A few raindrops turn into a downpour

I went to my niece's first birthday party last night. I've written about how uncomfortable I've been around her, starting during her mother's pregnancy as I lost mine.

The baby was being a pill last night, she was really clingy with her parents and didn't want to hang out really with anyone else. It didn't help that my period showed up yesterday (and wasn't it a full moon or just about as well?) After dinner we gave our presents, a dress I bought at the Lavender Festival last summer, plus a box to store baby keepsakes in and then a photo album in which I placed a bunch of our photos that they didn't have. Then my partner and his brother started playing the piano and guitar together doing old covers and my mother-in-law and I law on the couch. I was soooo tired with the cramps and drop in hormones and all, plus too much socializing all week long.

Then it started, just a couple tears at first which I subtly wiped away pretending my eyes were tired or itching. It's okay, I thought to myself, maybe just letting a little bit out will help me feel better. But as I continued to sit there, the feeling of not being acknowledged for my losses began to swell and gradually I couldn't contain it any more.

I walked over behind my partner who was facing the wall near the piano and whispered in his ear that we needed to go because I was crying. He nodded and then turned his face as he played and kissed my cheek through my hair that I was using to cover my face. At the end of the song he got up and said that it was time for us to go, I was already by the door with my things, and he quickly said goodbye. His brother came over to open the door and saw I was crying and asked if I was okay to which all I could say was its the anniversary of my dead babies not being born, how could I be okay? Which he didn't understand at all as he called after me as I walked into the darkness outside, "what? what?"

I totally lost it then as we drove back home, coughing and crying. My partner understood though, I was grateful for that. I told him that I couldn't keep holding it back, especially around his family since I don't really get any acknowledgement from them because I don't know how to talk to them about it. I told him that I thought that in some ways it was healthier for me to not be around babies and small children because then I could just focus on the me I am and not the me that I'm not, the losses that I've had in that area.

When we came home I continued to cry and it came to me that this time of year, with my two due dates going by without my even being pregnant, it's like having to keep driving past the finish line that you never get to cross.

Now that the family has seen me cry though, the first time I think, I don't know what to do. My instincts are to avoid them now because they couldn't possibly understand having never experienced this type of loss themselves. My other thought is to send them an email, my family and friends as well, and point out to them that January 23rd and February 13th are a time of mourning for me and that I just need a little acknowledgement of that. But I just don't know how that would go over.

Sperm Chromatin Damage from SSRIs

There's a study underway right now, I just read about it but it totally underscores what I suspected based on our experience with my partner's sperm count and subsequent improvement when we got him off of Paxil and onto vitamins to deal with some nutritional deficiences -- from 2% morphology to 5% morphology in just four months. We've not ever had his sperm chromatin checked but take heed -- those SSRIs aren't necessarily helpful for all of what ails you.

Federal Grant Awarded to Study Effects of Antidepressants on Male Reproductive Health

Study on Antidepressants and Male Fertility Generates International Interest

WSU Spokane Scientists Launch Clinical Research

Soy Might Impair Your Fertility and Hormone Balance

A lot of hype has gotten Americans consuming soy products in large quantities, in addition to the hidden additives of soy to many processed foods. But soy has hormonal affects and can be disruptive to your endocrine system, primarily interfering with thyroid function but it also may impair your ferility. Check out these links to learn more.

"Processed soy (actually, ANYTHING processed) is indeed bad. But, why soy? Three reasons: (a) contains chemicals that 'pull down' the thyroid (leads to hypothyroidism); (b) contains phyto-estrogens that block important minerals like Zinc and Magnesium from being absorbed into the body (2 VERY important minerals especially for women since having a deficiency in either one can cause numerous problems due to an estrogen/progesterone imbalance); and (c) does not contain essential amino acids. Soy products are commonly linked to weight gain and other hormone imbalances for these very reasons. It's also among the top allergens in this country, (the other top allergens include wheat, corn, dairy, chocolate, eggs, shellfish, and citrus). Many people have food allergies to soy and don't even know it. "
From: http://www.allergydir.com/Article692.php

"Soy foods couldn't possibly have a downside because Asians eat large quantities of soy every day and consequently remain free of most western diseases. In fact, the people of China, Japan, and other countries in Asia eat very little soy. The soy industry's own figures show that soy consumption in China, Indonesia, Korea, Japan, and Taiwan ranges from 9.3 to 36 grams per day.1 That's grams of soy food, not grams of soy protein alone. Compare this with a cup of tofu (252 grams) or soy milk (240 grams).2 Many Americans today think nothing of consuming a cup of tofu, a couple glasses of soy milk, handfuls of soy nuts, soy "energy bars," and veggie burgers. Infants on soy formula receive the most of all, both in quantity and in proportion to body weight."
Whole Soy Story: The Dark Side of America's Favorite Health Food

Chemical Found in Soy Products, Legumes Could Damage Sperm, Impair Fertility, Study Says

"The estrogen receptor beta is also known to respond to environmental and dietary chemicals that can mimic the effects of estrogen and stimulate the body's natural hormones. One example is genistein, a common component of soy products. These new studies by Korach and colleagues suggest that such environmental exposures could interact with estrogen receptor beta and possibly alter ovarian function in women."
from: New Discovery May Help Doctors Treat Infertility

Uterine adenocarcinoma in mice treated neonatally with genistein

It's not just that but most soy beans are genetically modified nowadays:

"Genetically modified soy has been on the market just five years. Yet it already accounts for two-thirds of the U.S. soybean harvest. Soy products are used in hundreds of processed foods, often to add texture and protein. So the biotech beans end up in pancake mix and baby formula, chicken soup and margarine, crackers and salad dressing, ice cream and granola bars."
From: Long Article on Roundup Ready Soybean Controversy

Some people say what choice do we have, but really there is a choice but we've not been given the chance to give our opinion. I remember listening to some FDA guy on the radio a few years ago as they debated GMO/GE crops and he said that the American public didn't care about the controversy and that they were fine with it. But, they didn't tell us that they were putting these products into the market, they just snuck them in. But other countries around the world weren't asleep and their press and public took action and blocked the use of these crops/products pending further scientific evaluation.

Corn is another crop that's largly GE these days in the States. It's hard to find any manufactured food items that don't contain corn or some corn-derivative. You have to look for products made overseas.

If you are interested in more info sign up for the Organic Consumers Association email newsletter -- http://www.organicconsumers.org

Too much information

I saw this site linked from another blog so I decided to try it out. You can get t-shirts printed up with a "word cloud", a dynamically generated image based on content from your blog.



I have to say that seeing it all laid out like that, and even thinking about the possibility of seeing it on a t-shirt, it makes me feel a bit glum. Not really fun stuff at all, and is it really worthwhile?

And It All Comes Rushing Back

Sick and twisted girl that I am, dropped by the records department for the hospital/clinic to see what I was missing so I wouldn't have to pay $20 for getting a whole lot of chicken scratch. I've got most of the information already and just wanted the bits that I was missing. Instead what happened was that I got to sit around with my file and relive the first miscarriage and my surgery. How I was able to stand w/o dizziness after the first d&c (they check this stuff for patient release post procedure); how I was "pleasant", walking around, or having "tea colored" urine after my surgery. All these details came into sharp focus in my mind again: the color of the tile floor, calling for help with the PCA pump, sitting on the toilet trying to pee and having nothing come out after they first took out the catheter and the anxious voices behind the door. All the little notes they made, the nurses and doctors and patholgist too, and I felt like I was swimming in memories that my mind had put away for safe keeping, or rather to protect me from them. While I walked quickly and confidently to the office building after work, after picking through the file I left in a daze. And even more frustrating is that there isn't really any good information to be had from my second m/c. There was no pathology done, just blood work and some scans. I felt partly like there might be answers in that thick file and partly that it was sad that there weren't.

On the way home I dropped by to visit my friend, the one who was close to divorce a few months ago (and had a miscarriage a year ago). She's been diagnosed as bi-polar and is on lithium now. She's having a bit of a hard time adjusting to the meds and finally some of the mania she was experiencing is starting to dissolve and so she can remember things a little clearer. We talked a bit about how crazy it was that it was four years later and I was still talking about TTC. For now babymaking plans are totally on hold until they figure out which end is up.

Baby Steps

I bit the bullet today and scheduled an initial consult with my RE (the RE who did my surgery and helped me through 1-1/2 miscarriages). We're going to see if we can stick with her, recognizing her limitations but also the leverage we have with her and her staff.

