I had my post-round-one-of-tamoxifen consultation appointment yesterday. I learned a lot of interesting things. First of all, long before I started the tamoxifen, I got a p+7 blood draw the results for which took literally three months for the blood lab to return (no explanation given). The results were:
Dr. L said that the progesterone was in the normal range (over 12), though she would prefer to see over 15 - but the real problem was its relationship to the estradiol, which is supposed to be 1:10. (It's 1:6.) The estradiol was just way too low - she said it should be over 150. (I asked her whether this was a sign of, say, premenopause, and she said it was just a luteal phase defect. Hmm.)
Then last cycle I had a p+7 draw (admittedly I had to guess when p+7 was) and the results were:
That's almost exactly ten times, and both numbers are good. Dr. L was beaming. Rarely do doctors get excited about one's health (I think they're sort of bored of it), and nobody ever says nice things about mine (even when my blood pressure this time was 96/60, the nurse was totally unimpressed. DUDE, THAT'S REALLY GOOD. Actually, she told me not to WORRY because it wasn't "TOO low"!!!), though I can certainly see why not, given what they have to work with.
Anyway, I brought up the CM problems and my extreme dissatisfaction with them. I asked three different ways whether the HSG and SHG, or the colpo, could have caused the problems, and she was adamant that this was impossible. It sounded totally possible to me, but OK. She also said that since my estrogen was clearly higher, I should have had more CM, not less. Nevertheless, she obligingly wrote out instructions for me to take Mucinex (apparently I need to take TWO of my crazy extra-strength pills that I bought), and amoxicillin (apparently I need three a day to do the job). I'm to start taking both on CD11, or four days before I expect peak day (I appear to have ovulated on CD14 last cycle, so maybe I'll start on CD10?). I figured I'd fill the prescription on Friday, which will be CD8.
Her nurse had told me via phone that she does not treat thyroid problems, so I already got a referral for an endocrinologist from a friend and made an appointment for September 3rd - the first slot available. I planned to ask Dr. L whether that was too far off; I'm certainly hoping to have it moved up, since as I understand it ttc is pointless until I get on thyroid replacement, and also I plan to start my diet (that no-artificial-carb diet) and exercise kick as soon as I get the pills. To my surprise, instead of starting with a disclaimer that she doesn't treat thyroid issues, she said I should at least be on some replacement for now, and wrote me a prescription for (I think) thyroxin or whatever it's called. She also wrote a requisition for a full blood lab for thyroid testing, and told me to fill the prescription and start taking the meds when they call me with the test results (unless they advise otherwise). I was going to get the blood drawn tomorrow morning, but as it turns out, she circled "thyroid panel" on the requisition, and my lab has stated that they do not do "panels" and the doctor has to circle the individual tests. So I left a message at the clinic, and hopefully I can sort this out and I can go on Thursday. About a week for the results to come back means I'll be lucky to start on the meds before ovulation, but maybe they'll help anyway. I'm just delighted that she did this already. I did ask whether she could determine a dosage before further testing (my TSH level was 7.04, BTW, and I believe normal is under 2.5), but she said she was starting me on a really low dose. I was startled when she said it was 50mcg. One of my aunts is only on 10 - my mother takes 50! But, I'm not a doctor, and I'm so happy I'm getting something to treat this now, instead of in September after I've wasted months on tamoxifen that won't work and been tired and depressed for longer.
I had one other question about the thyroid blood draw, and maybe y'all can help me with this: does it matter what cycle day I do it on? I know my first one was on p+7, but maybe that's just because I was having progesterone and estradiol done that day already? I'd really like to do the draw as soon as possible.
So that's the story from the doctor's office, but I'm not done. This is the Cervical Mucus Sequel and it makes the first chapter of the mystery sound bland and really unmysterious. So anyway, I'm clearly having an improved cycle (thank you, tamoxifen) - other than the several extra days of cramps I can't medicate away, of course. I had NO tail-end spotting - NONE. And on CD3, when I fully expected the spotting to start, it was practically heavy (normal flow). Unusual for me! Anyway, today is CD5. I started the tamoxifen on CD3 as I was supposed to (though I took it in the late afternoon on CD3 and CD4, and in the morning today). I still have faint spotting today, but I also noticed this morning...slippery. I did the stretchy thing and there was no stretching at all, so I decided that didn't count (since I had a similarly weird interlude last cycle). Then in the middle of the day (this is gross, sorry), I noticed that I had a clear spot on my pad, which stretched almost an inch. Wasn't sure what to make of that, but I wasn't sure that on a pad counted. I got home from work and though I've still got spotting color, this time there's a little bit more slippery (not the drowning-in-CM I'm accustomed to for 2-3 days of my fertile phase EXCEPT RECENTLY, but clearly some), and it stretched almost two inches. There's no ignoring that one.
So apparently somebody decided I should start my buildup to peak (or otherwise have a bizarre day?!) on CYCLE DAY 5. I now have no idea when to take the Mucinex and amoxicillin or even when to fill the prescriptions - or whether I need them at all! And another question that requires your collective wisdom to help me answer (keeping in mind that I'm STILL bloated and crampy): do I have sex with my husband tonight???
I swear all this stuff is designed to confuse me.