Thursday, December 29, 2011

Today's Award For The Best Person On The Planet

First of all, I hope everyone had a very Merry Christmas, a very Happy Hanukkah, and, in general, a wonderful and relaxing holiday season. Check out the present I got this year - the beginning of my baby bump!! ~:o)

Today I went back to pilates for the first time in about a month. I stopped going several weeks ago to make time in my schedule (and in my limited energy) to go to physical therapy multiple times a week to attempt to fix the problem with my SI joint. Unfortunately, as I explained in my last post, that physical therapy experience didn't turn out to be successful. At all. And, as expected, the increased dose of Tylenol my rheumatologist put me on isn't helping significantly either. So I sent a message to my rheumatologist to find out what options I have for the next step, because the pain isn't really getting any better - but my belly is getting bigger! - and I'm worried about the pain increasing as my pregnancy progresses.

In the meantime, I went back to pilates. I am so very happy that I went. My pilates instructor totally wins today's award for best person on the planet! For one thing, after an hour stretching and bending and moving under the careful direction of my pilates instructor, I think my back is actually feeling a tiny bit better. And that is seriously awesome.

But, even more important than that, is how my pilates instructor makes me feel about my body. No matter what kind of crazy combination of problems I bring her, she always manages to find something that I actually can do. And it's never something simple - it's always a challenge. I find myself thinking and breathing hard and actually exercising, but all without much pain because of how precise she is with the movements she asks me to make and how much she thinks about it before she asks me to do it. Instead of giving up on me, my pilates instructor seems to deal with the complicated set of issues I bring to the table as a challenge that she is excited to face and figure out. Granted, she has had a year and a half to get to know the crazy that is my body, but she has been up to the challenge since day one. She makes me feel empowered that I can actually take control and do something about the issues my body throws at me - and that is worth more than anything else.

And I am so, so, so grateful.

Thursday, December 22, 2011

SI = Sad Inside

Several months later, my right SI joint is still not a happy camper. I have to be honest: it is really starting to get to me. 

Since pain is certainly not foreign to my everyday life, I don't run to the doctor as soon as something starts hurting (or I'd be there constantly). I usually settle for stretching, taking it slow, taking some anti-inflammatory meds, and hoping it will go away. It's only after something bothers me for a good long while that I will give in and finally call the doctor. 

So, when my lower back started bothering me on the right side back in October, I didn't think too much of it. I did some gentle stretching, took some Tylenol (which is safe for my pregnancy), and tried to ignore it. Then I got distracted by the lump I found in my armpit (when it rains it pours?). In fact, the pain in my back didn't really start to worry me until my pilates instructor told me in November that she thought it was being caused by some inflammation in my SI joint. The thought of the pain being associated with a joint started to make me nervous.

But I still put off calling the doctor until my OB told me that I ought to check in with my rheumatologist. So I did. And then my rheumatology team prescribed some physical therapy in an attempt to deal with the problem without having to take any extra meds. Thus, for the pasts couple of weeks I have been seeing a physical therapist twice a week to learn stretches, posture, and exercises to lubricate the joint, as well as getting focused massage in that area to try to get the muscles around the angry joint to relax. 

Unfortunately, it really hasn't been helping that much. I'm not getting quite as much sharp pain as I was before, which is good, but I'm still dealing with a fairly large amount of dull, constant pain in my lower back on the right side. It hurts to stand. It hurts to sit. It hurts to lay. It hurts to carry. It hurts to lift. So most of the time I'm not exactly sure what to do with myself. My belly is finally starting to show, so I'm also starting to get a lot more nervous about the future. If I can't take the pain now, how will I deal with it when I've got extra weight to support? But I've been diligent with my stretches, posture, and exercises and I was still optimistic that my physical therapist/massage team would have something up their sleeves to get me through.

Until yesterday.

Yesterday, my physical therapist essentially gave up on me. We talked about how I was diligently doing everything they had taught me but that it still wasn't really helping. And, it seemed to me, she just got overwhelmed. I got the distinct impression that my combination of problems - SI joint pain, RA, and pregnancy - was just too much for her to figure out. It felt like she just wasn't up to the challenge. Instead of offering me PT solutions, she told me that she thought it was time for me to speak to my rheumatologist about anti-inflammatory meds or getting an injection in the joint. She even offered to cancel my upcoming appointments until I had a chance to speak with my doctor.

Maybe she's right. Maybe it is time fore me to move on and consider other options. But I left physical therapy feeling pretty discouraged about how she had basically washed her hands of my problem. I mean, I realize I have a complicated set of issues. I know that sometimes stuff is going to hurt no matter what I do because of the RA. I understand that being pregnant makes me difficult to treat because I can't do everything you want me to. But I just felt so discouraged that she didn't have any more ideas.

I did call my rheumatologist and the nurse got back to me this morning. He's going to have me try taking 650mg of Tylenol every six hours for the next week to see if that helps. Unfortunately, this doesn't seem to be significantly more Tylenol than I have already been taking on my own to deal with the pain - so I am not super optimistic that it is going to solve the problem. The next step is to consider an injection to the joint, but my rheumatologist says he would prefer not to do so, so that makes me nervous too. 

I don't want to feel worried. I don't want to be stressed. It doesn't make me happy and I know it isn't good for the baby. But I can't help feeling a little overwhelmed by my inability to do anything at all about the pain in my back. And I'm starting to feel pretty scared that I have been working so hard for weeks to fix this problem but I haven't managed to make any headway. What on earth will I do as my belly grows?

Wednesday, December 21, 2011

Second Prenatal Appointment

We had our second prenatal appointment, as well as our first trimester screening, a few weeks ago - but I decided to wait to post about it until I was done posting my secret posts so my story wouldn't get too out of order. Happily, all the results were very good!

We finally got to hear our baby's heartbeat, but the very best part was seeing our growing baby on the ultrasound monitor (the regular abdominal kind of ultrasound this time - not the kind they used last time). The thing that surprised us the most was that our baby was moving - and not just a little bit! The kid was practically disco dancing in there!! Kicking off the walls of the placenta, rolling over, waving arms around. Because the baby is still too small for me to feel, it actually didn't occur to me that he/she would be moving around in there, so it was really crazy to watch. Especially because the still picture doesn't really convey how vivid the video was - the video was so clear that we could even see the baby swallowing. It is so weird that the baby can be so very small and still have so many distinct features and so weird that it can be having a party in there without me even knowing it.

