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Monday, November 29, 2010

Putting Myself On Time Out!

I would love nothing more right now than to hop on a plane, fly to my “home away from home”, rent a place on the beach and just totally cut myself off from the rest of the world if only for a couple of weeks. Unfortunately, though, I can’t at the moment and this just adds to my current frustrations.

Don’t tell DH, but I ADMIT that this time of year always has its way of bringing out the, ahem, “best” in me… but this year things are extra “special” so I am having a bit more of a rough time than I have in the past. Between the usual holiday time stuff, treatment complications, DH travelling so much, and a bunch of other smaller things piling up I am really in need for a time out even if it means I have to stay grounded here at home.

So, that is exactly what I am doing. For the next month or so there is nothing really going on in terms of treatment. Generally, I fill in the gaps between TTC postings with other stuff but this time I am going to take a break. I will post from time to time but much less frequently until the holidays are over most likely. I have a few things in the works but nothing complete and I am having a bit of writer’s block at the moment so there is no end in sight; ironically, also not unusual for me at this time of year. Notice a trend? Anyone want to guess which month of the year I hate most? A candy cane to the first person who figures it out!

Anyhow, back to reality… backing off the blog for a bit… and now back to work!

PS. To “Doppler Girl”, thank you for giving me one of the best gifts in the world ever . I love you!

Friday, November 26, 2010

Are you a Carrot, an Egg or Coffee Bean?

A young woman went to her mother and told her about her life, and how things were so hard for her. She did not know how she was going to make it, and wanted to give up. She was tired of fighting and struggling. It seemed as one problem was solved a new one arose.

Her mother took her to the kitchen. She filled three pots with water. In the first pot, she placed carrots, in the second she placed eggs and the last she placed ground coffee beans. She let them sit and boil without saying a word. In about twenty minutes she turned off the burners. She fished the carrots out and placed them in a bowl. She pulled the eggs out and placed them in a bowl. Then she ladled the coffee out and placed it in a bowl. Turning to her daughter, she asked, "Tell me what do you see?" "Carrots, eggs, and coffee," she replied. She brought her closer and asked her to feel the carrots. She did and noted that they got soft. She then asked her to take the egg and break it. After pulling off the shell, she observed the hard-boiled egg. Finally, she asked her to smell and sip the coffee. The daughter smiled, as she smelled and tasted its rich aroma. The daughter then asked, "What's the point, mother?"

Her mother explained that each of these objects had faced the same adversity- boiling water-but each reacted differently. The carrot went in strong, hard and unrelenting. However, after being subjected to the boiling water, it softened and became weak. The egg had been fragile. Its thin outer shell had protected its liquid interior. But, after sitting through the boiling water, its inside became hardened. The ground coffee beans were unique, however. After they were in the boiling water they had changed the water. "Which are you?" she asked her daughter. "When trials and adversity knock on your door, how do you respond? Are you a carrot, an egg, or a coffee bean?"

Think of this: Which am I?

Am I the carrot that seems strong, but with pain and adversity, do I wilt and become soft and lose my strength? Am I the egg that starts with a passive heart, but changes with the heat? Did I have a fluid spirit, but after a death, a financial hardship or some other trial, have I become hardened and stiff? Does my shell look the same, but on the inside, am I bitter and tough with a stiff spirit and a hardened heart?

Or, am I like the coffee bean? The bean actually changes the hot water, the very circumstance that brings the pain. When the water gets hot, it releases the fragrance and flavor. If you are like the bean, when things are at their worst, you become better and change the situation around you. When the hours are the darkest and trials are their greatest do you elevate to another level?

How do you handle adversity? Like the CARROT, the EGG, OR the COFFEE BEAN?

Wednesday, November 24, 2010

Round 1 (IVM): Cancelled

I had my second ultrasound this morning and there were no changes since Saturday unfortunately. I met with the nurse right after and we set up my “calendar” to try again. This round is not exactly considered as being cancelled seeing as I didn’t get anywhere, so it is essentially postponed. In other words, this will NOT count as one of the rounds covered by the government. Also, instead of going the Provera route again and getting stuck, they are giving me 1 month of Birth Control to do the job. It has been a long time since I have seen these! I just hope they work. Oh, and the good news is... even if AF doesn't arrive when it should I still go in for an ultrasound as though it did.

I am surprisingly not too upset about it either because the timing of things should work out extremely well if everything is smooth. My retrieval should fall over the Christmas holidays (and yes, possibly on Christmas morning if necessary) so I won’t have to worry about missing work and I can stay home and relax. And then, the transfer should come just before or after New Year’s so I will have an extended “vacation” if you want to call it that. Not a bad way to start 2011 I guess.

