg Clomid CD5-9 and do an u/s on CD12. It's a little different than what we did when I got PG with Lily. With Lily I took Clomid CDs 3-7 and did an u/s on CD9, but that was because I had ovulated very early the previous two cycles. My RE wants to start off being a little more conservative with the Clomid (CDs 5-9 has a lower risk of multiples). And he wants to try to minimize ultrasounds. He originally wanted to do an u/s on CD14, but I begged for a CD12 u/s, because last month I O'd on CD14.

I am in such a different place right now than I was last time we went into IUIs. I have Lily, so I'm not worrying about whether or not I am going to be a mother. I haven't obsessing about TTC with OPKs and temps. And I have a history of success with IUIs, so at this point, I feel confident. I also know it may take a few tries, so I'm not planning on the first one working. I feel like this one is just a warm-up. Of course, if it did work, that would be awesome. So, my fingers are crossed!

Lily Weaned

On Thursday, Lily nursed for the last time. On Friday, Saturday, and Sunday, when I asked her if she wanted to nurse, she said, "Shake!" (which is a yogurt smoothie). So I considered her weaned. We made it 22 months, 26 days. I am so happy it ended on her terms. I was dreading having to stop so I could take clomid. I thought there would be a lot of crying, and it would break my heart. Instead, I reached the fabulous milestone of nursing her until she was done!

And, I have to say that nursing Lily is one of my proudest achievements. The beginning was so hard, and then I almost had to wean at 10 months. And then there was the cutting out dairy, her not taking a bottle, the sleepless nights, etc. She nursed every 2-3 hours during the day until she was 11 months old. It was hard! But also so sweet and rewarding.

I am feeling a little sad about it - I don't get many snuggles now. But I am enjoying the extra time in the mornings - we can get out the door so much faster. Also, surprisingly, she no longer wakes up crying all.the.time. And I'm looking forward to TTC #2!

Still Waiting....

This cycle we planned to start IUIs to TTC #2. AF arrived last week, I called the RE's office, and they called-in prescriptions for Clomid and Ovidrel, and they set up a CD14 u/s.

And then I had a meeting with my allergist. He told me that I could move on to the final bottle of allergy serum. The goal is to get to an allergy shot dose of 0.50 ml, and then I will be at the maintenance dose. Once I get to the maintenance dose, I will continue to get weekly shots for a few months, and then I can start going every other week. Eventually, I will only have to go once a month. To get to the maintenance dose, I have to get a shot once a week starting at 0.05 ml, and then increase the dose by 0.05 ml each week. However, if I get pregnant, I can't increase the dose. I have to hold the entire nine months of pregnancy, continuing to go every week, and then I can start increasing once I deliver. So, basically, if I get pregnant now, I will extend the weekly shots by nine months and will have to go once a week while taking care of a newborn.

So, Greg and I decided the no-brainer answer was to wait to get PG. I just have to get to the maintenance dose before I get a BFP. And I can actually get a shot every five days, which will knock a few week off the schedule. So, this means waiting one more month. Sigh, I'm bummed, but I know it's the smart decision, and it's only one month.

In CF-related news, my allergist wants to do more to address my nighttime wheezing. His goal is for me to no longer need my inhaler at night. So he put me on a stronger steroid inhaler. He also switched me from Symbicort to Flovent + Serevent because the latter has better data regarding safety during pregnancy. I was very happy about that, because I'd also like to get rid of the night time wheezing!

Thyroid Levels are Good!

Eeek! We are now officially allowed to TTC. My RE's office called yesterday and said that my TSH was 2.5, which is good. And now they just want me to call on CD1 so we can start IUIs again. I'm currently on CD8, so I may be starting an IUI cycle in less than a month! I am a bundle of nerves right now - for a while there, I was terrified about the idea of another baby because the first year was so hard. But know we know this is what we want, and we know that the super hard baby phase ends. I'm just scared to go back to it again! But now is a good time to do it, considering Lily is almost two, I am 35, and it may take a while to get pregnant.

The only thing that might hold us back is my sinusitis. Today I visited the ENT just to make sure my sinuses look okay (I have a hard time telling if I have an infection because I'm always stuffed-up and having sinus headaches). He said I looked good, but he took a culture just to make sure I don't have a staph infection. I should know by Monday. But he said he does not want to do another surgery, and there is probably a medication he can prescribe that is safe for TTC, so this most likely won't impact anything.

I dusted off my basal body thermometer and ordered some OPKs so we can try on our own this cycle. I would LOVE to be able to get PG on our own (but I'm not holding my breath) - especially because I am going to have to wean Lily by CD3 of my next cycle so that I can take Clomid. She is still nursing twice a day and I have a giant knot in my stomach about the thought of taking that away from her - but we are only a few months away from my goal of two years, so I know it's not a huge deal. It's just going to be so bittersweet.

Thyroid Still Not Fixed

Last week I had my follow-up bloodwork with the RE to check my TSH levels. I had been on Synthroid for three weeks. The nurse called and said, "Everything was normal except for your thyroid!" which made me LOL a bit because the only thing I was having tested was my thyroid. I forgot to ask what the numbers where, but my RE wants me to stay on the same dose of Synthroid for two more weeks and then get re-checked. I'm glad we went to the RE early, because I have been hit by the baby rabies and am so anxious to start TTC!