I set up an initial consult with her since we never had one with her. I just ended up in her care after my previous RE left the clinic and trusted her with my surgery and that's where it was left off. I sort of feel like let's start over with all this and see where that gets us. Yes, I have lots of information and opinions but we also want to know her take.

I think I mentioned before, but the plan that was laid out for us by more then one RE was:

1. Have surgery to remove fibroid
2. After healing (3 months), try on our own for three cycles or so
3. If not pg then move onto Clomid/IUI for three cycles
4. If not pg then consider moving onto IVF (possibly with ICSI -- though with the SPA test his sperm performed really well so this shouldn't be an issue)

We were going to do a trial of Clomid/IUI in July '04 but then got pg and had the firsst m/c. Then we started TTC again after my surgery and retained tissue experience in Feb '05 only to get pg the third cycle and then lose that one as well. It's like we never get to go to the next step. Sharing it with you guys just reminds me of the feeling I had with each loss that maybe God was trying to tell me something -- it's so hard to know that though.

My appointment is scheduled for February 14th - Valentine's Day. I know that's a bit of a downer but at the same time it fits in really perfectly with my cycle -- so if we don't get pg this cycle (and chances are we won't based on our past lack of success) then AF is due right about then and there will be time to either get right into a Clomid cycle or do the HCG or both. There's a chance we might change the appt so to not ruin v-day but for now that's where it stands.

I also just set up a time to review my medical records so I can pick out the sections that I need for my files, which can supplements the ones I already have so I can transfer the files to my RE's new clinic.

One step at a time, right?

Sometimes a pregnancy goes by like a vapor

Today was my EDD for my second pregnancy. I know two other online gals who had that due date -- one is in labor today (how perfectly on time!) and I've not caught up on the details of the other gal.

What helped me last year with the EDD of my first loss was to consider the week before to be a time to help come to closure about it. I was sort of forced to do it by the birth of my niece that same week -- based on advice from women online I bit the bullet and went to see her on the day she was born at the hospital. Yeah I cried a little too but I feel like I was able to change my perspective a little.

Since my surgery would have required me to deliver by c-section early, the second baby would have already arrived so in that sense there is no date for it really, it just would be here already. I don't have time to take off from work right now so I'm just trying to find some resolution about it.

Now, my niece's first birthday in a couple weeks might be more difficult (I still have some tension when I'm around her) but whatcha gonna do.

For all my stocism thought I'm still feeling a bit mucky about it. But it's been a long time since I was pregnant though so how could I really feel it, it's not like I was physically about to have a baby today. And from visiting with my niece yesterday, it's not like I know anything about the minutes/hours/days/weeks/months of attention that it has taken to get her to this point where she is taking her first steps. My past year (and then some) have been about a different journey.

Behold the Wonders of the Cervix

The Behaviour of the Cervix over the Phases of the Ovulatory Cycle

The Discovery of Different Types of Cervical Mucus and the Billings Ovulation Method

There are several methods of tracking your fertility that exist, the newer methods are actually more sophisticated than just counting days as in the Rhythm Method. Now we have charts, and even software to help us track our cycles and fertility patterns.

The ones I know of include:

Billings Method -- pioneered by Dr Evelyn Billings and promoted in the US by Billings Ovulation Method Association - USA

Fertility Awareness Method -- as described in Taking Charge of Your Fertility by Toni Weschler and incorporated into the Ovusoft/TCOYF ovulation calendar software

Creighton Model Fertility Care System -- promoted by Fertility Care Centers and the Pope Paul VI Institute and referenced in this article "Infertility Care and the Role of the Compounding Pharmacist" (PDF)

Easing Into It

I've been trying to ease my brain into the idea that it might be time to go that route, the possible IUI/Clomid route (and who knows what else). Even though we did it on our own twice there are reasons for us to see about other options as the clock keeps ticking.

I've been trying to slowly give my partner more info about it, he sometimes acts like he knows everything so I try not to jump on him with too much info. The other night he told me to hand him something to read so I reached in my nighstand and a copy of Conceive magazine was there and I gave them to him while I brushed my teeth. He read the ad for Preseed and saw how bad Astroglide is for sperm and he was like "I didn't know that!" To which I replied that I had told him over and over and even suggested that we try Preseed a year ago and he said no. He then said "Yeah but I didn't know you meant that bad"

Yesterday I sent him links to the three main fertility clinics in our area -- I've seen docs at all three. My partner and I talked about it briefly last night and he said that our greatest issue was with the profession and not the doctor per se, so he thought we should stick with Dr. Marshall who did my surgery and just coax her into trying things our way for the progesterone. I'm friends with one of the nurses in the office so that's a help too. Still, I loathe having to go back in. I had that consult last April where they told me to hang tight for a while and then got pg right after that and then lost it. My last appointment with the RE was in July, and then the ob/gyn appt but that was just for a pap.

I'll just have to ease myself back in slowly.

TTC After 35

Here are links to some articles I found when looking for info about my advanced maternal age.

Female Fertility After 35

36 and Over

How Aging Affects Fertility

Pregnancy After 35 - March of Dimes

Age Related Miscarriage


You might also appreciate:

How to increase your chances of conceiving and preventing miscarriages

Vitamin C: Too Much of a Good Thing

Commonly in fertility diets vitamin C is mentioned, it's really good for you and aids in iron absorption and tissue repair. There is a point when too much vitamin C might actually interfere in female fertility. Men can take twice as much and it will help with semen factors but here are a few points about what too much does to impact female fertility.

Other things which can cause infertility include taking more than 1,000 mg of vitamin C a day. If a woman is doing this and trying to get pregnant, she should decrease it to 500 mg a day. Infertility caused by a higher dose should resolve within a few weeks.
From: Effective Holistic Treatment for Infertility

Vitamin C and bioflavinoids help strengthen the blood vessels lining the uterine wall. When C is too high, however, it can decrease the absorption of copper, a mineral necessary for ovulation, and increase the risk of both infertility and miscarriage.
From: Alternative Health Care Methods of Improving Fertility

Women should avoid megadoses of vitamin C because it can dry up cervical fluid, preventing sperm from reaching the egg. Limit the amount you take to the dose included in your prenatal vitamin.
From: Natural Ways to Boost Your Fertility

What do you think we should do?

It just struck me that I've never asked your opinion of what you think we should do for 2006 in our pursuit of having a child. I don't have a plan right now at all and I'm really wondering what other people think when they read about our situation.

Do you think we will get pregnant again on our own? (it's been 5 cycles since we started trying again -- though the past two cycles I haven't been trying trying just not preventing. It's also been over a year since my myo)

Should we try an IUI? With Clomid or not? (what about the excess estrogen and The Infertility Cure mentioning that it tends not to mix well with liver qi stagnation -- I wonder if I still have that...)

Should we go straight to IVF? (even though this offends our sensibilities and makes it all seem so desperate and only heightens the stress of the situation)

Should I consult a new RE or stick with the one I've ended up with who isn't up on progesterone supplementation? Should we consult with someone outside of our area in another state -- preferably a larger metropolitan area?

What do you think? Please share. Thanks.

Cute Diapering Accessories

I did say that I was going to share some of my pregnancy and beyond links so here are some really cute bags and things.

Diapees & Wipees -- cute little holders for a few diapers and some wipes.

Darling Diaper Bag from Lexie Barnes


I'll add more to this post as I come across more things worth noting.

More Thoughts About Fibrocystic Breasts

So the common things they say to do if you are having PMS and fibrocystic breasts are:

Increase calcium consumption

Decrease caffeine consumption

Make sure there isn't a thyroid problem

Cut back on refined sugars

Increase dietary fiber

Increase B-vitamin consumption

Increase magnesium consumption

Drink more water

Use natural progesterone cream

Increase vitamin E consumption



-----

So I used to eat a fair amount of dairy and I had bad PMS but cutting back to almost none hasn't made any difference so dairy doesn't seem to do anything for me favorable. Less dairy does seem to help with my allergies and digestion so I'm going to stick with that plan.

I've always been a very moderate consumer of caffeine, I didn't drink coffee or cola. I do eat chocolate and have some black or green tea but in moderation. So, that didn't seem to make any difference at all -- in fact I recently started drinking a little more coffee than usual (a few time a week instead of once a month) and it's made no difference.

