Monday, July 28, 2014

Definitely Not Trying Hard Today

Hello, long lost internet! I've been up to my eyeballs in bags and boxes, driving back and forth from the old house to the new house, spending inordinate amounts of time and money at Lowe's, Bed, Bath, and Beyond, Best Buy (oddly enough), and Target (although that's not specific to this move, that's an every day kind of thing), and then lying in a pile on the floor unable to move from moving so much crap. I promise, I have been taking a ton of pictures and will write an entire post dedicated to our moving adventures... but not today.

Today I am here to link up with Kate and Adam of The Florkens for Don't Try So Hard! This is a link-up about appreciating our natural beauty. In blogging and in life, I know that I'm constantly trying to look better, impress people, seem like I have it all together, and if you've been reading this blog for any length of time or know me in real life, you know that I struggle with self-love and even self-like. I am actually REALLY nervous about sharing this no make-up, no hair style photo with the internet at large, but hey... you can be afraid and you can do it anyway, right?


Here's how the link-up works, from Kate and Adam's blog: 

1. Take a picture of yourself -- without "trying so hard." Remove the makeup, forget the hair, don't overthink it, and just let your natural beauty shine through.
2. On Monday, July 28th, let your picture take center stage on your blog and remember to include at least one thing that you find beautiful about yourself. (Use the hashtag #donttrysohardlinkup on Twitter & Instagram to share your pictures and posts!)
3. Follow your hosts and linkup your post!
4. Click around to others who have linked up and show them some positive feedback in the comment section. Do you love their eyes? Do they have cute freckles? Maybe they naturally have a beautiful glow! Let's soak the blogosphere in positive thought and self confidence for one day!
5. Sit back and remember that you don't have to try so hard. While it's nice to do our makeup and hair, wear trendy outfits, stage the crap out of our pictures, etc., it is so much more important to remember that you are beautiful just as you are! Cheers!
 
So, I took this photo last night around 10:30 pm. It was the day after we moved, and I had spent the majority of Sunday painting the bedroom in our old condo (only to find out, moments after we finished painting, that we didn't have to paint it anymore... thanks, landlord). Then I got a headache that I attributed to paint fumes, dehydration, and low blood sugar, so Ken and I went to our favorite Chinese restaurant. Then we got home and I unceremoniously threw up all over our front step, and then all over the downstairs bathroom, because apparently, I had a migraine. WHEE. After cleaning everything up, I took a shower and my blood pressure decided to plummet, so then I couldn't stand up, which was super fun. I summoned the strength to blow dry my hair, only so I didn't soak through my pillow while being unconscious, and then took this photo. So yeah, I was really not trying hard at all.

 
Here it is, in all of its glory. However, I do have pretty great skin in this photo, my teeth are white, my hair is pretty blonde, and I have always loved having blue eyes. For 10:30 pm after a weekend of moving, I think I look pretty great. Honestly, I'm surprised I was standing at this point, so screw it, I look fabulous.
 
So there you have it. I hope that this post reminded you that you are beautiful, just as you are. Even if you spent the whole weekend moving and you had a migraine and threw up all over the front step of your new home. Yes, even then. 
 
I'm going to go back to sorting through the chaos that is my life at the moment, but I'll be back tomorrow for Listed Tuesdays... moving edition! Don't forget to head over to The Florkens to link up your own post and check out everyone else's! Leave someone some love today on their au natural photos. We all deserve it.
 
- A

Wednesday, July 23, 2014

Confessions from the Last Day

Yikes, that title sounds kind of morbid. I swear, I'm not dying (at least, not any faster than usual) but it is my last day in my office! It's very sad here because all of my cute cartoons and pictures are gone. All that's left are some helpful documents about how to determine whether a patient has CNS leukemia at diagnosis, which consent documents should be used when, and a brief from COG about lymphoma. I also have my Men With Cats calendar, but that's coming with me. Here's the photo from July, in case I never shared it:


That cat looks really concerned.
ANYWAY...

There are some office supplies that I'm leaving here because they belong to the office, and I've left the useful phone extensions on the whiteboard for my replacement... even though he isn't starting until August 18th, and until he is physically in this building, the team is entirely skeptical that he'll show up since two other people have taken the job and subsequently withdrew they're acceptance. So... yes. None of that is my problem, in particular, but I would like to think that the program won't collapse like a flan in a cupboard (if you can name where that came from, we'll be friends forever) when I walk out the door this afternoon.

So, since it's Wednesday, I am linking up with Kathy over at Vodka and Soda for our weekly dose of confessions!

- I totally lied on Monday when I said that I'd be back on Tuesday for Listed Tuesdays. I really would have rather been blogging, but I was taking a biochem exam for most of the afternoon and dealing with nonsense the rest of the day. Feh, I say.