Clinic Visit Outcome

Everything went well at my clinic visit on Thursday. I had a long talk with my doctor about a bunch of different things.

The most important subject, of course, was Kalydeco. He was very surprised when I told him that my insurance says they will cover it off-label, and he seemed a bit hesitant to prescribe it for me because of the cost, but he also said, "I don't want to be the road block to you getting it." So he said he would call Vertex and see if he could get the in vitro data. However, he also felt that, even though Kalydeco is a Pregnancy Category B drug, he didn't think the benefit was the worth the risk of me being the first pregnant human to take it. Maybe if my lung health were worse, he would have felt differently...I'm not sure. But I realized, the second he said that, it was was answer I wanted to hear because I was nervous about taking it while pregnant. So now it's time to get knocked up! ;) I am still looking forward to hearing back from him about the in vitro info, though!

I also asked him about taking Pulmozyme twice a day, either as a regular course of treatment or while sick, because I had read some research that said it may be a good idea for people with mild lung disease. He said there was no benefit. I also asked when I should take pulmozyme. He said the time of day didn't matter much to him, as long as I did it at some point during the day. In addition, I asked if I should leave some time between hypertonic saline and Pulmozyme. He said there was some in vitro data that suggested hypertonic saline might interact with pulmozyme, but there was no concrete evidence that this was necessary. Because I have the luxury, I am going to play around with when I take my Pulmozyme to see if it makes a difference for me.

I also asked if he thought my CF was asymptomatic. I asked this question because I recently requested my records from the CF clinic I attended until I was 22. I was surprised to read in the records that they considered me "completely asymptomatic"....despite my having repeated episodes of bronchitis, culturing Staph and H. Influenzae, and even having one bought of pneumonia that put me in ICU. My (current) CF doctor said that he did think I had symptoms of CF, but that my manifestations are primarily sinus related. The is good news to me, because hopefully it means that my lungs will still be in good shape by the time I am able to take the exciting new CF drugs.

And speaking of sinuses, he thought I had a sinus infection (after I told him I started having night sweats, feeling run down, coughing more, and having congestion after cedar season kicked in here in Austin...which was six weeks ago!) So he prescribed two weeks of Cipro. He also wants to talk to me ENT about putting me on an antibiotic that I could nebulize through my sinuses. Yay for more nebs! (said with sarcasm)

The other thing I asked about was Azithromycin and the study that showed it may increase the risk of culturing MAC. My doctor said that the CF Foundation is looking into that, but at current time, the proof is still questionable and he thinks the potential benefits outweigh the risks. So I'm going to keep taking it.

So that's pretty much all of it! My FEV1 was 115% - down 3% since last visit, but still 2% higher than it had been for the past two years. Hopefully the cipro will make me feel better!

Kalydeco!

The CF world has been exciting since my last post! I'm sure all CFers (and many non-CFers) know that a few weeks ago the FDA approved a revolutionary CF drug, Kalydeco. I saw one news story say that Kalydeco was "to CF what insulin is to a diabetic." AMAZING. It may be very close to a cure for some people with CF. The stories of people getting their prescriptions filled is so freaking awesome - tears of joy, even from the pharmacists! One parent even videotaped their son taking his first pill :)

The downside is that Kalydeco is only approved for some people with CF, people with the G551D mutation who are six and older. Clinical trials have shown that the drug is a miracle for these people, but that it is not for people who have the most common mutation. Thankfully, there are two drugs in the pipeline that are addressing the most common mutation. So there is so much hope in the CF world right now!

So, now for what I have been doing - researching, researching, and more researching. I have the R117H gene, and the moment I saw the phrase that Kalydeco is a potentiator of the R117H mutation, I started trying to learn everything I could about how the drug might work on my mutation. Might this be a cure for my CF??? Might this stop the night sweats, the coughing, the post nasal drip, the days where I just feel like crap, the pulmonary episodes, the sinus infections, etc.? Might this mean that I no longer have to worry: "Will I meet my grandchildren?" "When am I going to start needing regular hospitalizations, and how will that affect my family?" "Should I bother to save for retirement?"

Based on everything I have read, I think I have a lot of reason to have hope. And last week, I almost died of shock and excitement when I learned two things: Kalydeco is a pregnancy category B drug! This means I could potentially take it during pregnancy and nursing and not worry so much about getting sick. AND, my insurance claims they will cover it off label! I especially could not believe the second one, considering the medication costs $294,000 per year. Holy.freaking.cow.

So now to the next step - asking my doctor for his help. I have gathered all of my research, printed it and done some highlighting, and this is what it boils down to:

-The cause of CF is that certain ions are not processed correctly in cells. One of the problems is with an ion channel, which Kalydeco addresses. It is the first drug that directly fixes the CAUSE of CF, not just the symptoms of thick sticky mucus, inflammation, infection, digestive issues, etc.