I've had my thyroid checked several times including a full thyroid panel last summer as it comes up as related to many of my conditions (fibroids, elevated estrogen, PMS) -- each time the test results were so normal it was boring. My mother has thyroid trouble so I thought for sure this might be related for me but evidently not.

Due to my naturopathic and TCM treatment I was told to cut back on refined sugars. It's helped me to feel better but I was never a total nut about eating candy or anything. I've made a concious effort to be careful about my intake of simple carbs. Still I've got sore breast in my luteal phase.

Increase of dietary fiber does seem to help me feel better generally but it hasn't seemed to help with the breast issue at all. Since this helps your body to eliminate excess estrogen I'm sticking with this for general health.

I eat a largely vegetarian diet (though I am an omnivore) and the foods I eat contain a lot of vitamin B and magnesium. Stress depletes b-levels and my work can be stressful and sometimes I don't get enough foods rich in vitamins B or magnesium but I really do try. I was never on birth control pills which can rob the body of B vitamins and magnesium so that's not an issue with me. I have been trying to be better about taking my vitamins but the best I usually do is 4 times a week -- better than nothing in my book.

I am bad about drinking enough water every day -- mostly when I'm at work. I'm much better than I used to be I think.

Natural progesterone cream didn't really seem to do much to help, maybe a little, but it mostly makes my breasts seem to swell more, not necessarily become more lumpy or sore.

And then there's the Vitamin E thing. It's in my prenatal and that on it's own doesn't seem to do anything.

But then there's that DIM/Vitamin E thing. It really did seem to help over the past three days. Today I'm spotting so AF is just around the corner but previously I used to not have my breast stop hurting until I had full-blown AF. It seems so curious to me. And some of the links I've found mention that vitamin E can increase estrogen levels, and also that DIM might do the same -- it just doesn't seem to be doing that to me -- it seems to be helping something hormonally.

(Vasectomy and) Vasectomy Reversal Information

I'm surprised that I haven't really posted about it before but I guess since my partner's reversal was so long ago (1998) that I haven't really gone into it in much detail over the past three years. I'll try to remedy that so that others can learn from what I've learned.

My partner thought that he was going to help out the overpopulation problem and in a fit of idealism and with encouragement from his wife at the time, underwent a vasectomy. That was several years before we met, and as it would happen, on the cusp of the end of his marriage. I can't really speak too much as to how his post-op recovery was though I know that he went in for the procedure alone and was hurt that she didn't even come to see him home afterwards. (Lesson #1 -- it is an emotional thing and the female partner should be there to provide support).

I've had a few sexual partners in my past and so I was a little familiar with what ejaculate looks like. What was weird about my partner's prior to his reversal was that it was thicker than the intact guys I engaged with. I guess this is due to the ejaculate just containing the portions from the prostate and seminal vesicals. After his reversal it returned to a normal looking consistency.

The final product of semen that you see when you come contains only 5% sperm; the other 95% is made-up of secretions from the seminal vesicles (considered an extension of the prostate) and prostate fluid (about 80% of the final mix), which gives ejaculate its whitish color.
From Premature Ejaculation


From when we first started dating he told me he intended to have a reversal, he had already worked through his regrets about having the procedure and so we knew it was on the horizon. From what we learned online at the time, having a reversal within 4-5 years of the initial vasectomy supposedly would help to ensure a greater likelihood of success.

The first step was to locate a doctor who specialized in vas reversals as we wanted this done right the first time. I searched online and at the time, Columbia University had and still has some great vasectomy reversal info and doctors who looked pretty good but through a friend's father who is a urologist in Washington, we learned about Dr. Dale McClure , a urologist specializing in fertility at Virginia Mason Hospital. My partner, since we were still just dating at the time, went for his appointments without me. I remember feeling embarrassed when he came back and told me that Dr. McClure asked about the fertility of his partner (me) and he provided some answer about my having regular cycles -- ack! things were going really fast for me and we'd only been together for a couple years.

The surgery was scheduled to be done through a facility at Group Health Hospital on Capitol Hill; there was some reason it was done there which if I recall correctly might have had to do with both insurance and the technology available. I insisted on being at the hospital the day of the operation, knowing how hurt he had been by the lack of support when he had his vas.

On the Internet prior, we had learned that the medical term for a vasectomy reversal is vasovasostomy and that there was a microsurgical technique used to sew the tiny vas deferens back together again using a fancy sewing technique under intense magnification -- this techique was supposed to have a higher success rates than older techniques.

Prior to the procedure my partner was sedated in a pre-op are and I was able to spend time with him and massaged his feet and kept him relaxed and calm (it was from this experience that he learned how to take care of me surrounding my first d&c and then my fibroid surgery which was really nice for me). The nurses told him that he better be really nice to me and that I was a "keeper". When he was good and loopy on the meds I stepped out into the waiting room and he went into the operatory. I told him that I would be there the entire time he was being operated on so he should know that he wasn't alone ever.

[Graphic detail]
From what he's told me, in the operatory he was awake but sedated during the operation. There was a camera pointed at his testes throughout the procedure, with a screen within his view which was fairly intense for him to watch. The doctor made two incisions into the front of he scrotum and lifted out his testicles to have access to the surgical site (in contrast, vasectomies are done through very small incisions through the back of the scrotum). When it would get too intense for my partner he would tell the nurse to dose him more. It took about two hours to do the operation and then he was moved out into post-op where I was able to come in and see him and rub his feet some more.
[end graphic detail]

We left the hospital that afternoon and went home to rest. He was instructed to not ejaculate/have sexual intercourse for four weeks after the operation to help with healing. Since then I've heard of other doctors wanting to have men begin ejaculating sooner (10 days post-op) to help keep the vas open. I don't know if there is a standard, I assume it is still going to be based on your doctor's own experience and preference. While he was healing the most noticible thing was that his scrotum was HUGE. His balls were swollen to the size of large oranges at least and it took weeks for the swelling to go down.

I believe he was meant to have a semen analysis within a few months of the procedure but we weren't ready to start a family yet and the doctor said that he had found sperm during the procedure from the testical side of the vas. I think it was fear of it not working more than anything that made my partner delay his semen analysis. Finally over a year later he went in and had it done and the results were pretty poor by WHO standards. He was instructed to come back for another test in a few months if I recall correctly. He asked the doctor at the time about some ongoing pain that he had in his scrotum/testes and the doctor thought it might just be part of the healing process. We felt a bit discouraged but only time would tell.

Specific things we learned along the way from our experience:

There might be pain for a while

Sperm counts might be low for a while and continue to improve over time without intervention (we saw significant improvement after 2 years)

Ejaculate consistency will change after the reversal, to a more normal consistency

You should be sure to have a semen analysis based on Kruger morphology standards and not just WHO standards, and also make sure you are tested for anti-sperm antibodies as well

MFI supplement cocktails can actually improve morphology

The our doctor felt that our chances of conception would be better with a repeat reversal (though it wasn't required ultimately because things improved on their own) than with trying TESE/IVF

General post vas reversal fertility info:

There is a greater chance of having ROS damage to the sperm

That the success rates post procedure have more to do with the health and age of the female partner than just on the time between vasectomy and reversal

That there is about a 50% chance of conceiving on your own post reversal

Vasectomy and Vasectomy Reversal Links:

FIND A SURGEON

Society for Male Reproduction and Urology (SMRU) - Member Search

INFORMATION ABOUT THE PROCEDURE

The Patient's Guide to Vasectomy Reversal

Microscopic Vasovasostomy

Vasectomy Reversal - Introduction

Microsurgical Vasectomy Reversal

What's New in Male Infertility Treatment at Cornell
Vasectomy Reversal: The Microdot Method for Precision Suture Placement

Google Groups: alt.support.vasectomy

International Center for Vasectomy Reversal

Vasectomy Reversal - Johns Hopkins

Building Bridges to Conception - Vasectomy Reversal

Vasectomy Reversal Questions &s; Answers

Microscopic Vasectomy Reversal

Vasovasostomy

The Infertility Center - FAQs - vas reveral Qs and As link

Cary Urology Vasectomy Reversal

Vasectomy.com

ARTICLES ON VARIOUS RELATED TOPICS

Warning over vasectomy reversals

Vasectomy - Can it be reversed?

Morphological changes of spermatozoa in proximal vas deferens after vasectomy

Microsurgical Vasovasostomy versus Microsurgical Epididymal Sperm Aspiration/Testicular Extraction of Sperm Combined with Intracytoplasmic Sperm Injection

Some vasovasostomized men are characterized by low levels of P34H, an epididymal sperm protein.

