More about cortisol (hypercortisol)

I opened up my reproductive endocrinology textbook this morning and found some info about cortisol. Evidently your body will produce excess cortisol in a variety of situations (addison's disease, cushing disease, anorexia/bulimia, tumors, etc.) but stress will increase it's production most certainly.

Low blood sugar will also cause an increase in cortisol production and it is related to blood sugar levels that you will have the night sweats, it has to do with some metabolic thing that happens overnight with the blood sugar.

Facts You Should Know About Night Sweats...

Here's another thing, excess cortisol will interfere with your thyroid hormones but your TSH and T4 will show up normal. It's the T3 and anti-T3(?) that will e low, and those aren't tested unless you have a full thyroid panel done, normally they only test for TSH and T4. Other signs of this pathology include low blood pressure -- how very interesting that I have that and it runs in my family. I'm also really sensitive to stress, one of my responses is to lose my appetite and thirst -- which only makes this cycle worse as it adds to the stress.

Thyroid and Anti-Thyroid Drugs

One test for adrenal function is a 24 hour test where you collect all your urine and they are able to see how your body is handling its sugar. My partner had this test a couple years ago and it showed he was hypoglycemic.

I did find mention of surgery increasing cortisol production in the body and it can be related to amenorrhea as well.

There was a liver component as well where one of these hormones (I also looked up prolactin but I don't think it was that one) in excess interferes with liver function. Potentially one might assume that this might result in one other possible cause for excess estrogen in the body -- oh yes, I've got that too -- and estrogen excess is linked to fibroids. (also too much cortisol will impair immune functioning, which might be why so many women seem to notice fibroids occuring after periods of extreme stress such as divorces and deaths in the family).

And I remembered one more thing, with this type of pattern of excess cortisol interfering with T3 and the blood sugar issues, they noted (in the case of anorexic/bulimic women) that fertility decreased during the Fall and Winter months. It had something to do with the affect of adding increased melatonin into the mix, melatonin production evidently increases as the amount of daylight decreases. How weird it all is.

In all that I've read though, the best ways to reduce your bodies cortisol production is by resting, taking regular exercise, cutting back on sugar and salt (craving these are one indicator of adrenal exhaustion), reducing stress, and eating small, regular meals. Parsley might be a help (of all things) as it is a adrenal tonic. Also rhodiola rosea which is an adaptogenic herb.

This page has more info about dietary things to do:

Adrenal Glands Revival

Look what I came across, this is what one medical author described pregnancy as:

"...a neoplastic, endoparasitic (i.e. neoparasitic) autoinfection of relatively high pathogenicity and low average virulence which is localized, self-limited, and nontransmissible; "

And we want to do this to ourselves why?

It's an article about whether or not pregnancy might be considered a disease. You can read the full thing here:

THE ILLNESS PARAMETERS OF PREGNANCY

Cortisol and Night Sweats

I'm onto something, a few things really but the one that has my attention right now is cortisol. I had really bad night sweats at the beginning of my pregnancy. Evidently panic attacks are associated with night sweats and I know from my partner who has panic anxiety that adrenal exhaustion triggers cortisol production. I came across a reference last week that mentioned that kidney yang deficiency was akin to adrenal exhaustion and I've been diagnosed with kidney yang deficiency -- boy doesn't it all come full circle with the night sweats.

ADRENAL FATIGUE

I found a couple of links about cortisol and pregnancy loss which I posted to the progesterone and miscarriage post, look towards the bottom of the links.

I've also been looking up about heparin and blood thinners to help stop immunological rejection of pregnancy. I posted a few weeks ago about some similar cases treated with chinese herbs that contained dongquai which is a blood thinner so I wonder if trying the blood thinner route might be worth it -- and then it is a matter of eastern or western medicine.

Just a quick one. I got my period today finally, the first time since April. Granted I had the bleeding with the miscarriage but if you've been there, you know it is different and doesn't count as a period. I had cramping and spotting last night and today and now just a somewhat normal flow. I don't think there will be anything dramatic this time, I sure as heck hope not.

It's hard not to be reminded of the last time I had cramps a few weeks ago and all that crazy hemorrhaging.

We're planning on going on a trip to Europe in a few weeks and I think we may need to hold off trying again until after that as my ovulation this cycle will land us not at home with my medical and acupuncture care in the early weeks of a possible pregnancy and I so don't want the experience of pregnancy and possibly loss while travelling, not with my brilliant history. I guess we can just do FAM for a cycle for avoidance.

I know that casually on the Internet it has been suggested here that you start trying again when you are ready, or as soon as your first post-partum AF has came and went, but lately I've been thinking differently. I'm not even going to go into emotional healing before TTC, but strictly about how strong you are post m/c.

With this second loss I found myself completely knocked to the ground with anemia. I lost a lot of blood, probably more than 2 pints over several hours, it is so hard to quantify as it spills out of you into the toilet. I was having horrible head rushes where everything would go black if I got up ever so barely quickly, I had no energy, I've been cold, out of breath, my skin looks a bit dry, my gums are pale, etc. All symptoms of anemia. My RE had my blood levels checked and I'm anemic, not dangerously low but need to get it up there you're not healthy low.

When healthy people donate blood, they usually only give one unit of blood (close to a pint I think, maybe someone can correct me). They tell people to wait 8 weeks before donating blood again and I've heard that it takes a month to rebuild a pint of lost blood.

It's common for women to get anemic in pregnancy due to the greater demands on her blood supply, which increases to help support the pregnancy. I was just talking to a friend of mine and she's 21 weeks pg and anemic. I imagine that she wasn't very anemic, if at all when she went into her pregnancy. Its probably doubly challenging to build your iron stores when you are already pregnant.

How unwise would it be then to get pregnant if you are definately anemic? I've just started AF, the first one since my loss, and I just don't feel like my body is up to it yet. I'm due to go in to see my RE this week and I'm going to get my ferritin checked, that's where they look not just at how many red blood cells you have but they are able to determine what your body's iron stores are like. From my uterine fibroid friends I've learned that even with just low ferritin and not low red blood cells you will have symptoms.

Based on all that I've been feeling and then learning more about this I think it would be most wise for me to wait until September until I TTC again. I did have the two losses and surgery this year so I might be a bit unique. I just wanted to share in case it helped you in your journey as well.

I've compiled some info about treating anemia and iron-rich foods previously.

With the way the medical establishment is managing obstetric care many women don't get in to see their docs until they are 8, 10, 14 weeks and sometimes later. But when you have a hard time getting in to see your doctor they are also giving you a signal that they aren't available to provide care to you in those early weeks, right when there might be catastrophic problems as in ectopic or molar pregnancy, not to mention missing other things like progesterone deficiency which some of the time is likely a cause and not a result of failed pregnancy (Coming to Term mentioned this).