Then, after dancing for about 15 minutes and totally thwarting the ultrasound tech's attempts to get the measurements she needed, our baby fell asleep. And what I really mean here is stone cold passed out. Unfortunately, the baby passed out with its hands right in front of its fact, further thwarting the ultrasound tech's attempts at measurements - so the ultrasound tech had to jab me in the belly to try to get the baby to move its hands. It took at least 20 minutes for her to get all the measurements she needed - which was ok by us because it gave us time to stare open-mouthed at the little person dancing and sleeping inside of me.

So. Crazy.

Tuesday, December 20, 2011

Guest Post on CreakyJoints!

Check out my first guest post over at CreakyJoints!

Monday, December 19, 2011

Secret Post #22: Kids, Even Unborn Ones, Are Expensive

NOTE: This post is part of a series that I wrote in secret during the months before I announced my pregnancy. The series chronicles my pregnancy journey: from weaning off my RA meds, to trying to conceive, to searching for helpful advice and information, to discovering I was pregnant, to the ups and downs of my first trimester. You can read all the posts in this series here.
 
 This Post Written November 18, 2011
TMI Warning: This post contains details about pregnancy that you may consider to be too much information. Don't say I didn't warn you!

Today's pregnancy lesson: kids, even unborn ones, are expensive. 

Every year in Boulder there is a week in November called "First Bite," where a bunch of fancy restaurants offer tasting menus - 3 courses for $26. It's a tradition among our friends to splurge on 2 or 3 nice dinners every year during this week. On Tuesday I wasn't feeling that great, but I forced myself to go to one of these dinners with my girlfriends. I ended up being able to nibble on some of the delicious food and really enjoying myself. And on Wednesday I felt better than I have in weeks and weeks.

Last night APL and I went with a bunch of our friends to have another nice dinner at a southwestern grill. I again wasn't feeling that great, but I really wanted to get out of the house and spend some time with all our friends. I forced myself to eat some of the food, thinking that would make me feel better like it did on Tuesday, but as the meal went on I only felt worse and worse, though I did manage to remain upright and even enjoyed talking with our friends for most of the evening.

But when we got home I immediately barfed up the whole fancy meal. Oops.

NOTE: This is the last post I wrote in secret before I announced my pregnancy, and so it marks the end of my secret pregnancy posts (and pretty much gives you the taste - ew, bad choice of words - of my first trimester). Back to posting in real-time when I've got something to say!! 

Sunday, December 18, 2011

Secret Post #21: Smoothies!

NOTE: This post is part of a series that I wrote in secret during the months before I announced my pregnancy. The series chronicles my pregnancy journey: from weaning off my RA meds, to trying to conceive, to searching for helpful advice and information, to discovering I was pregnant, to the ups and downs of my first trimester. You can read all the posts in this series here.

This Post Written November 17, 2011

Morning sickness is the worst. It is constant, it makes you feel disgusting, and the only way to combat it is to eat - which is actually the very last thing you want to do. And the things you are willing to eat (read: able to force-feed to yourself) - saltines, bagels, cheerios - are hardly the most nutritious things on the planet. Happily, I have finally discovered a solution to get some much-needed nutrition into my body: smoothies.

Turns out drinking a smoothie is a lot easier for me than chewing anything when I am feeling nauseous. They are tasty, easy to make, and you can hide all kinds of good nutrients in there. Here is how I've been making my smoothies:
  • Frozen fruit (APL went to Costco and got big bags of frozen berries, peaches, and cherries)
  • Banana (great for potassium)
  • Skim milk (for calcium)
  • Greek yogurt (for protein)
  • Protein powder (for extra protein - I find getting enough protein significantly changes how I feel. A tip for tasting the powder less is to blend it with the milk before adding any other ingredients)
  • Flax seed meal (for omega-3s - also good to mix with the milk so you won't even notice it)
  • A cup of ice (some hydration is good for you too!)
That's what I came up with on my own. Then I did a little research on the What to Expect When You're Expecting website and came up with a few more ideas:
  • Calcium-fortified orange juice 
  • Pineapple juice
  • Wheat germ
  • Peanut butter (oooh! peanut butter banana....)
  • Honey
  • Soy milk
  • Cooked carrots  (if/when I start feeling brave?)
And let me tell you how much better I feel after consuming a smoothie!! SO. MUCH. BETTER!

Saturday, December 17, 2011

Secret Post #20: SI Joint

NOTE: This post is part of a series that I wrote in secret during the months before I announced my pregnancy. The series chronicles my pregnancy journey: from weaning off my RA meds, to trying to conceive, to searching for helpful advice and information, to discovering I was pregnant, to the ups and downs of my first trimester. You can read all the posts in this series here.

 This Post Written November 16, 2011

Today I went to see my rheumatologist's assistant about the pain I have been having in my SI joint. Considering that I will be supporting considerably more weight in that section of my body over the next few months, having back pain during the first trimester is making me pretty nervous. Having it be associated with a joint is making me even more nervous.

But it turns out that RA doesn't usually affect the SI joint (usually). And though there are some other inflammatory diseases out there that do affect the SI joint (like AS: ankylosing spondylitis) apparently it's pretty rare for those to go hand in hand with RA. She said another option is OA in that joint (awesome), but that is also unlikely given my age. So this is a good thing - she said whatever is wrong with my SI joint it isn't likely to be caused by an inflammatory disease or OA.

She said it was more likely that the joint just got out of alignment and the muscles got mad. She prescribed some physical therapy, so I'm going to try that first. If that doesn't work then we are going to consider a short course of anti-inflammatories, as apparently there are a few that are considered safe at this stage of pregnancy (though of course we'll get my OB's approval if we go this route.)

Hopefully one or both of these plans will be enough to make the pain go away. If not, I'll have to suffer through it until the baby is born and it's safe to get some x-rays of the area. But, since the stretches I do every week with my pilates instructor actually do seem to help alleviate the pain (at least a little bit), I am optimistic that the physical therapy will be enough.

Even though my rheumatologist himself didn't have time for a full appointment with me today, he did pop his head in while I was with his assistant to say hi, see how I was doing, and offer his congratulations on my pregnancy. Also, my Arthritis Ambassador assignment this month was to ask my rheumatologist to join the Arthritis Providers and Researchers Advocacy Alliance and he told me today that he would join, which is very cool of him. His awesome nurse (who has helped me so much with insurance nightmares in the past) said congratulations too. The whole office is really excited for us, and that made me very happy. After all, these folks have been a big part of my life for the past three years. It's really, really nice to have their support.

