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.


------

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.

Can I obsess a little?

Here are my symptoms:

Sore bbs
Runny nose
Spotting
Pain on the left side of my uterus yesterday afternoon prior to spotting
Uterus feeling full and a little crampy
and here's a nice one, a sore, itchy vagina

These symptoms are all within the realm of possiblity for early pg.

I looked at the cycle gallery on Ovusoft and some FAQs about HPTs and implantation and you need to wait 2 days from the time of implantation spotting to test. Soonest might be tomorrow. But what if it is just due to my being sick last weekend? And what if I am pg and it fails again?

TCM Tongue Diagnosis Tool

In Traditional Chinese Medicine the practitioner is trained to read signs of your health from your tongue. It's a little odd at first but it isn't without any parallel in Western medicine -- when I contracted Salmonella poisoning in France back in 2000 the French doctor asked me to stick out my tongue and he knew right away what my illness was. My tongue then was coated with a thick grey coating, it looked so awful.

One of my online buddies found this great tongue diagnosis tool which helps you figure out what's going on with your body based on signs on your tongue.

You will want a mirror in a well lit area when you do it, plus write down notes as you go as it tells you things on each screen but it doesn't give you a summary of what it all means.

Tongue Diagnosis Tool

My diagnosis right now using this tool is blood deficiency and dampness with substantial phlegm, deficient Qi and Yin, Heat or blood Stagnation in the lower Jiao (lower belly). I've got to stay the course on my TCM diet right now and nourish myself to help get rid of some of this stuff.

Ick

I totally had to push myself for work and of course I got sick. Sick, starting with a cough a week ago. A dry cough that progressed into bronchitis and all that fun on friday. I've missed two days of work and I still feel like crap. Mostly I'm just achy and tired right now.

You should see my tongue, it's awful pale and white coated -- in TCM this means I'm a mess. My acu said last week that it was related to my sickness.

I'm 5 dpo, actually based on my ovulation pains last week I would say I'm already at 6dpo tonight. At any rate, do you think Robitussin DM affects implantation?

Is it possible to get a BFP in the middle of this misery? Actually my partner got sick as well and he never gets sick so I think it was just a really nasty virus going around the office.

Here's to feeling better quickly.

Busy, busy.

Work is ceaselessly busy right now. It makes it hard to stay relaxed, rested and the like. Still, it's a lot better than when I was younger, or when I was dealing with my fibroid. I can deal so much better now.

I'm drinking my pre-ovulatory tea twice daily, taking my prenatal vitamins and iron supplements, temping each morning, charting CF, using the fertility monitor (starting in a couple days) and then I've got my acupuncture treatments. Qigong has been off the radar for a while, other than doing breathing exercises when I remember, lately almost every day, and then some movement sequences occasionally. Classes started up again last week but work has prevented me from being able to go. Maybe in a few weeks. I did make an effort to go for a jog with my dog tonight. She loved it so much, I love to watch her run -- she's 15 years old already.

I can't believe that I ovulate again next week. When will this endless dog track end. When will the rabbit die?

Interesting info about Anemia and Infertility

"Be sure your iron levels are adequate. A blood test (a ferritin level combined with an iron level and iron binding capacity) will tell you this. Unfortunately, doctors are trained to say the iron is normal if your ferritin level is at least 9 ng/ml. Although a ferritin level of 9 shows you have enough iron to prevent anemia, one can have infertility from ferritin levels less than 40. Because of this, I would look at your ferritin test results yourself and make sure the level is at least 40 ng per ml. In a study of women with infertility with ferritin levels less than 40, half of the women quickly became pregnant when put on iron. If for some reason you are unable to get your ferritin level checked, it is not unreasonable to take iron (e.g. Ferrous Sequels 1 tablet 1-2 times a day for four months). I also would take iron if the percent saturation of iron (calculated from the iron & percent saturation tests noted above) is under 22%."

From: Effective Holistic Treatment for Infertility
By Jacob E. Teitelbaum, M.D.

