Saturday, September 23, 2006

About Uterine Polyps

A new buddy of mine online just posted that she was diagnosed with a polyp. Here's what I shared with her:

Fibroids and polyps can change the microenvironment in your uterus by irritating the lining and causing a reaction akin to what an IUD does I believe. You end up with your body reacting to the "foreign" object but at the same time it's so hyper active from an immune standpoint that it disallows implantation. (some of this is sort of subjective on my part but I've read a lot about implantation, fibroid, etc.)

Do you like your ob/gyn? Don't they have a backup? If you are really feeling put off then maybe try finding help elsewhere -- though here in Seattle getting in to see an ob/gyn as a new patient takes 2 months plus.

Here are some links for you:

Emerging endometrial polyp during controlled ovarian
stimulation affects IVF/ICSI outcome

Results: In the patients with endometrial polyps, no pregnancy was achieved. Clinical pregnancy rates and implantation rates of the second group were 28.35% (55/194) and 13.05%, respectively. Fifteen of the pregnant women (27.27%) experienced miscarriages. In some of the patients, hysteroscopy was performed for removal of the endometrial polyp. In part of them, after the polyp resection, spontaneous pregnancy occurred.
Conclusion: Our results reveal that endometrial polyp <10 mm, appearing during COS is a rare complication and it may have a negative influence on the IVF/ICSI outcome. In order to improve embryo implantation, we need to remove the above mentioned endometrial polyp. Abnormalities at the endometrial level and abnormal embryo–endometrial dialogue may be responsible for some cases of implantation failure. Endometrial polyp may be an impediment to embryo implantation because it acts as space occupying lesion and/or disturbs the expression of various endometrial products such as pinopodes, integrins and cytokines. It is not clear whether the expression of such factor as the endometrial polyp is the reason for implantation failure or is just a reflection of other abnormalities taking place in complex cascade of events.

From: ESHRE Meeting, June 2006 - Implantation

Surgery is usually recommended for polyps, for several reasons:
To try to improve fertility. Polyps may interfere with implantation of a fertilised egg in the lining of the womb, so they're often removed to try to improve the chances of conceiving.

From: Uterine Polyps

Leiomyomas and polyps are growing tumours and thus produce significant plasma glycodelin levels. Uterine glycodelin flushings are elevated in patients with both polyps and leiomyomas. Elevated glycodelin levels in the follicular and peri-ovulatory period may impair fertilization and implantation.
From: Glycodelin levels in uterine flushings and in plasma of patients with leiomyomas and polyps: implications for implantation.

Endometrial polyps appear to be organized overgrowths of the uterine endometrium, although the precise mechanisms leading to their development are not clearly defined. The endometrial lining of the uterine cavity grows in response to estrogen and is architecturally restructured in response to progesterone. If the response to estrogen is excessive, either in the presence of unopposed estrogen (such as during periods of anovulation) or whenever the bioactivity of the circulating estrogen is increased (such as with increased numbers of estrogen receptors or with decreased metabolism of estrogen) overgrowth of the endometrium may occur. If these overgrowths organize and develop their own blood supply then they become polyps.

The mere presence of polypoid overgrowths in the uterine cavity may (at least theoretically) interfere with implantation and fertility. I have envisioned polyps as acting sort of like IUDs in the cavity, creating a hostile environment for embryo implantation. I remove endometrial polyps in women with reproductive problems and these women (anecdotally) seem to do remarkably well in subsequent fertility efforts. A well designed research project describing fertility outcome after treatment for different types of endometrial polyps would be valuable.

Endometrial polyps are not always benign. I removed one normal appearing endometrial polyp hysteroscopically and this was found to contain an endometrial adenocarcinoma (cancer) on pathology report. Therefore, in the presence of any atypical overgrowth of tissue it is always important to think about the possibility of cancer

From: Miscarriages - Causes and Treatments

Cloth Diapering & Elimination Communication Links

I've been bookmarking diapering sites for a while and now that we have the baby on the way we're committed to not using disposables. I was a cloth diapered baby so it's nice I can ask my mother for background information on frequency of changes, quantity, etc. -- though things have changed a lot from the early 70's.

Cloth Diapering -- by Teachingmama
A well rounded site with links to other great diapering sites and resources.