Vasectomy Myth Debunked: NewYork-Presbyterian/Weill Cornell Study Finds Vasectomy Reversal Highly Effective, Even After 15 Years

Vasectomy Reversal & Sperm Antibodies

VASECTOMY

Vasectomy Blog

Vasectomy Information

Requesting Patient Medical Records

It's a good thing to keep a copy of all your records, particularly when you are dealing with an ongoing condition (but generally as well). Request the records be sent to you if you are switching practices as well and then you can bring copies of the records to each new doctor you see --- you will be better informed and it will cost less too.

Some doctors are very strange about not giving you access to your records, they are actually required to do it under the Federal HIPAA law. You have to make a formal written request, and you need to specify both the time period and sometimes even the specific test results/appointments/etc. you are looking for. They have the right to charge you a reasonable fee. (See HIPAA and Medical Record Copy Charges

Here's a great site from the Health Information Management Association about Creating a Personal Health Record with some excerpt below.

Your Rights Under HIPAA:

Right to access, inspect, and copy health information
Right to request correction or amend health information
Right to request accounting of disclosures of health information—who has received it

Accessing Your Health Records
You have the right to access your health records. You may view or receive copies of your records, or instead request a summary of the information. If you receive copies of your records, the office holding the records has the right to charge you the cost of making the copies. You may have to submit a written request to view or receive copies, so the office has a record of your request.

You also have the right to request that changes be made to your health record. If you believe that information in your record is incomplete or incorrect, you can request an amendment.

Amendments can be requested by either contacting the person who made the entry (such as your doctor) or by contacting your healthcare organization's health information management professional. If your request for an amendment is denied you may still request that your request for a change be kept with the record and given to anyone who requests a copy of your health information.


Here's another link that you also might read to help bolster your confidence as a health care consumer if you are having surgery:

Quick Tips -- When Getting Medical Tests

Bad Estrogen

Sounds dramatic doesn't it but there really is estrogen known to be the bad kind, the kind that can lead to cancer. Since I'm not doing acu treatment or chinese herbs right now and its just up to me to try to fix me I decided to do some more research into PMS and estrogen. It's that time of the month (mid-luteal phase) and my breasts are so uncomfortable. The only time I've had real relief for a while was after both pregnancies, I guess due to the pregnancy types of estrogen being dominant then.

So here are some of the links I came across that interested me:

Predictors of the plasma ratio of 2-hydroxyestrone to 16-hydroxyestrone among pre-menopausal, nulliparous women from four ethnic groups

The relationship between physical activity and 2-hydroxyestrone, 16alpha-hydroxyestrone, and the 2/16 ratio in premenopausal women

DIM (Di-Indoly Methane)For Natural Protection from Estrogen's Effects

What I picked out that might relate to me are:

...that since dietary therapy alone hasn't helped, and my mother had PMS as well that there might be a heriditary factor.

...that exercise really might help my body to metabolize the bad estrogen more

...that taking DIM for a while might not be such a bad idea, at least to see if I can detect any changes.

Back from Paradise

So I can now say that if you feel like infertility is getting you down that you haven't been pampering yourself enough and you should make plans to go to Fiji. The people are lovely, the sun and sea and coral are beyond compare, and it's far enough away that you don't find lots of families on vacation -- provided you pick the right island resorts.

I've been happier than I've been in years -- no sign of depression for me (though I've got a touch of PMS right now). All that wonderful sunshine and the warm sea -- we went swimming every day and there was no need for a towel it was so hot every day. My biggest decisions each day would be which bikini to wear and whether or not I wanted a cocktail at happy hour. Sooooo incredibly relaxing.

Oh and here was a thing, my myomectomy incision, the bikini-cut, it fell just below the top edge of my string bikini. How about that? I've never worn a string bikini before but I thought why not start now.

I got lots of exercise as well while on holiday -- running, playing volleyball, swimming, snorkeling, and hiking -- which helped work off some of my fluff. (Some I said, not all)

Seattle is so cold, dark and damp in comparison -- I think I'll just have to move to Fiji and learn how to weave mats.

The Boo-hoos Caught Up With Me

Yeah so I'm not invincible. Finally Friday night, when my partner came home from visiting with friends I erupted. Two of his friends are currently TTC with their girlfriends and finally he has guys to talk about it with. But for all his enthusiasm it's been an anguishing time for me personally, what with the miscarriages and anemia and all. I hate feeling like he's just lumping us in with these other women who have just started trying, even though I know enough about them to know that they both have infertility issues (a 21-day cycle for one and fibroids and a miscarriage for the other). He comes back from hanging and talks about how he told them about how I chart and all that and how so-and-so's girlfriend wouldn't do that because it would make her obsess too much. It just makes me want to scream. I'm not like them, it's been too many years, we both had surgery, I've been through two losses and seen all those doctors and charted and temped and used a fertility monitor and got bloodwork and still no baby after more than three years.

So I started crying and I cried and told him that he better leave me and I just kept crying in the dark on the pillow and so I got up and I cried more, for another hour at least. Crying and blowing my nose and all that for a good long while.

When I woke up on Saturday I pulled out a journal and made a list of all the things about our fertility that are bothering me -- and cried some more. I read it to him and the rest of the day Saturday I just felt emotionally drained. Sunday I felt a bit better though.

I'm still congested from the flu and a little queasy as well. Everyone in our office has been sick. Half of them have had the stomach flu but no one has had both. I hope that I'm just feeling the remains of the same flu and its just lingering and not because I'm going to get the stomach flu as well. Oh please no.

Looking forward to sunshine

We're going away to the tropics for a couple weeks in the sun. I'm so looking forward to it and the break from work and everything, though I will miss my pets while I'm away.

My period showed up today, right when Ovusoft said it would; a little crampy in the morning but not too bad so far. A nice, average 29-day cycle.

It's hard for me to lurk on my TTC buddies, so many of them have gotten pregnant this year, even ones that had infertility problems. A fair number are still waiting in the wings as well so I don't feel a total freak but it's still pretty ouchy knowing that for some of us this is not something that happens anything close to easy.

Still, this year had things arranged in a way so that it was for the best. We had some staff turnover and our business really needed our attention. It wouldn't be an easy thing to be expecting a baby right now. And you know I wouldn't be going to the tropics right now if I was pregnant. Even AF is cooperating with the plans and should be cleared out before we leave town.

Hysterosalpingogram (HSG)

An HSG is a hysterosalpingogram, an x-ray of the interior space of the uterus and fallopian tubes using a contrast dye. It can be used to look for uterine abnormalities and adhesions, determine how much infringement fibroids are making into the interior of the uterus (to some degree), and identify if your tubes are open (referred to by docs as "patent"). Some docs do it standard a few months after a myomectomy, mine did not. The dye does have what my RE referred to as a "voodoo effect", where there is some slight increase in pregnancies after the procedure, speculated to be caused by the dye perhaps causing the little hairs (cilia) in the tubes to function better.

It can be done by your doctor in a radiology facility or by a radiologist -- mine was done by my RE and she was a lot more comfortable with the procedure than the radiologist I could tell.

They insert a catheter to insert the contrast dye through your cervix; a good cough evidently will open up the cervix so it is less painful. The dye feels like pressure going in, and it can cause a drop in blood pressure. It's generally uncomfortable and causes some cramping. My RE tried to manipulate my uterus for the xray shots using the special speculum and I found that to be very uncomfortable with my 6-7cm (at the time) fibroid.

Here is an link detailing Guidelines for the Performance of HSG - it advises taking 1000 mg of NSAIDs prior to the procedure.

Rarely it can cause infection, and some people are allergic to the contrast medium. Some docs give antibiotics preventatively ahead of time, they also might have you take a heavy dose of Tylenol an hour beforehand.

Here are some links to sites showing images from HSGs:

HSG Link 1

HSG Link 2
HSG Link 3

I should go pick up my x-ray film from the University of Washington Radiology Department, where I brought it when I consulted about UAE a couple years ago. I'd like to scan it and and post it here so you can see what my distorted uterus looked like.

DIM Plus for PMS? (and more about estrogen excretion)

On one of the discussion groups about healing fibroids naturally I learned about this dietary supplement called DIM Plus which was supposed to help your body rid itself of excess estrogen. Evidently some of the cancer circles were talking about it. I bought some a while back and tried it for a week or so, no side effects that I could see but since I was doing chinese herbs and trying to get pregnant and you aren't meant to take it if you are pregnant I didn't continue using it.

