Quick drive-by post here. I will be moving to NYC in a month. I need to pick a new RE there. One very logical choice is Dr. Liccardi (the guy who writes 'The infertility blog') at NYU.
I know that quite a few people from NYC have to come by here...have you been a patient with Dr. Liccardi, and if so, what is your experience? Also, do you know of any RE's specializing in recurrent pregnancy loss who you would highly recommend?
Muchas Gracias in advance!
Out of the funk!
on Friday, January 7, 2011
After 2 days of utter misery (I was bursting into tears at the craziest things), I'm back to my normal even keel and I could kiss the ground in gratitude. I'm still far way away from being anything close to happy though. I just miss being happy, its something all of us are entitled to, but its gone from so many lives on the blogsphere now. A lot of us see life in greyscale. For me, some of the colors are starting to seep back in, but I want glorious technicolor and I'm not going to get it for a while.
Since its going to take about 1 year to wrap up my life here to return to India, I have to take that much time off from babymaking. My mom requested only one thing from me; in this one year, live life instead of obsessively pouring over this process. I'm working on it, but yet, here I am home with my blog on a Saturday night while my friends are getting dinner and a movie. But there is a reason for that...I want to see as little as possible of one of them.
From my current group of friends, only 2 people know about the pregnancies and the losses. One of them is 33, kind of single and is a party animal. She has told me repeatedly that she does not 'get' what I'm doing. According to her I should be out looking for a guy (while having oodles of 'fun', her style) and not attempt such madness as in trying to conceive as a single person. On the day I found out my baby had died, both she and the other girl forcibly came over to 'comfort' me. I made the mistake of talking about what was my next step, and she looks at me like I'm crazy and says, 'you should wait, find a guy, and do this naturally', like it was the unnaturalness of this process that was killing my children. That was the final straw, I knew I never wanted to see her again. Unfortunately, both of us are part of a really large group that hangs out all the time, and I quite like everybody else there. This is where I become grateful for the workings of fate. In October, I found out I *had* to move to NYC. I loathed the idea at the start. Over time, I got used to it and even a little excited. Now I'm happy, it offers me an out from this uncomfortable situation. Maybe somethings in life DO work out for the best!
I'll be seeing this person tomorrow. There is really nobody to be angry with when something like this happens, though you really wish you could find a target to rage at. This woman, with her arrogance, presumption and ignorance is the only person I can be comfortably angry at, although its certainly not her fault (or anybody else's) that my babies died. But on the surface, I have to be civil, UGH. Thank god its only for 3 more weeks!
Since its going to take about 1 year to wrap up my life here to return to India, I have to take that much time off from babymaking. My mom requested only one thing from me; in this one year, live life instead of obsessively pouring over this process. I'm working on it, but yet, here I am home with my blog on a Saturday night while my friends are getting dinner and a movie. But there is a reason for that...I want to see as little as possible of one of them.
From my current group of friends, only 2 people know about the pregnancies and the losses. One of them is 33, kind of single and is a party animal. She has told me repeatedly that she does not 'get' what I'm doing. According to her I should be out looking for a guy (while having oodles of 'fun', her style) and not attempt such madness as in trying to conceive as a single person. On the day I found out my baby had died, both she and the other girl forcibly came over to 'comfort' me. I made the mistake of talking about what was my next step, and she looks at me like I'm crazy and says, 'you should wait, find a guy, and do this naturally', like it was the unnaturalness of this process that was killing my children. That was the final straw, I knew I never wanted to see her again. Unfortunately, both of us are part of a really large group that hangs out all the time, and I quite like everybody else there. This is where I become grateful for the workings of fate. In October, I found out I *had* to move to NYC. I loathed the idea at the start. Over time, I got used to it and even a little excited. Now I'm happy, it offers me an out from this uncomfortable situation. Maybe somethings in life DO work out for the best!
I'll be seeing this person tomorrow. There is really nobody to be angry with when something like this happens, though you really wish you could find a target to rage at. This woman, with her arrogance, presumption and ignorance is the only person I can be comfortably angry at, although its certainly not her fault (or anybody else's) that my babies died. But on the surface, I have to be civil, UGH. Thank god its only for 3 more weeks!