- Yesterday's biochem exam was rough. I was really upset when I saw my raw score, but somehow by exam magic, it turned into a passing grade. The good news is that the grades for the summer part of this program don't matter at all, but I'd like to think I at least have SOME idea about what is going on. The bad news is that apparently, I've forgotten everything I ever learned about DNA. Whoops.

- There are some bloggers out there that I really would love to just message and be like, "OMG LET'S BE BEST FRIENDS FOREVER!" but I don't want to be a total creeper, so I don't do that. You're welcome.

- I am actually feeling a little sad that I'll be walking out of this building for the last time (as a research employee) today. My team gave me a card and a sweet gift, and the card made me cry. I really will miss them.



- Leaving my job makes everything else happening in my life feel that much more real. The house, the move, med school! My entire life is changing ALL AT ONCE. Cue flailing.

- I bought Skittles from the vending machine today, but the bag got stuck, so I had to buy another bag. Then I ate both bags. Eek.

- I started binge-watching Hemlock Grove, and I blame Becca entirely. I'm not sure I love it yet, but it's definitely... interesting. Yes, that is a word I would use to describe Hemlock Grove.

- Payday is tomorrow and I have 15 Bed, Bath, and Beyond coupons burning a hole in my pocket! Definitely will be picking up one of these to take care of the hardwood in the house (that is EVERYWHERE!), a blender (because I finally joined the smoothie craze and want to make my own), another set of sheets, new pillows... the possibilities are endless! Well, almost endless. Also, I'm pretty sure that my excitement over home purchases for Bed, Bath, and Beyond makes me officially old.

- I can't wait to see my rheumatologist next Wednesday because my hips are still really bothering me. However, I am totally terrified of the very real possibility that he will stick a giant needle full of cortisone into my joint and he'll have to peel me off the ceiling from the pain.

- I am really excited to get our new bedroom furniture on Saturday when we move, but I am a little sad to be getting rid of the set that I've had since I was 2! It's beat to hell or I would keep it, but... it's time to move on.

- I am finally getting around to getting a new Social Security card, since mine seemed to vanish into thin air a few years ago. Maybe I'll also get a new passport while I'm at it, since that disappeared a couple of years ago, too. NB: Don't give me your important papers. #adulting

- I didn't finish the amendment revisions OR the continuing review for my study. #sorrynotsorry

- I feel weird using hastags in a blog. ::shudder::


And on that note... I am leaving my office. For the last time. Goodbye, 9-5. Hello, medical student.

- A


Monday, July 21, 2014

Muzak-Induced Psychosis

I'm not sure if anyone has ever done a study on whether listening to hours of hold muzak has a negative effect on one's health, but over the past 5 days, I feel as though I have definitely exceeded whatever limit one would place on how many hours of muzak are considered safe for human consumption. Today I'm linking up with the new and improved Weekly Wrap Up, hosted by Rachael and Lisa! Head on over to their blog to link-up and see what everyone else did this past week!


Ameliorer la Vie

Last week was a big one for us! Monday and Tuesday was quiet on the blog because I was essentially up to my eyeballs in mortgage, work, and school nonsense. On Wednesday, I finally let the cat out of the bag that Ken and I are starting on the road toward babies, and gave the Reader's Digest Condensed Version of my litany of health issues. (Fun for all ages! Not really.) I also went over to see my piano students before they moved to Ithaca on Thursday. I'm going to miss them so much!


On Thursday, I filled in the blanks, and seriously considered throttling my mortgage broker and South Jersey Gas. The mortgage broker thing was eventually solved because I found the documentation they needed, despite the fact that 6 weeks ago when I asked if they needed this particular documentation, they said no. The only reason no one got punched in the face is that I didn't have to call my father, who is currently in Europe for the next three weeks, to get him to send me copies of his bank statements. South Jersey Gas was a more difficult issue to resolve, and in fact, is still being resolved.

I called to get the gas switched into our name, but first the guy couldn't find our address, which was hysterical because they already service that address. Then, they couldn't switch the gas into our name because apparently, there was a balance on the acct, so they told me to send them a contract or closing papers and a copy of my license. I emailed them that and contacted our realtor to tell her about the balance, and she replied that the balance had been paid off the week prior and gave me the account number. I then called back three separate times and SJ Gas said that they hadn't received the papers that I emailed them, and then they finally did, but said that the balance was definitely on the account and that the gas had been turned off. I told them that they were wrong because people were still living in the house and I had seen the gas functioning (as the fireplace is gas and it turned on quite nicely). They told me that someone had to come out on Monday (today) to turn on the gas (that is already on) and that the service tech would call me 15 minutes prior to arriving at the home. I said, "Well, he's going to have to give me a little more time than that, seeing as my husband and I both work like normal people during the day and aren't living int he house at this moment in time." So then he said he could give me a range of times from either 7:30 am to noon, or noon to 11 pm and I said, "That really doesn't solve my problem, genius."