Diaper Pages -- Karen's Cloth Diapering Site

Real Diaper Association

Diaper Pin - Cloth Diapers, Tip, Reviews and More

One Stop Diaper Shop -- sew your own

Kelly's Closet - Cloth diapers and accessories

Tiny Tush - Natural baby boutique

Katie's Kisses -- Cloth diapers and more

Full Moon Baby Gear -- Diapering and more



Snappi -- diaper fasteners, covers and more

And if you are really wanting to get away from diapering there is always the Diaper Free angle:

DiaperFreeBaby -- information about elimination communication.

Friday, September 22, 2006

Sick and More about the Ultrasound

Ugh, I've been sick today. I was fighting this virus that was going around the office, not having too many symptoms really but then I overdid it this week and last night I came home aching all over. I've been aching since -- my knees, my elbows, my back. Only a little more post nasal drip -- my immune system behaves totally different when I'm pg. Normally I would get the full blown flu and be sick in bed for a week. I still need to baby myself equally as if I had the full blown thing. Hopefully this passes sooner though.

My partner's been so excited about the baby since our u/s on Tuesday. He's also just gotten a web-enabled phone and has been texting everyone and mostly about the baby. He's so relieved that the baby looked so right on the scan and he's starting to bond to the idea of a boy already. He said that was the first of many characteristics our child will have.

During the u/s the scanner moved across the face front-wise a couple of times and you could see his little face. It wasn't a 3-D u/s, I was more used to the profile shots you see and didn't know that you could see stuff like that with regular u/s. He says the baby is cute and you can tell already.

The other image that I was amazed by was being able to see the
umbilical cord connection. The scan managed to capture the swirl of the arteries and it looked fairly large. For some reason it just captivated me. Though it is in part the big connection between the kid and I.

Tuesday, September 19, 2006

Big Ultrasound

I had my big ultrasound today and the baby looked perfect and was moving all over. It was amazing for a little while but then after it went on and on as the technician took all these shots from multiple angles of all the body parts I wanted to cry as I was so ready for it to be over -- all that pressure on my sensitive belly.

We are really pleased though and it looks like we are going to have a little boy.

I had the technician check out my fibroid and its grown to be 5x8cm (!) but wasn't bugging the kiddo at all. It looked like there was another small fibroid up top. I'm waiting for the full ultrasound report -- it had to be reviewed by the radiologist and then my OB. Brother if there is but it was pretty small still.

My OB said we wouldn't remove the fibroid (big one) at delivery unless it was pedunculated which it is not. He did say that typically they grow a lot and then around mid-pregnancy the growth will taper off some, just like for the baby.

Sunday, September 17, 2006

Info About Panic-Anxiety

I'm sorry to read that you aren't doing well. My partner had bad panic-anxiety and it took work but with work we were able to turn things around for him and he doesn't need meds.

Eat regular meals and snacks to help keep your blood sugar level up

Reduce stress, incorporate activities for exercise that you enjoy to help relieve stress more

Consider any nutritional deficiencies you might have. My partner was a vegetarian for years and even though he would eat the occassional piece of organic chicken or fish, he saw big improvements when we added in zinc, arginine and carnetine into his diet.

Arginine is known to help support the adrenals though how much is safe to take in pregnancy is questionable.

Also note that from a Traditional Chinese Medicine (TCM)perspective, pregnancy uses a lot of the kidney energy. Particularly in early pregnancy as your body is making a lot of pretty monumental shifts. I noticed this in myself as I had lots of pains in my inner ankles and feet that were on my kidney channels. The symptoms you are having are also related to the kidney channel. I also found I couldn't sleep at night -- another symptom of your kidney energy being off. I continued seeing my acupuncturist throughout the first 10 weeks of my pregnancy and I thought it was a help for my symptoms, particularly for helping get rid of the throbbing pain in my ankles.

You might consider acupuncture treatment to see if it might help your body to adjust a little easier.

I've posted about natural treatments and lifestyle changes my partner made to deal with his panic/anxiety and it worked to the point that he didn't need to take meds any more.