A very dark outpouring
on Wednesday, January 5, 2011
Blue-that been my mood for the past 2 days. It is not terribly surprising. Immediately following my loss, I boarded a plane back home to India. In the following month, given the circumstances, my emotional recovery could only have been described as superlative. It was so because I was surrounded by the people who loved me and I was never really alone. Now I'm back in USA, at home, except it does not feel like home anymore. I've lived alone for the past 8 years and have been fine by myself. I've had the fun social life (I still do, for what its worth) and I was completely self-contained, happy in the quietness that is part and parcel of living alone. But for the first time in my life, that quietness seems suffocating. I think its just a combination of vulnerability and sadness that should quickly pass, buts its tough going sometimes. Yesterday to get my mind off things, I called up friends I'd been meaning to catch up with for a while, and they told me they were 3 months into an 'oops' pregnancy. Now, these people are amazing and I'm really happy for them, but of course, given my mood yesterday, that really reinforced the sadness and victimization I was feeling. I really did not need that, I can only marvel at a fate sneaky enough to make me call them on the one day that even a hallmark card could get me bawling.
I'm very good at recognizing my own limits, and the one thing I cannot EVER do again, is go through pregnancy while being alone. It would be really nice if I suddenly met somebody tomorrow and we got to navigate this choppy sea together, but I'm not holding my breath. So I have to wait until I'm about 2 months away from wrapping up my life (temporarily) in the US and I'm ready to make that short term move back to India. Only then can I try again.
I'm going to be candid in saying I am now utterly petrified of pregnancy. Even when I get past the first trimester, I'm going to be thinking of all the other horrible things that can go wrong. A big part of this is because of the Turners syndrome diagnosis. When you know beyond a doubt that you have produced one bad egg, you keep thinking about what if the next time the baby actually makes it through to 5 months, and THEN you find out? I'm going to need help keeping sane the next time, obviously. Several months ago, my brother had asked my why I don't come back and go through pregnancy in India and I had unequivocally dismissed the idea. Pollution, mosquitoes, heat, monsoons...who needs that while pregnant? Moreover, I had wanted my child to be born in America so there would be fewer immigration issues to work out. Now, those concerns seem laughable, and of course, famous last words.
If you have read this far, thank you. This post is mostly like lancing a boil...I'm praying that it does not refill, I don't want to keep feeling like this.
I'm very good at recognizing my own limits, and the one thing I cannot EVER do again, is go through pregnancy while being alone. It would be really nice if I suddenly met somebody tomorrow and we got to navigate this choppy sea together, but I'm not holding my breath. So I have to wait until I'm about 2 months away from wrapping up my life (temporarily) in the US and I'm ready to make that short term move back to India. Only then can I try again.
I'm going to be candid in saying I am now utterly petrified of pregnancy. Even when I get past the first trimester, I'm going to be thinking of all the other horrible things that can go wrong. A big part of this is because of the Turners syndrome diagnosis. When you know beyond a doubt that you have produced one bad egg, you keep thinking about what if the next time the baby actually makes it through to 5 months, and THEN you find out? I'm going to need help keeping sane the next time, obviously. Several months ago, my brother had asked my why I don't come back and go through pregnancy in India and I had unequivocally dismissed the idea. Pollution, mosquitoes, heat, monsoons...who needs that while pregnant? Moreover, I had wanted my child to be born in America so there would be fewer immigration issues to work out. Now, those concerns seem laughable, and of course, famous last words.
If you have read this far, thank you. This post is mostly like lancing a boil...I'm praying that it does not refill, I don't want to keep feeling like this.
Goodbye 2010
on Saturday, January 1, 2011
I’m writing this post out in midair to San Diego. Very reluctantly, on New Year’s Eve, I packed up and left the comfortable cocoon that is my parents’ home. I’ve spent a wonderful month there, I spent the days rolling on the floor with my 2 dogs, playing with our newly acquired cat (pictures coming soon), having long conversations with my parents and brothers and getting ridiculously pampered. This past month has saved me, no doubts there. We all need support structures in trying periods and mine unfortunately is half a world away, but once I got to it, it was pretty darned wonderful.
I entered into 2010 a girl who had never experienced loss of any sort, as somebody starting out on this journey with stars in her eyes. I’ve been pregnant almost half of this year, and all I have to show for it is 2 D&Cs, one yeast infection and 3 karyotyping results (my 2 babies and mine). I could hate this year. Loathe it. Be angry and miserable when I remember it. But I don’t feel that. I actually don’t know how I’d describe 2010 one day in the future, but I’m waiting to find out.
I’ve had numerous philosophical conversations with my mom . One theme we keep revisiting, is that as souls go through their various lifetimes, they can evolve (or devolve, if you think about somebody like Ted Bundy). Obviously, it is only suffering and challenges that evolve the soul, not the wonderful, easy times. I don’t want to be one the evolved souls. I wish I was a slightly ditzy type got married to the love of her life early on and plonked out 3 perfect kids and had a uneventful life. I wish I had not an ounce of complexity and that my soul got through this lifetime with not one darned lesson learned. But that’s not what was in store for me and since I’m being force-fed all this crap, then I might as well get something positive out of it.