It's so hard to know what feels right when so many of the symptoms of early pregnancy just feel like crap anyway. And we all know that when people post on teh pregnancy board that they are having spotting in early pregnancy and people reassure them that it is normal, we know that they aren't always right. I'm sure there are a bunch of women here for which that was the case. Or how about having your symptoms lessen? Lots of people say that it can happen that your body adjusts -- well this last time that didn't happen for me; that was when my pregnancy failed. Then when you add inaccess to medical care due to practice management* of course you are going to end up with a lot of anxiety.

* Practice management has to do with how medical office manage their practices. It's become a more organized routine with workshops being offered by outside agencies to doctors and their office managers. We see it as patients when you see a nurse practitioner instead of a doctor or are told you need to wait 2 1/2 months for an pelvic exam or that you can't see a doctor until you are 15 weeks pregnant and that you will see a nurse practitioner at 10 weeks. These things are not entirely based on what insurance will or won't cover, it has to do with maximinzing the number of patients the doctors can see and increasing their gross revenues some of the time.

Progesterone and Miscarriage

I've found a few links that I've bookmarked about progesterone and I'll add to this post as I'm able to comb through more. I think that progesterone is part of my problem.

"I myself give progesterone. I'd rather take a chance on delaying a miscarriage than writing off a baby that just might make it..."

"Note: The normal level of progesterone is usually "15-20." If the progesterone level is ~13 or so, this is seen as salvageable. If the progesterone is <5, I've not really seen progesterone do any good."
From: Exercise in Early Pregnancy: Risk, Low Progesterone, and Miscarriage

Hormonal causes for recurrent pregnancy loss

Progesterone Therapy (PDF)

Luteal Phase Progesterone Level(s)

Also estrogen dominance can lead to prolactin excess and low progesterone production. Here's an article about elevated prolactin and miscarriage
High Prolactin Linked To Recurrent Miscarriage

Progesterone Therapy in Pregnancy

Possible Ways to Prevent Miscarriage

"The researchers found stress hormones such as cortisol are raised in the bloodstream, suppressing the production of progesterone - a hormone which is crucial to the maintenance of a healthy pregnancy."
From: Stress 'linked to miscarriages'

"Increased levels of cortisol are associated with pregnancy. Physical and emotional stress can also elevate cortisol levels."
from: Cortisol tests

Birth control patch linked to higher fatality rate/ Estrogen thickens blood?

Birth control patch linked to higher fatality rate
Report: Device has three times greater risk of stroke, blood clot
than pill

"Blood clots are an accepted risk from hormonal birth control because estrogen promotes blood coagulation."

Had you heard this about estrogen? In Traditional Chinese Medicine
blood stasis as one of the causes of fibroids. Chinese herbs that I
took last year that did cause a reduction in my fibroid size included blood thinners (which I noted since I used them during my period accidentally and had some crazy bleeding for a few hours). Very interesting...

BTW--

Since I'm Ms. Infertility I've had lots of blood work done to check
on my hormones, I've tested borderline low for progesterone and
elevated estradiol (at least at last check)

How many of you have had your cycle day three bloodwork done by the
way? It's a common panel dones for women who are trying to conceive,
especially when you are experiencing infertility, but I'm not sure
how common it is for regular ob/gyn care. I don't expect that many
women to have had their progesterone level checked (7 days post
ovulation), another common blood test done for fertility. I just
wonder how many of us are running around with hormonal imbalances
that are going unchecked, treatable perhaps by diet and lifestyle
changes.

I'm doing okay.

I had my acu appointment yesterday and the practitioner asked how I was doing about my recent loss. I told her I was feeling a bit confused still about it, as to whether or not anything could have been done and that the idea of meeting with my RE makes me mad (if there was something she could have done last time why didn't she just do it). I'm feeling better than I have for weeks and I think the nice weather and having the workmen out of our house has helped with that. I've actually been doing housework again, I was slacking for a long while and the house was showing it.

I told her that my SP6 had been bothering me (point a couple inches above the ankle bone on the inside of your leg, a point associated with ovulation and the joining of the kidney, spleen and liver channels) and also the kidney points in the indentation on the insides of my ankles had been throbbing. She put in a bunch of needles and I felt better after that. She said my liver pulse was a little wirey but it tends to feel that way for most people, but the most problems were my spleen, blood and kidney were weak.

Today I will start going to qigong class again. I've been doing some on my own but haven't been to class since March.

My fear right now, and not at the forefront of my mind but just there, is whether or not I'm destined to keep losing my pregnancies. We're a couple weeks away from TTC again so that's what comes to mind (as if we should be so lucky to get pg again on the first try[:|]). I told my acu yesterday that I just don't see how the next time will be any different at this point.

I'm supposed to go in to talk to my RE but I don't see the point. I should do it anyway and not be so arrogant because maybe she'll have something interesting to say. I was thinking of bringing in my list of symptoms and see what she says about it -- I'm sure many of them she won't have any idea about though they are recognized as symptoms in TCM.

I'm making myself drink more water, struggling still but trying. I don't get thirsty and it really isn't healthy for me to be so dehydrated.

I'm sure many of you read the Little House on the Prairie books by Laura Ingalls Wilder. I bet you missed this part, or that it didn't make sense to you then. I reread the series last Summer while waiting for my miscarriage and this small section was so much more vivid based on what I know now:

...and then one day that was really warm they drove the four miles to see their good friends, the Boasts.

Mr. and Mrs. Boast lived by themselves on their farm They had no children and could hardly make fuss enough over Rose.

When at last the visit was over and Mr. Boast was standing by the buggy to see them start, he started to speak, but then hesitated and finally said in a queer voice, "If you folks will let me take the baby in to Ellie for her to keep, you may take the best horse out of my stable there and lead it home."

Manly and Laura were still in astonishment, and Mr. Boast went on. "You folks can have another baby and we can't. We never can."

Manly gathered up the reins, and Laura said with a little gasp, "Oh no! No! Drive on, Manly!" As they drove away, she hugged Rose tightly; but she was sorry for Mr. Boast as he stood still where they had left him, and for Mrs. Boast waiting in the house, knowing, she was sure, what Mr. Boast was going to propose to them.

From The First Four Years, by Laura Ingalls Wilder.

As it happened the Wilders had their little girl Rose and then a son who passed away in his first year. They had no other children of their own after that. Still, I wonder what the true backstory was of the Boasts and what conditions and circumstance had left them childless and so convinced that they would have none.

Today's my birthday. I'm 35 now. That means that in Western medicine I'm now considered advanced maternal age. Whatever! I can't believe I'm 35 and I don't have any children. Life just pulls you along sometimes and there you are, not where you expected to be.