In a letter to the Editor of The Lancet, a group of British physicians has presented evidence suggesting that depleted iron stores, as indicated by low serum ferritin levels, may prevent conception.

A total of 113 women with increased scalp hair shedding associated with reduced serum ferritin values (40 ng/ml or less), were treated with daily supplements of 35 mg iron and 200 mg vitamin C to achieve optimal hair growth. Seven patients became pregnant during treatment. Three of the seven had histories of infertility and the other four had not become pregnant before iron/vitamin C treatment, despite regular menses and unprotected sexual intercourse. All seven conceived within 28 weeks of starting iron and vitamin C, and all had shown substantial increases in serum ferritin before conceiving.
From: Serum ferritin and fertility

In slim women with PCOS, a SHBG is particularly helpful. This will usually be below a level of 80 IU/l. The serum prolactin level will be modestly raised (>350 IU/l) in about 15% of women with PCOS. A high proportion of women with this condition will also have a low serum ferritin. This is probably caused by raised levels of insulin-like growth factor III in response to hyperinsulinaemia. The raised IGF-3 levels inhibit the production of transferrin, which will then reduce iron absorption. Correction of any iron deficiency is particularly helpful for women with scalp hair thinning and for women with PCOS-associated sub-fertility. A ferritin level of >50 ng/ml is generally needed to meet the iron demands of any pregnancy.
From: POLYCYSTIC OVARY SYNDROME AND THE USE OF METFORMIN

Women's Health: Iron May Be the Answer for Some Infertile Women, U.S.News.com 10/31/06

My ferritin two years ago was at 22, I took lots of iron and got it up. After my June miscarriage my ferritin was down to 9 and I still feel it being low. My new ob/gyn said to just keep taking iron and that I'll have to take it through my entire pregnancy (we are still optimistic that this can be done).

I think I explained about Ferritin elsewhere, but it is a protein that your body uses to store iron in the body, this site is interesting and confirms what my naturopathic doctor and acupunturist have told me about anemia/blood deficiency-- plus what I myself have experienced:

"Chronically low iron causes numerous adverse changes in your immune system, resulting in recurrent colds, flus, & other infections."
(from: FERRITIN)

Anemia and Copious Cervical Mucus

I came across this today and thought how interesting that my copious fertile quality cervical mucus was actually associated with my anemia.

"Anaemias are usually accompanied by an increased amount of L and S mucus. After treatment, these symptoms cease."
From Diseases and the Billings Ovulation Method

S- refers to "sperm-transmission" mucus (the kind that lets the sperm through easily) L - stands for "locking-in" mucus "because of the capacity of that mucus to attract and enclose malformed sperm"

One more sign of anemia to watch for.

I was at two parties yesterday with lots of kids. I kept getting asked which one was mine (*sigh*) and then someone pointed out that we were one of two couples there without children. Nice. Yeah, we actually do have babies. Dead babies. The first one's due date was in February and the second one was due in January next year. There's no winning the infertility game.

See also: Treating Anemia/Iron Rich Foods and Advice to Someone Trying to Build their Iron Stores

A Wacky Start to My Next Cycle, But Improvement

AF this time is just odd odd odd. Usually I won't have more than half a day of spotting prior to her arrival, this time I've had two. I feel totally hung up, sort of like when I was waiting for my m/c to start in June and it took a whole week before my body was ready. Today I marked as the start of AF but it's just barely stronger than spotting and dark red/brownish. It's so weird. I had a really great chart, I wonder if things have started to move in a new direction for me hormonally. Sounds scary a bit, but it could be a good thing as I had that fibroid, anemia and excess estrogen working against me before, which were all bad things.

At acupucture this morning she noted that my tongue coating looked better (it was awful and white coated last week out of the blue), confirmed that my liver qi stagnation was not an issue any more (I had noted this myself), and said that we're just dealing with minor stuff right now. She said that the spotting and symptoms of the cycle transition from LP to the Blood Phase were related to my qi deficiency and spleen qi deficiency.

My treatment helped dissipate a lot of the pain I was having (thank goodness) and she gave me a handout with some qi building foods on it. I've also got a pre-O herbal powder to take starting CD4.