The lessons 2010 has taught me:
Patience: When such horrible things happen to you in a short period of time, you zoom in on the pain. You magnify it and you forget that it is only a moment in time. So much can change so quickly and there all these journeys and paths waiting for you, and you never know what will come in 6 months, one year or 5 years. What I need to do now: wait for it, with equanimity. I’m doing this…after a fashion. Diana Gabaldon (my all time fav author) has a line in her book which goes something like this: If Time is akin to god (in its ability to heal pain), then memory is the very devil. It is true. I have cried very little I found out Turbulence had died, mostly because my brain does not think much of that time, of her, or what she might have been. If I go there inadvertently, I back off like I’ve been scalded. On the plane I was sitting surrounded by children. On the seat ahead of me was this adorable baby that kept playing peekaboo with me. I played with him for about 10 minutes then suddenly, I was sobbing helplessly, something I had not done in weeks. Memories, they are the devil.
Humility: I thought I could control my life. I thought I could plan these all important things and they’d turn out the way I’d imagined. 2010 has ruthlessly demonstrated that I have no control. I have none over my biology, over destiny, over anything really. How do you deal with this sense of utter powerlessness? The only recourse (available to me) is humility and say that I’ll do whatever I can to achieve my goals, but be ok with whatever results emerge, even if they are horribly cruddy ones. It’s an exercise in faith actually, to say no matter what comes, I’ll be ok with it, that I’ll see it as a blessing. Sometimes I feel I’ve gone a little way towards this, and at other times I think of my worst case scenarios and my throat still closes up. But still, I’ve come a long way from where I was at the start of this year.
So goodbye 2010.You were a pretty harsh teacher, I hope 2011 will be kinder.
WOW (edited)
on Wednesday, December 29, 2010
For those of you who are following the vitamin D3- AMH story, here is the latest.
3 weeks ago, I was in the deficiency/low range for both Vitamin D3 and AMH.
Vitamin D3= 16 ng/ml, AMH= 1.1 ng/ml.
The low AMH sparked off an avalanche of fears about diminished ovarian reserve. Then I took gigantic doses of Vitamin D (60000 IU weekly) for 2 weeks
Then I gave blood again, and tested both Vitamin D3 and AMH.
Vitamin D3 = 70 ng/ml (perfect) and most amazingly AMH= 5.18 ng/ml (high and now in PCOS range)
Overall, a four fold increase in AMH levels (going from 'low fertility' to 'optimum fertility' in the lab classifications), which I found just incredible. Its always possible the first lab really messed up the test, but I think that there is really a fair chance (based on the study I posted about) that AMH went up because Vitamin D did. Anyway, I've let the group at Stanford studying this know and maybe one day a formal study might be launched.
Right now, the primary emotion is massive relief that I'm not dealing with a case of low ovarian reserve here.
Interestingly, my testosterone levels also changed dramatically, they went from being fairly high in the Vitamin D deficient state to being low after my deficiency was corrected.
Currently, my theory (derived from combining very few facts with a lot of speculation and intuition) is that my problem could be two-fold, first low vitamin D3 (found in about 40 % of cases with PCOS ) and a possible undetectable issue with insulin resistance, which could be addressed with metformin.
Other than the now corrected Vitamin D deficiency, my only PCOS parameters are lots of antral follicles and now high AMH and slightly high DHEAS- The million dollar questions are:
1) is this messing up egg quality and thus responsible for my two losses?
2) Is it tied to sugar metabolism and be fixed by metformin?
I have a very strong family history of type 2 diabetes (practically everybody in my father's side develops this), though I could find no indication whatsoever of insulin resistance in me. But still, metformin has been shown to help even when there is no overt insulin resistance. Nothing is a sure-fire fix. Last time I attempted conception I was praying the thyroid hormone would be the magic fix I needed. The next time, I will be hoping its all of this.
3 weeks ago, I was in the deficiency/low range for both Vitamin D3 and AMH.
Vitamin D3= 16 ng/ml, AMH= 1.1 ng/ml.
The low AMH sparked off an avalanche of fears about diminished ovarian reserve. Then I took gigantic doses of Vitamin D (60000 IU weekly) for 2 weeks
Then I gave blood again, and tested both Vitamin D3 and AMH.
Vitamin D3 = 70 ng/ml (perfect) and most amazingly AMH= 5.18 ng/ml (high and now in PCOS range)
Overall, a four fold increase in AMH levels (going from 'low fertility' to 'optimum fertility' in the lab classifications), which I found just incredible. Its always possible the first lab really messed up the test, but I think that there is really a fair chance (based on the study I posted about) that AMH went up because Vitamin D did. Anyway, I've let the group at Stanford studying this know and maybe one day a formal study might be launched.