My partner got in the "mood" this morning so I thought why not. I don't really have any sex drive right now but that shouldn't stop everyone from having a good time. In the middle of it though I started crying, tears kept running down my cheeks. It wasn't anything in particular, just happened. I think it is everything starting with having to use a condom during BD to prevent pregnancy, yeah that's what I want to do right now. I have to manage my fertility. Why, because the rational part of me knows that my body needs a break and I need to make sure that I'm not hurting myself by throwing a possible pregnancy at my tired body right now. I need to wait. But waiting just makes things feel even less normal right now. Then there's so much else hovering. Like all the people who don't know. I feel like I'm putting up a brave face and all but I want everyone to know what hell I've been through. Hardly anyone IRL knows the challenges we've been through in our pursuit of a child. And now, losing my second pregnancy, I just want a little more love and kindness. But I don't want to have to tell them. Can't they just know?

I've continued feeling weepy all day and my right ovary is aching; I fairly feel like I'm going to explode somewhere inside. I think the crying is the hormones, probably the biggest drop in my estrogen level that I've had in a couple months as my body prepares to ovulate. I've got to just ride out the hormones, wave by wave, somehow. But mostly I just feel like I wish I didn't have to feel it at all.

Hey, how about that?

My ovaries started hurting last night. First the left one which I thought was curious as that is my stronger ovulating side and it was the side that had the corpus luteum that sustained (or didn't) my last pregnancy. Then a little while later my right ovary started aching. Just aching and aching off and on for the rest of the evening.

A couple weeks ago, when I went for my scan after that big weekend of labor and hemorrhaging, my ovaries were hurting badly as well. The nurse practitioner took a look at them and there wasn't anything that showed up physically in the scan, no cysts or anything, just plain ovaries. It was interesting to me that I could feel so much and an ultrasound didn't show anything. I wonder if one of those color scans would show up differently though, they show blood flow and heat.

But I digress... Late last night when I got home from dinner with my friend I had my first encounter with EWCM since the end of April/beginning of May. Hey I thought, my body is trying to ovulate. I don't think it has happened yet but we're on our way. And that means that I'll get my period in a couple of weeks. Hmmmmm... a couple of weeks from now...when I'll be in New York visiting family. Argh! AF and family visits don't mix very well, especially with my family being as dysfunctional as it is, my having not been there for a year and a half (the longest ever), my friend with her twins that I need to meet (now just over a year old), my mother with her cancer and treatment and me, anemic and still recovering in some ways from my miscarriage. Sounds like a party right?

I had acupuncture this morning and she did an Internal Dragon treatment after I told her that my body is still a bit confused about what just happened to it and that I'm feeling like my whole being is a little confused about pregnancy now as it's such a start and stop experience that never reaches fulfillment. She said it was a good time to try to clear that out. I shed a single tear during the treatment which was done lying on my back and without an open window this time. The needles were in one just below my sternum, one on either side of my navel but out about 1 1/2", on in the outside of each upper thigh and one in each ankle. Again I was to think about letting the grief and confusion go, ask my mind to not block it and ask for help from a higher power. Definately qi was moving around my body, I really could feel it, how resolved I will be from the treatment I don't know. I did go in with bad allergies this morning and after treatment I was cleared up, pretty amazing. My primary thing to work on is my blood deficiency still, everything else in my system is present right now.

spot.spot.spot.
when's it gonna
stop.stop.stop?

My temp went down to a new low of 97.3 F this morning, a nice pre-ovulatory temp if I ever did see one. I don't get lower temps than that, if I did it would mean there was something wrong with me.

I can't wait until AF shows so that my system will be fully cleaned out. Hopefully then I'll slide back into a normal temp.

I did qigong while I was camping and it was so weird, I could feel my deficiencies. Earlier this year I could feel my liver qi excess and stagnation, this time it felt kind of empty. My heart qi was weak and on Monday morning my Spleen qi was deficient. I'm not feeling any excess, just deficiency. I've got to keep my practice up.

I've got acupuncture tomorrow AM (not today like I thought) and hopefully things will be ticking along better than normal soon enough.

Blood Draw Results

I'm going to celebrate today because my beta level came back at 12. Last summer it took until the end of October to get that low, and I miscarried/had my d&c in July (I had retained tissue remember).

My hematocrit is low but I can treat it with continued iron supplementation and eating iron rich foods. My acupuncturist also has me on a blood building herb formula.

We're still going to take a break until August so I can build up my reserves.

It's still hard though, I thouhgt I was doing well and then I went into Borders at lunch and passed by the wall of pregnancy books and it just made it a little harder to breathe. I remembered standing there a few weeks ago and hoping in my heart that I would have reason to need some of them. Maybe next time.

A summer of last hurrahs

So last night I went out drinking and dancing with friends. I let my hair down, got all girlied up and boogied. It was a lot of fun. If I was pregnant or had a kid already then hanging out until 2 am would not really be an option. But since I'm not, I can have one last hurrah, actually a summer of last hurrahs. No babysitters for me, I can just throw on a cute, sexy outfit and hit the town.

It's really rather amazing. It's like getting that card in monopoly where you get to go ahead and get $200. I'm going to take it for the gift it is.

We're also thinking of going to Barcelona in September for 10 days. That would be so awesome. I'm going to help make it happen.

I'm still spotting a little but physically I'm feeling pretty okay. No big emotional stuff lurking or anything, I think it all went out the window during my dragon treatment on Thursday.

I'm off camping for the weekend. I hope you have a nice one too. Don't forget to celebrate what you do have.

Whoa.

I had acupuncture this morning and after reviewing more about my history (emotional as well as physical) she said she would like to try an acupuncture treatment called a Dragon treatment. It comes from Japan she told me and the points don't make sense in a traditional channel sense but they seem to unlock where we hold onto grief in the body. She wanted to clear out the grief from my body. I told her aside from the early weeks after this BFP where my mood lifted, that I had sadness for the better part of the past year.

She told me to ask my body to let it go, ask my mind to not fight it and if I could, to ask a higher power for help.The needle points were at the crown of my head, two just below my neck on either side of my spine, two in my lower back and two in my ankles. Then she opened the window and told me that was a part of the treatment.

She left the room and I started weeping. I lay face down on the treatment table and the room was silent. Everything was running, tears and my nose. I cried for having this happen to me. For my dead babies. For not being pregnant now. For having two, my twin angels, due within three weeks of one another. For both times being able to start planning for what was to come in my life and then to have it dashed away. I asked God to help me. Not in any particular way. Just to help me. I thought of the footprints in the sand. I thought about how my partner doesn't want to think of them as dead babies. I thought of how I had all the gushing surprise and expectancy last time though the baby seemed less real to me. This time I felt less gushing but since my fibroid was gone I felt more like there woudl be a baby at the end. I cried for having to manage my pregnancies and fertility to this degree. I didn't blame anyone though.