It's so weird though, but perhaps my body pushed through to the other side of its deficiencies. I don't know if you had noted this but I've heard/read that sometimes the deficiency of something will trigger its excess. So heavy menstrual bleeding can be a sign of deficiency, excess estrogen can be a sign of yin deficiency and so on.

As I've mentioned I was anemic for years, even as a child I had lots of nosebleeds ages 5-12, the last big on was when I was 14 that I recall -- I got my period later that year. In TCM not being able to contain your blood is a sign of deficiency though it's harder to pick which one it might have been as it was years ago. I do think it is possible that my body got used to operating in a state of deficiency so the journey has been to reset the expectations so that it can adjust to a healthy pattern. In some ways no different than for people who have blood sugar issues, etc.

Some more miscarriage links

Check it out, lots of interesting information about early scans, percentage rates of various situations, etc.

Management of Early Pregnancy and Loss

Page of stats about miscarriage

First Trimester Miscarriage from Dr. Spoock

Dr Alan Beer is mentioned in the book Coming to Term as a repeat loss specialist. I took a quiz on the site and it said that it wasn't likely that I had an immunological reason for my losses. Probably pretty accurate for me, though the mention of retained tissue leading to an immune reaction (at link below) kinda freaked me out since I had retained tissue for so long with my first loss.

I found this page about RPL testing with posts from patients which is interesting

I'm CD 15 today and feeling heavy with achey ovaries. I started spotting yesterday and I can't wait until AF shows up as at least that will indicate that things will soon be better. I've got acu in the morning, hopefully that will help. I hope I feel better by the weekend when my MIL is in town.

Thyroid Information

Some of the links I've found helpful in understanding thyroid health, and its relationship to fertilty and reproduction.

American Thyroid Association

Thyroid Tests -- Normal Ranges and Interpretation

EndocrineWeb: Thyroid Gland Diseases

Thyroid Problems in Women

Physician Interview: Richard Shames, M.D., on Treating Thyroid Dysfunction, Chronic Fatigue Syndrome & Fibromyalgia

Maternal Thyroid Function During Pregnancy

Postpartum Thyroiditis

Thyroid Power
I've got the book and I found it interesting.

Also I know that some women have noted better results than Synthroid when they have taken Armour Thyroid as it contains T4 and T3 and not just TSH.

My Medical Care Providers Over the Past Three Years

Before having to deal with infertility I had the unfortunate luck to have been injured in a car accident back in 2000. Through that experience I realized that my healthcare providers didn't have my best interests at heart, they wouldn't let me know to come in for a follow-up appointment, sometimes I was referred to lame care providers. I came to understand that the only one fully vested in my recovery and well being was me. That helped set the stage for the adventure that started when we got into TTC.

September 2002 -- Internist diagnoses fibroid (dump internist due to issues with getting appointments and information from her in the couple of years in her care -- I had to wait a week for an appointment when my neck went out and I was in constant pain and couldn't turn my head).

October 2002-March 2003 -- worked with a naturopathic doc who helped me gain better balance in my diet and lifestyle but also wanted me on a ton of supplements. She asked me if I had considered adoption and how long I intended to cut back on alcohol and taking prenatal vits in a way that wasn't entirely supportive so I stopped going there.

February 2003-May 2003 -- Met with RE#1 who I liked and she did an okay job but she left the State and clinic after a few months. She told me I should have my fibroid out after my HSG but to find a new surgeon. Even though my basel temps charts showed that I had regular cycles and temp rises consistent with ovulation she dismissed them after saying "yes you ovulate" and then told us we should do the HSG and then move onto IUI with Clomid and that she could "make me ovulate" which I didn't like the sound of at all.

June 2003-Nov 2003 -- Met with RE#2 to try to figure out if I needed to have fibroid surgery or not. He decided to give me a fertility work-up (just blood work) and wasn't a good listener. He told us that my partner had anti-sperm antibodies almost certainly and we would need ICSI to conceive (you won't be able to conceive on your own he said). While he knew his stuff I really didn't like him and his arrogance so I left him after one last consult in Nov to review my pooled progesterone results and to see if he would provide care if I had a fibroid embolization instead of abdominal surgery for my fibroid. It ended with a strong conversation about fibroid embolization.

