Waiting. Waiting. Waiting.

The RE wants me to wait out the weekend then go in for an ultrasound on Monday morning before deciding to do drugs or a d&c. Okay, I'm all right with waiting a little longer. I don't want a freaking d&c.

I thought I might be lucky enough to move it out last night but nope. That feeling of nausea and pressure must have been something else, or else the upper part of my cervix was trying to grab at the tissue and wasn't having any luck. I have the occasional cramp now and again but mostly my uterus is quiet.

We had a work party last night out and were out on the town. The streets of Capitol Hill were teaming with people, probably due to it being the end of the school year/start of summer and gay pride weekend. Whatever the reason I liked it as I got to just be another person having a good time.

While at this one bar one of my coworker's wives asked me if my partner and I planned on having kids. I told her that we'd see how things went, my typical vague answer which leaves people thinking that yes we are interested in having kids and might actually be trying now or in the near future. Then she told me that they had started trying and that she had a miscarriage a couple of months ago. So I decided to tell her about mine, the last one some people at the office knew about (due to one blabbermouth who no longer works with us) but this time no one knew. I figured that it was okay to tell her though and even if she tells her husband as I suspect she wll it's okay, sometimes it is good for people to know this stuff about you. Especially since I didn't much miss a beat at work (as far as anyone knew).

This morning I have a little hangover and maybe that wasn't the best idea considering my weakened condition right now but I kind of needed the time out and it was fun.

For Someone Going in for Her First Infertility Appointment

If you are going in to see an RE (reproductive endocrinologist) it is good to have an idea about what will happen, know more about things that will be tested and also understand the range of things that could contribute to your fertility non-performance.

Usually the plan is to start with the least invasive testing and analysis and then progress into more invasive as required. Here are the usual steps:

1. Blood work
2. Semen analysis
3. HSG (before trying IUI or Clomid)

Here are some links to sites and article that I've found over the past couple of years that have been the most helpful about the general infertility workup (I've got loads of links on specific conditions and hormones as well, but I'll have to publish those in other posts.)

I like this section quite a bit for getting a handle on what you want to get out of your fertility treatment. It's very thorough.

Making Your Fertility Treatment Plan:
How to Avoid Hit-or-Miss Fertility Treatment

Here's a good link about testing:
A Comprehensive Infertility Work-Up

Here are hormones levels to reference:
Hormone Levels & Fertility Bloodwork



Another page about infertility tests

This article (Infertility Care and the Role of the Compounding Pharmacist - PDF format) has some info about how your chart can indicate different issues with follicular development and hormones

This page is for a group in Britain that does pre-conception consultations. They are after healthy mothers and babies, it might give more insight into nutritional issues for you:
FORESIGHT PREPARATION FOR PREGNANCY PROGRAMME


Remember at your appointment that your treatment plan needs to match up to your social, financial, spiritual and ideological beliefs. Be sure to communicate if you are not comfortable with anything they recommend. I've known couples that wouldn't have a semen analysis due to religious beliefs so don't be shy about standing up for yourself.

About Qi and Spleen Qi Specifically

Someone posted on the uterinefibroids message board about having a watery light colored period.

I looked it up in The Infertility Cure by Randine Lewis and it says that this is a sign of a Spleen Qi deficiency. You are meant to "avoid sugar, refined carbohydrates, starches, dairy products, cold drinks and raw foods" to help restore the spleen (those things listed damage the spleen). There are herbs mentioned (ginseng is one) but those are best taken under guidance of a qualified herbalist.

Someone else was interested in what spleen qi was so I wrote this up and I thought you might be interested as well. I have spleen qi issues as well as I've mentioned.

Qi (pronounced chee and sometimes spelled chi) is most easily described
as energy. See this page for more about qi

Traditional Chinese Medicine recognizes channels or meridians in the body which are associated with different organs. One book I read described how this is so by explaining that from our early embryological development certain tissues developed in relationship to one another and from certain groups of cells. The body retains this memory and energetic map of the body throughout our lives.

This page describes more about the functions of each organ channel

Spleen qi refers to how well that channel is performing its functions of aiding in digestion (transformation of food to energy and blood specifically) and control of the blood.

Here's more about the Spleen

Here's a map of the spleen channel on one side of the body, it is on
both sides in the same places.

I've been amazed at what they have been able to treat in me over the past year, things which Western medicine don't even recognize as problems, such as: feeling full of cold water; slightly swollen glands gone in seconds; inflamed back gone in minutes; a subtle ache across my stomach yesterday which turned out to be very blocked channel that was painful to open up but I feel much better now (I'm going through a miscarriage right now so my body was quite out of sorts and Tylenol wasn't helping at all in the end).