All in all, I am ok with all of this. It’s too bad it didn’t work out right now but at least it’s because my body woke up for once and not because my condition got worse. Another month won't make that much difference in the greater scheme of things.

Monday, November 22, 2010

Round 1 (IVM): Step 2 (Expect the Unexpected)

There are times in life that simply do not make sense… and this weekend was one of them. On Saturday I went in to the hospital for a CD3 ultrasound, the first of this cycle. In the past, I have always seen a number of tiny follicles at this point waiting to grow and nothing more which is good for that stage of the cycle. This was also my hope for Saturday, but not the case.

When using both Clomid and Gonal-F in the past, the goal was to reach a follicle of about 18mm in diameter so that I could continue the process in order to get pregnant one way or another. However, this never occurred and all of my follicles simply remained around 8-9mm. We began to think that reaching anything larger was impossible and this is why I changed to IVM. There was no use continuing on with daily injections if they weren’t being effective.

On Saturday, the doctor started to do the ultrasound and the first thing we both see is a large black circle on the screen. He measured it and, sure enough, it’s a 20mm follicle! That’s great, in the sense that it means I am not completely useless and I can actually do it (and on mine own - without medication), but it is HORRIBLE timing. Basically, there is no way to be exactly sure what it is and what it is going to do at this point. It is definitely left over from my last cycle, but is it empty? Is there an egg inside? Will it go away in the next couple of days to give room for the new follicles? These are all questions that remain unanswered for now.

If it is in fact a proper follicle with an egg in it, taking Provera has messed up my “natural cycle” and has now ruled out the possibility of using that egg. And if there is an egg inside that is still giving off estrogen it will cause the other follicles around it to make lesser quality eggs and I need high quality eggs to continue with IVM so we would have to wait until it is gone to try again. The other side to this is that it may be empty and ready to shrink down any minute now. Who knows?

Initially the plan was to cancel the cycle and try again next month. But, after speaking with a nurse, they have decided to give this a second try. They took a blood test to check my estrogen levels and called me back later in the day to schedule another ultrasound for Wednesday (CD7). If all goes well, they will allow me to continue… but if the larger follicle is still there, I will have to start all over again next month!

Expect the unexpected! That is all I can say at this point.

Thursday, November 18, 2010

Parsley... To The Rescue?

Yesterday I hunted high and low for solutions to my AF problem. The only solution I found that seemed to have any truth to it was… parsley; plain old boring parsley.

It seems that parsley is a mild emmenagogue (an herb which stimulates menstruation). It is said to work like a charm at bringing on a missed or late period as long as pregnancy is not the cause of the delay. This being said, you should probably avoid drinking this if you are pregnant so that you do not miscarry or abort accidentally (although it seems that some people also use it precisely for this reason – to terminate a pregnancy).

There are a couple ways that parsley can be used; either as a tea (infusion) or as a pessary (you can look that one up for yourself). The tea can be made either from the dried herb (1 tsp per cup of water) or from the fresh herb (1 tbsp chopped per cup of water). Simply bring the water to a boil, then pour the boiling water over the herbs and let it steep for about 20 minutes. Using a mason jar is helpful for this because it keeps the heat in nicely. From the information I found, it looks like 2-4 cups a day are recommended and it seems that many women have successfully seen AF anywhere from a few hours to a couple of days afterwards. The only warnings I found were possible allergies and that individuals with inflammatory kidney problems or diseases should not use these methods. Oh, and it is also a colon cleanser according to some other sites so don’t go overboard either.

So, last night I went home and made the tea right after dinner. I drank all 3 cups (from fresh parsley) in an hour. The tea was light green in color and it didn’t taste bad at all. Kind of like a light mint with a hint of lemon and “green” taste. A tablespoon of sugar helped sweeten it up nicely too. I read that you could add honey or milk as well but I have not tried these yet. And I am not sure what it did but it did something! I have been having some cramps over the last couple of days but nothing like the parsley brought on. I could definitely feel something and it intensified with each cup. As for the pessary… maybe I did, maybe I didn’t!

This morning I had some spotting and called the hospital to make my appointment for an ultrasound on Saturday. Hopefully I will have full blown AF by then! And until I do I will continue drinking my tea because it really isn’t bad at all!

Wednesday, November 17, 2010

Round 1 (IVM): Step 1 (continued)

It has been 3 days since I finished the Provera... and still no sign of AF! Not one sign! In the past it has always been 3-4 days max that I had to wait. I am not completely freaking out (yet) but I knew this would happen. The one time I really need it to work and it has to go and do this on me. ARGH! I have never been so upset to not get AF. May try some herbal remedies to see if I can get thgins going... can't hurt, right?