July 2003-Sept 2003 -- Gyn #1 who I was scheduled to have my fibroid surgery with but I got such a bad feeling from her that I cancelled the surgery 10 days before and decided to pursue other options.

November 2003 -- consulted with an interventional radiologist about having my fibroid embolized (they block the blood flow using small particles through the uterine arteries). He was nice but I wasn't sure and couldn't find a gyn to provide support to this procedure.

Dec 2003 -- met with Gyn #2 who was all right but a little young and I cried in her office and she just looked at me, offered no consolation or anything. Her office was hard to book appts with so I decided to bag them.

Jan 2004-May 2005 -- started working with acupuncturist #1 after prompting by a couple of friend in alternative medicine. He was very nice

April 2004-current -- fell down the stairs and reactivated my back injury from a car accident in 2000 prompted a visit to chiropractor #2 (chiro #1 took bad care of me after my car accident)

Jan 2004-July 2004 -- met with RE#3 who was very nice and a good listener. We were going to try clomid/IUI under his care in July but we got pg on our own in May. He did my first d&c but left the clinic the following week; he told the nurse that I didn't need to have my beta checked post procedure which was wrong. I had continued bleeding for weeks afterwards due to retained tissue and had to see RE #4.

August 2004-current -- RE#4 took care of me after my m/c showed to be incomplete. We decided to wait it out rather than try methotrexate to avoid doing a repeat d&c so soon after the first one. With my enlarged fibroid not decreasing and the retained tissue not resolving on its own she was the one who did my surgery on both in November.

June 2005-current -- acupuncturists #2/3 work together in a practice that specializes in fertility. I went to see them first the week of my miscarriage as I was in so much pain.

Sept 2005 -- gyn #3 was very sympathetic, but gave signs of being a little conservative such as 37 week c-section due to my myo though he did say that they would take good care of me on a subsequent pg.

I'm not really a problem person but I wasn't really to take standard b$ care from my docs, especially after seeing how lame they were 5 years ago after the car accident --- you have to look out for yourself.

Report from the ob/gyn visit today

My appointment went well but I was really upset by the end of it, having to explain about all I've been through. The doctor was very nice though and when he saw that I was getting upset he switched over and started saying lots of consoling, positive things which was what I needed. We talked about a c-section delivery and how he would do that and I learned some about their practice. He was a little confused as to why I was seeing an RE without having fertility treatment but finally I think he got it, just circumstantial that we hadn't yet gotten to any fertility treatments. I feel like Annie in the musical, "I think I'm gonna like it here."

I dropped by my RE's office which is now on the next floor down to say hi the office staff who know me pretty well now. Still feeling upset, I decided that I wasn't ready to go in to the office so I went home and took a nap for an hour and a half (I did get up at 5:30 this morning) and then felt tired and icky after I woke up. I cooked lunch and made some passionflower tea to calm my nerves (good stuff) and realized that I was holding my muscles related to my uterus. I've been feeling crampiness like after my HSG. I think it was the PAP that set it off, probably brought back pain memories as well.

I finally got into work after 2pm. C'est la vie right?

Stuff about Crohn's Disease and Ulcerative Colitis

[I'm always searching out weird topics so I thought I would share this recent post]

I met the author of the book Eating for IBS once a few years ago and thought she had an interesting perspective on how to manage IBS and other diseases of the bowels using diet. You can visit her site here:

HelpforIBS.com

I don't have this condition but it's totally plausible to me that diet/lifestyle/medications were contributory causes. It isn't a normal, healthy, homeostasis condition. Here are some other links that you might find interesting:

small-bowel bacterial overgrowth(SBBO)

Bacterial Overgrowth Syndrome

Breaking the Vicious Cycle - The Specific Carbohydrate Diet

Cultured Cabbage Juice - Make the Best Lactobacteria

I've also found reference to birth control pills sometimes being a factor -- making the condition worse or better, which seems to indicate a hormonal contribution as well. Knowing that progesterone relaxes smooth muscle tissue and changes the way our bodies deal with blood sugar levels, it isn't so far fetched that hormones coud affect all aspect of our system.

