I didn't get my period for many months after the twins were born, even after I stopped nursing , which was frustrating since I was trying to eat right. I had hoped that my body free of all the hormones from fertility treatments would find its equilibrium again. But that wasn't happening. I suspected my crazy work schedule was throwing it off. With 18-month twins at home, I was exhausted and at 39 years old I started to experience strange menopausal symptoms. My hair was brittle and a significant number of strands would come out during shampooing. At night, I was dehydrated and hot. And most unusual, for the first time ever I was experiencing insomnia. I'd always been a world-class sleeper, so it was a foreign feeling to pop awake at 2 or 3am and be unable to get back to sleep.
In April of that year I went to see a renowned sleep expert in NYC. He prescribed Ambien. I tried it. It didn't work. I called him back. He gave me a prescription for Ambien CR. I took it faithfully from June to August. It sort of worked, some nights, not always. The expert was out of suggestions.
On April 10th, I went to see my own ob/gyn for my annual exam and he had some theories about what I was experiencing. A blood test revealed that i was not in menopause but my lack of estrogen was making me have many of the same symptoms. He suspected I might have poly-cystic ovarian syndrome (PCOS), which I immediately dismissed, knowing PCOS would have been detected during all my fertility treatments. He insisted on doing an ultrasound and bloodwork. Using the familiar wand, he scanned my ovaries but didn’t see any of the telltale "beading" of PCOS. Still, he said he couldn't be sure until my bloodwork came back. He called a week later with his grand discovery.
"You have hypothalamic dysfunction."
No shit. I’d known that for years. He said this meant not only was I experiencing menopausal symptoms, I was at risk for osteoporosis. We’d have to figure out how to treat it since I couldn’t take the usual solution of estrogen with my MTHFR.
“Come back in three months”, he said. “Until then, keep a chart of your cycles and we'll take it from there."
Once again, Western medicine seemed woefully inadequate to solve my issue. So I went back to the famed acupuncturist I'd seen when pregnant. I told her I was exhausted but suffering from sleeplessness. She did some acupuncture and prescribed a batch of Chinese Herbs, which I was to take every day. They were unpalatable as usual but I did it and prayed it would balance my cycles and give some relief.
On July 11th, I dutifully went back to my ob/gyn to discuss the game plan. I'd heard that black cohosh could be used for women who needed estrogen. Could that work for me? Charting my cycles during those three months had been easy because there was nothing to chart: I still hadn't gotten a period.
My ob/gyn shook his head, my hypothalamic dysfunction was worse than we'd thought. Because of a lack of estrogen, I’d developed osteopenia and was headed towards osteoporosis. Then he said the words that echoed in my ears.
“The biggest problem with your condition is, should you ever want to have another child, it would be impossible without a lot of medical intervention."
It was strange, even with twins at home, I felt that familiar pang of fertility failure.
For the next week, I almost forgot about my hypothalamic dysfunction as I was surrounded by my best friends from high school, college and beyond. We'd all rented a big house at the beach to celebrate the momentous occasion of mine and my husband’s 40th birthdays (though mine had passed three weeks earlier). I hadn't seen some of my closest friends in six months and we were feeling particularly festive. One of them had discovered a recipe for Ginger Gin-and-Tonics which we drank with abandon around the clock. Against the label's warning (and my better judgment), I was still popping the Ambien at night and I was still faithfully swallowing the herbal concoction everyday -- but now I was adding in daily Advil for the hangovers. Luckily we were eating a lot of delicious food to accompany the wine and gin-and-tonics.
Being so tired all the time had made going to the gym all but impossible. So not only was my hair falling out, my waistline was expanding -- another delightful menopausal symptom I’d developed.
But on July 21st, I woke up and saw something particularly disturbing. I had what could only be described as strange abdominal distension.
"Holy shit! Look at this!" I said as I turned sideways to give my husband an eyeful of my girth.
"Weird." He said.
I looked down at the pants i couldn't button and started panicking,
"Oh my God! I need to go to the emergency room." I called my friends to our bedroom and pulled up my shirt.
"You guys, look at this! I think I have a cyst or a tumor or something. Maybe my appendix exploded."
My friends agreed it looked like I had a cyst. I started panicking and lay down on the ground to see if I could feel a lump in my abdomen. My brother, an abdominal surgeon, suggested an ultrasound. I begged my husband to take me to the hospital but he felt we should wait until we got back home two days later. Then my brother tried to lighten the mood,
"Maybe you're pregnant." That was cruel; had he not been paying attention to my struggles over the past three years?
"Maybe you should buy a pregnancy test to make sure," he suggested.
An hour later one of my friends returned from the store with more wine. She'd also bought a pregnancy test. She handed it to me.
"Just take it so you know for sure."
I didn't want to. I knew my body. But what was the harm, she'd already bought it. So, without telling anyone, just before I got in the shower, I peed on the old familiar stick. A plus sign would mean pregnant, a minus sign would mean not pregnant. I left it sitting on the sink counter for the prescribed minute or two, then peeked at it. And there was the single, solitary line I knew so well from my years of failed attempts. One line equals not pregnant.
"Of course", I said out loud, shaking my head and feeling that old twinge of loss and sadness. Somehow the pain of infertility was still right there. I tucked the pregnancy test into my suitcase hoping no one would ask anymore about it.
We left the next day and first thing Monday morning at 8am, I called my doctor only to get their answering service. I told the operator it was an emergency. My ob/gyn's partner called me back an hour later to say my doc was on vacation. I told her about my strange abdominal distension and that I feared I had a cyst or tumor.
"OK, she said, "how old are you?"
"40" I said.
"And do you get regular periods?"
"No," I said.
"OK, why don't you come in and we'll take a look."
I made my husband go with me, fearing I may need immediate surgery. As we walked into the exam room, the doctor said that she'd pulled my chart.
"I see you have some issues", she said.
"You’re 40 years old, you have hypothalamic dysfunction, an ovulation and ammenoreha.”
She told me she wanted to do a manual exam, which sounded like a waste of time to me. I pleaded for an ultrasound but she said she was old-fashioned and wanted to start with a manual. As she stuck her hand in and started poking around my ovaries, she looked stricken.
"OK, I feel something. I'm going to get the ultrasound."
Now she was worried – she thought she’d felt a tumor. She wheeled in the sonogram and inserted the wand. Her eyes grew wide and she gasped,
"Oh my God!"
"What??" my husband and I both shrieked.
"There is a BIG BABY in here!"
We stared at her in disbelief.
"This is not a new pregnancy", she said. "You're like 16-weeks pregnant! You've missed your entire first trimester! I've got to sit down."
A mere 23 weeks later I gave birth to an 8lb. 8oz unbelievable surprise baby boy. Given all my years of infertility and all my strange symptoms, I would imagine you probably have some questions right around now -- as I did for my doctor when he got back from vacation. But what could he say? Sometimes when it comes to baby-making, miracles happen.