In other news, I got a message today that the bloodwork from my first prenatal appointment came back. Everything looks good, except that my thyroid dosage needs to be increased a little bit. I'm actually really glad to hear that, because the increased dosage ought to help somewhat with the intense fatigue I have been experiencing.

In more different other news, I wonder if the nausea is finally starting to die down and if the cravings are starting to set in? Because I'm pretty sure I'd do anything for an In-N-Out burger right now. ~;o)

Friday, December 16, 2011

Secret Post #19: First Prenatal Appointment

NOTE: This post is part of a series that I wrote in secret during the months before I announced my pregnancy. The series chronicles my pregnancy journey: from weaning off my RA meds, to trying to conceive, to searching for helpful advice and information, to discovering I was pregnant, to the ups and downs of my first trimester. You can read all the posts in this series here.

 This Post Written November 15, 2011

TMI Warning: This post contains details about pregnancy that you may consider to be too much information. Don't say I didn't warn you!

Yesterday we had our first prenatal appointment! The morning started out a little bit rough (I barfed in the driveway before we even left the house) but the appointment ended up going really well, though it took almost three hours.

First we met with a nurse who asked us a ton of questions about my health history and the health histories of our families. She answered a bunch of our questions too. Then I peed in a cup. Then we met one of the OBs (the clinic we chose has 5 practitioners who rotate during your prenatal care so that you are familiar with whoever is on call when you deliver.) The OB did a breast exam, pap smear, and finally an ultrasound - with ultrasound technology I didn't even know existed until it was literally inside of me (yes, you did in fact read that right, see below). Then I had to get quite a bit of blood drawn. Then we finally got to go home, where I went immediately back to bed for most of the rest of the day because I was seriously exhausted!!
Technology lesson: (a.k.a. Things No One Tells You!) Transvaginal ultrasound is not at all like the abdominal ultrasound you see on TV. Instead of doing the ultrasound through the woman's abdomen, a (rather large) probe is placed inside the vagina. Our doctor said it can be used in pregnancy when the fetus is too small to be seen via abdominal ultrasound. So there you go. You learn something new every day.
The slight awkwardness of the necessary technology was totally forgotten when we saw our baby on the monitor. The baby was looking right at us, its tiny eyes and arm buds glowing and its heart visibly beating in a circuit. But despite the, ahem, very intrusive technology and the fact that we were both standing right there looking at the monitor, both APL and I had the same thought: "look at that. Someone is having a baby." It still feels slightly surreal that it's us!

In slightly less great news, my SI joint is still misbehaving. My OB thought it would be a good idea for me to check in with my rheumatologist, so I have an appointment to see my rheumatologist's assistant tomorrow afternoon. I don't know whether they will be able to offer me any sort of relief from the pain, but probably best to keep my RA team in the loop with my pregnancy anyhow.

Thursday, December 15, 2011

Secret Post #18: Continued Mostly Morning Sickness

NOTE: This post is part of a series that I wrote in secret during the months before I announced my pregnancy. The series chronicles my pregnancy journey: from weaning off my RA meds, to trying to conceive, to searching for helpful advice and information, to discovering I was pregnant, to the ups and downs of my first trimester. You can read all the posts in this series here.

 This Post Written November 4, 2011

TMI Warning: This post contains details about pregnancy that you may consider to be too much information. Don't say I didn't warn you!

There's nothing like starting off your morning with a little bit of dry heaving. Ok, make that a lot of dry heaving. For the life of me I don't understand how I can feel like barfing when there is obviously nothing in my stomach to barf.

This week has been REALLY ROUGH. Constant nausea - and I'm not exaggerating when I say constant. There is currently zero food that is appealing to me. I've been force-feeding myself saltines and chicken soup and whatever else I think I might be able to (try to) keep down. Nasty headaches - and there's nothing safe to take to relieve them. Extreme boob and nipple pain - to the point where I've been sleeping in a sports bra. And while fatigue isn't exactly a new symptom in my life, combined with these other symptoms it has actually taken quite a toll on me. I feel like I have been hit by a truck - a REALLY BIG TRUCK - this pregnancy fatigue feels way worse than my RA fatigue ever was (though to be fair I am most likely dealing with pregnancy fatigue on top of RA fatigue). I really just want to lay on the couch and watch stupid movies all day, which, given my current lack of a job would be totally possible if I didn't have to pee every 15 minutes! Some nights the constant peeing keeps me from sleeping too.
Biology lesson: (a.k.a. Things No One Tells You!) It's common knowledge that pregnant women have to pee all the time, but I always thought that was just later on in the pregnancy when the baby is resting on your bladder. But no! The constant peeing starts right away - for me it was almost immediately after conception - because your blood volume is increasing to build the placenta.
I must admit that I honestly thought getting pregnant was going to be the hard part. Turns out being pregnant is way harder than getting pregnant ever was. (And, I assume we will soon discover that raising a baby is even harder than being pregnant).

As someone who functions on a regular basis while not feeling that great, I've actually been quite surprised about how extremely awful I have been feeling this week. And, more than that, by how incapacitated the not feeling good has made me. I have been entirely useless this week - accomplishing absolutely nothing (other than, you know, the baby I'm growing inside of me). I am so grateful that I don't have a job right now and that APL has been helping with things around the house - because I don't know how I would be functioning right now if I actually had responsibilities. How do women do it?!?! Go to work? Care for other children? Make meals when the sight of food makes you want to die? They are seriously amazing and I salute them.

Luckily, there is good news in all this horribleness: my doctor told me that the more early symptoms I experience the less likely I am to have a miscarriage. And, judging by how the symptoms have totally beat me up this week I'd say I'm carrying one strong baby! So, when I'm curled up on the floor next to the toilet, I try to remind myself that it's actually a good thing!! And (dear god knock on wood!) the morning sickness should only last for a few more weeks.

However, though the pregnancy seems to be progressing well, I have to admit that I'm still not sure exactly what my RA is doing. I've obviously been tired and sore - but is that from the RA or from the pregnancy? Is that feeling going to stick around when the morning sickness ends? (oh god, let the morning sickness end, knock on all the wood!)

And I did have a little bit of cause for concern at pilates last week. My instructor helped me figure out that what I thought was just general low back pain was actually coming from trouble with my SI joint (the joint in your pelvis). This makes me nervous because (1) I've never had trouble with my SI joint before and (2) clearly I'm going to be needing to use my pelvis in the upcoming months! I have pilates again today, so I'm looking forward to seeing if my instructor sees any improvement in that joint - though the pain hasn't seemed to change much over the course of the week. Then again, I've been so generally miserable that I think I need an outside opinion at this point.

