Behold the Wonders of the Cervix

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

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

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

The ones I know of include:

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

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

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

Easing Into It

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

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

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

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

TTC After 35

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

Female Fertility After 35

36 and Over

How Aging Affects Fertility

Pregnancy After 35 - March of Dimes

Age Related Miscarriage


You might also appreciate:

How to increase your chances of conceiving and preventing miscarriages

Vitamin C: Too Much of a Good Thing

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

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

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

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

What do you think we should do?

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

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

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

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

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

What do you think? Please share. Thanks.

Cute Diapering Accessories

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

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

Darling Diaper Bag from Lexie Barnes


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

More Thoughts About Fibrocystic Breasts

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

Increase calcium consumption

Decrease caffeine consumption

Make sure there isn't a thyroid problem

Cut back on refined sugars

Increase dietary fiber

Increase B-vitamin consumption

Increase magnesium consumption

Drink more water

Use natural progesterone cream

Increase vitamin E consumption



-----

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

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

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

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

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

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

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

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

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

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

(Vasectomy and) Vasectomy Reversal Information

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

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

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

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


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

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

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

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

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

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

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

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

Specific things we learned along the way from our experience:

There might be pain for a while

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

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

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

MFI supplement cocktails can actually improve morphology

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

General post vas reversal fertility info:

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

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

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

Vasectomy and Vasectomy Reversal Links:

FIND A SURGEON

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

INFORMATION ABOUT THE PROCEDURE

The Patient's Guide to Vasectomy Reversal

Microscopic Vasovasostomy

Vasectomy Reversal - Introduction

Microsurgical Vasectomy Reversal

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

Google Groups: alt.support.vasectomy

International Center for Vasectomy Reversal

Vasectomy Reversal - Johns Hopkins

Building Bridges to Conception - Vasectomy Reversal

Vasectomy Reversal Questions &s; Answers

Microscopic Vasectomy Reversal

Vasovasostomy

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

Cary Urology Vasectomy Reversal

Vasectomy.com

ARTICLES ON VARIOUS RELATED TOPICS

Warning over vasectomy reversals

Vasectomy - Can it be reversed?

Morphological changes of spermatozoa in proximal vas deferens after vasectomy

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

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

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

Vasectomy Reversal & Sperm Antibodies

VASECTOMY

Vasectomy Blog

Vasectomy Information

Requesting Patient Medical Records

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

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

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

Your Rights Under HIPAA:

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

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

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

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


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

Quick Tips -- When Getting Medical Tests

Bad Estrogen

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

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

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

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

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

What I picked out that might relate to me are:

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

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

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

Back from Paradise

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

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

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

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

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

The Boo-hoos Caught Up With Me

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

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

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

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

Looking forward to sunshine

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

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

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

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

Hysterosalpingogram (HSG)

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

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

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

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

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

Here are some links to sites showing images from HSGs:

HSG Link 1

HSG Link 2
HSG Link 3

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

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

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

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

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

DIM Plus by Nature's Way

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

Hormone Balance - Hormonal Health (about DIM)

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

Foods for Cancer Prevention

Estrogen Dominance Syndrome

Nutritional Factors in Menstrual Pain and Premenstrual Syndrome

Liver Detoxification Pathways

Estrogen's Two-Way Street

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


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

About Prolactin and Abnormal Breast Discharge

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

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

Elevated Prolactin (PDF)

High Prolactin Levels

Hyperprolactinemia (High Prolactin)


Prolactin-Lowering Medicines: Your Questions Answered

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

Bromocriptine Addendum


Nipple discharge - abnormal

Nipple Discharge


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

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

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

Revelations

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

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

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

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

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

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

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

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

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

Little hope links

For you Crystal, for when you need them.

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

Footprints in the Sand

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

Should I be happy or sad?

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

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

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

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

Talking about it

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

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

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