Herbs, acupuncture, movement such as qi gong which is like tai chi or any exercise really, plus the foods we eat, how we think/feel all affect the qi.

More about intercourse timing

Timing Intercourse to Achieve Pregnancy: Current Evidence

"Timing and Frequency of Intercourse During the Fertile Window
Intercourse on multiple days throughout the 6 days of the "fertile window" raises the overall probability of conception further, though not additively. In couples of apparently normal fertility, daily intercourse during the fertile window is preferable to less frequent intercourse because each day of intercourse raises the probability of pregnancy. Although sperm concentrations drop with increasing frequency of intercourse, in most men performing daily intercourse the drop does not reach a threshold that would reduce the added conception benefit of each act of daily intercourse. Whether intercourse less often than daily would be of benefit in men with baseline low sperm concentrations has not been studied."

This totally fits in with my theory and practice outlined in a post last week. See, my math, research and observations are not too bad.

Back from acupuncture

I went over and met with two women acupuncturists today who both took case notes and my pulse. Obviously we had a LOT of information to go over since I've been there and back over the past three years.

They were a bit amazed that we hadn't tried any fertility meds, not because they thought we ought to have but just because I had been seeing REs (4 total) and all I've had them do is provide consult, an HSG, some bloodwork, 2 d&cs and a myo.

After going over the here and now miscarriage stuff, then into my pregnancy a bit and then over my cycle history and the fibroid stuff finally we got to do some needlework. I was like a porcupine today with them all up and down my legs, on my hands and feet and across my belly. Two particularly painful areas were the palace of the uterus (down low near my bikini line) and my girdle (aka belt) meridian. The needles were fine but some of the movement they were trying to get to happen was fairly painful, not acute but really sore. Evidently my kidney channel was depleted, my lung qi was being drawn on heavily and it was depleted (channel associated with grief go figure) and my heart channel had some stuff as well. My spleen/stomach channel was doing its almost usual weirdness as well and of course, liver qi stagnation.

I feel much better now, not so entrapped by the changes my body has been going through. I'm going to sort out next steps with my REs office in the morning if the sac doesn't move out by tonight and then we'll see about medical management or herbs to try to move things. I'll have another acupuncture appointment next Thursday with them to follow up on getting my body out of this miscarriage phase and then we can start focusing on building me up again.

It sounds like a good plan to me.

In response to Anna's post about the neighbors...

Doesn't all this infertility secrecy, hurt and frustration (sometimes pain and grief too) make you realize how many people are going through bad things. Since my loss last year I now try to remember that around me are people who are hurting because they lost their father, or someone in their family is sick or things aren't going well in their life right now. There are some things that you can't say though you wish you could wear a badge sometimes and have people be nicer, more understanding.

Thanks for checking in on me.

Headache is just about gone today.

I went grocery shopping after work yesterday and did a little instinctive shopping, I see what I start craving as I start walking by the food. I offer my body things like apples, strawberries, kale, potatoes, fish, meat, broth and last night it told me to buy a pineapple, more grapes, beef broth some red meat and red cabbage (not spinach for certain). I bought other things for my partner off of our regular shopping list. When I got home I washed and ate a bunch of grapes and then cut up the pinapple which was very ripe. My headache started to dissipate after the pineapple, the bromelain it contains is a natural anti-inflammatory. Then I made beef noodle soup for myself and had it along with a cup of my dong quai/peony tea. My head felt a bit better after that as well.

When I woke up this morning I could still feel something, congestion or heat, but the killer frontal headache is gone for the most part.

I got a call back from the acupuncturist this morning. She had a cancellation so I'm going in to see her at 1pm and see if we might be able to work together. Wish me luck.

This evening I'm feeling frustrated, just a little bit but it's there. How did this happen to me again? How is it that I was so close and then the whole project got called off. Why wasn't I consulted? I don't feel like I lost a baby, I feel like I lost a pregnancy. Next time, if I can sort it out so that we don't lose it I imagine people coming up and asking me "oh, is it your first?" and I will answer "No, it is my third pregnancy and no I don't have any children."

When I'm coming to and from the house I think of my neighbors and how they must perceive our life as this childless couple. Little do they know what has happened in their midst. Yet again.

I wish I could be even trying again but I'm still in the midst of getting rid of the remainder of this loss (still haven't passed the tissue -- I think I'm going to have to try drugs this weekend).