I said to put a request in for after 5 pm on Monday, but also added that this entire thing was pointless because the gas wasn't actually off, so I still wasn't sure why we were having this conversation. Somewhere during this mess, I had tweeted to SJ Gas that it was absurd that no one knew wtf was going on with this acct and someone DM'd me back and said they'd have customer service call me. So, after I finished arguing with this guy over whether the gas was on, he asked if there was anything else he could do and I said that he could make this situation less stupid and actually know what was going on, but that obviously wasn't going to happen, so no, and hung up the phone. Not 3 minutes later, customer service called and I recognized the number, so I answered and said, "If this is SJ Gas, what do you want?" and the poor girl was like, "I was told to call you,...?" I said, "Well, I already solved the problem, after much wailing and gnashing of teeth, and I am 100% sure that there is nothing you can do to fix the stupidity that I just had to endure, so I'm hanging up the phone." So that was most of my afternoon on Thursday.

On Friday, I had to call Comcast and wished that I could throw some booze in my coffee. I also talked about the insanity that is happening over the next month and filled out the Blogmopolitan Quiz that was hosted by Erin. I got to meet all kinds of new bloggers through her link-up!

Oh, also on Friday? Ken and I bought a house!

Pre-final walk-through selfie!
Post-settlement thumbs up!
The rest of the weekend was pretty busy. The rest of Friday was spent eating lunch and buying ALL THE PAINT!
Not pictured: 5 gallons of ceiling paint
And then Friday night, Ken went to NYC to visit his friend Liam who was in from Seattl. I spent the evening watching Hemlock Grove and trying not to go into anaphylaxis and die. Apparently, I'm way more allergic to carrots than I thought I was, so when I ate a dozen baby carrots with my dinner, my chest got really tight and I was wheezing and I couldn't find my inhaler. It was not good. I ended up popping a Benadryl and 20 mg of prednisone (such a wonder drug!) and I managed to survive. It was a very exciting evening, let me tell you.

On Saturday, I woke up early to meet the painters at the new house and get them started. We are having the three bedrooms painted upstairs, and downstairs we're having the dining room, kitchen, and half bathroom painted. My mom came over and brought me a set of octopus salt and pepper shakers, as well as my Peace Lily, which she was rehabilitating after it almost died under my care. Apparently, I did not get her gardening gene. So far, the plant seems pretty happy, so I am hoping I can keep him alive. After that, I went to The Pop Shop and met my friend Jackie for brunch. Can I just say that Cinnamon Bun French Toast should be available everywhere?


After the indulgent brunching, I picked up my friend Patricia from the train station and we headed back to the new house to celebrate!

Mazel tov!
My brother came over to the house to check it out, and the three of us went to Target afterwards. I dropped Patricia off to the train and then met my mom and brother for the world's latest dinner. Then I went home and did school work, because I know how to rock a Saturday evening, obviously.

On Sunday, I really wanted to sleep in but I had to get out of bed by 9:30 because our landlord was showing the condo to potential renters at10. I spent about 20 minutes in my car out in the parking lot, then found out that the landlord had booked a second showing at 11, so I ran back inside between showings and headed out to Starbucks. I claimed a table near an outlet so I could do work, and while I was in line, someone tried to steal it! Fortunately, the nice woman sitting at the table next to mine stopped the random dude from absconding with my table. I then had this conversation with my brother:

Me: A random stranger saved my clearly claimed table from being stolen by a random dude while I was in line at Starbucks. Thanks, random stranger! +10 points for you. (Random dude? -10 points for you, sir.)
Levi: Random dude, I demand you give your 10 points to thoughtful stranger.

If only it were that simple, right? 

After my Starbucks excursion, during which I totally confused the barista with my order, I went up to East Falls to visit my friend Lauren, who is an OB/GYN resident. She works crazy hours, so I was really excited to grab some time to catch up. We went to the Plymouth Meeting Mall where I bought 2 dresses and a pair of pants from LOFT (once of the dresses is going back) and then we had lunch at Whole Foods. On my way home, I picked Ken up from the train station and then he and I went to the new house so he could see the paint and how things were looking. We discovered that our sofa is way bigger than we thought it was and I had a minor meltdown that we might have to sell our (intensely comfortable and amazing) sectional because it is comically large. However, we think we figured out a solution. 