Thursday, November 11, 2010

Round 1 (IVM): Step 1 Begins! (Steps Included)

“In Flanders fields the poppies blow
Between the crosses, row on row,
That mark our place; and in the sky
The larks, still bravely singing, fly
Scarce heard amid the guns below.”

Remembrance Day has always been close to my heart as both of my maternal grandparents were in the war and I grew up hearing all of their stories. My grandfather passed away when I was 12 but my grandmother is still alive today and I love her to pieces! I am hoping, though, that Remembrance Day of 2010 gives me even more to remember and be thankful for than ever before because today I officially begin my first attempt at IVM! I did not pick this day specifically, more so because it worked with our schedules, but it feels like a good day.

These are the steps and how things should go in an ideal world. Obviously, when dealing with the human body, anything can happen so this is not at all set in stone!

Step 1: Since I still do not have a regular cycle, I need to take Provera (a synthetic variant of the human hormone progesterone) in order to begin AF. I need to take 2 pills a day for 3-4 days and then I can expect AF shortly after, bringing me to CD1.

Step 2: On CD1 I call the hospital to schedule a couple of ultrasounds in order to monitor the growth of my follicles followed by an injection of Human Chorionic Gonadotropin (hCG) to mature the eggs 36-38 hours before egg retrieval.

Step 3: Egg retrieval. This will not be the most pleasant experience from what I have heard but it must be done. Once I know more about it and when I am scheduled I will post about it. The interesting thing about this day is that my pregnancy test will actually occur 16 days after this date. In the “normal” baby-making process, this would be the date of conception basically. At this time I will also begin taking Estrace and Prometrium (a combination of Estrogen and Progesterone to help support the endometrium - lining of the uterus), and Doxycycline and Medrol (an antibiotic and a corticosteroid to help create a favorable environment for implantation of the embryo) in addition to the other medications I am currently taking.

Step 4: My collected eggs are matured further in the lab, fertilized using ICSI, and then monitored for a number of days afterwards before transfer. Not all of the eggs will make it through this process but the hope, obviously, is that at least a couple of them make it through the process strong, healthy, and ready for transfer. The embryos that are not transferred will be frozen for a future attempt so that I can avoid repeating all of the previous steps. This could be a month after (if IVM is unsuccessful) or years later for a sibling.

Step 5: Transfer time! I will go in and meet with the Embryologist to choose the best looking, strongest, and healthiest embryo. They will then perform what is called “assisted hatching” on the chosen embryo and then transfer the embryo to me. And then we wait. I will be placed on a 2 week sick leave in order to give me the best possible chance of success; little activity, no stress, lots of rest, fingers and toes crossed... you get the picture. I will stop taking Doxycycline, and Medrol at this time but stay on everything else.

Step 6: The blood test. If positive, I schedule an ultrasound 2 weeks later to determine the number and position of any pregnancies (yes, twins are still possible) as well as an appointment to see the high risk doctor. If negative, I go back to my fertility doctor and schedule round 2 (using the frozen embryos) as soon as I am ready.

Wednesday, November 10, 2010

Round 1 (IVM): Begins Tomorrow!

About a month ago I said that I would post more details about my IVM schedule and the medications involved… and the time has come!

I have to say that it feels good to be getting back into the baby-making process! I feel like so much time has passed and been wasted since we last tried this past May, but we are back in the saddle, we overcame the roadblocks, won the battle, and we are now “back to work”! And, bonus, it’s going to be paid for by the government! Yay!

So, to answer a couple of questions, what is this IVM I keep talking about? IVM stands for In-Vitro Maturation. It is a much newer procedure than the In-Vitro Fertilization we have grown up hearing about (the first baby born through IVM was in 1999), but for a variety of reasons it is the best option for me right now.

Basically, immature eggs are collected from me, matured in the lab for 24-48 hours (thus no hormone injections for me, yay!), and then fertilized one by one using Intracytoplasmic Sperm Injection (ICSI) and left to mature once more. About 2-5 days after fertilization, one embryo is transferred back into me and then we keep our fingers crossed. Before the government was involved in the process I would have been able to try with 2-3 embryos at one time, but now I am limited. But, at least it is free! They will cover 6 rounds of treatment per pregnancy. I have posted this link before, but once again, you can read more about this and even see some pictures here.

And, as some of you know, I have had a long running joke that I will get pregnant by my doctor while DH is out of the country and some other person (friend, family or nurse) holds my hand. Well, it WAS a joke but it seems like it will also be the case! DH is currently away on business again, and then he will be home only briefly before leaving once more (and hopefully for the last time in 2010). So, if things go as “planned”, he will only be here for my egg retrieval! It still makes me laugh, but don’t get me wrong… it isn’t easy. As a friend said to me a couple of weeks ago (about her own life), “My husband missed pretty much all the big events in my life too because of work! Not to sound insensitive but I am used to it, calloused if you will... Everyone thinks I am so strong too, but it's a facade that you have no choice but to put on, otherwise you crumble”. I couldn’t have said this better myself.