What I felt during my brief pregnancy

It was probably more than liver qi stagnation but here were things that I noticed:

SP6 kept throbbing -- it didn't bother me last year

Breast pain that felt like I was having knives stabbed into me for days. This pain surfaced at a new greater level over Memorial Day weekend after which, a couple days later, my symptoms backed off and I had the faintest amount of spotting one day. I think that weekend was when things tipped and my body fought back against the disruption the pregnancy was causing.

Cold feet -- they were as cold in the evenings as they ever were. It didn't feel right to me.

Sweating at night

I had and still have this odd sensation of pressure above my navel.

I emailed Eastern Harmony yesterday and got a referral to someone who has studied with Randine in Seattle. I'm trying to get an appointment to see if we can't do more to rectify my imbalances. I like my acupuncturist but he doesn't specialize in infertility and I've had to suggest that we try herbs or different approaches a bunch of times. He's a little too needle work focused.

----
Here are my general symptoms we've been treating:

Uterine fibroid -- associated with blood stagnation and liver qi stagnation

I was anemic for years (just enough to have it not be a problem for my docs evidently) and this gave me other symptoms such as phlegm issues (coughing a lot, especially after meals), getting sick a lot (so much so that my friends were worried for me)

PMS symptoms starting right after I ovulated including irritibility, depression and breast pain including fibrocystic breasts (this was somewhat improved based on naturopathic and TCM diet changes and tx)

Night sweats during LP

Heavy periods that last 6-7 days

Cold feet at night, cold hands

Constipation

Stress makes me lose my appetite and thirst

Fatigue generally, depressed somewhat

Basel temps tend to lull a bit mid LP (horse pattern as per that article you/I recently posted); jaggy temps during the cycle fairly frequently

Tend to shed hair during LP and also since my surgery also during follicular phase

It's hard to be totally objective since I feel like crap (physically) right now but that's most of it.

I've had headaches since last Saturday, I think it is due to the blood loss, low blood pressure and also some qi disturbances. I'm still bleeding but my body was craving the dong quai herb mix my acupuncturist gave me and so I had some this morning. I drank the entire cup which is unusual for me, I usually only have half a cup of anything. I'm still craving more, though it is a bit of a blood thinner so I'm trying to be conservative. I'm also coughing, I think it is related to being a bit blood deficient as this was a chronic sypmtom I had while I had anemia for years (it's been better since I supplement regularly but I lost a lot of blood last weekend). My hands and feet hurt at night and when I wake up in the morning.

I emailed to the Eastern Harmony clinic and asked for a referral to someone who had trained with Randine Lewis, author of The Infertility Cure, and they sent me to this clinic here in Seattle.

They are pretty close to my office and in the same building as the dentist I go to so that would be convenient. I like my acpuncturist but I don't feel like we have made enough ground in the almost 18 months that I've seen him. Granted that was peppered with my getting pregnant and have a miscarriage and then the surgery and all but I think that I've still got too many old patterns sitting tight. I've beenthe one to suggest different approaches to my issues and I think we've learned more from those times than from anything else (that's just my opinion though).

I still haven't passed the sac. I'm going to do some yoga and qigong later this afternoon to try to help my body move things along.

Still thinking about that qi and what it might have had to do with this all

"Although invigorating the uterine blood can be risky during pregnancy, when blood stasis is present, if it isn't addressed and resolved, the fetus will abort."

"The herbal formula I prescribed for Christine is often used to treat endometriosis and uterine fibroids, and other manifestations of uterine blood stasis."

"[She] suffered from very severe PMS. About a week before her period was expected she became extremely depressed and irritable....Her menses were regular, coming every 30 - 32 days. She bled rather heavily, and the menstrual blood was dark red and clotty. She was always cold, especially her feet."

"During one visit, Claudia off-handedly told me that every month she experienced vision changes premenstrually. She had told her gynecologist and reproductive endocrinologist that her vision would dim and she saw floaters just before her period arrived, and they both told her it was insignificant. According to Chinese medicine, the liver, which governs the eyes and vision, also supplies blood to the uterus. This clue allowed me to hone in on another aspect of Claudia's menstrual disharmony. Although the liver qi had been rectified, the liver blood remained relatively vacuous and couldn't supply both the eyes and the uterus."

From: Immunologic, Autoimmune Factors, and Recurrent Miscarriage

Those things are my symptoms, my normal symptoms I have lived with for years.

I feel like there was something to how painful my breasts were that last weekend I felt pregnant. I think it was related to stagnation. My body didn't feel happy at all and while I know things like morning sickness also show that the body isn't happy there is something that tells me that my body was trying to protect itself instead of giving in to the pregnancy.

I like my acupuncturist but I think he's a little less practiced in fertility. I think a deeper understanding would be a help for me. I sent an email to Eastern Harmony Clinic to see if they know anyone to refer me to in Seattle. I don't see how any other treatment is going to work as just using progesterone last year made me feel so sick and I don't want to go through this again.