Re: Panic attack/anxiety/ unbearable fear

Cut back on sugar, caffeine, simple carbs
Keep blood sugar levels up
Get regular exercise
Stay hydrated
Eat more protein
Lower stress levels -- reduce responsibilities, take mental breaks, don't take things so seriously...your health is more important
Try aromatherapy with lavendar and geranium
(there are herbs one can use -- Passion Flower, Kava, Valerian but I wouldn't use them in pg)
Go get a massage
Listen to music, go out with friends, smile, read, knit, paint, meditate

I also wanted to add that one of the things that helped was going to Barnes & Noble and looking up books in their health section about panic/anxiety. also has loads of books with reviews from people who have been able to help themselves with the information in these self-help books. We found tips for diet, exercise, attitude, aromatherapy and all together they helped.

You also might want to learn more about how your nervous system functions, particularly things that help trigger the parasympathetic nervous system which can help reduce your symptoms. Not many people understand the dynamic between the sympathetic and parasympathetic nervous system functions. I read recently that shifting the focus of your eyes to use the peripheral vision can help to get your parasympathetic kicked in.

I also wanted to add that this past week my body was freaking out and getting more and more stressed. I don't know what I was doing to trigger it but it wasn't getting better. Finally I made an appointment for a massage in the middle of the workday (thankfully there's a spa on the next block). I only got my lower legs and feet done -- a quickie massage -- but it helped me out soooooo much. Sometimes I think we just need to give our body a hand so don't rule out getting some massages as well.

And of course you could take meds, but I'm of the opinion and have seen it work first-hand, that trying to help deal with the underlying conditions is the best way to start.

Doctors aren't trained in treating conditions in this manner so they won't even suggest it (you could be living on potato chips for all they know or care). Even today the American medical student gets less than 30 hours total information on nutrition during their education and that's dispersed throughout their curriculum.

I did think of one other thing yesterday, I was watching a documentary a few months ago on cable about panic/anxiety and it mentioned that people who experience it are much more sensitive to carbon dioxide levels in their blood. As part of the panic/anxiety reaction causes you to breath less deeply you need to try to also counter this by slowing down and taking deep breaths and filling your lungs all the way.

I hope that you are able to get results soon.

When/how to tell employEEs that I'm pregnant

I'm pushing 18 weeks now and I haven't told anyone at work that I'm pregnant. I work mostly with men and they don't seem to notice, I dress carefully and I'm not showing so much yet.

My hang up is that I don't want to be treated differently. I'm okay being a pregnant woman outside of work but within the work context it just isn't something I want to make a big deal of.

I also have to factor in that this will create some lack of certainty possibly for my employees -- perceived or otherwise. I don't want to just have it be all about me and have them feel like I'm abandoning them.

My partner (also business partner) thinks I should just casually, when appropriate, mention that I will be taking a few months off starting in February. First though we are trying to staff up my replacements so I have time to train them. We are recruiting actively but it's hard to find qualified help who are a good fit.

When and how would you tell people you are pg if you are the boss?
I got up this morning and wrote a two page letter to my SIL, I figured I should at least get my thoughts down about things. I decided to share it with my partner as anything I do or share with his family he should have some input in I believe. He thought that it was too long and detailed and that I was oversharing. He also suggested that I should meet up with my SIL in person and give it to her then so we could talk about it. I just don't feel comfortable with that. For all of what I share of my feelings online I don't feel that safe sharing them IRL due to past rejections of careless friends and acquaintances.

I tried to explain to my partner how I felt that this wouldn't necessarily go away on its own, how there are wounds that I have and that having my SIL react to me in this way was even more alienating. He thinks it was her and that she was PMS-ing or something as she even snapped at our nephew last night, something she never does. He also felt like he was being attacked as when he offered that we do talk about our pregnancy with our friends his SIL answered "I consider us more than friends, we're family".

My partner thought that maybe he should first start by calling his mother and ask her what she thinks we should do. He won't likely be phased by this exchange and we'd also be able to figure out if she was contributing to this drama behind the scenes.

I've been crying more today than I have in a long while. It's like all the infertility and loss grief are right there and I don't know if I'm supposed to do something or not. Should I share my deepest feelings? What am I supposed to be doing in my pregnancy that I'm not when I never see my SIL anyway. I'm feeling upset and frustrated.

My lovely friend Christy (newly pregnant after two losses -- send her sticky thoughts) shared these article links with me this morning:

Pregnancy After Miscarriage
The Ups and Downs of Trying Again
By Roxanne Williams Snopek

Easing the Anxiety of Pregnancy After Miscarriage