Crohn's Disease and UC came up while I was searching for information on Chronic Fatigue Syndrome as well. Do a search for more information though, the terms "crohn's disease chronic fatigue" turned up a bunch of interesting results.

Gyn Appt

I posted a couple places today about looking for a good Seattle ob/gyn and someone on Babycenter's fibroid board gave me her docs name. I called over there to speak with them and let them know my story: 35, TTC, 2 m/cs, fibroid surgery, RE, etc. and also about how lame my other ob/gyn's office was and asked if they could do better. They had an opening tomorrow so I set up an appointment for a pelvic exam -- with a doc whose name had been given to me by a friend a while back -- she switched her ob in the 8th month of her pg to this guy. I'm a bit nervous as I hate having to deal with allopathic doctors and their myopic view of medicine, but I still keep hope that he's going to be nice to work with.

I'll have to go through the medical records I have at home tonight and bring along copies with me to the appointment. Oh and they told me not to insert anything vaginally for 48 hours prior to the appointment. I mentioned the prog supps and the person on the phone said not to use them. I'm mid LP though. What should I do? Use one tonight and not in the AM? It would be dissolved by then. It probably has to do with the PAP though I doubt it will interfere in a measurable way -- who knows.

I have checked my temp during the night as my partner keeps coming to bed after 1am (grumble) and waking me up. I haven't yet had a sustained high temp overnight. When I was pg the first time my temp was 98.6 in the middle of the night as well as when I woke up. I also don't have an itchy forearm which happened both times I was pg. I tested yesterday with my last FM stick and it just showed a little LH as it did last cycle around this time. The curiosity got the best of me this AM and I used one FRE (I so want to be one of those gals who goes in for a beta on CD9 and has a raging great result) and it came back negative as anything. It's still early though and the cycle I got pg last I tested negative on CD9 and ended up getting a BFP on CD13 so perhaps there's hope yet.

It could have been me

Last night I went to a community BBQ and brought along my SIL and my baby niece and nephew. I watched the baby while my SIL followed round her son as he played on the playground equipment at the park we were at. There were lots of people there I know from around the neighborhood, due to my community activism. Almost all of them came over to ask me if my niece was mine.

Yes, I don't see these people all of the time, mostly only in email and at occasional meetings. Yes, I was holding a baby with dark hair like mine. But really folks, an 8 month old infant doesn't come out of thin air and most of them have seen me within the past year when I would have looked pregnant. Many of them knew I had abdominal surgery last year as well, though not what kind of surgery and I suppose that still didn't exclude me from having a kid now.

So, it was a mixed thing. A little fantasy about what it would be like if I had a baby, this baby that I held that was born the same week as my first [a] was due. There was also the stupidity of it all, the frustration as well. Of course I want a baby, no this isn't my baby but it could have been -- at least in an alternate reality. I guess I should be thankful that no one asks why I don't have children yet. As if there is any easy answer to that question, because even I don't know why we don't have children now.

(P.S. I'm at 10dpo and no sign of anything vaguely pregant with me yet. Two things I'm looking for are an elevated basel temp in the middle of the night and an itchy right forearm -- my symptoms that are particular to when I've been pg)

Types of Iron

There are two kinds of iron, heme (heem) and non-heme. Heme is found in animal sources of food (red meat, liver, clams, salmon, eggs, etc.) and non-heme is found in vegetables (spinach, raisins, kidney beans, lentils etc.) Heme iron is easier for your body to absorb, though in what I've read your body can absorb more non-heme iron in the presence of heme iron.

So you want to have some spinach with your lamb curry and then you'll have your bases covered. As an anemic gal trying to build her iron stores I've been eating like that (by the way indian and ethiopian are great ways to get good iron in your diet from plant and animal sources) and taking my prenatals plus my chewable iron as well.

