Struggle

One of the huge questions I had for my doctor with my recent test results was "Can I get pregnant with a prolactin level of 38"- down from 47.  He indicated that every women is different and there are more factors than simply lowering your prolactin even though that plays a major part.  He also mentioned that you need to stop drinking, caffeine, etc. and start maintaining your body and nutrition.  I have started taking my vitamins again religiously and I have also started exercising again.  I am not a doctor so I cannot say what is adequate for every women.  My first piece of advice is start with an ovulation predictor so you know when your most fertile dates are.  Secondly, cabergoline can be increased slowly if you consult with doctor and your results have not changed research shows - pituitary network association that certain patients will need to increase their dosage ever slow slightly as your body may not respond to the lighter dosage.  Remember I am not a doctor so make sure to consult with your physician.  My physician and stipulated that when I want to get pregnant in the months prior increase my pill by a half to help in decreasing.   I have been trying to get my levels down for almost 2 years due to the simple fact that my previous doctor was not increasing my dosages properly and I was simply sitting on the fence.  Now that I have increased my dosage I have seen significant results in 2 mths.  Many patients have had some success in increasing the medication enough to rid their body of the tumour as I have done some research via the pituitary network association but remember each individual is different and your doctor should okay everything prior.  In addition, we each have different bodies so you basically need to work with what you feel comfortable with and your doctor as well.  I have been very happy with the results lately as I am well aware that my levels are starting to move.  Breathe of the fresh air but you need to stay on top of your medication and health.  I have also started changing my diet.  Less processed foods and more organic and healthier alternatives.  I think that we consume too much preservatives and it can't hurt.  So I am thinking that if my doctor would of increased my dosage several years ago and switched immediately to cabergoline (dostinex) I probably would have had results sooner but they usually like to take baby steps.  I have noticed that I still do get the stuffy nose late at night which my GP doctor recommended I take a reactine to help.  So my daily dosage of vitamins includes the USANA essentials or a multi-vitamin and vitamin B6 (check your dosage of vitamin b6 though I take 50mg a day) as sometimes too much is not healthy either. So the answer to my original question was that every women is different but you can get pregnant with a prolactin level of 38 as I have conceived with a prolactin level of 41 but it's much more difficult.  This is my experience and everyone is different so there is no true answer to the question. 

Pituitary Network Association

Summary of Important Points (Quoted from Pituitary Network Association Website)


Prolactin levels allow the important distinction between a true prolactin producing adenoma and a nonfunctional adenoma with stalk effect to be made with relative security in most patients.

Patients with prolactin secreting pituitary tumors (prolactinomas) should be treated as first line with Dopamine agonist therapy, while nonfunctional or other tumors should not.

Surgery may still be necessary in a prolactinoma and is almost always needed as first line treatment in patients with other functional pituitary tumor types.

Because the hormonal systems of the pituitary are complex, a wide variety of clinical syndromes can be caused by tumors. However, because the majority of pituitary tumors are either prolactinomas or nonfunctional tumors, the symptoms of those two types (menstrual disruption, infertility, galactorrhea, headache, and/or visual disturbance) should raise the issues of a pituitary tumor in patients who complain of one or more elements of that constellation.

The cognitive and psychosocial disruption exhibited by patients with pituitary tumors is real and should be viewed as manifestation of physical disease that can be amenable to appropriately directed therapies.

Although women with pituitary tumors may be diagnosed by their obstetrician/gynecologist, ultimate treatment of such tumors should be carried out under the joint care of an endocrinologist and neurosurgeon

Increase in dosage

I haven't posted for quite some time.  Since the test results I have decided to keep increasing my dosage as my doctor stated that if I was interested in getting pregnant in the next few months I should consider doing.  So I have now increased to 2.5 pills twice a week.  I have noticed that I have been feeling better.  I seem to have more energy.  I guess since my hubby and I will be trying again come May I should start getting used to the ovulation saliva predictor.  I have heard some pros and cons about this type of predictor but as recommendation of the doctor I have decided to try.  It was 100 CAD and what the heck go to town.  The thing that is nice about it is that you never have to buy more predictor indicators for the kit.  So my fingers are crossed for another excursion.  I do admit that I have my negative thoughts.  I hate to have the disappoint again.  The emotional run of trying to conceive is exhausting.  But I will remain as positive as I can. 
We did discuss if this doesn't work perhaps we should start reviewing fertility drugs, etc.  So I know there is one more option after this but I am hoping HOPING that we don't have to go that route. 

Test RESULTS

Sooo...I am happy to say that the test results have come back with a 38 prolactin level, down from 45.  I have started increasing my dosage to 1mg twice weekly and the medication seems to be helping.  My doctor has advised me to increase my dosage slightly since I would like to conceive in the near future.  So I will do as the doctor asks.  I have been complaining about an increase in fatigue which they believe may be a result of the side effects of my medication but honestly at this point I don't care about the fatigue as much as I care about getting my prolactin down.  I purchased a new ovulation predictor (via saliva) which has been recommended to see if I can determine my fertile days.  We will start with that this month and see whether it works.  I am a little happier now that I know the medication seems to be working as we are increasing my dosage.  Fingers crossed - all aboard let's do this.