And don't worry, pictures will be posted as soon as I take them and we move in and I figure out if we have the internet (since Comcast and I seem to be speaking different languages). So yes, that was my week last week. I bought a house and didn't commit a felony, so overall, all good things. This week is my last week at work and they finally hired someone... who can't start until the middle of August.

Good luck with that one, guys.

I'll be back tomorrow for Listed Tuesdays... be sure to check it out!

- A



Friday, July 18, 2014

Oh Hey, Friday // Blogmopolitan Mash-Up

We made it to Friday, yet again! Technically, yesterday was my Friday since I took today off of work to go sign 900 pieces of paper and buy a house! Craziness. So, while I'm doing that, you get to read this!


First up, linking up with Karli Belle and Amy for a Friday link-up. This week? Five things that are happening in the next month.

1. If you're new here... oh my God, we're buying a house! Today! At 10 am, we'll sit down to close on our first home, and as far as I can tell, that entails 2 hours of non-stop signing of papers. Then we get the keys. A happy dance may or may not occur. There will probably be adult beverages. If you're lucky, we'll do a happy dance after a few adult beverages, and then I'll get a video of the silly dance and post it on the internet, against my better judgment. What do you think? Yay or nay?

2. I'm leaving my job! There are 3 work days and 5 actual days left of my 9-5 (or 8-4... or 10-6) life and I am alternately totally thrilled and absolutely terrified. I won't be making any money... but I'll be a full time student! I will be working towards my dream... and probably really stressed out! So, 7/23 is the last day I'll walk into CHOP as a research coordinator. Someday, I plan to walk back in as a med student... and maybe, if I'm lucky, a resident. Fingers crossed, my friends. Fingers crossed.

3. We're moving! This makes sense, seeing as we wouldn't just buy a house and then continue to live in our rented condo. A week from Saturday, the movers are showing up and packing all of our earthly possessions into their truck, because after we used movers for our last move, we swore we'd never go back to bribing our friends and family with pizza and beer to move our stuff. Seriously, if you need to move and you're over the age of 23, it's time to use movers. Trust me on this one. So, the 26th we officially move into our new place... which hopefully will be painted by then, if all goes according to plan and the painters don't fall off the face of the planet. Here's to hoping.

4. I'm going to NC to be the "best groomsmaid" in my best guy friend's wedding! Mike and I have been friends since 6th grade when we were paired up to do some corny project in math class. He also happens to be a phenomenal cellist, pianist, and vocalist, so we spent a lot of time together in various orchestras and choirs. He currently teaches string instruments to elementary students, so you can tell that he has the patience of a saint. He is marrying a wonderful woman named Jen, who we went to high school with, and she is a counselor. They are two of the sweetest people I've ever met, and they are perfect for each other. I am so honored to stand up with them on August 9th for their wedding. Don't worry, there will be pictures and a post about our trip, I'm sure!

5. I'm starting med school! Holy. Crap. On August 3rd, I'll get my white coat with much pomp and circumstance, and then after a short orientation (and a whirlwind trip to NC for the wedding), I'll jump into full-time classes on the 11th. Hello, anatomy, biochemistry, microbiology, genetics, physiology, and histology... goodbye sanity, sleep, and social life! I'm mostly looking forward to it, but I am definitely nervous to get back into a schedule of full-time studying with little division between home and school. It will certainly be interesting...

So those are my five gigantic plans for the next month. What are yours? Please tell me about all of your fabulous vacations that you have planned, because I need to live vicariously through you since I will be up to my eyeballs in packing, moving, and med school.

Before I head out, I'd like to direct your attention to Blogmopolitan 2.0, presented by Erin of Two-Thirds Hazel. I thought this was such a fun idea, I just had to jump on board. Make sure you head over to her blog to see everyone else's answers. You might just make a new friend!




I'll see you all back here on Monday, only then, I'll be a homeowner. What the crap is happening to my life!? Have a good weekend, all!

- A

Thursday, July 17, 2014

Fill in the Blank

So, I'm definitely not playing along with Blog Every Day in July, but this prompt caught my eye on Lisa's blog, so I decided to write my own!


Directions: Complete the sentences below.


When I open the fridge, I always hope I find... fresh milk, fresh eggs, strawberries, chilled water, and these sparkling juice beverages that I found at Wegman's. Or leftover pork fried rice with no onions.

My favorite article of clothing is... my Drexel School of Public Health hoodie and my black foldover pajamas pants made out of the best fabric ever, modal.

Last week I was really pissed when... I had to scan yet another pile of papers to the mortgage brokers, because apparently, you have to document every moment of the last 5 years of your life for these people.

One thing nobody understands about me is... that despite my outgoing personality, I am 100% an introvert who needs her alone time. Or else I will probably lose it. For real.