I just have to keep reminding myself that whatever I end up having to go through - and whether my RA goes into remission or attacks me for the next 7 months - it will all be worth it so APL and I can start our family.

Wednesday, December 14, 2011

Secrect Post #17: "Morning" Sickness

NOTE: This post is part of a series that I wrote in secret during the months before I announced my pregnancy. The series chronicles my pregnancy journey: from weaning off my RA meds, to trying to conceive, to searching for helpful advice and information, to discovering I was pregnant, to the ups and downs of my first trimester. You can read all the posts in this series here.
 
 This Post Written October 27, 2011

TMI Warning: This post contains details about pregnancy that you may consider to be too much information. Don't say I didn't warn you!

Well, I just barfed up my breakfast and my morning prenatal vitamins. And though I didn't actually barf yesterday, I had "morning" sickness literally all day yesterday. Like, every hour of the day.

I hope these intense symptoms mean I'm carrying a really strong baby! At least that's what I'll keep telling myself as I pray to the porcelain god.

Tuesday, December 13, 2011

Secret Post #16: Pregnant!!!

NOTE: This post is part of a series that I wrote in secret during the months before I announced my pregnancy. The series chronicles my pregnancy journey: from weaning off my RA meds, to trying to conceive, to searching for helpful advice and information, to discovering I was pregnant, to the ups and downs of my first trimester. You can read all the posts in this series here.
 
 This Post Written October 18, 2011

It's official! We're having a baby!!! My primary care doctor confirmed it last Friday. We are due in June and we could not be more excited! The months and months of getting off my RA meds to prepare, the resulting fatigue and extra joint pain, and the anxious process of "trying" paid off - and way sooner than we had dared to hope too!

I pretty much want to shout off the rooftops that I am pregnant, but since the chance of miscarriage is actually quite high during the first trimester we're going to try to keep it pretty quiet for the time being. Though we have told our families - and it was fun to hear how excited they all are!

As for my RA, if it is going to go into remission it hasn't done so yet, as I've been having a considerable amount of trouble with my hips (particularly the left side) and my knees. The frustrating part is that now there isn't really anything I can take to help with this pain - and it seems like some of my other pain relief options, like sitting in the hot tub, might be off limits too. So I'm still trying to figure out how to deal with that.

But, honestly, right now I'm so happy that I don't really care about the pain or the symptoms. They are all totally worth it!

Monday, December 12, 2011

The 2011 Jingle Bell 5K Run/Walk for Arthritis

Just like last year, yesterday was a gorgeous, sunny day - the perfect day to take a walk!! Most of the alumni from last year's Team Z returned to walk again, and with a few more additions this year we had a team of 13 people and 3 dogs!! 

APL and I went down to the walk early to volunteer. During registration, we each wandered around with a clip board and asked for signatures on a petition urging Congress to fund much-needed arthritis research. Between the two of us, I would say that we probably collected at least 100 signatures, maybe more. (Want to sign the petition yourself? There's an online version you can sign!). We also signed up those who were interested to become Arthritis Foundation E-Advocates, who will receive Action Alerts when important arthritis-related issues are debated on Capitol Hill and can now add their voices to the issue in less than 5 minutes. (Want to become an E-Advocate yourself? Sign up here! It's a super simple way to help out!!)

This year the Denver Jingle Bell Walk raised around $76,000 for arthritis research. Team Z was responsible for $2,055 of the funds raised - and we came in third for overall fund raising. Thank you so very much to each and every one of you who supported Team Z!!

I'm also excited that my friends and family, once again, walked coast-to-coast against arthritis!! My sister, her boyfriend, and two of their friends walked "with us" in Seattle yesterday. And my brother-in-law's girlfriend, MK, had a team of 12 at their walk in Arlington, VA on December 3rd. They dressed up as the 12 days of Christmas and won the costume contest for their walk!! (MK is particularly amazing for doing the walk this year as she was recently diagnosed with ankylosing spondylitis, another type of chronic inflammatory disease that primarily affects the SI joints, spine, and hip joints. She has her own blog about her journey with AS, and she is an inspiration!)  Between the three teams, my friends and family raised over $3,500 for the Arthritis Foundation this year. And that is really amazing.

And how did I do volunteering and walking yesterday while pregnant and dealing with completely untreated RA? I'm not going to lie - I'm seriously achy today. My back, hips, legs, and ankles are killing me. Honestly I think the 2 hours I spent standing while collecting petition signatures was the hardest part - I was sore before the walk even started so I really struggled through that 5k. But I finished, and I'm really glad that I did. It felt like an important accomplishment to cross that finish line, holding River's leash and APL's hand - with our newest family member on board too.

Secret Post #15: !!!!!!!!!!!

NOTE: This post is part of a series that I wrote in secret during the months before I announced my pregnancy. The series chronicles my pregnancy journey: from weaning off my RA meds, to trying to conceive, to searching for helpful advice and information, to discovering I was pregnant, to the ups and downs of my first trimester. You can read all the posts in this series here.

 This Post Written October 13, 2011

!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!
 !!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!

Sunday, December 11, 2011

Secret Post #14: Fatigue

NOTE: This post is part of a series that I wrote in secret during the months before I announced my pregnancy. The series chronicles my pregnancy journey: from weaning off my RA meds, to trying to conceive, to searching for helpful advice and information, to discovering I was pregnant, to the ups and downs of my first trimester. You can read all the posts in this series here.
 
 This Post Written September 7, 2011

I know we have been extremely busy this summer - what with the wedding, the honeymoon, JA camp, my recent hip pain, and all the other busy weekends. But, even with all of this activity, it's not as if I'm any more busy than when I was in law school. In fact, considering that I am still currently unemployed, I am actually significantly less busy these days than in previous months.

I'm happy to report that, after taking the nabumetone for a week or so, my hips are feeling a lot better. But lately I have been experiencing a level of exhaustion and fatigue that I haven't had to deal with in a long, long time. I am not otherwise ill and my joints are all (mostly) behaving. But: 

I am JUST. SO. VERY. TIRED.

Since I don't have a job, I have actually been spending a lot of my time resting. However, no matter how much I rest, I just can't seem to gain any ground on this fatigue. And that is really frustrating.

When was the last time I felt so very fatigued without an obvious explanation? Actually, it was about 3 years ago, before I really had my RA under control and just as the effectiveness of the Remicade started to wear off. Which means that, at the time, I was basically dealing with untreated RA. And today, having been off my meds for 8+ months so that it is safe to try to get pregnant, I'm basically in the same situation.