Bowling and Babies

We had a company bowling event last night and in addition to my niece being there one of our employees bought along his wife and baby. The baby was 5-6 months and babies that age just remind me of my first m/c and make me really uncomfortable (that could have been me, ya know?) I didn't even say hi to the woman, I'm sure she thought I was cold. Other people from our company were carrying the babies around and the like but I just feel like babies are a loaded subject for me. I could see the wife of another employee staring at the babies as I know they are interested in starting TTC. It just made me think of how much heartache TTC has brought me and as I fell asleep last night I kept thinking to myself that maybe I would be better off just not having babies.

An update on the dysmenorrhea

I had a stomach virus or something. It was connected to a different virus I caught weeks ago with a temperature and everything -- the connection was the stomachache that lasted for weeks. It's possible it was some sort of micro-organism as in the end several of the symptoms were similar to when I had salmonella, though the timing was spread out and the symptoms didn't happen all at once. I felt like I needed to throw up two weeks ago, and also like I was going to have diarrhea. I made mention of it to my acupuncturist. The following Sunday I woke up and felt really ill and proceeded to empty my digestive tract over and over for several hours. That seems to be the end of it though my acupuncturist today noted still some disturbance in my stomach channel.

Pretending

Lately I've been feeling like it's all just pretend. I'm pretending that eventually I am going to have a baby. I'm pretending that this is something that will happen to me. Like looking at some Hollywood actress or rock star and thinking that I could do that (don't we all have those moments?) Since its been so darn long I just feel like I've been pretending for a long time, that small piece of hope left seems almost a little silly.

The other side of it is that I worry that I'm just getting too comfortable in my own life (not such a bad thing) and that I'll not be able to adjust to sharing my world with a wee one. That I should even be so lucky. It's been an ongoing worry of mine, though feeling comfortable is a newer addition.

But then here I am in the 2ww again (2dpo) and that little piece of hope (and distraction) lifts its head and says "what if..." If it wasn't so sad it would be aggravating.

We went camping over the weekend and I brought along my digital basal thermometer to temp with. Of course it was freezing at night (38 degrees) and so I slept with a hat on and a wool blanket over my head but who knows if my temps are what they would have been otherwise. It was challenging getting one BD session in with our friends there with us. We had one session Saturday morning before we left and then one on Sunday afternoon and then I ovulated on Monday. Not as much as we usually try to get in but maybe the timing was good enough.

I had acupuncture today and it was very relaxing. I'm on a luteal phase herbal formula that tastes okay though a little smokey. Fingers crossed pleased that we catch another eggie.

Unbelievable indeed.

Last week I got an email from an old boyfriend announcing his engagement. We've stayed friendly all these years, it was only a little thing we ever had, so I was happy for him. This morning however he follows up with an email blast to all his friends announcing that he's expecting a kid next March. WTF? It sounds like they weren't even trying though if she's due in March then they have known for a while now.

It's nice how he phrases it:

Unbelievable really as we were always told it would take ages once you were in your thirties etc, etc and hey presto wham bam, first time trying ! Always knew I'd be super fertile ;-)

This guy has said for years that he would never get married and never wanted kids. Uh, yeah right.

Feeling poorly

I'm on cycle day three of my 38th cycle charting. I've been feeling so poorly these past couple of days that I finally looked up dysmenorrhea (painful periods) and I fit the definition to a T this cycle. What's up with that? I've got stomach pain, lower GI discomfort, headaches, I'm not sleeping well. Its actually not a normal pattern for me. I've also still got symptoms from that virus that's been going around the office, others have the same symptoms -- sore back, sinus congestion, faint numbness in hands and feet. One of my employees saw her doc about it today and was told it was indeed a virus and that it might take another 2 weeks for the symptoms to clear out.