Next she will have me take an herbal formula but the one she wanted originally wasn't in the office so she wanted some more time to review my case and then try to come up with something that's a good fit. We're going to try to clear out any remaining stagnation from my abdomen, any blood stasis, etc. My tongue shows signs of digestive issues, I feel that as well. I'll be eating more blood building foods going forward, redoubling my efforts.

I can breathe a little better now.

doing better.

My hives went away after I left the office early yesterday afternoon. I guess all that repressed emotion had to come out somewhere. I picked up some Rescue Remedy at the natural health store and had some when I got home.

I didn't feel like cooking at all. I put some potatoes on the stove to boil and finally my partner agreed that he would cook if I would please doing some painting, we're finishing some renovations at home. So I painted and thought about Scarlett and Lisa and wondered how she was doing. (I know her in passing). We ate dinner and my appetite had come back finally so that was a good sign. I had a little bit of a hard time going to sleep again last night but nothing the lavendar eye mask and some ear plugs couldn't fix. My nervous system has been a little overstimulated lately plus all these hormonal changes ya know?)

I'm still spotting lightly and having light cramps but mostly things are settling down a bit. I took one of my fertility monitor tests this morning and both lines came up so I've still got some good beta going in my system (LH predictors will show up positive as well for beta HCG in case you didn't know).

I'm glad I don't feel like hell and hopefully I can just start looking forward to our next try. The best try ever.

Last night I was so tired and not hungry. I ate a small dinner my partner cooked for me (he's trying so hard) and then after a while I was exhausted and went to bed at 9:00pm. I was emotionally exhausted and completed uncomfortable. I was having cramps and feeling awful in no particular way. I used a hot water bottle because I was so freezing and couldn't get warm. I used my lavendar eye mask for a while but then I started crying. Eventually I passed out asleep and had weird dreams. I dreamt about my sister and a doberman and Christmas at my parents and the Girl Scout house where I grew up with my two employees who just quit doing a religious ceremony. I woke up this morning covered in sweat and it's cold here (60 degrees).

I have a cough and post nasal drip today. I've got hives on my face, neck and shoulders that are itching me. My eyes feel a bit puffy and coming in to work I kept getting misty.

I am grief.

Just to give you a little "aww..." moment I came across this article and thought you might like it

http://news.bbc.co.uk/2/hi/health/3105580.stm

(ignore the part about the pro-life people, it ruins the moment)

Here's a link to a site showing ultrasound images of retained POC (products of conception)

Spontaneous abortion - Retained products of conception

Here's a link which explains how to read ultrasound images of the uterus.

My scan today showed something in the upper part of the uterus but my RE said it wasn't there last time so it is likely just some clots. I sure hope so. I'm ready to be done now.

I had my scan this morning. I did indeed pass the gestational sac and whatever. There is still something higher up in my uterus and I'm feeling some cramping still today; my RE thought it might be some clots that I needed to pass. I'm not convinced but whatever it is I want it out of me.

I am tired and grouchy today, even before I went in for my scan. There was a slow driver in front of me as I went to park to go to the clinic and I yelled at her out of my open window to "Drive!" and she said "I'm driving". I thought to myself, "get out of my way so I can go and get a scan showing that my uterus is empty of my dead baby now," oh if that woman only knew.

They were behind schedule at the clinic and I did see the RE and not a nurse but it took a while. I read some magazines while in the operatory waiting with that paper thing across my lap. I read about how to redecorate your summer porch with wicker furniture and day beds. I also read about how some director of an upcoming Nicole Kidman movie (something called The Translator?) hates to direct. Or how this guy changes out his plants in his window boxes four times a year and they were showing how lovely the coleus was looking.

The RE asked me after my scan how I was doing and reminded me to come back in for a consult in a few weeks. She was trying to be nice but I wanted to not be having this experience, not to have people wondering how I'm holding up or feeling bad for me.

How do I feel? I feel like crap still and I wish someone would come cook for me. The house is a mess and I need cleaning help. My ovaries ache, I have those cramps, I feel like crying and I hate all the women who are pregnant now and didn't have to experience yet another scan showing that their pregnancy didn't develop right. I want to pretend that none of this happened. I don't want to have doctors and acupuncturists hoving over me this next time but I believe that I'll need it in order to actually do this pregnancy thing. My partner says that he's glad that I'm not all big and pregnant and that he gets to hang out with me for a while longer. We're going camping next weekend and I can't wait. I need to get the f*ck out of here.

Acupuncture & Traditional
Chinese Medicine Links (TCM) Related to Fertility

These are a selection of links a TCM buddy group I'm on helped compile over the past two years. I want to thank everyone who contributed to this list. I'm only posting them here in the hopes that they might offer assistance to others dealing with infertility.

GENERAL RESOURCES
Acuxo
Chinese Medicine Sampler
The Institute of Classical Five-Element Acupuncture
Internal Healers - TCM Diagnosis and Treatment
Traditional Chinese Medicine (TCM) Foundations and Philosophy
The Three Treasures and Women's Treasure
Yin Yang House
The Five Stagnations: The Mother of all Diseases
NCCAOM Practioner Directory

TONGUE AND PULSE DIAGNOSIS
Tongue Diagnosis
TCM Acupuncture Theory - Tongue Diagnosis
The Significance of Traditional Pulse Diagnosis
TCM Acupuncture Theory - Pulse Diagnosis

DIET
Fertility Retreats Diet Info
Traditional Chinese Medicine Nutrition Theory and Applications in Dietary Therapy
Chinese dietetic therapy
Food Therapy
Chinese Dietary Therapy
Food Energetics
TCM Lifestyle/Nutrition and diet
Chinese dietary therapy
Diet suggestions for Blood Stasis
Diet suggestions for Excess Heat

GYNECOLOGY AND FERTILITY
Eastern Harmony Clinic - Medical Articles
Overview of Gynecology - Menstrual cycle in TCM
Acupuncture in Acupuncture in Gynecology and Obstetrics (PDF)
Pregnancy in Premature Ovarian Failure after Therapy Using Chinese Herbal Medicine (PDF)
Influence of acupuncture on the pregnancy rate in patients who undergo assisted reproduction therapy (PDF)
Acupuncture in Fertility Medicine (PDF)
Treatment of Female Infertility - A New Approach in Chinese Medicine (PDF)
Gauging a Woman's Health by Her Fertility Signals (PDF)
Various Menstrual Diseases
Li Dong-yuan's Gynecology

OTHER
Crane Herb Symptom Search
IVF & Acupuncture
Honso Herbs
Forms of Qigong

I passed a hunk of something this morning. I took a three mile slow walk (I'm am fairly blood deficient right due to the bleeding of the past week now so a fast walk was out of the questions) around the neighborhood last night and that must have done it. It wasn't anything exciting, it mostly looked like a large blood clot but it was denser and more formed than a blood clot. Maybe it was the placental tissue.