Still working on it

My ultrasound this morning showed that the gestational sac has moved down towards the area of the cervix but it has not passed yet. It still showed up as a dark blog on the screen so it still is fluid filled, though that doesn't have anything to do with it being still in there.

The nurse checked my cervix and boy did having that speculum opened feel like a treat. Everything is a little more sensitive down there right now, even the cotton swab she used to move blood away from the cervix opening was intense and ouchy.

My doctor, the nurse and I agreed that avoiding a d&c was worthwhile (see there is a reason I named my blog that) so I will just have to let my body do the remaining work to move the remaining tissue out of me which should happen within a few days but maybe a little longer. We'll reevaluate later on this week if nothing has happened by the end of day Thursday.

My head is foggy and my body still feels weird, unresolved as it was. Not as hormonally hung up as last time though but somewhere in between. I've realized that the hormonal changes your body goes through for a miscarriage somewhat impair the analytical part of the brain. Oh well, if I can just push through and focus on design work and not on any more proposals or client meetings I should be able to make it through the week.

It's 1:15 am and I can't sleep. I had a nap earlier this evening because I felt sleepy and heavy and then I woke up. I've been surfing around and not working on this proposal that is still hanging over my head.

I wish I felt tired. I feel like an insomniac.

I also wanted to thank you all for coming and lurking and posting and sending me prayers and good thoughts. It helps to make this seem less of a lonely time. I wish it was because we were all celebrating instead of worrying over this non-event.

Today I kept thinking of this song by Sarah McLachlan,"Out of the Shadows". It's from her first album. It's a pretty song but a bit moody. Reading the lyrics they hover around what I'm feeling, but I'm not going to let myself be depressed. Well okay a little. But not in a big self-indulgent way. Just a measured amount.

I'm going in for an ultrasound in the morning. I don't believe I passed any tissue, the so-called Products of Conception, over the weekend. When I called the nurse she wanted me to come in sooner rather than later. From last time I know that you can have retained tissue for a while without any problem. From other women who have gone through miscarriage I know that there is a real risk of infection. They said they might want to do a procedure tomorrow. I so don't want that. There is always the possibility of using medications to try to bring on contractions again, but who knows how long that will take. It's hard to be discreet about these things when you are dealing with nature and nature takes its own good time.

I spoke to my mother today and told her about it. First I sent her an email after she sent me a nagging one about not calling for Father's Day. I just was blunt about it, no details or anything. We talked and she was okay about it. I don't know why she was this time and not last time. Maybe it is because I've already been there and she knows it. Maybe because she has already seen me wounded. I told her maybe third time's a charm. She said that is what happened for her. I wish we didn't have so much in common.

If I can get my miscarriage to be resolved I could try to go visit her this weekend. The next two weekends after that we are busy and then it is the middle of July. She's going to start her radiation therapy and she would like to see me while she still has energy. Though isn't it ironic that I won't have any. I can't win at this game.

I'm so beat. It's like the life has been drained out of me. I woke up today at 5am to a flooding sensation and then went through hours of passing large clots and having awful pains. I still haven't passed any tissue though (argh!)

I was bleeding so much that in spite of using a cold pack and taking 1000mg of vitamin C there was no stemming the flow. I talked to my partner about how we would know if I needed to go to the hospital, it was pretty scary for a while. I took a shower around 8am (?) and it looks like that shower scene from the movie Psycho for a while. After a while longer sitting up with intense pains I started getting sleepy and so I went upstairs and fell asleep for several hours. When I awoke the bleeding was less. I sat on the couch all day and knitted.

This evening we went over to see my niece and nephew as they are going out of town for a couple of weeks. It was a good break from all the torment of the weekend but I'm absolutely wiped now.

I've got some proposals due for work that I can't get around so I'll just have to push on through and then make up with more rest and shorter days during the week.

It's been such a different experience this time around, I think last time was punctuated by needing an abortion (d&c) to get rid of the failed pregnancy while my hormones were still high and that was immensely difficult for my body to deal with. This time things waned and while I'm sad a bit it's much more okay, I can manage.

I didn't call my father for Father's Day though. Last year I called him on Father's Day to tell him that he was going to be a grandpa and then that was dashed a few weeks later. I was feeling so drained that I knew that I would have to say something of why (or at least I would want to) and I just couldn't bear to pass on that sadness today. Not on this same freaking holiday.

We've talked some about when we will try again. I'm feeling like August might be a good time, give my body a chance to recover hormonally. We'll see how it goes in the coming weeks.