I had an acupuncture treatment this afternoon and she treated me for blood stasis in my abdomen that was causing me a lot of menstrual pain, as well as my immune system and also to help stimulate follicle development. They told me to take a break from the herbs for a wee while and see how my body does. I told her about how when I was younger and stressed out my stomach would hurt me (I spent many hours in the nurse's office in 6th grade with stomach aches when my parents were fighting constantly and close to divorce and I wasn't doing my homework), and sometimes if the emotional stress was intense I would get diarrhea (first bad breakup I couldn't eat for a month and when I did I had diarrhea -- I lost 10 lbs). Certain types of really bad stress would even cause me to have mid-cycle bleeds, but never annovulation, I never missed a cycle. She said that it fit in with what she knew already that I have an overactive liver but that normal Western testing wouldn't show any dysfunction and it ties in with my other complaints as well. In TCM the liver is associated with emotions and I'm such a freaking sensitive person and a bit neurotic as well (but I'm sure you noticed that by now). Its just who I am and while I've made lots of changes I don't know how much more I can do. To think that sometimes just being can be the thing that throws you off. I don't even want to know about it. I fell asleep during the treatment at any rate, for a good 40 minutes, which felt good.

While sweeping our back porch the other day I was thinking to myself about what someone on the boards wrote to me after my first loss; she said "God must really love you to put you through so much." I too know that I'm stronger in some ways, maybe more wise to the ways of the Universe and my connection to the world around me. My losses are a part of who I am now.

Sometimes lately I've been thinking of just getting used to the idea that we won't have kids. It's been such a very long road so far. At least I'm needed at work and I'm getting to do more consulting work. I don't know what the future holds and I talked to my great-aunt about it when I was in New York. There are places for all kinds of mothers in the world, and not all of them are biological. You don't even have to be an "adoptive" mother to make a difference. You know I've heard that for troubled children even a 15 minute positive encounter can build esteem enough to help that child find hope and change direction. Maybe there's a place for me there in the world. I just don't know yet.

Tonight I did a brief liver qi cleanse as I missed my qigong class for the second week in a row. This time because I wasn't feeling well, last week was due to traffic and class just not being at the park where they were supposed to be.

Call back from the nurse

The RN asked me if the RE had planned on any more bloodwork since my recent panel came back normal except for ferritin being dead low.

She said there is a lot that can cause nightsweats but w/o having blood work to show what's going on it's hard to know what the deal is. I noticed as well in doing some searches and looking at my reproductive endocrinology textbook last night that estradiol levels in the late luteal phase is not really something that is covered a lot; it isn't interesting or something.

She mentioned that Clomid might be an option, that the goal was to get me to have a healthy egg and a healthy pregnancy. I totally agree. I told her that the only reason I'm being such a spaz about trying to figure out if there's something we've missed is that I really really really don't want to have another m/c; if I can do anything at all to help prevent it then I will.

I've only been able to try 4 cycles since my fibroid surgery, one of those cycle I got pg and the last one was my first try after my m/c so my stats aren't really that bad again...yet...

Honestly I'm on a much better course of health than I was when I started TTC. I don't have a large fibroid any more, I'm working on building my iron stores, I'm much more relaxed, I eat better and more regularly, I'm not spotting when I ovulate, I don't have BV. That's how I was when I started out. What a winnner eh?

I've had the night sweats for years, I remember them as early as when I first moved to Seattle when I was 23 so it's not a peri-menopausal thing for me.

I'm waiting for the NP to call me back now as my RE is in surgery today. I'll let you know if I find anything out. I'll also bring it up with my acu next Tuesday and find out what her perspective is.

Chinese Herbs I'm Taking

I just looked up the herbs I'm taking from my acu, the ones I haven't been great about taking lately and if I did they might help out with this. Anyway they contain:

White Peony
quote:

Traditional Chinese applications: Blood deficiency affecting the uterus, with irregular menstruation, dysmenorrhea, or excessive bleeding; spontaneous sweating and night sweating; abdominal pain or spasm; pain of the hands or feet; headache and vertigo due to preponderance of liver yang

Dong Quai (or Dang Gui)
quote:

Traditional Chinese applications: Blood deficiency syndromes; irregular menstruation, amenorrhea, and dysmenorrhea due to deficiency and stagnation of blood; abdominal pain due to deficiency and cold; pain due to stagnation of blood; traumatic injury; pain and numbness in muscles and joints; boils and carbuncles; constipation due to deficient blood and dry intestines

(carbuncles?)