I'm going to go for another long walk today with the dog and hopefully whatever else is in there will clear out so my scan will show that I'm done. That would be great as my uterus can then heal and I can get my blood levels back to normal and soon enough we can get a little intimate (it's been a few weeks since we BD).

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.

It started finally. I woke up around 4:30 this morning to some cramping and when I went to the bathroom I was bleeding. The cramps got stronger after that so I couldn't go back to sleep so I'm up watching a moving on cable with my hot water bottle against my lower back.

I have my last drawing class of the session today but I don't think I will be going. It's not a good time with these cramps all.

At least it is the weekend.

In spite of my aching ovaries we went out for a nice dinner together last night. My partner ordered a fabulous bottle of red wine, 1998 vintage from Europe (he loves '98 and '99 from Europe as they were noted as great years for growing grapes). The wine helped, getting a little tipsy helped.

I was so tired by the end of the day yesterday, it's be a long week. I had work to do last night but I couldn't do it so I just made do today.

My spotting has progressed some, it reminds me more of what you get after the peak of your period. Still there is more stuff in there than my lining and that will have to come out sooner or later. I felt bad this morning so I called in sick and told them I had food poisoning. Whatever. I've been working from home but so far nothing exciting happening on the miscarriage end of things. Maybe soon, over the weekend.

I was just thinking that for all the time I said "Please God. Please God" it didn't work. I've had to work so hard to get pregnant and then I lose another one. My partner did get me pregnant twice within a year period. And the third cycle since our last pregnancy and my surgery. That's not too bad right? We should have hope.

A bunch of my infertile and miscarriage buddies have just gotten pregnant recently, I'm a tiny bit jealous but I'm also so excited for them. They too have worked hard and waited a long time for their tiny heartbeats. Hopefully I'll be pregnant again soon enough.

I got a letter in the mail from my RE's office yesterday; she's leaving the clinic. That's 3 for 3 RE's that I've seen and they all left that practice. They do excellent work. During my d&c last July one nurse mentioned that the hospital administration was the issue. Too bad and sad because people really need good help and they were all excellent. I would never go to the group that had formerly been at the University of Washington so let's just hope that we can do this on our own. Again, so far so good right?

My ovaries hurt! Ow!

Hmmmmmm...

Slow slow slow.

I did some qigong again last night after nothing much happened yesterday and even the spotting was slow. Spotting picked up right away after that. Still slow.

This morning I started stimulating some of the acupoints that are forbidden during pregnancy. A couple hours later I had a little more spotting with a touch of pink.

Now I feel still a bit blocked. I want thing to flow. I'll have to do some more qigong.

I have a meeting tonight but I think I will cancel so I can deal with this instead. It's a reasonable excuse, no? Well, but the excuse I will give is that I am sick. I'm not actually, but I don't feel well. I feel ick and stuck and not like dealing with an evening meeting.

Nothing much to report. Pretty consistent brown spotting now, cramping on and off but not very active cramps yet. They slacked off a bit yesterday but then picked up again right as I was going to bed but I was able to sleep through unaided.

People online have been so nice and supportive. Some of them are so sad for me that it makes me get teary. I don't feel that bad, I'm a bit more sensitive but I'm also feeling a bit quiet about it. It's very different this time.

I was pregnant and it grew -- my breasts, belly, nausea and peeing -- then it started to decline and it's almost the same but backwards -- smaller breasts, smaller belly, no nausea and regular peeing. It's weird but having had two losses diagnosed around the same time in my pregnancy, it starts to tweak you sense of reality a bit. Pregnancy for me is something that begins and ends, but not with a baby. It's just a weird uncomfortable hormonal routine and then it goes away. I wonder how I will feel if I ever get past the first trimester.

Who are those people who get pregnant and go on to have babies the first shot? That used to be how I thought it went but not really anymore. I expect something to go wrong. Those people must be a different species than I.

I just called and cancelled my scan. The nurse Debbie at the RE clinic I go to said that was fine and she understood. I told her that I would wait a week to see if things resolve on their own and then we could decide if we need to do a scan or bloodwork or anything.

My partner dropped me off at the office on the way to his consulting gig. That was nice of him. I'll have to take the bus home (or a taxi) but today has been pretty uneventful.

By the way, I really don't think at the end of the day that my liver qi stagnation had anything to do with my loss. I think something just went wonky with it. Maybe it was the delayed ovulation, maybe late implantation. Someone else I know had a beta level at 350 or something on CD14 and while I know that beta levels are all over the place for me it might just be a sign that something wasn't right. Maybe it was because I waited until CD 8 to supplement my progesterone. Maybe it was just messed up DNA.

I'll do some more qigong when I go home this evening to see if that will move things along. I can't remember if I mentioned it here (I must have) but in October when I went to a health resort with my friend and we first tried qigong, several hours later I passed a chunk of my retained tissue that how I know that it can move the immovable.

We are climbing Jacob's ladder,
We are climbing Jacob's ladder,
Higher, higher.

I think this is going to be easier this time around. My hormones have been dropping I believe for the past two weeks so it won't be such a dramatic dive as the d&c caused last time. I'm thankful for small blessings.

I'm still a bit crampy at work, but mostly it is like bad menstrual cramps. It isn't the kind of cramps that take your breath away. They still might come, usually it is when the cervix starts to dialiate that you feel those and some nausea (it would happen when I was passing clots from heavy menstrual bleeding as well).

I feel a little spacey and tired and I have a bit of a headache. In the center of my head. Maybe it is my hypothalmus or something getting adjusted.

Cramps, cramps and more cramps

The cramps started yesterday evening with increased spotting. Still nothing that dramatic, no bleeding yet. I slept with a hot water bottle to help alleviate some of the discomfort. I feel a bit relieved that things appear to be moving along on their own though dealing with the bad pain and bleeding which is almost inevitably in my future during a busy work week when we are short staffed and have numerous deadlines isn't much fun.

I'm sipping passionflower tea this morning, it's a nerve tonic and hopefully it will help calm the cramping a bit so I can function at work. I've been trying to figure out which is better to drive to work or to take the bus. They take almost the same amount of time but one I have control over and the other I don't though if I take the bus I can always take a taxi home if I don't feel like driving. Blah.

I had faint spotting last night. That and some vague cramping that I could feel in my lower back and just all over my abdomen. Nothing happened over night and this morning there isn't more spotting but I expect to start bleeding sooner rather than later and if so I'm a bit relieved. That would be a lot easier than last time.

