Lemon Buckwheat-Vegetable Soup -- Great TTC Recipe!

This installment of the Simple Saturday Project is actually a recipe. I know what you're thinking -- buckwheat?! Before you totally rule this one out, read below the recipe to see why buckwheat is an excellent TTC food for both women and men.

Ingredients:

Olive oil

1 carrot, diced1 celery stalk, diced1 small onion, diced
1/2 teaspoon sea salt6 cups chicken (or vegetable) broth1 small yellow summer squash, diced1/4 cup buckwheat, rinsed and drained2 wide strips of lemon rind (removed with a vegetable peeler)
1/2 lemonFreshly ground black pepper
Optional: Grated parmesan cheese

1. In a large stockpot, heat olive oil over medium heat. Add carrot, celery, onion and salt, cook for 5 minutes.
2. Stir in the broth, yellow squash, barley, and lemon rind strips. Carefully squeeze the 1/2 lemon into the pot, while being careful to keep the seeds from falling in. Bring to a boil. Simmer, uncovered, until the vegetables and barley are tender (about 20 minutes). Discard the lemon rind and season with salt and pepper to taste. Top with parmesan cheese once served into individual bowls, if desired.
3. Enjoy! We both gave this recipe a big thumbs up.

Why Buckwheat?

Packed with B vitamins, it is an ideal food to support fertility and energy levels. It is a good source of thiamin, riboflavin, and folate. It also helps to naturally lower blood sugar. Due to all the amino acids it has, it helps with blood flow and can assist with implantation. It is not only good for TTC, but also a great option for the first few weeks of pregnancy when you should be boosting folate intake to support that growing spinal cord and brain. Since it is also an energy-booster, it is also great to combat that early pregnancy fatigue. 

Diagnosis & The Endocrinologist

On Wednesday, we met with the reproductive endocrinologist for the first time. Our local clinic is one of the Boston IVF clinics (Here's a link to all of their clinic locations across the U.S.). My gynecologist actually dealt with infertility herself and referred me to the same endocrinologist she personally worked with. We are not actually classified as dealing with "infertility," as that requires six months of trying without conceiving to be diagnosed. This actually works to our advantage in this instance for billing purposes, as insurance will cover treatment for hyperprolactinemia but not infertility. I knew this, which is why I wanted a diagnosis and treatment before those magic 6 months passed. 

Prior to our appointment, we had a long list of information to complete online. Known family history of genetic abnormalities, infertility, multiple miscarriages, etc., as well as a laundry list of possible health conditions for both of us. The very good news is that we have no other known health conditions. We've both had blood work in the last three months and received a clean bill of health. Thyroids functioning normally (very good news on both fronts for conceiving) and no signs of chronic health conditions.

Confirmation of Prolactinoma

As my gynecologist had initially suspected, I have a microprolactinoma. Also called a pituitary adenoma, this is a small, benign tumor (mine is 5mm, anything 10mm or below is considered "micro") on the pituitary gland that secretes excess prolactin. The great news is that it is not a macroadenoma, which may have required surgery. I found the above image in a Google search to show how close the pituitary glad is located to the optic chiasm. In the case of a macroadenoma, it can press on the optic chiasm and cause visual disturbances. We are very happy this is not the case! 

We are not sure how long I have had a prolactinoma, as my cycles have always been irregular whenever I was not taking birth control. I may have been born with it, or may have had it since I first started menstruating as a young teenager. 

While this benign tumor is not likely to cause major health issues, the excess prolactin will negatively impact my ability to ovulate every month. Although this does not mean every cycle is anovulatory (a cycle in which the ovaries fail to release an egg), there is a good likelihood that I'm at least not ovulating some of the time. Without treating the prolactinoma, my cycles would remain irregular and it would likely take an extended period of time to successfully conceive. 

Treatment Planning

In treating a prolactinoma, there are two medication options to shrink the tumor and limit its release of excess prolactin. The older medicine is bromocriptine (Parlodel) and would be taken daily. Bromocriptine has a high incidence of adverse side effects (78% of patients) in the variety of nausea, headaches, dizziness and vomiting. Additionally, the research suggests it is at least somewhat less effective than a newer drug available.

The other option, cabergoline (Dostinex), is better tolerated than bromocriptine (68% of women reported adverse effects) and the pill only needs to be taken twice weekly (Source). Collaboratively, we agreed that cabergoline was the drug of choice. The only downside is that cabergoline is more expensive. Although the cost per pill is significantly higher, the overall monthly cost is hardly noticeable -- $20 more per month for cabergoline. I'm willing to pay that difference to have a more effective and better-tolerated medication!

Here's a comparison of how each of these medications treats the excess level of prolactin:

(Source)

A quick glance at this chart shows cabergoline would be expected to quickly drop my serum prolactin level within 4 weeks. Once my prolactin level dropped below 20, we would anticipate it would also be much more likely that I would ovulate every month. 

I will begin my treatment with cabergoline next week and will plan to chronicle my progress here. I will also have a follow-up MRI in 6 months to determine if the cabergoline successfully shrunk the prolactinoma. I really like the endocrinologist we were referred to, and will create a separate post of what else the endocrinologist recommended outside of treating my prolactinoma. 

The MRI Scan Experience

*Not my brain -- borrowed from www.mstrust.org.uk

Yesterday, I had my MRI scan to rule out a pituitary adenoma. I had never experienced an MRI scan before so this was a brand new experience. I thought I would make a post to document what the experience was like. 

When I made the appointment, the MRI office mailed me a packet of paperwork to complete. Due to the strong magnetic field used to create the images, I had to verify that I had no wire implants, mesh, or other metal pieces that would potentially dislodge or otherwise be affected by the strong magnetic field. I do have a metal wire bonded to my bottom teeth (permanent retainer from when I had braces) but called in advance to make sure the bonded wire would not present a problem. I was also instructed to not wear any clothing with metal zippers, buckles or fibers. I opted for a dress (no zipper).

Once I arrived, the tech informed me the scan would be performed both with and without contrast. My doctor who ordered the test told me it was just without contrast so this was a bit of a surprise. I was then situated on the MRI table. My head was placed in a sort of metal bowl. A cage was then placed over my head to immobilize my head for the scan. Two pads were added to either side of my face to hold my head in the same position throughout the scan. While I couldn't move my head, the cage had large holes so I could still see.

The scan took about 90 minutes in total. The first 60 minutes were without contrast. The MRI machine is very loud with buzzing, clanging and chirping sounds and the tech forgot to turn on the music in the room for the first 30 minutes. Without the music, time seemed to drag by while I focused on trying not to move. Then the nurse came in to insert an IV with the contrast solution. After the contrast, I had a bit of vertigo -- try lying completely still while feeling dizzy! Luckily the dizziness subsided fairly quickly.

I was provided with a CD copy of my images to take to the reproductive endocrinologist. I'll update in a few days after my doctor's appointment to share what we learned from the MRI.