One thing I don't understand is... why people can't just GROW UP.

The world would be a better place if... everyone went to therapy for at least a year. Let's all learn how to communicate openly and honestly.

If I had a million dollars I'd... pay off my student loans and the rest of my debt, then invest the rest for our retirement. I'd probably also buy a really nice car. Or a miniature pig.

If I could change one thing about myself, it would be... my health. I would love to have a day where I had no joint pain, no nausea, no fatigue, no migraines. I'd love a lot of days like that.

Something that can always make me happy is... sleep.

Something I'll never blog about is... politics.

If I could go anywhere I would go...  on a Mediterranean cruise to Italy and Greece with Ken because we want to eat all the food and relax by the ocean.

If I were an animal I would be a.... cat because they sleep 18 hours a day and can get away with looking like absolute spazzes and still be cute (mostly).

A job I've always wanted is... to be a physician. And damn it, it's happening! 2018!

My idea of a perfect day is... waking up without an alarm after sleeping for at least 10 hours, drinking perfect coffee, laying in bed and reading, knitting, snuggling, or watching TV, and then spending some time on the beach under and umbrella with the perfect cocktail and a slice of awesome pizza.

If I knew I'd die next week, this week I'd... eat whatever I want, see all of the people I love, and write my life story and everything I want to tell people after I'm gone. And let's be honest, I'd go see my therapist.

How would you complete your sentences?

- A



Allieology

Wednesday, July 16, 2014

It's That Time Again!


It's Wednesday, but it's technically my Thursday because I am taking off on Friday! HURRAH! I haven't had much time to blog this week because my brain is in 947 different places between trying to wrap up things at my job and oh, we're also buying a house on Friday, so that's kind of a big deal. So, since it is Wednesday, it's confession time with Kathy from Vodka and Soda!

Vodka and Soda

Last Friday, I said that I met with some new doctors and now had a lot to think about, and then I ended my post because I am cruel. Well today, I'm going to talk about that. Settle in, it's a doozy.

About a year ago, I met with Dr. S, a reproductive endocrinologist. I had just had my second laparoscopy for endometriosis, and my gynecologist who did the surgery was strongly suggesting that I take Lupron again.

Pause.

For those of you who are unaware, endometriosis is a condition where the lining of the uterus grows in places it's not supposed to grow, like everywhere in your abdomen and pelvis. It's extremely painful and can cause infertility, but they don't really know why. The treatment is often birth control pills to help control the hormones, but the only way to get rid of the growths is to have them surgically removed. Except they grow back. So that's fun. Lupron is a drug that induces menopause, which is the only "cure" for endometriosis (besides pregnancy, which is just so adorable since many people with endometriosis can't get pregnant. Thanks, nature.)

Okay, unpause.

Anyway, I had been on Lupron in 2005 after my first surgery and to put it mildly, it sucked. If your mother ever complained about menopause, let me tell you, she had every right to do so. Hot flashes and night sweats, along with weight gain and crazy mood swings are NO JOKE. After 6 months of hell, I said enough was enough and stopped taking it. Unsurprisingly, I was not totally enthused to try that drug again. My doctor was being really pushy and I didn't like it, so I sought a second opinion with Dr. S at Penn. He was quite lovely and after looking at my records and listening to my history, said that he wouldn't require a patient like me to go on Lupron, especially since I hated it so much, and that the only risk I might face was that my endometriosis might come back, but that was a risk anyway. I was thrilled. No Lupron for me!

Then Dr. S asked if Ken and I were thinking about having kids, and I told him that we weren't ready to do that yet. He (gently) impressed upon me that idea that younger is better, as far as fertility is concerned, especially when the patient (see also: me) has reproductive issues like endometriosis (and PCOS, for extra fun). He also remarked that since I had just had the endometriosis adhesions removed, now was probably the best time to try and get pregnant. I politely declined to do that and said we'd be back if we changed our minds. He ordered some genetic testing for the Jewish genetic diseases, just because I think he thought he needed to do something besides tell me I didn't have to take a drug, and I went on my way.

Pause again.

PCOS, also known as Polycystic Ovarian Syndrome, is a poorly-named metabolic disorder. It was named back in the day when the hallmark of the disease was thought to be, you guessed it, lots of cysts on the ovaries. That can still happen. However, the diagnostic criteria for PCOS now are insulin resistance, hormonal imbalance, and irregular periods. I was diagnosed about 2.5 years ago after gaining 40 pounds in 3 months, having a lot of my hair fall out, growing hair in weird places, and having wildly high cholesterol. I was put on some meds for the insulin resistance, started thyroid medication (because apparently, I also have hypothyroidism), and subsequently lost almost 50 pounds. And my hair stopped falling out. Yay. PCOS is problematic for a number of reasons, but reproductive-wise it is an issue because many women with the disease don't ovulate, and as you can imagine, no ovulation means no baby. No bueno.

