Thursday, April 19, 2007

Getting better and trying again

Claire still sounds a bit junky, and obviously feels somewhat under-the-weather, but she is materially better than she was on Tuesday. I wouldn't say she is well yet, but at least I can see ahead to when she will be well. Katherine, too, is still short of 100% healthy, but she is approaching it. G, thankfully, is completely recovered, and gods be praised, I never got it in the first place.

What I did get instead was a diagnosis of mild obstructive lung disease. As previously mentioned, I went to the pulmonologist this week to find out why I wheeze and need steroids every time I catch a stupid cold, and it turns out that's why, It's not clear yet whether I have asthma or another disease like chronic bronchitis, because the primary difference between them is whether steroids and bronchodilators help (asthma) or whether it's irreversible damage (chronic bronchitis). The doctor put me on several different and shockingly expensive medications, and I'm to come back in August for another round of lung function tests to see if the drugs work.

I was nursing Katherine in the exam room when the doctor walked in, so we had some discussion to see whether it was OK to start the meds while I'm still nursing. He asked me how long I planned to continue nursing, and I told him hopefully a year. Pre-pregnancy, I was a little uneasy about the concept of toddler nursing, but now I understand a lot better how it happens. I don't think you necessarily start out saying you'll nurse until two, just that it never seems like it's quite time to wean them completely, and I'm aware of how I'll miss the nursing relationship and how easy it would be to prolong it. However, extended nursing is probably not going to be the way for us, because we want another baby.

(Warning: TMI stuff ahead)

As of recently, I suppose you could say that we're trying to get pregnant again. I don't really expect this to actually happen, but we're not using any birth control, so theoretically, it could. I categorically refused to go back on the Pill or any of its variants after the girls' birth, not only because of the breastfeeding but also because I wanted to give my hormones a chance to normalize. I got fitted for a diaphragm instead, and we tried the sponge, but neither of them has worked out very well. We're also not crazy about condoms, and IUD isn't an option right now since we want to have another baby quickly. So, for the first six months, we let lactational amenorrhea and infertility be our primary methods of birth control.

Now that the girls are seven months old (and nearly crawling!), lactational amenorrhea doesn't technically apply any more. I still haven't gotten my cycle back, and it is an open question whether I will or not. I am nearly-exclusively nursing twins -- they are eating solids once a day, but it's still more recreational than nutritional -- and so it's reasonable to expect that my prolactin levels are sky-high and are preventing it from returning. On the other hand, it's not like I did a stellar job of having a cycle back before I got pregnant, so who knows if there's anything to return to. It's like the old question about the tree falling in the forest -- if a woman's hypothalamic amenorrhea is prolonged by nursing, is she still infertile?

In a perfect world, I would get pregnant naturally, and baby #3 would be born roughly two years after the girls' birth. Realistically speaking, the plan is to wean at a year and see what happens, then head down the ART path if my cycle doesn't come back in a couple months. In the meantime, though, we're open to it happening. This is maybe a little sooner than I'd like to get pregnant, but I gave up a long time ago on trying to plan babies. I'm not wildly optimistic about it happening at all, but I'd be lying if I didn't say I had a tiny little shred of hope.

Last time around, we completely skipped the normal have-sex-and-see-what-happens phase. I went off the Pill, and never started my period again, so we got dropped into the world of reproductive endocrinology almost immediately. This time, we can't really go there until I quit nursing, so for now, we do get to try and see what happens, and hope that my cycle will come back by itself. Sure, it isn't back yet, and in the absolute, my chances are still somewhere around zero. But I also haven't yet flunked any of the basic reproductive tests, haven't had any BFNs or rounds of negative OPKs or failed Provera challenges. I'm still normal, even if I know that the chances of descending into abnormality are good. More importantly, unlike the last time, there are no questions about whether I'll ever be able to identify as a mother, or be part of a family and not just a couple. I have two perfect, wonderful, magical daughters, and even if I don't get to have any more, I'll still consider myself beyond blessed.

I guess I'm just greedy for more, is all. I was never much of one for nirvana, and am all the less so know that I've experienced the joy of it once.


Nico said...

Oh, I SO know what you're talking about! I also used to kinda think "toddler nursing - ick", but I get it now. I was planning on BFing for 6 months and then seeing what happened... but I got there and saw no reason to stop. The only reason is that we'd also like to have another about 2 years younger, and I'm wondering the same thing about my period. I'm hoping that given that I am no longer exercising like a fiend, and my weight is still about 15lbs higher than it was when I was first diagnosed with HA, that I will get the old Biatch back. That's what I keep telling myself anyway. And I hope that you do too! (Although my theory is that our systems are much more sensitive than your average bear to hormone levels, so the chances of getting AF while nursing are slim to none).

FWIW, there are a number of women with HA posting on the HA thread linked to from my blog who have managed to cycle normally after cutting exercise and gaining weight, so I don't think it's entirely out of the question that we will.

Suz said...

I know what you mean about a third...good luck!

Eva said...

Thanks for sharing. I hope your new meds work and that you are feeling better soon. I hear you on nursing.

Wow, baby number 3! I mailed all of my maternity clothes, and boy baby clothes, off to a friend recently. It wasn't until after I had mailed them that I realized, oh, I guess this means we decided we aren't having more. I sometimes regret that we won't get to do the baby thing a second time, that we did it once rather than the twice we imagined... but I'm old (older than you, I am pretty sure) and I don't know thatI have it in me to have the grown-ups outnumbered by the children. But I admire those of you who do!

Dooney said...

I ended up getting my first period 5 months after my son was born. I was a little dissapointed that it came back that soon but we also wanted to have another one quickly.

We just never thought in a million years it would be as quickly as it was since it took over a year to get pregnant the first time. It's a bit scary to think about having two 15 months apart, but I know we'll manage.

I really hope that things go more easily for you with #3! Maybe having gone through a pregnancy is what it would take to straighten things out? Who knows?

Emma B. said...

Nico, I have the same thought about extra-sensitive hormone systems. I suspect I'll have to wean entirely -- the girls have been night-weaned since about 10 weeks, and that hasn't made a difference. Of course, weaning means I need to figure out how to feed them solids more than once a day...

Are y'all planning on trying for more, Suz? I'm always interested in hearing people's plans and reasons. Guess I'm nosy like that, hmm?

Eva, you could always buy more maternity clothes, you know! I gave away pretty much all my tiny girl clothes to another twin-mom-to-be. If I have another girl (or two), I'll have to buy more.

Also, we are already outnumbered by the dogs (three standard poodles). One more baby won't appreciably change the chaos dynamic anyway ;).