And it sucks. Particularly when I get in a grumpy mood.

The day before yesterday I saw a conversation on Facebook between two of my high school classmates that made me want to punch someone and/or jump out a window. Both girls are currently pregnant, and they were discussing the awful fatigue they are experiencing with their pregnancies. Don't get me wrong - they have every right to be frustrated by the fatigue they are experiencing. But it made me want to cry because while their fatigue is a temporary side-effect of their pregnancies mine is part of my everyday life and is turning out to be a huge hurdle to overcome in even trying to get pregnant in the first place!! Even three years later I sometimes get overwhelmed by the unfairness of it all.

Here's to hoping that I manage to reduce this fatigue at least slightly by my next ovulation. Otherwise this whole exercise is pretty pointless!!

Saturday, December 10, 2011

Secret Post #13: My Axiety

NOTE: This post is part of a series that I wrote in secret during the months before I announced my pregnancy. The series chronicles my pregnancy journey: from weaning off my RA meds, to trying to conceive, to searching for helpful advice and information, to discovering I was pregnant, to the ups and downs of my first trimester. You can read all the posts in this series here.
 
 This Post Written August 8, 2011
Today someone very important to me found out that we have been trying to get pregnant, and she was very hurt that we hadn't told her about our plans. Despite my best efforts, I couldn't seem to explain that it was my own anxiety and mistrust of my body - not anything to do with her - that kept us from sharing. I found it really hard to explain what it is like to be actually afraid of what your own body might do - to feel pressure that it won't be able to perform to the point where you are almost embarrassed to admit what you are trying to do for fear it won't even be possible. Somehow I found it impossible to explain how progress checks, however well-meaning, would only exacerbate my anxiety.

When APL and I made the decision not to tell anyone that we were trying to get pregnant, at least for the first few months, we did it with the intent to reduce my stress level and make this difficult process a little bit easier.  We never meant to hurt anyone, and I'm frustrated that we did. 

I'm also frustrated that something that is supposed to be so joyful can become so complicated and difficult. And, not counting the months I spent coming off my meds, we have only been trying for three months!! It could get a lot more complicated and difficult than this - and that makes me anxious to think about.

Friday, December 9, 2011

Secret Post #12: New Hips Please

NOTE: This post is part of a series that I wrote in secret during the months before I announced my pregnancy. The series chronicles my pregnancy journey: from weaning off my RA meds, to trying to conceive, to searching for helpful advice and information, to discovering I was pregnant, to the ups and downs of my first trimester. You can read all the posts in this series here.

 This Post Written July 29, 2011
TMI Warning: This post contains details about sex and trying to get pregnant that you may consider to be too much information. Don't say I didn't warn you!

I am ovulating this week.

THIS IS REALLY NOT A GOOD TIME FOR MASSIVE HIP PAIN.

NOT. AT. ALL.

RA, sometimes I really, really hate the impact you have on my life. I'm trying so hard to accept you and adjust to you, but you always seem to find new ways to make it difficult for me to do the things I want to do.

It makes me so sad.

Thursday, December 8, 2011

Secret Post #11: Doing What's Best for Me

NOTE: This post is part of a series that I wrote in secret during the months before I announced my pregnancy. The series chronicles my pregnancy journey: from weaning off my RA meds, to trying to conceive, to searching for helpful advice and information, to discovering I was pregnant, to the ups and downs of my first trimester. You can read all the posts in this series here.

 This Post Written July 28, 2011

Today I posted about Christina, who started her own blog because there are so few resources out there for women trying to get pregnant while dealing with arthritis. And I wholeheartedly agree!! I am one of those women looking for resources!!

I have to admit that Christina's bravery in telling her story has provoked some feelings of guilt for keeping my own story a secret for so many months, especially after being so open about everything else on this blog for the pat few years. I am aware that this blog is itself a type of resource for others out there, though a small one, and maybe I could be making a difference in the lack of resources for women with arthritis trying to get pregnant. It's a really weird feeling - to feel guilty about maybe possibly not helping someone who could potentially use it. But it's how I feel today.

However, it still holds true that my biggest worry related to pregnancy and RA is the anxiety and pressure of having to "try" to get pregnant with a body that I feel like I just can't trust anymore. I'm irrationally worried that my body will be physically incapable of getting pregnant - which is why it worries me so much to have everyone know that we are trying. I know that questions and comments from friends and family would be well-meaning, but I'm afraid that if it takes us a while to conceive the concern of our loved ones might actually turn into a stress factor that would make it more difficult than it already is to conceive. So I'm doing what's best for me and holding my tongue about it, at least for now.

Hopefully, when I am able to publish the last 11 secret posts (and whatever secret posts come after this one) I will actually be able to contribute to the lack of resources out there. In the meantime, I'm glad I could tell the world about Christina!

Wednesday, December 7, 2011

Secret Post #10: Losing My Job

NOTE: This post is part of a series that I wrote in secret during the months before I announced my pregnancy. The series chronicles my pregnancy journey: from weaning off my RA meds, to trying to conceive, to searching for helpful advice and information, to discovering I was pregnant, to the ups and downs of my first trimester. You can read all the posts in this series here.
 
 This Post Written July 12, 2011

Losing my job certainly throws an interesting wrinkle into our plans to start a family. We specifically chose this time period to try to have a baby because we thought both of us had stable jobs to give us a solid start. And now I have no job at all.

I think an ordinary couple might put off trying to get pregnant for a couple of months and focus on figuring out how to pay the bills. But we are not an ordinary couple. We've already come way too far in our journey of getting me off my meds to get my body healthy enough to conceive. We're not even pregnant but we've been preparing for this baby for months and months already. We can't give up now. We have to keep trying and hope for the best.

But it does throw an interesting wrinkle into looking for a new job. Not only do I have to decide whether or not to tell them about my RA, but there's also a possibility that I would need to go on maternity leave very soon after starting. It makes things...complicated.

Tuesday, December 6, 2011

The Cookie Press

This weekend, I decided that I wanted to try the cookie press that my aunt gave us as a wedding gift. So I contacted my aunt, got my Nana's cookie press recipe, and gave it a go. Having never used a cookie press on my own before, I was a little unsure about how sticky the dough was supposed to be, so I think I might have added a little too much flour. But the cookies still turned out super cute and they were really fun to make.