Unpause.

So, on top of endometriosis possibly making it impossible for me to get pregnant due to scarring from adhesions, blockage of ye olde plumbing from endometrial growths, or damage to the organs that are important for baby-making, I might not even ovulate. We won't know until I get off the pill and start trying to do this baby thing.

Of course, this is further complicated by the fact that, oh by the way, I have some unknown autoimmune disease that is either RA or lupus, so I'm on a lot of medications that are completely contraindicated if you'd like to grow a human. Isn't this fun?

Ken and I knew that we wanted to have kids way before we got married. In fact, we talked about kids on our third date. Yes, our third date. No, he didn't run screaming. It was impressive. We also knew that we wanted to wait at least 2-3 years after we got married to bring a baby into our lives, mainly so we could enjoy being married and get the hang of that whole thing for a bit first. When we talked about how old we thought we'd be when we became parents, we said, "Oh, 28... 29... 30. Somewhere in there." Suddenly, we were married for almost 2 years and we were both approaching that magical age. And yeah, we still wanted kids. Yes, even though I'm going to be in medical school. More on that later.

Anyway, I knew from the start that this wouldn't be a case of simply throwing the birth control out the window and, for lack of a better phrase, getting down to business. I knew that I would need guidance from my (multiple) physicians with getting off of my medications and possibly to even get  pregnant. This was not going to be spontaneous and romantic, this was probably going to be more like a science project. Whatever, I was determined to be positive about this! And also terrified. But hey, you can be afraid and you can do it anyway, right? Right. So, I went back to Dr. S.

To say he was surprised when I sat down in his office and told him that Ken and I were ready to start a family would be an understatement. He was, of course, very pleased with our decision. We went over a few things, including my multiple medications, and he expressed his concerns. I was surprised when he said that he wasn't very concerned about the endometriosis/PCOS issues. In fact, he said that he has had many patients with similar histories to mine in that regard, and they were able to get pregnant very easily with very little intervention, if they needed any at all. He said that the bigger issue to him was the autoimmune disease and how I wouldn't be able to be on any of the strong, good, medications that had been controlling most of my symptoms. This roughly translates to, "You're probably going to feel like absolute garbage, and since it might take you awhile to get pregnant, that might suck. A lot." He even suggested that if we wanted to be super aggressive, we could go straight to IVF and try to get me pregnant as fast as possible. I said that at this moment, no, we did not want to be super aggressive and instead would like to try this the old-fashioned way first. Because he is a sane, nice, understanding man, he said that was fine... but that if I wasn't pregnant after 3-4 months, he was going to investigate the plumbing and see what was up. I'm okay with that.

I'm not sure what else I thought he'd do that day, but he referred me to the Maternal Fetal Medicine department at Penn because I'm automatically considered a high-risk pregnancy due to the autoimmune disease. Last Thursday, I met with Dr. E and her resident and fellow physicians, and they were all really great. I spent about an hour with the resident and fellow, during which they took an extremely detailed history, and then we went through all of the risks to me and potential baby... of which there are many, of course.

For me, there's an increased risk of pre-eclampsia (high blood pressure, protein in the urine), which is a precursor of eclampsia (seizures during pregnancy). The only cure for pre-eclampsia is to not be pregnant, so... yeah. There's also an increased risk of Preterm Premature Rupture of Membranes (PPROM), which is when the amniotic sac breaks way earlier than it should, and there's an increased risk of my autoimmune disease flaring, which would lead to anything from increased pain to organ damage and hospitalization. I also am at an increased risk of development gestational diabetes because I am already insulin resistant from the PCOS. For potential baby, there's an increased risk of being born small, preterm, or being stillborn. Aside from that, it should be totally fine...?

After that joyous conversation, I met with Dr. E and she went over my meds again and we set up a loose plan for going forward. I stopped taking my methotrexate back in June after discussing potential babies with my rheumatologist. Methotrexate is a Class X drug for pregnancy, which means under no circumstances can you take it, period, end of story. This makes sense, since methotrexate stops rapidly growing and dividing cells from doing so. Since growing a human requires that the cells grow and divide rapidly, stopping that process would be... less than ideal. Methotrexate tends to hang out in the body for awhile, so I have to be off of it for a few months before trying to get pregnant. Within three weeks of stopping the MTX, I started to feel my symptoms coming back. Morning joint pain and stiffness returned with a vengeance, and since I am 307 years old, I now have what appears to be bursitis in my hips. I have had a few low-grade fevers, and two face rashes, and I can tell my fatigue is getting worse. Last week, I stopped the Orencia, which is the injectable drug I started a few months ago. I wasn't sure it was actually improving my symptoms when I started it, and to be honest, I haven't felt any worse having not taken it last week, but again, it's only been a week.