Yesterday I started thinking more about whether or not my liver qi stagnation and depleted kidney yang could have impacted my pregnancy. It was the fact that my breasts started hurting again that suddenly I realized that my liver qi stagnation was acting up yesterday since I really didn't feel more pregnant; it was likely caused by the emotional trauma of Wednesday's scan. What if the dagger feeling two weeks ago was related to my liver qi stagnation as well? Granted the majority of miscarriages are due to genetic problems with the embryo but what if the qi issue had something to do with it. We won't ever know but I did find some interesting mentions about it.

The next three quotes are from Chinese Medicine and Infertility; Ancient Solutions for the Modern Couple

"Infertility due to Liver Qi Stagnation manifests mostly in women and is a frequent cause of unexplained infertility. This is because this type of Liver stagnation effects the blood flow in the pelvic cavity. Acupuncture at the right time in the menstrual cycle, in conjunction with an herbal formula and some counseling, is effective in dealing with this issue. However, because of the often long standing nature of this condition resolution and the restoration of balance may take several months of treatment. In the final analysis it really depends on each individual's specific symptoms and circumstances. Despite the amount of time involved, the resulting pregnancy is a more than welcome reward along with the added benefit of emotional clarity that arrives when the Liver organ/meridian is less toxic (stagnated)."

"Dysfunctional family factors also play a major role in the upset Liver, and may cause the condition to exist for quite some time." [oh yeah, I've got this one nailed]

"In oriental medicine we say that all chronic imbalances effect the Kidney organ/meridian network. What this means is that if a person has a weak constitution i.e., is pale, feels cold is undernourished, etc., then this is a result of either prenatal (genetic) influences and or a lifetime of habits and illnesses." [I was getting sick so regularly that my friends were all concerned. From colds to flu to bronchitis I would get sick every 6 weeks or so. With the lifestyle changes I've made this is no longer the case, I still get sick but definately not as frequently]

Here are some other references that piqued my interest:

"in TCM it is said that the Blood nourishes, the Qi protects, and the Kidney Qi holds the fetus."

"In TCM theory, the liver ‘stores blood’. The liver is the organ most closely related to our emotions. Good emotional balance comes from the smooth flow of liver Qi, and the normal flow of liver Qi depends on sufficient blood nourishment."
Alternative Woman's Health - A Look at Traditional Chinese Medicine

If there is itching of the nipples, this is stasis heat in the liver channel
A Discussion on the Diagnosis and Treatment of Infertility

"In addition to giving herbs for infertility problems, traditional Chinese medicine recommends herbal formulas for such problems associated with pregnancy as morning sickness, threatened miscarriage, and postpartum depression. One well-known formula, recommended to be taken three to six months before attempting conception, is called "The Rock on Tai Mountain Decoction."

The formula is intended to build up both the woman's qi, or life energy, and her blood. In Chinese medicine it is thought that the mother's blood nourishes, the qi protects, and the qi in the kidneys holds the fetus. Chinese practitioners use acupuncture to assist conception by clearing the stagnation of qi in the liver; to prevent miscarriage by conserving qi in the kidney; and to induce labor."
Pregnancy Treatments

I've found little references here and there that one can continue using dong quai in pregancy to continue to help with liver qi stagnation issues.

Unfortunately my acupuncturist is away for a month and won't be back for another two weeks. In the meantime though I'm going to keep doing my qigong since that seems to be helping.

Saturday Morning

I came home from work last night and took a nap for maybe an hour. I just needed to give my nervous system a break. After I got up I realized that I just felt blocked inside so I decided to do some qigong. My acupuncturist told me that I needed to be careful what I did since certain types of qigong movements can cause you to miscarry. I haven't practiced in months but I had to try something, nothing was moving in my body. I did a portion of the Jade Body routine I learned at the beginning of the year and right away I started getting that shivery feeling of energy starting to move in my body. I felt a lot better afterwards. Later after dinner and a movie we had a bath in our new jetted tub and soaking in the warm water helped me feel more relaxed.

My breasts hurt. They have continued hurting, but not in the same way from day to day. Last night the pain started building again and this morning they are killing me, almost like that knives sensation again. How fun. How completely distracting.

Here is a list of my symptoms as they peaked and what I've noted over the past week:

Fatigue -- was needing to take naps from the week after AF was due until Tuesday after Memorial Day when I strangely didn't need them anymore.

Sore Breasts -- On and off but became significantly less a week ago Wednesday though the pain picked up again today.

Swollen Belly -- peaked Memorial Day weekend and gradually has receded so that you can't really tell but I'm still more bloated than normal.

Hair growth -- My chin hair (yes, it's true) was growing so quickly up until last week that I needed to tweeze every day because a new hair would show up. It was freaking me out.

Nausea -- only faint boughts, last episode was at the beginning of this past week

Thirst -- I normally don't get thirsty very much but I've noticed that the increased hormones make me more thirsty. I wasn't thirsty for much of the past week.

Increased need to pee -- I was having to pee lots all the time, though thankfully not at night. That wasn't really happening this past week.


Who the heck knows. My partner wants me to go for the scan on Wednesday. I asked him if just he and my uterus could go and that I would stay home. Either that or that I be able to be drunk when I go in so I don't have to deal. I'm not a big drinker at all (to such a degree that many of my friends don't think I drink at all) but it is just that painful and stressful to be dealing with all this.

Intercourse Frequency -- Why more might be better

[I hadn't posted this info before and I want to get it out there. I know its not entirely topical at the moment but I hope you don't mind the diversion]

Since we have a bit of a sperm morphology issue we first tried the every other day routine recommended for MFI. But after having no success and then playing around with the numbers it seemed to us that loading up the EWCF with sperm prior to ovulation would help get more swimmers in there and ready to catch the egg. We've used this strategy both times we have gotten pregnant.

I looked up more research and articles related to ejaculatory frequency and I found some interesting things that I thought I would share:

"The characteristics were examined of 87 consecutive semen samples obtained from participants of an intra-uterine insemination (IUI) programme. The population investigated comprised 65 normozoospermic, 13 moderately oligozoospermic and nine severely oligozoospermic individuals. The samples were produced after 4 days abstinence for the first IUI and after a further day of abstinence for the second IUI. Semen volume, sperm concentration, total sperm count and total motile sperm count for the whole population decreased significantly between the first and second samples. [b]The characteristics of the second sample were significantly decreased only for the normozoospermic group.[/b]"
The effect of ejaculatory frequency on semen characteristics of normozoospermic and oligozoospermic men from an infertile population.
Matilsky M, Battino S, Ben-Ami M, Geslevich Y, Eyali V, Shalev E.
[Note: Normozoospermic is normal counts, oligozoospermic is low counts. The numbers seems to jump down more if you have normal counts -- the higher you are the harder you fall.]