Unfortunately, squeezing the trigger on the cookie press turned out to be too difficult for my hands after a couple of sheets. My hands just sort of ran out of steam, and that was a little bit frustrating. Luckily, APL wanted to help and he turned out to be a champion cookie presser! And then we got to bake cookies together, which was way more fun than doing it all by myself.

Secret Post #9: The Truth About Lube

NOTE: This post is part of a series that I wrote in secret during the months before I announced my pregnancy. The series chronicles my pregnancy journey: from weaning off my RA meds, to trying to conceive, to searching for helpful advice and information, to discovering I was pregnant, to the ups and downs of my first trimester. You can read all the posts in this series here.
 
 This Post Written July 1, 2011

TMI Warning: This post contains details about sex and trying to get pregnant that you may consider to be too much information. Don't say I didn't warn you!

In articles about how to improve your sex life with RA (and articles about how to improve your sex life in general) one piece of advice that is given regularly is to incorporate the use of lube. I personally think it's good advice. Lube does make things a lot easier - allowing you to focus your attention on overcoming other hurdles, such as joint pain or fatigue and, of course, enjoying yourself.

Except if you are trying to conceive. This is a very important piece of information that I just stumbled upon, and I can't seem to figure out why it isn't mentioned in articles recommending the use of lube.

Because here is the truth about lube: it can actually reduce your chances of getting pregnant. Apparently, most types of lube slow sperm down, making it more likely to die before reaching the egg and, thus, making you less likely to end up pregnant. Here are some reputable sources that agree: The Bump, Baby Center, Baby Hopes and MedicineNet.

Luckily, for those of us who already have enough hurdles to overcome in trying to conceive, there appears to be a "fertility friendly" lubricant out there: Pre-seed (worst name ever? Possibly.) They claim that Pre-seed "mimics natural body secretions to relieve vaginal dryness while providing an optimal sperm environment."

Personally, I think it's worth a try. With all the complications presented by my RA, figuring out how to even have sex in the first place can be difficult enough. I don't need anything reducing my chances of getting pregnant! So we're going to try Pre-seed. And I guess only time will tell if it helps!

Monday, December 5, 2011

Secret Post #8: Expert Advice For Improving Your Sex Life With RA

NOTE: This post is part of a series that I wrote in secret during the months before I announced my pregnancy. The series chronicles my pregnancy journey: from weaning off my RA meds, to trying to conceive, to searching for helpful advice and information, to discovering I was pregnant, to the ups and downs of my first trimester. You can read all the posts in this series here.
 
 This Post Written June 28, 2011

TMI Warning: This post contains details about sex and trying to get pregnant that you may consider to be too much information. For reals, this entire post is about sex. Don't say I didn't warn you!

After reading fifty articles about sex and RA, I have compiled any and all useful information and advice the articles offered about actually improving your sex life when you have RA (and I've left out all the depressing stuff!)  I have grouped that advice into several categories below. While I am not sure I agree with every single piece of advice, this list pretty much covers what "the experts" out there have to say (at least according to my research).

And, if you're brave enough to muddle through all of the horrifying statistics, I have also included links to all the articles I read at the end of this post (some of which were 100% useless). The titles of most of the articles are depressing enough. Read them if you must - but don't say I didn't warn you.

Expert Advice For Improving Your Sex Life With RA

Sex is Not Just Intercourse
(NOTE: This is probably the largest category of advice out there about sex and RA - the general idea being to find other fun activities if the difficulty of having intercourse is too much to overcome. While this advice is pretty much the opposite of useful when attempting to get pregnant, I've included it here because it is certainly relevant if you are just looking to improve the pleasure you get from your sex life.)
  • Remember that sex is not just intercourse. There are many other ways for you and your partner to find pleasure with each other.
  • Other ways to feel satisfied and intimate besides intercourse include: synchronized breathing, eye gazing, fantasizing, guided imagery, visual stimulation, holding hands, hugging, cuddling, touching, kissing, sensual massage, oral contact, stroking, fondling...

Work on Your Relationship
(NOTE: After promoting other forms of sex and intimacy besides intercourse, the next biggest category of advice out there about sex and RA falls into the relationship category. I am certainly not trying to downplay the importance of this advice - the way I see it every relationship should work on these things. APL and I certainly have. But, even when your relationship is strong you may still find that sex with RA can be difficult - hence my search for other useful advice that specifically addresses dealing with RA.)
  • To improve your sex life, make sex a priority.
  • Try to work as a team at all times.
  • Work with your partner to reduce other sources of stress. 
  • Find ways to improve your emotional connection with your partner. 
  • Be patient with yourself and your partner.
  • Stay positive through the process of trial and error.
  • Keep a sense of humor.
  • If you encounter setbacks, try not to become discouraged. 
  • Open and honest communication about your needs, desires, and difficulties is vital.
  • Try beginning your sentences with "I" and not "you." For example: "I feel loved when you hold me close" is more likely to invite dialogue than "you never touch me anymore."
  • Consider outside help - your doctor, couples counseling, etc. - if you have difficulty communicating with your partner about sex.

Incorporating RA Into Your Relationship
  • Make sure your partner understands how RA works and the pain it causes you.
  • Try to think of the difficulties caused by RA as "our" problem - not the sole problem of the partner with RA.
  • Focus on promoting new intimacy and appreciating what you have - try not to have expectations of "good sex" before RA.
  • Remember that both partners do not have to participate equally on any given day.

Things You Can Do To Prepare For Sex
  • Do things that help you feel good about yourself and improve your confidence - a new outfit, a new haircut, a song that makes you feel good.
  • Don't be embarrassed to talk to your doctor about medications that may impact your sex life - or about getting pain medication to assist with your sex life.
  • Your doctor or physical therapist can recommend exercises to help with stamina and mobility.
  • In your everyday life, pay attention to the types of movements you can do without pain and bring those types of movements into the bedroom.
  • Right before sex, do some gentle stretches to improve your range of motion.
  • Consider taking pain medication or muscle relaxants 30 to 60 minutes before sex.
  • Try a warm bath or shower to limber up before sex - perhaps with a partner as foreplay.
  • Have your partner give you a gentle massage as foreplay and to help with stiffness.
  • Use an electric blanket before or during sex to help relieve stiff joints.

Timing
  • Plan ahead for sex and arrange your day so you won't be tired from other activities.
  • Try scheduling a nap before sex.
  • Consider what time of day (morning, noon, night) you are least sore/fatigued and have sex at the appropriate times.
  • Be open to having a "quickie," which causes less strain and exhaustion.