Well, with my breasts sore as ever for the second luteal phase in a row, I decided finally yesterday to take one capsule to see if it would help. Forget just about the fertility stuff for a minute and know that for me, feeling bad PMS symptoms mean that my body is still lined up for more fibroids -- something I really don't want. The recommended dose is 2 capsules but I took just the one, and then coincidence or not my breast pain receded. They are still sensitive and full and fibrocystic but not just aching me outright now. Was it possibly the DIM Plus?

Here's the link to the product page on the manufacturer's site:

DIM Plus by Nature's Way

Estrogen Metabolism and the Diet-Cancer Connection: Rationale for Assessing the Ratio of Urinary Hydroxylated Estrogen Metabolites (PDF)

Hormone Balance - Hormonal Health (about DIM)

Physiological Functions of Phytonutrients (PDF - info about DIM starts on p.9)

Foods for Cancer Prevention

Estrogen Dominance Syndrome

Nutritional Factors in Menstrual Pain and Premenstrual Syndrome

Liver Detoxification Pathways

Estrogen's Two-Way Street

Premenstrual Syndrome Types -- I mighta have posted this link elsewhere in this blog, but it might be helpful to you in this context so here it is.


It makes me think, why is it that many doctors don't consider things a problem until they might kill you? Why do I have to live with hormonal imbalance and cyclic breast pain for years. Pooh on them. And honestly I've tried the no caffeine, no dairy, no meat, no alcohol approaches and they didn't help me. No chocolate, well that's not really an option and my acu told me that with Spleen Qi deficiency it was a common craving. Like pica (craving and eating clay and ice and stuff) I guess but better.

About Prolactin and Abnormal Breast Discharge

A hodge-podge of links related to prolactin for your light reading.

AMSR Patient's Fact Sheet: PROLACTIN EXCESS (PDF)

Elevated Prolactin (PDF)

High Prolactin Levels

Hyperprolactinemia (High Prolactin)


Prolactin-Lowering Medicines: Your Questions Answered

WHAT YOU SHOULD KNOW ABOUT PARLODEL® (bromocriptine) from Novartis

Bromocriptine Addendum


Nipple discharge - abnormal

Nipple Discharge


Lack of expression of endometrial prolactin in early implantation failure: a pilot study

The Environmental Estrogen Bisphenol A Stimulates Prolactin Release in Vitro and in Vivo*

A murine model of adenomyosis: the effects of hyperprolactinemia induced by fluoxetine hydrochloride, a selective serotonin reuptake inhibitor, on adenomyosis induction in Wistar albino rats.

Revelations

I've been sick all weekend with an awful cold virus. Using up boxes of tissues and my joints are aching so much. Not much fun. I didn't go out shopping so instead I've been doing what I call "cooking something from nothing"; we're having long grain and brown rice with roasted brussel sprouts, carrots and turnips. It tastes okay but this is not one for the recipe book.

I've been thinking about the holidays this year. I'm making some effort but it feels hollow and I wasn't sure why until I started thinking about it. I used to go back East to see my family; they would drive me crazy but they were my family. Now my mother isn't talking to her family, my grandmother and I aren't speaking since she was so awful in relation to my first pregnancy (a disgrace to the family she said), my sister is in Seattle but I hardly ever see her (though we were best friends when we were growing up) and I find it hard to talk to my brother, he's not grounded in reality unfortunately. Add to that how little support my family gave to me during my miscarriages and after my surgery last year and it feels like my family has fully disintegrated -- and much of it feels to me to be related to my fertility issues.

So my family isn't really there anymore, and the family we were going to have hasn't materialized. Add to that the feeling of general alienation the past few years have engendered in me and socially I've been feeling isolated as well -- probably more through my own doing than not. It's no wonder really that I hit the wall with the TTC business.

Years ago, a friend of mine told me when life felt out of control to me that I needed to create touch stones for myself in my life. I did take that to heart and it was within months of hearing that message that I met my partner and met a few of my good friends. Over the past years though people have changed jobs, pursued different interests, moved away and so there are fewer touchstones that there once were. There haven't been many people IRL to talk to about what we have been going through, it's hard to talk to friends who know they don't want to have kids about infertility and pregnancy loss. Then the ones that have had kids, well their kids are getting older and so they have parties with a bunch of four year olds, etc. and since we don't have kids we don't get invited (though really I wouldn't want to go anyway).

So I feel like I'm standing at the edge of a bridge, trying to leave one side, two failed attempts to cross that bridge that hurt me, and a bunch of nasty momminess, child care, teething, diapers, terrible twos etc on the other side (is that supposed to seem appealing?) And more and more I feel like I won't be able to cross the bridge without medical intervention, which I don't want to do. It just feels wrong to me.

I think that my current RE is part of the problem. Over and over in my head do I hear those words from a couple weeks ago "that's (low progesterone) not what's wrong with you" which makes me want to scream back THEN WHAT THE HELL IS WRONG WITH ME?!

If I feel the time comes for another consult I might just consider going with a different RE. Maybe we should even consider going for a consult outside of Seattle, there's too much crap going on with the fertility clinics here. It makes me the patient feel like a pawn or an asset instead of like a person.

By the way, Virginia Mason Hospital decided to close the fertility center outright. Dr McClure, the urologist who did my partner's vasosostomy (vasectomy reversal) was the only one left after Dr Marshall, my RE left to open Pacific NW Fertility. My partner had some crappy frozen sperm there, from before we knew what we weren't going to do and since it was only about 1% kruger we're going to dump it.

That's enough of a book for one night. Thanks for your replies and talk to you soon.

Little hope links

For you Crystal, for when you need them.

The Flood (even more poignant in light of the recent flooding of New Orleans)

Footprints in the Sand

Why Good Things 'Don't' Come to Those Who Wait

Should I be happy or sad?

Ah sh*t I'll just be cranky, the PMS is really doing me in this month. All the acu and herbs and diet changes and here I find myself back at square one. At least I know how to manage my stress better and I can fight my anemia a little better without the heavy periods. My breasts are killing me, I'm feeling uncharitable to say the least and I would love to just go home and sulk by myself for the rest of the day.

I also think I'm coming down with a cold -- I'm sneezing and mid-LP my immunity always plummets. My theory is that it has something to do either with the hormones or the anemia or perhaps both. Progesterone compromises your immunity slightly and then with my body devoting more blood resources to building up my endometrium this time of month maybe it just tweaks my anemia and my resistance slumps. Who knows.

I've found out in the past day that two of my fibroid sisters are pregnant now, both moving along okay so it seems. I coached both of them through the pre-myo stress and now they are going to have babies. Considering how many more women with fibroids I know online who aren't getting pregnant I should be celebrating the miracle. Me, I just feel a bit dejected. I think I would rather know that someone in a similar situation to mine was having success but still it bites a bit.

--------

Is anyone actually reading this blog? I get so few comments that it makes me feel like I'm a bad blogger or something. I appreciate the few of you who drop notes now and again. Thanks so much for your continued support.

Talking about it

Lately I've taken to selectively letting people know, when they ask about whether or not I've had kids that I've had two losses in the past 18 months. Rather than say "maybe" or "perhaps" I figure its better to speak the truth. It's something I've wanted to do anyway, let it out there and let others recognize it. I've also added when appropriate that we've been trying since 2002, just to let them know how long the road has been (too long).

I was on the phone with my mother last night and mentioned that we were going on vacation to some place tropical and that we might as well since we don't have kids. She responded in a way that sounded negatively to me, like I was lame or not trying hard enough to have kids. I think it is just her own disappointment at not having grandkids to spoil but it felt a bit selfish and mean to me. It was probably due to what I said, though you know that hidden behind that cavelier phrase is a lot of pain and agony over the same subject.

If my mother only knew that basically my heart is broken and that Christmas feels oddly hollow to me this year. That psychologically I'm bracing myself for the fun weeks ahead in January and February when I get to live through my EDDs of my two dead babies. That I'm in the middle of my luteal phase and trying not to think about it, about how my sore breasts mean nothing, how my period will show up again -- that my body feels like a punishment to me right now. Maybe if she knew she would be a little nicer. But who wants to go into that level of depressing details with me, no probably not even my mother.