"there was a significant positive relationship between the time taken to produce a specimen and sperm concentration. We conclude that the duration of preejaculatory sexual arousal is an important predictor of ejaculate quality for specimens produced by masturbation and that variation in the duration of preejaculatory arousal may contribute to within-male fluctuations in semen parameters over time."
Duration of sexual arousal predicts semen parameters for masturbatory ejaculates.
Pound N, Javed MH, Ruberto C, Shaikh MA, Del Valle AP.
[Note: we should be doing our best to get our guy intersted evidently if we want his best "effort"]

"Sperm numbers and semen volume increased with duration of abstinence. Abstinence did not influence pH, viability, morphology, total or grade A motility, or sperm DNA fragmentation. A short (24-hour) abstinence period negatively influenced chromatin quality."
Influence of the abstinence period on human sperm quality.
De Jonge C, LaFromboise M, Bosmans E, Ombelet W, Cox A, Nijs M.
[Note: Chromatin is what they are testing for in the SCSA test]

"The results have demonstrated that the motility and normal morphology of spermatozoa do not change significantly with ejaculation frequency. Also, while the volume of the ejaculate and the total number of spermatozoa decreased during a period of frequent coitus, an individual's depletion and recovery of his spermatozoal reserve could not be accurately predicted. It is suggested that coital frequency during the woman's periovulatory period could be modified by the partner's response to this test. Furthermore, while it is acknowledged that the variation in results from a 'routine' semen analysis is large, data obtained after depletion of the extra-gonadal reserve and recovery over a set time may have more value and could be the method of choice for the future."
Studies of human seminal parameters with frequent ejaculation. I. Clinical characteristics.
Matilsky M, Battino S, Ben-Ami M, Geslevich Y, Eyali V, Shalev E.

It just seems to me that the every other day BD routine might not be right for all MFI folks and that it is worth it to try upping frequency to see if it helps improve things for you. Since morphology and motility don't really necessarily seem to be affected it might be better to try out some sexy lingerie and a strip tease and learn some tantric breathing techiques to slow him down a little.

It's worth a thought.

Here's a chart showing why this might work:



I took two different hypothetical total counts and then reduced subsequent by 30%, just a random level that I pulled out of the air. Obviously real life generation rates could be better or worse than that, but note that based on this model having more sex results in a greater number of total sperm deposited.

Two other gals that I know online who were TTC post vasectomy reversal both tried this strategy and it worked for them the first try as well.

Some other random bits of info:

• The best sperm can live in a test tube at room temperature for a week
  
• it takes about 20 sperm to help weaken the zona pellucida enough to have one be able to penetrate the egg to fertiize it
  
• on the day of ovulation your body has already produced some progesterone which helps ripen the follicle. This progesterone can change the quality of your CF so that it is less hospitible to sperm so timing BD on the day of your peak day (the gooey EW day) or prior is probably the best.
  

I have this song in my head, it's one that we did across the floor exercises to in one of my modern dance classes...

"here I go again on my own...like a drifter I was born to walk alone"

I did a search and it is by WhiteSnake (Here I Go Again), oh the glories of bad 80s rock music.

Another one that has been going through my head is a very special adaptation of the Monchichi song from the commercial. ("Monchichi, Monchichi, Oh so soft and cuddly"), my version goes like this:

"My baby, dead baby. Not so soft and cuddly."

(It's my blog, I can say what I want. I never did own a Monchichi by the way, they came out when I was out of their target age range and I don't think I would have enjoyed them at all)

Yesterday's special phrase, my mantra of sorts for the anniversary of my first BFP coupled with the news of my second failed pregnancy was:

deadbaby
deadbaby
deadbaby
deadbaby
deadbaby
deadbaby
deadbaby

Oh and for the complete and total irony of the situation, since I had that fibroid surgery and I'm not allowed to go through labor for fear of rupturing my uterus and killing my baby (well, someday I might get that far) the only time I ever get to experience labor is through my miscarriages. How pleasant.

Good things, bad things and random things

Here are some of the things I've been thinking about:

Good things:

1. our embryo developed into a sac or something this time, it wasn't another blighted ovum
2. we got pregnant on our own
3. we got pregnant on the third cycle trying after my surgery
4. we got pregnant again before the anniversary of my previous BFP (or ovulation date)
5. I got pregnant before I was 35
6. I likely will be able to miscarry on my own
7. My pregnancy was in my uterus so at least one tube isn't blocked, maybe even both
8. I have wonderful buddies online who help give me support

Random things:
1. I can now finish working on the office renovations which is mostly painting work
2. I can stay focused on work for longer (well, trying to stay focused at least)
3. I get to keep my girlish figure for a little longer
4. I can look forward to some more time running around with my dog without sore boobs in the near future
5. we didn't tell anyone in real life so no one knows
6. I've been over this ground before so it isn't totally unknown territory

Grumble things:
1. I won't be able to get pregnant again until after I am 35
2. The gap between our potential babies and their cousins grows wider
3. We didn't get to see a heartbeat again, let alone an embryo
4. I don't feel like I'm in a good place to see my mother and deal with her illness
5. "I've been TTC for 3 years and all I got was this lousy t-shirt"

I feel angry today. I once read that anger was one way that our bodies/minds deal with stress. I must be really stressed out. It wasn't until I got to work that I felt it, like biting people's heads off. I'm going to try to hold my tongue since it isn't anyone's fault that I feel this way.

We went for a walk last night in a neighborhood park with our dog. It was nice and I wish my partner would come with me more often. I left the front gate open and after running an errand and stopping back at the house this morning the dog was gone. She's done it before and has her little routine for roaming the neighborhood but I hated having to leave for work and know that she wasn't safe at home.

I woke up at 4:45 in the morning and was up until 6:30 and then went back to bed. I'm trying to focus on just waiting for AF to come as I feel certain she will. Well likely its not going to be the same but I figure I'll just wait it out even it if takes three weeks since I would prefer not to have my third d&c in a year.

I'm feeling like I don't want to have a repeat u/s next week. It isn't going to provide me with good news, it has no therapeutic value and I'm going to have to pay for it. Why bother if the only thing to see is a further disintegrated sac with some schmutz in it. I hope I start bleeding soon so we can get it over with.

We are oddly a little relieved, as I posted just one day before my BFP some weeks ago, this isn't the best time. I'm trying to get my business back on track and I really need to focus on it right now for a little while more. Also, I was right in the middle of doing some painting prep work in our office and I wasn't going to be able to finish which bothered me but I was avoiding exposure to the paint fumes and toxins.

It's weird to know that when I started feeling better last week is likely when things stopped happening. So I'm making a mental note -- pregnancy is supposed to make you feel more uncomfortable, bloated, exhausted and in pain and having less of those symptoms is a bad sign.

I had a thimbleful of hope going in for my scan yesterday but I guess it was knocked over and now hope has dissipated.

I had my scan and there was a gestational sac with a little bit of schmutz in it but it dated 2 weeks behind (5w 4d instead of 7w 2d). I'll have a repeat scan in a week just to be sure but based on my beta numbers at 14/16 dpo and all its not looking at all favorable at this point.