-Kalydeco increases channel gating. This is why it works so well for people with the G551D mutation - the whole thing that causes their CF is defective channel gating. In CF, there are five classes of mutations, and G551D is in what they call a Class III, or "gating" mutation.

-In vitro studies have shown that Kalydeco also increases channel gating in many other gating mutations. These studies have been published. Based on these studies alone, the pharmaceutical company (Vertex) is requesting that Kalydeco be approved for ALL gating mutations in Europe. If I had one of these gating mutations, I'd probably be knocking down my doctor's door trying to get it off label.

-My mutation, R117H, is classified as a "Conductance Mutation." HOWEVER, I've read two sources that say the primary problem with my mutation is actually channel gating, not conductance (although there is reduced conductance).

-The in-vitro data for R117H has not been published. But it is good enough that Vertex announced they are going to begin clinical trials for my mutation this year (I whooped like I was watching football when I read that announcement!). I do not qualify for the trials because my lung function is too high.

-I know someone who has a contact at Vertex, and they sent this in an email:

"The answer to that question is that Vertex has not yet tested the effect of Kalydeco in people with the R117H genotype. However, based on testing on airway epithelial cells from patients with that genotype, we believe that Kalydeco could have a similar effect to that seen in individuals with the G551D genotype. We hope to study the effect of Kalydeco on individuals with this and other genotypes in the near future."

I called Vertex and asked about the in vitro results for R117H. They said my doctor would have to call for that information. I am planning to ask him to call, and if the results are similar to those for the gating mutations, I am hoping he will consider prescribing it off-label. I am very excited and nervous for the appointment, because I have dying to get ahold of the in vitro results for almost a year.

Of course, the other big "if" is if my insurance will cover it. They said they would, and I asked for a letter stating this. We'll see if I get it. But I do have hope because I already know of two people who have gotten it off-label based on age (they have the G551D gene but are younger than six).

Fingers crossed! I can't wait for Thursday!

Results

Good news! My prolactin levels are normal, so I don't have to worry about weaning DD! My TSH was 5.1, which my RE described as "borderline." He called in a prescription for Synthroid and wants me re-checked in three weeks. If my thyroid levels are normal, I think we will be back on the TTC train, although we decided to try on our own until after Lily's birthday.

My glucose tolerance test and vitamin levels were all normal as well.

Now if I could just shake this general "crappiness" that I have been feeling lately. I can't really pinpoint what it is, but I go through these phases where I get night sweats, wake up wheezing, cough up more junk, and just feel a bit crappy. I don't know if it's a sinus infection, reflux, or a lung issue. I thought maybe it was triggered by allergies because it seems to happen when the weather changes (especially when it gets humid), which is why I am getting the shots. It's too soon for the shots to be working, though. I am counting down the weeks until I reach the 3-6 month period where I might start to notice that the shots are working!

Back to the RE!

Last week Greg and I headed back to the RE! We went back a little earlier than originally planned after I got some abnormal test results from a routine physical. I had the physical back in October, and a month later I received results of the lab work in the mail. The results showed my thyroid stimulating hormone (TSH) was high. The paper said the normal range was 1-4.0, and mine was 7.4.

I didn't know what this meant, so I called my PCP right away. They took over a week to get back to me, despite calling repeatedly. In the meantime, I did a lot of Googling and read things about increased risk of miscarriages. So, I called my OB's office (the results were forwarded to her). The OB said that, because my free T4 was normal, I didn't require treatment. But this conflicted with everything I read online. When my PCP's office finally called me back, they also said I didn't need to be treated.

So I decided to make an appointment with the RE, and I am so glad I did! He was very surprised that I was not being treated. He confirmed what I read about miscarriages and also said a high TSH can cause birth defects. So, he ordered another TSH test and said he is (most likely) going to put me on meds. He wants to see my TSH below 2.5. So, I have to get the blood work done, start the meds, wait four weeks, and then get more blood work to see if the meds are working. And, once I get PG again, he will up the dose of the meds. So I'm glad we decided to go see him a bit earlier than planned, because this might take some time.

He also said that, although my cycle is back, the fact that I am still nursing could contribute to my IF by causing high prolactin levels. So he's also testing me for that. If it's normal, we might be able to start IUIs once my thyroid is under control, (but he has to do more research on clomid + nursing). Otherwise, I will have to wean DD before TTC.

Greg and I are not exactly sure when we want to go back for IUIs. Our goal is to have our children about three years apart, which would mean getting pregnant in August or September. But, we all know that you can't exactly plan when you get pregnant! I got my cycle back about 9 month ago, and we have been "not trying but not avoiding" with no success, so we are assuming we'll need to do IUIs again. The RE said he will do the exact same thing he did when I got pregnant with Lily, (which means 50mg clomid CDs 3-7) and follie checks starting on CD 9, so hopefully I will respond the same way, but you never know.

We may start as soon as March or April, or wait until after Lily's birthday. I'd really like Lily to be potty-trained before another baby arrives, but I would hate to keep waiting and then have a hard time getting PG. Hmmm....Well, in the meantime, we'll think about it and enjoy life!