So this is it for now. Tomorrow, I will post all of the steps and medications involved! Fun!

Thursday, November 4, 2010

Take the Fatty Talk Outside

This article written by Rosie Schwartz, a Toronto-based consulting dietitian in private practice and author of The Enlightened Eater's Whole Foods Guide: Harvest the Power of Phyto Foods (Viking Canada). You can find her on Twitter @rosieschwartz. You can find the original article here.

Take the fatty talk outside: It’s time to drop the fat bashing
In this PC age, Rosie Schwartz asks why making fun of overweight individuals is still okay

We've come a long way, baby. The concept of political correctness has yielded some big benefits: being prejudiced is no longer PC. But there are some prejudices that remain and seem to be tolerated - maybe because they aren't recognized as such. And intolerance to fat is right there up at the top of the list. Witness a recent post by writer Maura Kelly in her blog, A Year of Living Flirtatiously, who felt comfortable enough revealing her revulsion of fat to put it up on women's magazine Marie Claire's website. She would not have done it had she thought that it would create much controversy.

Her post, entitled "Should Fatties Get a Room?", a response to her editor asking her if she felt uncomfortable watching overweight people making out on television, was appalling. She wrote, "So anyway, yes, I think I'd be grossed out if I had to watch two characters with rolls and rolls of fat kissing each other ... because I'd be grossed out if I had to watch them doing anything. To be brutally honest, even in real life, I find it aesthetically displeasing to watch a very, very fat person simply walk across a room - just like I'd find it distressing if I saw a very drunk person stumbling across a bar or a heroin addict slumping in a chair." She went on to say, ""Now, don't go getting the wrong impression: I have a few friends who could be called plump".

Wow - isn't that enlightened of her!

The good news is that it ignited a firestorm of controversy. Judging people by how they look and how much they weigh may finally be recognized as unacceptable.

It's attitudes like this one that make overweight people prey to all kinds of quick weight loss schemes that simply result in their gaining even more weight. Or it keeps them shut inside away from the world because they're embarrassed to be seen.

Reactions to her post have been unprecedented. It's been a hot topic on TV programs like the Today Show and The View, while on the internet some have called for a boycott of the magazine's website. Canadian physician Yoni Freedhoff, in his blog weightymatters.ca, called it "perhaps the vilest, most weight biased article I've ever read." The headline on the topic on the blog Hairpin read "Woman Crams Remarkable Amount of Idiocy Into Single Blog Post."

While Maura Kelly did issue an apology and pointed to her past of having anorexia as a contributing factor, her blatant contempt couldn't be ignored. How often, though, is a lesser prejudice against fat simply passed over?

Too frequently, I would say.

But the fact is that a person's bodyweight is very a personal issue. Despite the fact that it's true that the obesity epidemic is a huge public health issue, commenting on an individual's body - unless you're their healthcare practitioner or family member is simply no one else's business.

I recently fell into that trap when asked by a reporter whether Toronto's mayor-elect Rob Ford should lose weight. I immediately spoke up with my thoughts about fat being a prejudice that people tolerate and how no one should be looking at another individual and commenting on their weight.

How many times have you commented to a friend or colleague about how great they look because they've lost weight? Why not leave it at "You look great!" and skip the weight part. Or have you ever remarked to someone about the weight an individual has gained? Somehow this comes across as being acceptable when in fact it means that you are checking out someone else's body just a little too closely.

Talking about other people's weight or even your own in front of others can lead to unexpected victims. For example, talking about how a person has let herself go - meaning they've put on weight - in front of a vulnerable teen who's feeling chubby can make them self-conscious about their own weight. Comments like these can contribute to the development of an eating disorder or start someone on the rollercoaster of yo-yo dieting. Even worse is the parent who chides him or herself or the other parent about weight issues.

These are issues that I always bring up when counselling clients about weight loss. When an overweight person says that they won't put on a bathing suit or shorts when they're trying to get fit, I suggest that they need to combat their own prejudices about being overweight.

While excess weight may be a health issue, it's also something to be very sensitive about. And so I answered the reporter's questions about weight loss once I had let my views on the topic be known. So you can imagine how mortified I was when I read the first line, "Ford better have waist management on his agenda if he's going to keep up with the hectic schedule of a mayor, a Toronto-based dietician said".
Weight is an issue for society as we live in an environment that promotes obesity. But it's time to recognize that fat as a prejudice is simply not acceptable.