I talked to a nurse about it and she thought that perhaps the delayed ovulation might have resulted in a poorer egg. I told her about how I had been having hormonal weirdness all year since my surgery which was why I tried the vitex under supervision of my acupuncturist.

She said that likely I will miscarry on my own, but the jury is still out. There is a vague (almost nil) chance that it was late implantation but that doesn't really jive with my beta numbers.

My symptoms haven't increased in over a week, in fact they have levelled out. I've been across this bridge before -- d&c, bleeding, cramps, etc. But this time would surely be less physically uncomfortable without the fibroid.

Oh well. Thanks for your prayers.

My partner told a longtime client today. She cornered him to ask about what happened with our pregnancy last year since she hadn't seen him. She said to him "you didn't have a baby did you?" He told her no but that we would find out tomorrow if we have another chance. It made me feel a little emotional to know that it was hanging out there in the wind, a few random people wondering here and there. Sheesh! I hope we don't have to go through that again.

My scan is in 24 hours (3pm PST). I can't wait for it on one hand and in denial on the other. I think to myself that maybe I can just ignore and things will happen or not. Right? I'll either have a miscarriage or a won't. I'll either have a baby in 8 months or I won't. Seeing the scan will just mean that I have to do something, feel something and part of me doesn't want to feel anything.

I feel a bit pregnant but nothing compared to last time when I was exploding with my fibroid. Realistically if there is an embryo inside of me it is the size of a pea or something, with the sac around it. Fairly small over all. My pregnancy symptoms have been pretty easy over the past week, my breasts still hurt but gone is that feeling of knives stabbing into them, my uterus feels a bit full, sometimes at the end of the day it actually feels extra swollen. My abdomen has adjusted to the hormonal bloat. I'm a bit moody -- alternating feelings last night of frustration, anger and wanting to cry. Overall it just feels like a bad case of weird PMS - is that how pregnancy is supposed to feel?

I talked to my partner last night about not wanting to tell anyone about our pregnancy and he said that he felt the same way. We're kinda of feeling like letting people find out if/when it gets noticible. We have no plans either way for telling or not telling -- I guess we'll just have to see how our appointment goes tomorrow.

I just remembered from a few weeks ago something that I thought you might find interesting. I had that BFP come up on the HPT and brought it into the bedroom. My partner and I just stared at it for a while and I remember we talked about the fact that it was probably a chemical pg and that there was a good chance that it might go away the next day. It didn't of course, but that just goes to show you how much we feel like this isn't for real.

We talk about it a little bit. We both want to have it go well but losing that pregnancy last year was really hard for us both. I woke up early this morning and remembered thinking to myself that if our scan goes badly will I be able to not feel so sorry for myself this time. I just don't know.

I'm doing okay but feeling very emotional today. My mother had her surgery and it went well, the cancer hadn't spread at all.

I'm still holding my breath until we have a scan that shows that there is something actually growing in there and not just a blighted ovum like last time. As the day for the scan grows nearer I find myself getting more and more emotional and scared about it. I've been trying not to get my hopes up at all but instead I've been feeling a bit alone about it. I just feel like I've got awful PMS and maybe it will stick and maybe it won't but it's a really hard place to be in. So when you add that on top of the other stuff going on in my life I'm having a hard time not crying while writing right now.

And depending on what treatment my mother has I might not be able to see her, because radiation would make her radioactive and pg women and children (sometimes adults as well) are supposed to stay away.

Even if you get a BFP there is no solace and you don't necessarily feel like you have accomplished anything other than a delayed AF.:(

I slept in this camisole with a built in shelf bra and I woke up in the middle of the night with my breasts absolutely killing me so I yanked it off and went back to bed. I've decided to go bra-less today which has felt a lot better. It's easier to do when the weather is cooler since the layers will hide my enlarged pregnant nipples better. They aren't grossly enlarged but still I like to leave a little more to the imagination when walking about, ya know?

My mother-in-law is in town for the weekend and so we've been around family more. That's all been fine but the key things are to avoid getting into discussions about my fertility since I don't want to outright lie about my pregnancy but we don't want to share about it either, and also to not give away any signs that something is up. The 2-3 hour naps I like to take now, my big boobs and my bloated belly are all things that we need to distract them from. So far so good (knock on wood).

I haven't mentioned it here yet, but at the end of the week when we found out we were expecting my mother called to let me know that she was diagnosed with breast cancer. It's really small and only in one breast and they caught it early but she'll be having surgery this coming Friday. Why is it that life has to send a good with a bad, it's almost like there was this trade-off that happened in the negotiations and it was decided that I could get pregnant but that something else bad had to happen in my life. Sigh. My mother and I haven't been getting along very well for a year now and still I'm making a better effort to call her and the like. She's loving the extra attention. We decided not to tell her about the pregnancy since she didn't deal well with my loss last year, not helpful to me and I think it brought back unresolved memories of her own losses. Better to wait until there really is good news.

Only 10 days until our ultrasound. My partner took the day off from work. I keep saying to myself over and over "Please God. Please God. Please God..."

So I had an A-HA moment this morning. I was seriously showing a lot earlier last time, which makes sense with the normal swelling of the uterus and growth of the sac and placental tissue but I also had a fibroid so my uterus was already enlarged to about 3.5 months pg equivalent in size, and it surely got up to around 5 months pg in size by 8 weeks post O. This is so much easier this time around.

What a relief!!

You can see how I was feeling at this point of my pregnancy in my post from last year.

I'm feeling okay. My thyroid feels very active, earlier today I had to pee and was thirsty at the same time and I'm a little extra emotional/irrational.

I walked down to where my partner is working yesterday and tried calling him but he didn't answer and didn't call back and I decided he was having an affair and at the same time I knew that was a totally crazy thing to think. He was at a client meeting in another city. It's just the wacky hormones.

I also have been hot while sleeping, also peeing a bit more and I have moments of pelvic twinges and bloating that comes and goes. If I push myself too long without a rest in the early evening I get hot flushes that are very odd. My acupuncturist said it is due to yin deficiency. I'm taking care to lay down and relax.

How is it possible that I'm pregnant? Two nights ago I woke up really early in the morning and was too tired to get up and one of the first things I thought was how this pregnancy is taking over my body bit by bit which caused me a little anxiety. I was half-asleep at the time and it's kinda funny thinking about it now.

I'm 16 dpo today and I just got back the results of my second beta. Monday=94 (14dpo) Wed=266 (16dpo). My progesterone was 13.2 but they aren't worrying about it and I'm already supplementing with progesterone cream.

I don't want to say anything until after my 6 week scan, since that was such a rough thing for us last year. After we see a baby then we will let everyone know.