Progesterone... is it really that complicated?

I have been MIA for two reasons: 1 - having a toddler and being pregnant is a new level of sacrifice on its  own. WOW, this little one gives me a run for my money all day! 2 - I was dog sick the first trimester, really sick. I even went and stayed with my Mom & Dad for a couple weeks so they could help me take care of Claire. With how sick I was, I was beginning to worry I wasn't taking good care of her during the day. That brings us to today, worn out and just tired. But I feel the need to write and share my progesterone journey with you. Its been different this pregnancy... and given some of the comments from the FTW medical community, no one was gonna help me until I found my midwife!

Shortly after conceiving baby #2, I was called by PPVI to talk about my T3 and have the nurse point out I was 16 days PO. Of course, as an infertile who needs a blood test to confirm HCG and progesterone, I wasn't even really excited about day 16 bc I knew I needed to schedule blood work. The nurse called me in an order and we confirmed I was pregnant, but progesterone was low again. PPVI sent out the progesterone injections and we started injections at 4 weeks, just like we did with Claire. However, this time we made a mistake and were only doing 100MG x2 a week. I had blood work again two weeks later and things looked fine. Now mind you, I can not find a lab in this 6th largest city of Fort Worth, that will send my blood to Omaha to be reviewed by PPVI. EVERYONE and I am serious when I say EVERYONE refused to fill this request. So for three months I have had Lab. Corp run my blood work. Which my levels were coming back fine. I had an early ultrasound done at 6 weeks. AGAIN, no ONE in this town would fill Dr. Hilgers request for an early OB u/s. I ended up having a midwife write the order so we could get it done. Baby looks fine, heart beat is good and I am actually further along...bc it took longer to get this all ironed out and actually have the u/s done. So I continue along with being sick, dropping weight and managing the progesterone injections. Lab results are coming back fine. Remember, I am NOT able to have Omaha look at my blood, everyone in the big corporate city is refusing to draw my blood and give it to me... or mail it themselves to Omaha. Even when I offer to pay a premium. (This was not a problem in Amarillo, nor was my ultrasound request)

The ONLY thing that is different this pregnancy, I am cramping. Mild cramping and then cramping that wakes me in the middle of the night. I am uncomfortable but figure it has something to do with my second pregnancy and the body doing this all over again. But the cramping continues to get noticeable... and wakes me up more at night. Like I am going to start my period cramping...which I have not felt since surgery in 2008.

I did consult a provider here in FTW during this time about my care and history of low progesterone. However, they were not interested in monitoring me. I asked why they were not concerned and she said, "Well, you have no history of miscarriage so we won't treat you for low progesterone until you have a miscarriage and we know its a problem." --- um, not comfortable with your office. I shared with her the current injection level I was on and the fact I felt this cramping. Still no concern.

Along the journey of the first trimester, I connect with a great midwife who takes my very seriously. She even agrees that she will draw my blood and we'll send it to Omaha to better manage my injection dose and watch my levels more accurately. At the end of April I have my first draw that I am able to freely send to Omaha.... within 48 hours I am getting a call from PPVI asking if I am having symptoms of bleeding, cramping etc. My levels are so low, might I miscarry? They don't say that, but the line of questions had me concerned. The nurse calls me back that afternoon to say, I need to double my injection and get in for another u/s. Mind you, I am 18 weeks now. My progesterone is low zone 1. I am cramping, but no bleeding. We double the injection that night and within 24 hours no more cramping and none since!!!!!!! SEE SOMETHING WAS WRONG!!!! The cramping was an indication. The national lab was way off on my numbers according to the standards PPVI compares levels to.

We have an 18 week u/s done and baby to perfectly fine. Injections are now 200mg x2 a week and cramping has never returned. I wonder, not that I would miscarry.... since some people argue that point with me, and not having a history of a miscarriage.... would I carry my babies to full term without the progesterone monitoring and support? Either way, I AM SO THANKFUL for my midwife who sees the importance of my care with Dr. Hilgers because of his history with me and my prior pregnancy AND for Dr. Hilgers and his staff. EVERY BABY COUNTS!!! We do not need to miscarry to see a problem.

We are at 20 weeks now and I am still in zone 1, but high zone 1. Which is better than at 17.5 weeks when we freaked out. So now I have added progesterone suppositories. Something different for this pregnancy. I didn't need them with Claire. I just had my blood taken today, and we will ship it tomorrow to see if the last two weeks have improved.

Who knew making babies was this hard :)

Anyways, thats the drama of the progesterone update. I'll keep you informed as we move along. As a side note, I am also on T3 again. I was taking it two months before we conceived.

Love reading everyones blog updates and new babies. Sorry I am not able to comment. I do most my reading on the iPhone these days.

Off to get some rest, morning comes early with a 2 yo :)

Nicole

A little picture to update you on Claire. Looks like she survived the first trimester :)