Fatigued

I know I'm out of shape, since with the miscarriages and surgery and anemia my body was feeling like hell; and then my back was terribly out of alignment as well so that caused further reasons to not want to move. I've been taking my iron for months to try to build up my iron stores but now I need to start dragging my butt out to get it moving to start gaining some more strength and endurance. Also, aerobic activity helps to promote the production of more red blood cells so provided my iron stores are closer to a normal range it should help build my blood oxygen in many ways.

I went skiing yesterday for the first time since 1989. Yes that's right, I haven't been downhill skiing since the 80's. In addition to my known fatigue I also knew that my muscles are a little weaker so I had to pay attention to how tired I was to make sure that I wouldn't injure myself by overdoing it. I only did four runs down the mountain before I finally fell (only once all day!) and decided that it was time to rest. My partner and friend went back out in the afternoon but I just rested in the lodge. On the way back home I was falling asleep in the car (unusual for me) and I went to bed at eight-o'clock and slept for eleven hours. How's that for fatigue?

Here are some links about fatigue that I found:

Fatigue: When to rest, when to worry

Anemia and Fatigue

Anemia Symptoms

Puzzled by fatigue: what can I do when my doctor says my lethargy is caused by stress and that there's nothing wrong with me? … and more of your questions answered here

Precaution Can Be the Best Remedy for Skiing Injuries

Fertility Symbols, Charms and Folklore

Sometimes you get so desperate that you start to look for folk cures for infertility. It's not like trying to conceive is anywhere near a scientific experience as doctors make out anyway. From stupid rituals like putting your butt on pillows after BD to pregnant women avoiding women who have miscarriages, it's all a lot of superstition that surrounds and weaves through the fertility process. So, why stop with basel temp taking when you can wear a rabbit charm and it might even make you feel better. Whatever keeps you going.

Fertility Charms from GoodLuckBoutique.com

Meanings of symbols & designs used in Native American arts & crafts

Fertility Symbols T-shirts from Materni-Tees

Fertility Folklore

Patron Saints against sterility or barrenness

Alternative Infertility Therapies -- Bach Flower Essences and Color

Hirsutism (Abnormal Hairiness in Women)

Here are a few links I've collected about Hirsutism, a common condition of abnormal hair growth for women with PCOS but there are other conditions associated with it as well. The key thing is that usually the woman's body is producing too many androgens (male hormones, in particular testosterone) due to some sort of hormonal imbalance.

Hisurtism (eMedicine)

Evaluation of Excessive Hair Growth (Hirsutism)

Hirsutism - Causes and treatments

Hirsutism and hyperandrogenism in women

The blood runs down
over my knees and ankles
large splashes of angry color
and mean pains.
The pool of crimson grows and grows
until it covers the earth;
there is nothing left in me,
I drown the world.

I am a flower pot that holds no soil
I poured out of me, so much
that which was meant to grow.
It all goes away and takes me;
there is less and even less of me;
a deficit really.
Call it hope if you must,
but to me it just feels like
I've been turned inside out.

Each baby is stolen from me
who are these witches?
They sneak up on you, like the fairies
and steal the babies
and not just their breath
like the cats can do.
They leave me empty and the emptiness only grows.

Or do they chase them away from me,
just as they were getting settled
like little birds flying in the November sky.

When I think of it
I made space in my life for
your coming, so many months.
You came, both of you
like fleeting sparks
Was that all?

In time
I can find a place
for the things I gathered to
welcome and warm you to the world
but never will there be
another place for
the indelible impression
you have left on my being.

There are grooves
running through me
like marks of a dogs teeth
on my bones
never totally healed

Memory remains in strands
of my hair, in my nails
the crevices on the back of my hands.

A little more worn, a little tired.

Infertility/Miscarriage Grief and the Holidays

I've been still going through a lot emotionally right now -- I don't know what I'm supposed to think anymore, and just the morning I realized that knowing that I was going to be around family (my partner's family) this weekend was really starting to stress me out. I don't really know if he told them or not about our second loss (I keep getting vague answers so it makes me think no) and I don't like feeling like there might be comments made about our fertility -- when I'm trying so hard to deal with the stress of the infertility as it is. Ya know?

I found a few links that I thought might be of help, we should all take time to read them and make sure we are doing what we can to protect and prepare ourselves as we go through the next few weeks.

Managing the holidays

What Can I Do to Get Through the Holidays?

Coping with the Holidays (RESOLVE)

Dealing with Infertility in the Holiday Season

Dealing with the holidays after a miscarriage

When Grief Comes Home for the Holidays

Silent Grief - lots of articles, though I didn't see any ones specifically about the holidays.

The short list of things to rule out

Still working on taking my break. Aside from marking down my period on my charting program and taking my first temp of the cycle (just to make sure it dropped appropriately) I haven't been charting or temping this cycle. Feels a little liberating.

I was talking to my partner the other day, and I told him that I feel as though there is something fundamentally wrong with our fertility -- though I don't know what it is. I see gals with fibroids getting pregnant on enough boards to know that fibroids alone aren't necessarily the only thing that causes infertility, though I know enough post myo gals to know that lots of them are having similar experiences to mine as well.

I've probably done this before but here's my list of things that might be possibly impacting our fertility without going out on too much of a tangent.

FEMALE	MALE
Anemia - low ferritin Low Progesterone	SCSA - sperm DNA fragmentation Repeat semen analysis (#8?)

I don't want to go in for a consult right now as that would make me cry and I'm trying to not put myself in situations like that right now. I called over to my favorite assistant at the RE's office and asked her to see about my getting my ferritin rechecked (since all evidence I've found online indicates that a level less than 40 can impair fertility) and a pooled progesterone test.

I can get the ferritin done at a lab, totally innocuous and generic place that I've been to before -- I think that will be less emotionally loaded for me. As it turns out the lab is way faster than the hospital lab was the last time I had it checked. I've heard that you can get your blood work done whereever -- and particularly for standard tests, as many hospitals and clinics are sending their lab work out of state because it's better for them, you as the patient might want to intervene and make sure that those cost-savings are yours or at least you are getting the benefit of the quick local turn-around. My ferritin test in July took about 3 weeks to get back. This lab can get it within a day or so -- they run the ferritin tests daily.

Then the pooled progesterone test, the assistant told me that my RE said that she didn't think that a pooled progesterone test was indicated by our infertility but that if I wanted to do it she would order it. I explained to the assistant that I had seen other REs, specifically as my first RE left the state, and that one RE in particular thought that I would need progesterone support on any cycle I was to conceive and that all of my progesterone tests had been on the low side. She said that was why working with more than one RE was difficult as they would of course have differing opinions. Still, I was welcome to do it if I felt like it would be helpful to me -- and evidently the other RE working in the same practice as my RE does do them frequently. I told the assistant that I would probably wait until the new year but at least I've gotten that sorted out.

So, I've got an RE not on the up and up with progesterone -- or rather definately not in the progesterone camp. Is that enough to consider working with someone else? Or should I just stick with her and just demand the care that would make me feel more secure -- particularly if I get pregnant again -- such as weekly progesterone draws until I'm out of the danger zone? Why does it have to be this difficult?

Then for all my spinning of wheels, it might not be me, it could still be the poor sperm morphology that's challenging things. Ugh, but with all that blood loss last June from the last miscarriage and how awful I felt subsequently, plus a couple of cycles that don't make sense (did something happen but not take hold?) I should at least rule out the impact my anemia might be having.

BFN

That's Big Fat Negative for you who are not yet indoctrinated into the web fertility acronyms. I bought a test this morning as my temps had been rising the past three days, not to the stellar 98.6 temp that has shown up when I'm pregnant, just back up to 98.3 from a low of 97.8 (below coverline). It was so very negative that test, it's the kind that you just keep staring at and hoping that something is going to come from the nothingness but then it stares back at you blankly.

I called my acupuncturist's office and cancelled my last two schedule appointments. I'm now waiting for Aunt Flo and starting my psychological break from trying to conceive. We'll see how I'm feeling in the new year I think, then probably go back in to see the RE.

I hate this time of the cycle

Actually I've gotten to where I hate most times during my cycle, though honestly Amy period is at least old hat at this point (after 21 years in September!). I'm grouchy at ovulation, I'm moody during my luteal phase, even the pre-ovulatory time of month can get my goat. I think that it's always been this way but I didn't know so much about what was going on with my hormonal system -- is it really this good to be so in tune with one's hormonal fluctuations.