Some of my symptoms are cumulative over many years, some over the past few years with my stupid fibroid, and then some very recently with my 2 m/cs and fibroid surgery. Boy it seems like I'm getting worse instead of better as I go down this infertility path. It's a good thing that I'm doing what I can to reduce stress, eat better and drink more water or else I would be a complete wreck.

I'm probably going to call and mention my luteal phase night sweats and my weird results with the FM test sticks to my RE's office since when we talked a few weeks ago she said that some women's body reacted more strongly to the drop in estrogen but my pee test shows it was actually an estrogen surge and not a drop.

Stupid Hot Flash or Something

I had a night sweat two nights ago and a hot flash yesterday evening that lasted quite a while. I did a FM test which showed really strong estrogen, stronger than the previous 5 days (mid-LP) which I was testing for just to see if there was any LH or reason to use a HPT (we can all have dreams right).

I read on a menopause site that some women have hot flashes even with elevated estrogen levels. I guess that would be me. But why is my estrogen peaking this late in my cycle (cd10?)(maybe its normal -- see hormonal chart on this page -- but why does it give me hot flashes and night sweats?)

I feel like I'm such a hormonal mess and I don't know if its genetic, environmental or what but for all the acu and herbs I've done (not too many herbs) why is my body still such a freak. I feel broken.

And since my mother's hormonal pattern was really similar to mine and she's recently been dx with breast cancer its even more concerning ya know?

I just came across this page about CFS and some of my symptoms/pattern are there, particularly the kidney yang/spleen qi and kidney qi deficiency. I want to be balanced, not deficient.

The Patron Saint of Fibroids (in Pregnancy?)

I just came across this and I'm fascinated because I know so many women here and elsewhere on the Net who have been through similar trials and yet haven't been beatified. But, at any rate, I guess we have a patron saint.

Gianna Beretta Molla (1922-1962)

"In September 1961 towards the end of the second month of pregnancy, she was touched by suffering and the mystery of pain; she had developed a fibroma in her uterus. Before the required surgical operation, and conscious of the risk that her continued pregnancy brought, she pleaded with the surgeon to save the life of the child she was carrying, and entrusted herself to prayer and Providence. The life was saved, for which she thanked the Lord. She spent the seven months remaining until the birth of the child in incomparable strength of spirit and unrelenting dedication to her tasks as mother and doctor. She worried that the baby in her womb might be born in pain, and she asked God to prevent that."

There's also a web site for The Society of Blessed Gianna Beretta Molla
(http://www.gianna.org/). Where you can learn more about her condition during her last pregnancy.

Crash and burn.

I think something may have been trying to gain a hold but then it didn't work for some reason as my temps the past two days have been down. Last night I had my typical luteal phase night sweat as well.

Here are my temps:

cd9 -- 97.5
cd10 -- 97.5
cd11 -- 97.5
cd12 -- 97.5
cd13 -- 97.5
cd14 -- 97.5 (Ovulation)
cd15 -- 98.1 / 1dpo
cd16 -- 98.1 / 2dpo
cd17 -- 98.0 / 3dpo (NPC)
cd18 -- 98.4 / 4dpo (NPC)
cd19 -- 98.1 / 5dpo (NPC)
cd 20 -- 98.1 / 6dpo (50 mg Rx Prog)
cd 21 -- 97.8 / 7dpo (50 mg Rx Prog) (dip to CL)
cd 22 -- 98.6 / 8dpo (50 mg Rx Prog)
cd 23 -- 98.7 / 9dpo (50 mg Rx Prog)
cd 24 -- 98.0 / 10dpo (50 mg Rx Prog)
cd 25 -- 98.1 / 11dpo

Sigh. Someday we'll figure this out. I wish I knew how to get my body and pregnancies to work together in a friendly long-term fashion.

AF is due on Sunday. It will be good to be done with this cycle so I can work more on building my blood stores.