The rest of my meds are ones that I can stay on until I am actually pregnant, although there is some debate over whether Dr. S will want to take me off of the Metformin (a diabetes drug that I am on for my insulin resistance). I would really rather stay on the Metformin if I can because it controls my PCOS symptoms really well and it is safe for use during pregnancy, but I will obviously defer to my docs. The only things I'll have to stop taking are my allergy med with the decongestant (no pseudoephedrine for developing fetuses, apparently), my NSAID (so sad about this... no Aleve, no Advil, and no Mobic!), and my cholesterol lowering med (because cholesterol is necessary for baby-growing). Oh, and the birth control pill, obviously.

I can stay on the non-decongestant allergy medication, Prilosec (for acid reflux), and Plaquenil, which is a drug for the autoimmune disease. Thankfully, I can also take Fioricet for my migraines if necessary, and I can keep getting my trigger point injections. I also was told, under no uncertain circumstances, to continue drinking 1 cup of coffee a day, even if I felt like I was going to barf, because the caffeine would help keep the migraines away, haha. Yes, ma'am!

l was surprised to find out that I can actually stay on my antidepressant, and in fact, it's recommended that women with well-controlled depression prior to conception stay on their SSRI's. Apparently, depressed women don't make healthy babies, and both mom and baby have worse outcomes following pregnancy when the SSRI's are discontinued. There is, of course, a risk to staying on them, the main ones being pulmonary hypertension of the newborn (which is apparently transient) and possible symptoms of withdrawal (also transient). Yet another thing to consider.

So, I left that office with instructions to see my rheumatologist, and it was at this point that I asked myself why my doctors' appointments always seem to breed more appointments. Then I decided not to ponder that further because it wouldn't get me anywhere, and instead called my rheumatologist. We had a semi-confusing discussion about stopping the Orencia, but in the end, he approved it and basically said that I would probably feel like crap and that we would deal with that if and when it happened. Thank God for prednisone, is all I have to say.

The other fun (?) part of all this is once I'm actually pregnant, we have no idea how my autoimmune disease will act. Since we're not sure if I have RA, lupus, or some strange mix, it's hard to predict what will happen. Women with RA often have remittance of symptoms during pregnancy, then flare immediately after, while women with lupus often get sicker during pregnancy, as well as in the post-partum period. It's yet another "wait and see" kind of thing. We all know how much I love those...

I also had to make an appointment with a new gynecologist who is a part of the Penn practice, because the rest of my doctors are over here and if and when the time comes, I will need to deliver over here anyway. Of course in typical Penn fashion, the first available appointment when I called yesterday is 9/24, so thank God it's not any kind of emergency...? Oh academic medical institutions... you slay me.

Questions? Comments? Concerns?

Let me address the elephant in the room. (Hello, elephant. Nice to see you. Okay, I'm done now.) But seriously, yes, I am considering getting pregnant, on purpose, while in medical school. No, I am not completely insane. Well, probably not, anyway. In fact, the physicians I've spoken to (both male and female) advocate for having babies during medical school over having them during residency, and I certainly won't be the first person to produce a child while attending medical school. In fact, I know a woman who had 2 of her 5 babies while in med school, and she lives to tell the tale. (Her kids are absolutely precious, too, haha.)

But yes, I am aware that this is kind of a crazy proposition. That being pregnant is hard, and that med school is hard, and doing both at the same time may make me wish that I were dead. I am aware that babies are expensive. I am aware that I will not have a lot of time to spend with said baby once it arrives. However, I also know that I don't want to wait until I'm finished medical school in 2018 to start trying to have a baby. I will be 32 when I graduate, and it is really ill-advised to have a baby during your first year of residency, so we'd be waiting until I was 33. Given the fact that it's probable that I will have problems conceiving, I don't want to be running up against the magic age of 35, at which point risks of all kinds of things shoot up. I also know that I am fortunate enough to have my mom nearby, and she has already volunteered to help as much as she can with potential baby. I also know that Ken is an amazing man who seriously wants to be a dad, and so while I don't know what parenting will be like (since I haven't done it), I know that Ken and I are on the same page with how we want to do it. At the very least, we know we want to tackle it together.  

Not for a minute do I believe that any of this will be easy, or even very fun. But I do believe that if I am meant to be a mom in this way, that it will work out. I know that I'm staring down the barrel of a lot of potential complications, but I have a great team of physicians and a supportive husband and family. I'm also ready to 86 the entire plan and move to alternate plans for becoming parents if I get too sick trying to get pregnant or if my body basically refuses to cooperate. Ken and I are both 100% okay with adopting if we can't have our own babies, and while we'd rather be able to do this "the normal way" (whatever that means), the important thing to us is being parents, not how we get there.