At any rate I'm at 11dpo today and yesterday my basel temp dipped below my coverline (how's that for jargon for your non sympto-thermal charters) and then this morning I had a wee little temp rise again but only by a few degrees (97.8 to 98.0 -- actually my temp was 98.1 overnight but then it dropped by 6:30 this morning). So I'm straddling something vaguely interesting again, part of me wanting it to be something and a lot of me knowing that I may well get my period by the end of the week.

I have no home pregnancy tests at home at any rate, my friend told me to wait until I had a couple days of temps after the rise and then to see. I live and work within walking distance of six drugstores so if I want one I can get one any time. By the way, I hate buying pregnancy tests, especially when the checkout person is a guy. They sort of search your face for a moment and try to figure out if you are testing because you hope you are or if you hope you are not. For me though, I feel both things at the same time -- at it all feels incredibly emotionally loaded to me either way. At least when you buy sanitary napkins they will usually look away, not trying to draw attention to the feminine hygiene products.

There's just no winning.

About Home Pregnancy Tests

These are great to refer to when you are trying to figure out which test to buy, when to test, etc.

Pregnancy Test Sensitivity and Early-Detection Testing

Home Pregnancy Test hCG Levels and FAQ

Peeonastick.com - The Secret of the Digital

Pregancy and Ovulation Testing Tips

Pregnancy Test - Sensitivity Comparison

Home Pregancy Test Information

i

About Implantation and Early Pregnancy

Want to know what's going on in there, here are some sites and resources that I've found informative.

Visembryo -- a great site to see pregancy development through all the stages

Life's Greatest Miracle (PBS-NOVA) -- Movie files showing stages of development from conception and embryological development to delivery

MedCalc: Pregnancy Wheel -- interactive pregnancy wheel like those used in doctors offices

Fertilization and Implantation (Very Early Pregnancy)

Pregnancy Diagnosis

Concerns regarding Early Fetal Development

Female reproductive system Implantation and formation of placenta

Implantation Bleeding

Implantation Diagram -- nice

Timing of Intercourse, Ovulation and Conception

Causes of Bleeding in the First Trimester

Researchers Discover How Embryo Attaches to the Uterus

Specialized Ultrasound Screening Can Be Key to Predicting Implantation Odds

IVIg for ART and Implantation Failure Controversy

Pregnancy Week by Week: First Trimester

Pregnant women 'starved of information' (I think this one came from Aliza)

Posting Pregnancy Information Posts

I've thought about posting pregnancy information posts with links I've gathered over the past 3-1/2 years. I was sort of holding out, hoping that I would get to post them in relationship to my own pregnancies or something but I'd rather put them out there so they can help others. So, stay tuned and watch for posts about implantation, post-partum, pre-term labor, breastfeeding, birth plans, cloth diapering, etc. Lots of links I've been bookmarking from all over, and with lots of grateful thanks to those who posted the information to the web so that I could link to them and we all can learn from them.

cheers.

The rest of my week

I've been taking a break from the fertility message boards this week. Lurking some as I'm still in transition form daily postings, but holding back. I have to say that it's been a good exercise and a very healthy change for me to make right now. I used to only check in on the weekends for a couple years, but after my first miscarriage I needed more support so I started posting and participating more. I've met lots of great women from all over the world and some that I've even met in person, and hopefully someday I'll meet even more.

So, since my post earlier in the week, the feeling of needing to cry continued building until Thursday afternoon after a particularly stressful situation with a client, I ended up bawling at my weekly acupuncture appointment. Sometimes a girl just has to have a good cry. I was worried about going back to work and looking like a mess but I had a meeting scheduled that I needed to get back for. I stopped by Sephora and checked myself out in the store mirrors to make sure I didn't look like hell -- not to bad actually, mostly just stuffed up and emotionally exhausted. After a slightly better day on Friday and dinner with my sister, I'm feeling less of a mess. Still I'm looking forward to a TTC break. That might mean that we don't avoid but heck if I'm going to try for anything -- well we'll see about that. But at least I'm able to shift gears, for that alone I'm pleased.

Your Birthdate: July 10

Independent and dominant, you tend to be the alpha dog in most situations. You're very confident, and hardly anything ever shakes you. Mundane tasks tend to drain you - you prefer to be making great plans. You are quite original. When people don't "get" you, it bothers you a lot. Your strength: Your ability to gain respect Your weakness: Caring too much what others think Your power color: Orange-red Your power symbol: Letter X Your power month: October

What Does Your Birth Date Mean?

Interesting...

Oh boy.

I walked to the Pike Place Market at lunch today, browsing among the vendors, buying my pineapple finally and some hazelnuts. At one booth I saw a table full of etched stones. When I stepped closer to see there was one stone that just grabbed my eye, it said "Everything happens for a reason". I almost lost it right then and there. Adjacent to it was a stone with a baby's footprint etched into it. I thought they might go well under my memorial forsythia in my backyard, but the longer I hovered the more I wanted to cry. Deep breaths. Deep breaths.

IUI and Clomid

I researched about IUI and Clomid a couple years ago, when we were thinking we might pursue that route. I'm sharing my best bookmarks on the subject, hopefully this will be helpful for you as well.

Intra-Uterine Insemination Links

A Beginner's Guide to IUI

Effectiveness of IUI Timing and Single versus Double IUI - INCIID

Frequently Asked Questions about Intrauterine Insemination (IUI) - FertilityPlus

Getting pregnant with IUI (Intrauterine Insemination)

Superovulation/IUI Statistical Success Rates

Patient Instructions for INTRAUTERINE INSEMINATION (IUI)

IUI Procedure

Artificial insemination for infertility - Intrauterine insemination - IUI

Clomid

Clomiphene - Infertility Physician

Fertility Drugs I: Clomiphene citrate - ivillage

Overview of Fertility Medications


Clomid Use and Abuse - INCIID

Human chorionic gonadotropin administration is associated with high pregnancy rates during ovarian stimulation and timed intercourse or intrauterine insemination

Folliculogenesis and ovulation

I learned from my reproductive endocrinology text that eggs are constantly moving from stasis into a maturation process. The lucky ones synch up correctly with the hormonal cycle and have a chance at ovulation. The other eggs are just reabsorbed.

Oocytes (unmatured eggs) are held in stasis by hormones, and the micro-environment of the follicle needs to move from testoterone-dominant to an estrogen-dominent in order to be considered for ovulation. Often women with PCOS or thyroid problems have issues with their hormones that might impair this process such as high levels of androgens.

It might be possible that prolonged development of the follicle might cause the egg not to mature as well as a tighter hormonal cycle but I haven't read anything to that effect -- mind you I haven't researched that specifically though.

So anyway, your ovaries are constantly maturing eggs regardless of your hormonal cycle. This might also explain why women can sometimes get pg at odd times in their cycle -- such as WWII wives who supposedly got pregnant when their husbands were on leave.

Here are some links to reference maturation of the oocyte:

FOLLICULOGENESIS AND OVULATION

Section 13: Female Reproductive System

During a woman's reproductive years, several follicles in the growing pool are recruited each cycle, and only one is usually selected for ovulation (see Fig. 234-4). It develops into a graafian (preovulatory) follicle, which can respond to the midcycle LH surge. The mechanism of selection is unknown.

The graafian follicle contains an antrum (fluid-filled cavity), created by proliferating granulosa cells, which secrete fluid and mucopolysaccharides. The increase in the follicle's size is due primarily to accumulation of follicular fluid under the control of FSH, which also induces the development of specific LH receptors on granulosa cells. LH receptors are responsible for the stimulation of progesterone secretion before ovulation and for continued production of progesterone in the luteal phase. The granulosa cells in the follicle also develop specific membrane receptors for prolactin, which decrease in number as the follicle matures; their physiologic role is unclear.
Merck Manual Chapter 234. Reproductive Endocrinology

Diagram of folliculogenesis

Controlling Uterine Bleeding

It's a topic that comes up in the course of many women's lives and it's hard to know what to do. Thanks to the cumulative advice and experience of the women of the uterinefibroids list though I've learned some simple things you can try at home to stem bleeding.

Lie down -- this reduces your blood pressure which will help to slow the bleeding.

Cold pack -- lie down and place an ice pack on your abdomen, wrapped in a towel of course. Don't have an ice pack? Try a bag of frozen veggies.