Experimentation
  • Try having sex at different times of day to see what works best.
  • Experiment with different positions (see below) and be open to changing positions halfway through if necessary.
  • Be creative and laugh together if it doesn't work.
  • Incorporating shared masturbation can be fulfilling when one partner is unable to be very active. 
  • "Fake it 'til you make it" - focus on enjoying yourself rather than your pain and fatigue and eventually the enjoyment might come naturally.
  • Let your partner know during sex what is working and what is painful with words, sounds, or a gesture you agree upon in advance.

Sexual Aids
  • Use lots of pillows or other pieces of furniture for extra support.
  • The Liberator line of pillows is specifically designed to support you during sex.
  • To ease strain on arms, hands, and jaws try props and toys - like vibrators. You can order on the internet for discretion, or consider visiting a respectable sex shop to make sure you can operate the buttons.
  • Consider using over-the-counter lubrication - such as KY Jelly.

Positions
(NOTE: Of the fifty articles I read perhaps four or five had anything specific to recommend concerning positions. These articles primarily talked about the positions in terms of heterosexual relationships and they seemed to assume that the woman was the one with RA. Obviously that is not always the case. However, I have chosen to keep the wording used by the experts in the hopes of clearly communicating the positions they were talking about, but know that these positions can obviously be adapted to any situation.)
  • For back pain
    • Avoid sitting positions.
    • Being on the bottom may reduce back discomfort.
  • For hip pain
    • Avoid being on top.
    • Turning your legs out (i.e. pointing your feet away from each other) is generally more comfortable.
    • Try positions that do not require you to spread your legs too widely.
    • Try having the man approach from behind:
      • The woman lies on her stomach, supported by cushions, and the man lies over her, supporting his own weight and entering from behind.
      • The woman leans her upper body over a chair and kneels on a pillow on the floor (assuming no knee pain) while her partner enters her from behind.
      • Spooning: both partners lay on their sides, with the man entering from behind.
  • For wrist/hand/elbow pain
    • Lying on your back or side is best so you don't have to support your own weight.
    • Try making a fist and keeping the wrist in a neutral position.
    • Support elbows with soft pillows.
  • For ankle/knee/leg pain
    • Maintaining the knees in a straight position is best.
    • Avoid kneeling or bearing too much weight.
    • If on your back, avoid having to lift or support your legs during sex, which can cause strain.
    • Use pillows - such as one under each knee - or your partner's body to support your legs.
    • Spooning: both partners lay on their sides, with the man entering from behind. 
    • Try the "crossways" position: the man lies on his side and the woman lies crossways/sideways against him with her bottom touching his lower thigh and her legs bending over his body.
  • For fatigue
    • Avoid positions where you have to support yourself.
    • Pillows under her hips may make the stimulation greater, allowing for orgasm in less time with less strain.
    • Be open to a "quickie."

      SOURCES:
      1. WebMD: The pain of RA does not have to mean the end of sexual intimacy.
      2. WebMD: 1 in 3 RA Patients Report Considerable Impact on Sexual Activity 
      3. WebMD: RA and Intimacy: Keeping Relationships Strong
      4. Healthmonitor: Ask the Experts: Sex and RA
      5. Dr. Gail Saltz: Dating, relationships, and sex with RA
      6. HealthCentral: A beginners guide to RA: Love & the Horizontal Tango
      7. HealthCentral: When Satisfactory Biologics Are Not Enough: Satisfying Sex with Rheumatoid Arthritis
      8. UW Medicine: Sex and arthritis
      9. Everyday Health: Rheumatoid Arthritis in the Bedroom
      10. Disabled World: Sex lives of patients are negatively affected by rheumatoid arthritis and SLE - Patients and their partners suffer but most reluctant to seek professional help.
      11. Celebrities with Diseases: Rheumatoid Arthritis can negatively affect sex drive
      12. About.com: Love, Sex, and Arthritis
      13. About.com: In Sickness and in Health
      14. About.com: Guide to Sexuality and Arthritis
      15. About.com: How Arthritis Complicates Sexuality
      16. About.com: Position Tips for Avoiding Painful Sex
      17. About.com: How to Enjoy Sexuality Despite Chronic Pain 
      18. About.com: Chronic Illness in a Marriage
      19. Arthritis Today: Health Benefits of a Happy Marriage
      20. Arthritis Today: Playing the Dating Game with Arthritis
      21. Arthritis Today: Marriage and Chronic Illness: One Couple's Story
      22. Arthritis Today: Keeping your Marriage Strong
      23. Arthritis Today: Marriage and your Health
      24. Arthritis Today: Rheumatoid Arthritis and Pregnancy
      25. Arthritis Today: Pregnancy and Arthritis
      26. MDJunction: Rheumatoid Arthritis Sex Newsletter
      27. Mayo Clinic: Chronic Pain Can Interfere with Sexuality
      28. The Johns Hopkins Arthritis Center: The Influence of Rheumatoid Arthritis on Marital Satisfaction
      29. SeniorJournal.com: How to Have Pleasurable Sex Despite Painful Arthritis
      30. MyDr: Arthritis: sex and intimacy
      31. ArthritisInsight.com: Sex and the Married Gimp - A Woman's Point of View
      32. National Rheumatoid Arthritis Society (NRAS): Sex & Rheumatoid Arthritis: "How Was It For You?"
      33. National Rheumatoid Arthritis Society (NRAS): The Effects of Rheumatoid Arthritis on Sexual Activity & Relationships
      34. Arthritis Care: Relationships, Intimacy, and Arthritis (PDF)
      35. Arthritis Care: Body Beautiful
      36. Arthritis Care: 50% of people with arthritis in Wales say pain prevents them from having an intimate relationship, according to a survey by Arthritis Care
      37. Daily News & Analysis: Rheumatoid Arthritis can dampen sex life
      38. Fifty is the new Forty: Dr. Gail Saltz: Rheumatoid Arthritis, Sex & Romance After 50
      39. Physorg.com: Sex lives of patients are negatively affected by rheumatoid arthritis and SLE
      40. MSN: Yes, You Can Have an Active Sex Life With Arthritis
      41. Pharma Knowledge Base: Rheumatoid Arthritis and Sex
      42. American College of Rheumatology: Sex and Arthritis (PDF)
      43. e! Science News: Sex lives of patients are negatively affected by rheumatoid arthritis and SLE 
      44. A Woman's Touch Sexuality Resource Center: Rheumatoid Arthritis and Sexuality
      45. Zeenews.com: Rheumatoid arthritis can dampen sex life
      46. Everyday Health: Ask Dr. Rodanthi Kitridou: Sex with Arthritis
      47. OneIndiaNews: Rheumatoid arthritis can dampen sex life
      48. healthtalkonline.org: Living with rheumatoid arthritis: Social life & relationships
      49. lifescript: Don't Let Arthritis Spoil Your Sex Life
      50. Health.com: Yes, you can have an Active Sex Life With Arthritis

      Sunday, December 4, 2011

      Secret Post #7: Let's Talk About Sex, Baby

      NOTE: This post is part of a series that I wrote in secret during the months before I announced my pregnancy. The series chronicles my pregnancy journey: from weaning off my RA meds, to trying to conceive, to searching for helpful advice and information, to discovering I was pregnant, to the ups and downs of my first trimester. You can read all the posts in this series here.

