Slim has left the building

When I was first diagnosed with PCOS, I was told I would need lots of help to ovulate and get pregnant. The probability that I would be able to do that without chemicals was slim to none. That idea didn't sit well with me, mostly, I think, because I found a lot of information on the disease that indicated that it was at base an insulin metabolism disorder, and I found information that said those are amenable to treatment with proper diet, in this case low-carb. Interestingly, Karen H, NP who diagnosed me, did not bring up low carb diets herself, but she told me to go and research the disease, and when I came back saying I wanted to try this, she was enthusiastically for it. I think there was a policy at the department that she couldn't promote a "fad" diet, but she could talk to me about things I found. So I set off to low carb in earnest, and a year later had my first ovulatory period. I was also some pounds lighter, felt tons better, and was exercising pretty consistently. Four more months later, I was finally pregnant.

Only to miscarry at six weeks. One of the scary things about it was not knowing whether my periods and my ovulation would come back. So while we waited, I went to see Dr.Fancy-Shmancy who my then-OB recommended as a PCOS and fertility specialist. She told me that there is no cure for PCOS, that I would have to do treatments to ever be pregnant again, and that the probability that I would do it without her services was slim to none. Remarkably, I felt signs of ovulation only three weeks after the miscarriage, had my period two weeks later, and got pregnant with Monkey on the very next cycle. Slim and I were getting to be good friends.

I was one of those lucky ones who loose weight while breastfeeding. By the time Monkey was 4 months old I was about 8 or 9 lbs below the weight I was when I got pregnant with her. I actually was kinda-sorta slim. I still had room to go, but I was better off than I could remember. I even bought new clothes, sizes 4 and small 6. One hypo-thyroid episode later, I was up at my pre-pregnancy weight. Where I remained up until Monkey was about a year old and was only nursing first thing in the morning and right before bed, when I gained, and I am not exaggerating, 20 lbs in one month. I quit breastfeeding and started on the strict low carbing again. I stopped gaining, but couldn't loose. Unbelievably, my period returned, as did ovulation. I started to believe that I had this thing all figured out. Another year later, frustrated by my inability to loose the weight, I went on Metformin, and later, Avandamet, both insulin-regulating drugs. I lost about half of it over the next two years. Then, on our first try, I got pregnant with A. Slim was positively moving in.

I didn't know what to expect after A died. It took fifteen months for my period to come back after Monkey, but only about 2.5 months after I stopped breastfeeding. I started Avandamet again less than two weeks postpartum. My first ovulation was a little less than six weeks postpartum. That was a big load off my shoulders. Slim, my old friend, was with me again. Throughout the thyroid escapades, the length of my period jumped around a lot. But I thought that was all about the thyroid, and while the length may jump, I wasn't worried about ovulation going AWOL, only about my ability to be vigilant enough to spot it.

Doubtlessly, you know where this is going by now. The test results are back. LH=19.7, FSH=7.5, and progesterone=0.6. That SOB Slim has left the building without so much as a goodbye. No "it was nice hanging with you," or "it's been fun," or even perfunctory "good luck." Asshole.

I was able to get a call into my OB's office before they switched to the answering service. Dr.B's nurse called me back a little later, took the info, and send the good doctor himself an email. If he doesn't get back to her before then, she will see him on Tuesday and will reiterate, in person, the urgency of the request. She is supposed to call me back that same day. In the meantime, I am gaining weight, despite the nontrivial dosage of Avandamet I am on. My game plan for the near term is to wait out Rosh Hashana next week and then to start a low-calorie diet that I used with success once before (before I was ever diagnosed) for a brief period, then switch back to my usual low carb in an effort to shock my body into ovulating again. I am not holding out much hope, though. I think this time Slim may be gone for good.