How do I feel about all of this? Terrified. Excited. Nervous. Anxious. Overwhelmed. Worried. Hopeful. Crazed. It's a lot of things. One thing it definitely is not is boring.

So that's my big confession this week. We're thinking of having a baby. We are moving towards starting the process of having a baby. I solemnly promise that this will not turn into a baby blog. Pinky swear.

That seems like enough news for now. In addition to linking up with Kathy, I'm linking up with Shanna for Random Wednesday. Yay random!?



Have a good day, all. I'll be over here deeply breathing and trying not to murder anyone from the mortgage company. More on that later.

- A

Friday, July 11, 2014

Oh Hey, Friday!

I am so excited that Karli of September Farm and Amy of The Farmer's Wife took it upon themselves to fill the void that was left when my other Friday link-up went on summer vacation. Also, I'm excited because this, my friends, is an extra-special Friday. It is the LAST Friday I will be spending in this office.

EVER.

Let's just let the gravity of that sink in for a moment, shall we?

Right, moving on. Back to celebrating Friday! Here are 5 random things I thought I'd share today. (Isn't that the best link-up ever? SO EASY.)



1. We are closing on our house 1 week from today. In fact, by this time next week, we should be done at the closing, which is scheduled for 10 am. I know these things can take awhile, but God help me if I'm still signing papers five and a half hours after we start. Can I just say that getting a mortgage is the most painful thing I've ever done in my life? Yes, even more painful than applying to med school, which entailed writing about 253 essays and painstakingly entering every single class, credit, and grade I've ever received in my higher education life. I would rather do that again than apply for a mortgage. After sending in months worth of bank statements, signed contracts, the homeowner's insurance policy, a list of every place we've lived and worked for two years, verification of checks leaving and entering our account for down payments, and multiple tax forms, I had to ask Ken this:

Me:
Can you scan me a copy of your employment contract? They apparently need that too.
Ken: Holy balls, do they need a copy of my birth certificate to make sure I was actually born?
Me: Apparently, we're also missing some other tax form that no one ever sent to us. Please kill me now.


As Victoria said, " I had to type up, sign, and scan an approximately two-sentence letter stating something to the effect of "I was laid off on X date. I was subsequently unemployed until Y date." Why anyone needed this, I have no idea. Not like I filed a 1099-G for the unemployment I collected or anything - OH WAIT, I did."

Ken and I had to provide a list of everywhere we had worked for the past two years, which would have made sense, had we not both worked in our current positions for the last 2+ years... as evidenced by our tax returns. I don't even... whatever. I will sign whatever they ask me to sign, just please, give me a mortgage. STOP THE INSANITY.

2. This weekend is looking pretty awesome. Tonight, I'm going to see Victoria play Sister Margaretta in a local production The Sound of Music, which should be really fun. Tomorrow, I'm sleeping in and then meeting up with Patricia for pedicures and lunch. Bonus? The pedicure comes with a glass of champagne! Then on Sunday, Ken and I are heading to Ocean City, NJ if the weather isn't crappy, and after putting on a wide-brimmed hat, slathering on 100+ SPF sunscreen, and renting an umbrella, I plan to sit on the beach and read, sleep, and people watch to my heart's content. And of course, there will be pizza. And custard. And possibly caramel corn and/or fudge. Because calories don't count when you're down the shore, right? Right.

3. We bought new bedroom furniture! After hunting high and low for the best deal, we landed at Ashley Furniture on Monday night. They were having a sale because of the holiday, plus they had free delivery and 5 years of interest-free financing. Craziness! We were there way longer than originally planned because the first set we had picked out ended up being discontinued, but in the end, we were happy with our choice. 



4. Apparently, I finally caught up with 2014 and I am really into smoothies. And no, I don't put kale in mine. I have an immersion blender that says it can make smoothies, but I don't trust it. Anyone have a favorite blender they'd recommend? I really like this one (in green) because it matches our KitchenAid, but $150 seems a bit steep at this moment in my financial life. The good news is that I have approximately 84 coupons for Bed, Bath, and Beyond, so once we move and get settled, we are going to have a good time there!

5. I met with some new doctors yesterday and realized, once again, that my doctor's appointments always breed MORE doctor's appointments! Chronic conditions are a full time job, my friends. And now I have a lot to think about. More on that later. Like next week. CLIFF HANGER!

And on that note, everyone have a great weekend! Wear sunscreen, sleep in, and have a glass of wine or three. Cheers!

- A