       This Post Written June 27, 2011
      TMI Warning: This post contains details about sex and trying to get pregnant that you may consider to be too much information. Don't say I didn't warn you!

      No matter how long I have been off my meds to prepare my body for pregnancy, to get pregnant I still have to have sex with my husband. That part is not rocket science. However, sometimes figuring out how to have sex while dealing with untreated RA feels a lot like rocket science. My knees hurts, my hips hurt, my jaw hurts, my fingers hurt, my mobility is limited, my body is stiff, I'm fatigued, I don't feel particularly sexy, and to top it all off, I feel guilty and frustrated about all of those things!! A girl could use a little help and advice!!

      But have you ever Googled "sex and RA" looking for advice?

      I have.

      I really don't recommend it.

      Unfortunately, the vast majority of the articles out there addressing the topic of sex and RA are seriously depressing. In order to weed out any potentially useful information or advice you have to wade through multiple paragraphs of horrendous facts and statistics about how likely your sex life is to suck after getting diagnosed with RA. In fact, it is shocking how often these depressing facts are repeated without offering much advice for how to overcome them. Facts such as:
      • If you have RA, enjoying sex is "likely to be difficult" and you may need to reduce your expectations of your sex life.
      • Studies show that RA substantially diminishes the sex lives of 1 in 3 patients, and 1 in 10 say sex is out of the question. 
      • People with RA can have poor self image - from joint deformities, weight gain, facial swelling (moon face), hair loss, depression, reduced libido, lack of endurance, medication-related vaginal dryness, etc. - which can seriously damage their sex lives. 
      • The healthy partner is often afraid to initiate due to a fear of hurting the person with RA or being rejected, while the partner with RA often feels guilty about "holding back" their healthy partner. This promotes feelings of insecurity and anxiety, which only worsens the problem.
      I'm sorry, did you just say that 10% of people with RA don't have sex at all?!?! (Actually, I found a French study where the number was 40% and an English survey where the number was 50%!!)  Also, thanks for that all-inclusive list of every single hurdle I have to overcome to feel sexy - I had actually managed to forget about a few of those and I truly appreciate being reminded!! I even found one article where a woman blamed her pending divorce solely on the impact her RA had on their sex life, and another article that said 85% of marriages faced with the challenges of chronic illnesses eventually fail.

      And the advice that is most often given to fix these horrendous issues?
      • Find other ways to feel satisfied and intimate besides intercourse: synchronized breathing, eye gazing, fantasizing, guided imagery, visual stimulation, holding hands, hugging, cuddling, touching, kissing, sensual massage, oral contact, stroking, fondling...
      While I appreciate that there are important types of intimacy besides intercourse, a lot of the articles sound like they are telling you to give up on intercourse all together! And that's a problem for me, because I'm pretty sure I can't get pregnant from holding hands!

      Reading these articles is enough to make you want to crawl under a rock and cry. Or possibly die. My point is - they are not exactly uplifting.

      And, although there are quite a few useful articles (and a great book) about pregnancy and RA, surprisingly those resources don't give much advice at all on how on earth you are supposed to get pregnant in the first place! I'm have no idea why they skip that step - it seems pretty relevant to me!!

      Thus, I have embarked upon a quest to read as many articles about sex and RA as I can stomach. I will then weed out all the horrifying and depressing statistics, and compile a list of actual useful and hopeful advice from experts on improving your sex life when you have RA. It will be in my next post!

        Saturday, December 3, 2011

        Secret Post #6: There's An App For That

        NOTE: This post is part of a series that I wrote in secret during the months before I announced my pregnancy. The series chronicles my pregnancy journey: from weaning off my RA meds, to trying to conceive, to searching for helpful advice and information, to discovering I was pregnant, to the ups and downs of my first trimester. You can read all the posts in this series here.

        This Post Written June 26, 2011

        TMI Warning: This post contains details about sex and trying to get pregnant that you may consider to be too much information. Don't say I didn't warn you!

        The first step to conceiving a baby is to have sex around the time that you are ovulating (duh!) But did you know that the egg is only ready for fertilization about 12 to 24 hours a month? Luckily, sperm are able to live anywhere from three to six days, so that gives you a slightly bigger window of opportunity. Especially if you are trying to conceive while putting up with the results of untreated RA, it really makes sense to have a good idea of when you ovulate - so that whatever attempts you are able to manage count!

        So how do you know when you are ovulating? There are a lot of methods for finding out. Here is an article that gives five methods.

        I chose to start by tracking my periods. I started keeping track way back when we first made the decision that I should go off my meds, so by the time it was safe for us to start trying I already had many months of data from which to predict my ovulation. But instead of writing stuff down and doing the calculations myself, I found there was an easier way. That's right - there's an app for that!

        The one I am using is called Period Tracker Deluxe. I started with the free version and then paid $1.99 to get more features and get rid of the ads. The icon on my phone is a little flower and says "P Tracker," so it's not quite so obvious what it is, plus you can set it up to have passcode to keep your period data private.

        With a tap of the button on the main screen, you indicate when your period starts and when it stops.  From that data, the app calculates the average length of your period and projects when your next one will occur. After entering a few months of data, I found it to be pretty accurate in predicting my period start date (assuming you have regular periods).  Using the same data, the app also predicts which day you ovulate and indicates that you are likely to be fertile for a day or two around it.

        You can also keep track of other symptoms like cramps, headaches, heavy flow, etc, and you can indicate on the calendar when you are intimate, which will be useful for determining your baby's due date when you do get pregnant. (Extra TMI Warning!) There's even a section for keeping track of the consistency of your cervical mucus, the position and texture of your cervix, and your basal body temperature - information that can be used for an even more accurate prediction of ovulation. Or, if you use an ovulation predictor kit and know for sure, you can input that information as well.

        All in all, I think it's a pretty good app.