Take Tylenol or Ibuprofen -- take approximately 400 mg of an anti-inflammatory like Tylenol or Ibuprofen. Don't take aspirin as it thins the blood and won't have the same affect.

Vitamin C -- a natural anti-inflammatory that helps to constrict blood vessels.

This worked well (within 20 minutes after two hours of hemorrhaging) when I was having really bad flooding in Spring 2004 but I tried it during my second miscarriage and I'm not sure if it worked then -- that's sort of a different situation though.


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Here is good reference about NSAIDs and menstrual bleeding:

Nonsteroidal anti-inflammatory drugs for heavy menstrual bleeding
(Cochrane Review)
Lethaby A, Augood C, Duckitt K

Von Willebrand's Disease can cause bleeding problems and isn't regularly diagnosed by docs.

Here's my post about types of bleeding and quantities, to help you understand what is problematic bleeding.

My back is a well of sadness. Go figure.

I've started back with chiropractic treatments on my back as my spine has been totally out of alignment -- two incidents with whiplash have left things a little less steady then they would have been otherwise. My first two treatments just pointed out how bad things have been and left me feeling a little better and a little unstable feeling in my back. Then on Monday this week he felt how there were all of these awful knots in the muscles of my upper back that were contributing to the alignment issues, pulling at my spine. He grabbed some sort of electric massage tool with multiple nodules on it and started working on that area -- it was painful at times but he did loosen things up a bit. He told me to go get some massage work done.

Tuesday I woke up and I felt normal enough but by the time I got to work I realized that in addition to feeling grouchy as anything that I was having an awful black, black mood. I cried off and on all day long, yelled at my partner when I got home and fell asleep with the assistance of a muscle relaxant to try to help take further edge off my back. There was no chance in hell of any BD even though I was within the stupid fertile window of my cycle.

I felt depressed the rest of the week, but not nearly as bad as Tuesday. At my acupuncture appointment on Thursday I mentioned about all the above and asked if it was possible that the body work I had done on Monday was a trigger. I have friends who are massage therapists in town and they have told me that people can store emotions and injuries in their body. One friend in particular did a lot of work on people who had been sexually abused as children and would try to help them work out these trapped emotions, she said it could be quite intense for both she and the patient.

My acupuncturist agreed that the two experiences for me were likely related and told me to not think about people who are having their second child. I talked to her a little bit about how tired I was of this TTC business stealing my time and attention and not producing results. She mentioned that the things that I have learned and shared along the way with others meant that it wasn't all in vain and that helping others to find their way along the infertility path was a good thing. Yeah well, that's true but it still doesn't remove the sting. She gave me a handout with information about how to take fresh pineapple to aid in implantation -- it's meant to help break down proteins in the endometrium that inhibit implantation. I'll buy the pineapple but since I've done it before on my own without any results I'm not feeling like it will do anything but I do like pineapple at least.

Infertility sucks....the life right out of you.

Why do I even bother?

This has been going on for so long, the charting, timed intercourse, researching, seeing various docs, and at the end of the game I'm not really sure I'm getting anywhere at all.

Frustrations...

All the people who have gotten pregnant, had babies, gotten pregnant again, had miscarriages and gotten pregnant again, done ART procedures and gotten pregnant and had babies.

Sadness...

All the people who had miscarriage after miscarriage, or are still waiting to conceive again after a loss, sometimes a very hard-earned loss. And also all the gals I know who have had myomectomies after dealing with infertility and pregnancy loss and now are still waiting.

Saturday will be one year since my fibroid surgery. It's been a long year.

At seven weeks?

Yesterday I was at a board retreat for this non-profit I work with. I'd sorta been out of the loop for a few months, I was involved in a big fundraiser (I found out I was pregnant again the week of the event) and then had to deal with my miscarriage and subsequent grief and anemia. I needed space. I could tell some people were wondering what was up with me so when one person asked me how I'd been I just said, "I had another miscarriage, my mother was diagnosed with breast cancer and I just had bronchitis" -- nice way to throw them off-guard. That really got them off my back quickly. Some people said sorry, others just said "oh."

Later on during the day another gal, who just got married in August, announced that she was 7 weeks pg. It just stopped my heart for a second. I hate hearing about ppls pregnancies now. I had to force myself to take deep breaths.

Why'd she have to tell everyone at 7 weeks? They say don't tell until after the first tri. Personally, I don't even know when to tell and what to tell any more. I'm pg, I'm not pg, I've got a dead baby inside of me, I'm still pg but it's abnormal, I'm waiting for a d&c, I'm going through m/c labor, I'm recovering after hemorrhaging for hours in pain, etc. They don't really want to hear any of it.

I think I'm fighting a cold right now as well. Darn cold season anyway and my lame immune system.

More normal

AF's been a lot more normal this cycle though I'm still amazed at how much less bleeding I have since my fibroid was removed.

Then since my acu was so excited by my last two charts (38 & 39) I reflected on some of my previous symptoms that have improved starting from the beginning (3 1/2 years ago) when I had spotting when I ovulated, to liver qi stagnation jaggy temps (look how bad one tx from my naturopath made my temps), or my mid-LP temp slump. Based on that history, my latest charts are really wonderful signs of improvement.

This past LP I didn't have a big night sweat (sweat rolling off of me kind of sweat) until the night before AF started and my feet had been warmer up until a few days before AF was due when they got cold again.

My partner said he would go in to see them and get the herbs. I sure hope they work.

Who's not disappointed?

So AF arrived today, my yeast infection cleared up with one treatment (the one that kicked in two night ago with a raging itch and burn), and I'm feeling okay but tired.

At acu this morning my acu was disappointed that I wasn't pg, she was sure from looking at my charts that we were getting closer. So we talked about my partner's MFI and low morphology, his basic health deal and she thought that getting him on some herbs would help. From the symptoms that I described to her, she said it sounds like he's got some damp heat, kidney and spleen issues. I also agree that it is time to readdress the MFI factor and make sure that we've done everything we can.

Today I feel frustrated but there's nothing I can do about that. I hope I can get my guy to do the 1/2 hour appt. and take the chinese herbs -- for some reason he seems skeptical of chinese medicine though he takes herbs for panic-anxiety and stress -- what's the difference?

I've just started my 40th cycle. Hooray for round numbers. (note sarcasm)

No Hope

I really, really don't think it will be a BFP in the morning. It's deductive reasoning. 12dpo and nothing, not even a faint mark? If that was implantation spotting last week then something sure didn't take that 5 days later there is nothing on an HPT.

It could easily have been related to my spleen qi deficiency. My spleen/stomach channel were all messed up by my illness last week. My tongue was super coated with white -- it looked awful.

I want a BFP as much (if not more) than the (average) next gal but I just am not feeling it. It's weird isn't it how you can convince yourself you are and then just as easily convince yourself that you are not.

No it doesn't get any easier.

It doesn't get any easier

I decided to use one of the 3-pack tests I bought this afternoon when I got home just now. I stared at it and stared at it and watched the dye flow past window number one, grab onto the line in window number two and then studied window number one under several different light sources and at several angles until I finally decided to lay it down and walk away. BFnothing. Nada. No how.

Maybe I'm just jacked this LP, with the bronchitis and spotting, digestive issues -- maybe my body is a bit trashed at the moment. I'll give the tests one more chance but it isn't looking good. So much for that little jump today though.

Obsessing

Obsessing again of course and right now I've been looking at the various sites to see which HPTs have the best sensitivity. I'm not going to use an FRE or Answer this time, I'm going to try Fact Plus and hopefully that will give me a better read tomorrow.

My partner has been rubbing my tummy and asking me if I'm pregnant which isn't like him at all. I haven't told him anything about my spotting or other symptoms so that's pretty weird.

If I'm not pregnant then I'm sure having a very weird LP this cycle.

Small temp jump this AM

I know that I'm prone to get them prior to AF's arrival though. Feeling a little boggy in the uterine area though and yesterday afternoon I passed out for a three hour nap. I'm not testing again until tomorrow, I'll pick up some tests today while at work. Hmmmmmm...

Not much too report

I'm now 9dpo and after doing an early HPT last night (I know, but couldn't help it) that was negative I decided to wait until Saturday. No extra signs of anything really, a little itch on the right forearm this morning. The spotting and vaginal itching subsided by yesterday evening thankfully.

I'm not feeling very much of anything. I don't feel like I am pregnant so we'll just have to wait. A temp jump would make things look more interesting on the charting end but that hasn't happened yet.