Exercise

The one word that everyone dreads.  I decided this past summer to start running again.  Although getting up at 5:15am doesn't exactly make me feel overwhelmed with joy the result is worth it.  I live in a very cold city come the winter season and the layers need to be piled on prior to your journey into the arctic wilderness.  Okay so it's really not the arctic but a few of these splendid mornings it sure did feel like it.  (the thought of summer is enough to cause a mental orgasm)  I digress.  So I think this helps to destress.  The dog doesn't mind it either, go figure.  I don't keep track of how far I run or how many calories I burn as I think the most important aspect is to get out there and feel better.  I do.  My legs hurt and I feel rejuvenated.   Now for the other aspect which I noticed several mornings - tender breasts. They friggin hurt like a bastard.  I feel as though I have been punched in the chest.  Time for a good sports bra - highly recommend doing your research rather than buying 6 and then determining.  (as noted - speaking from experience)  In the long run I have noticed that I feel better about myself - granted and I feel less stressed about the everyday issues and hormonal surges I have.  Thumbs up! I would definitely try to have a regular exercise routine regardless but I would really stress that if you have hormonal deficiencies - get on board and get fit while doing it.  I am still trying to locate my cross-country skis - garage is a little disorganized.  I am looking forward to getting out there on those skis as it's been ages (I believe I was 14).  So you may dread the word and the activity but definitely get your butt in gear.

Self Help

Need to start focusing on changing some habits.  Over the last few months my mood is all over the map and I need to start refocusing my thoughts.  I have been "maintaining" my life.  It's been at a stand still for quite some time.  I decided to try the self help books to see whether or not they could help with refocusing my thoughts and perhaps a new perspective on life.  I fully understand that the book itself is not going to help me solve my problems but I am thinking outside the box and what's the worst that could happen.  Exactly- live a little.  So far I have found it to be inspirational and I sampled a few before I found one that was not overly cheesy.  I do believe that I have tried to control aspects of my life but it's just not feasible or healthy.  Prior to my diagnosis I had a love for life and extraordinary enthusiasm.  I always enjoyed going with the flow and never regretted making decisions.  I guess in some ways I still don't but I can't help sometimes to think that there was something I did that caused this obstacle.  Bottom line I don't think I could of changed anything but it's stressful.  SO....... the book has helped.  It's helped to open my life to a new perspective and given me the spirit of life that I have sooo dearly missed.  It's nice to be able to take it off the shelf and dust it off.  I miss the old me and the love of life I possessed.   I would highly recommend grabbing one and sitting back to think outside the box.  I have also decided to start doing things for myself again.  Reclaim who I am and stop focusing on the negative aspect of infertility.  Bloody Hell, life is too short.  One of the exercises in my book; for one moment take in all the good, hold off on the bad and look upon your life and be grateful for what you possess, stop the negative thoughts from entering and realize the what you have right now is pure essence, and enjoy it.  When I took a moment to realize what I had I thought- wow this is pretty darn good.  I felt a release of pressure off my shoulders.  One of the biggest things I realized was that I was the culprit who kept putting the stresses on myself.  I can change that, and it's not my fault or anyone else's.  I am entitled to be happy.  Regardless of whether I can never have children there is something more to life and what I have is incredible.  "The minute you alter your perception of yourself and your future, both you and your future begin to change". - Marliee Zdenek

the new frontier

Well I have started back on the "stay positive" band wagon.  Logically it's the only thing to do.  I am hoping that my next blood test results are better (fingers crossed).  They will increase my medication again if there is no change from the last time.  Not the greatest but the last alternative will be surgery.  As I have heard surgery does not always work so I am a little hesitant to discuss that topic at the moment.  I am looking forward to my appt on the 18th.  (for the recent results) For some reason my conscience believes the results will be better.  Ah- the ache if I am wrong.  I haven't been running as much lately.  I am becoming a little lazy.  I believe that my endurance is not what is was 4 mths ago.  I am exhausted after 3 miles.  Not good.  It might have something to do with my stress level and my inability to quit smoking.  Yes, I am a smoker.  Go figure.  My better half has scalded me because of it and I have no qualms about it, he's right.  I guess I feel that if my levels were low enough, I would stop for the sake of wanting to get pregnant and for the safety and health of myself as well.  Right now though, I am smoking on occasion.  Bad yes, but satisfying for the 10th of a second.  YEsSSSSS!    Now I am sitting in my office wondering and worrying about, well, I am not sure.  Lately, i feel as though there has been this incredible tension between my sweetheart and I.  He gets grumpy quite often about things that he can not change.  I believe that you take it one step at a time and hopefully it will work itself out.  I don't know.  He wants to help but there is nothing that he can do.  He just has to be patient and supportive.  Perhaps I am wrong but I am entitled to my opinion.  "I will wait for you, should I fall behind, wait for me".  Nothing like a little Bruce Springsteen to satisfy your soul.  I definitely need some chicky movies and a good blanket.  Scratch that.  I need a huge comfy bed, a ton of chicky flicks and one heck of a good bottle of wine.  (perhaps 2, but I am a lush).  Did I mention the view from the bed needs to be absolutely incredible.  Dark, windy, warm, ocean, quiet, and absolutely breathtaking.  Yup....daydreaming.....