Right now, the primary emotion is massive relief that I'm not dealing with a case of low ovarian reserve here.
Interestingly, my testosterone levels also changed dramatically, they went from being fairly high in the Vitamin D deficient state to being low after my deficiency was corrected.
Currently, my theory (derived from combining very few facts with a lot of speculation and intuition) is that my problem could be two-fold, first low vitamin D3 (found in about 40 % of cases with PCOS ) and a possible undetectable issue with insulin resistance, which could be addressed with metformin.
Other than the now corrected Vitamin D deficiency, my only PCOS parameters are lots of antral follicles and now high AMH and slightly high DHEAS- The million dollar questions are:
1) is this messing up egg quality and thus responsible for my two losses?
2) Is it tied to sugar metabolism and be fixed by metformin?
I have a very strong family history of type 2 diabetes (practically everybody in my father's side develops this), though I could find no indication whatsoever of insulin resistance in me. But still, metformin has been shown to help even when there is no overt insulin resistance. Nothing is a sure-fire fix. Last time I attempted conception I was praying the thyroid hormone would be the magic fix I needed. The next time, I will be hoping its all of this.
Phew
on Friday, December 24, 2010
About 3 days ago I finally became negative on the urine beta HCG tests. Having gotten this green flag, I finally went in for my antral follicle count today.
And...phew. AFC is 15 follicles per ovary(!!!). Ovaries look polycystic but thankfully, ovarian volume looked normal. Most reassuringly, this definitely does not correlate with low ovarian reserve, which was my one gigantic fear since I found AMH was low. I also gave blood to retest for AMH and (for good measure), Vitamin D3 since I've been on massive doses of the latter for the past two weeks. Testing in India is cheap so I go nuts. Off topic, but I'm also getting Vitamin B12 tested (nothing to do with fertility that I know of), but Vitamin B12 deficiency is really common in the Indian population and has also cropped up in my family. Interestingly, severe deficiency of this vitamin seems to cause some mental issues (periods of rage, stress etc).
So, overall, it looks like I might have ovulatory PCOS (which according to my Indian RE may be compromising egg quality) but the jury is still out of the diagnosis. I'd be glad to have a confirmation, at least we would have something to treat.
And...phew. AFC is 15 follicles per ovary(!!!). Ovaries look polycystic but thankfully, ovarian volume looked normal. Most reassuringly, this definitely does not correlate with low ovarian reserve, which was my one gigantic fear since I found AMH was low. I also gave blood to retest for AMH and (for good measure), Vitamin D3 since I've been on massive doses of the latter for the past two weeks. Testing in India is cheap so I go nuts. Off topic, but I'm also getting Vitamin B12 tested (nothing to do with fertility that I know of), but Vitamin B12 deficiency is really common in the Indian population and has also cropped up in my family. Interestingly, severe deficiency of this vitamin seems to cause some mental issues (periods of rage, stress etc).
So, overall, it looks like I might have ovulatory PCOS (which according to my Indian RE may be compromising egg quality) but the jury is still out of the diagnosis. I'd be glad to have a confirmation, at least we would have something to treat.
On vitamin D
on Thursday, December 23, 2010
I came across two things which I beleive I should share. The first was a news report about a finding presented at a fertility conference. This group at Yale tested blood levels of Vitamin D in 67 'infertile' women. 93% of women had levels that were low or clinically deficient. That is pretty amazing, IMO.
The second is this recently published study, where they basically found that higher the vitamin D levels in your follicular fluid, the higher your chances were of achieving pregnancy in IVF.
My advice to everybody struggling to get or stay pregnant- do a blood test for this vitamin. Its not the most expensive thing and seems like a reasonable thing to check out. Testing your levels before taking vitamin D supplementation would be prudent because you would have to tailor your dosage to your blood level. I was clinically deficient. Granted I had taken my last vitamin D supplement 2 weeks before this blood test, but while I was pregnant, I was consuming around 1500 IU/day, which is about 6 times the daily recommended dosage, and my levels 2 weeks later were still abysmal.
Switching gears now. In my last post I had said none of my theories have been right. I just realized that was not true, I have been proven right in the most horrible way. As my second IUI rolled around, I had become really scared as I had looked at my cycle and realized that it was one with fewest days of peak estrogen ever and I was nervous that egg quality might be compromised. (Prophetic blogpost here)
I went ahead with the insemination because on ultrasound, everything looked decent and nobody knows what parameter really determines egg quality. I did conceive but it was my worst fear realized- a genetically abnormal egg. Its been only a month since that horrible ultrasound, that awful day. I'm doing very well though, all things considered. I guess I should thank god for small mercies.
The second is this recently published study, where they basically found that higher the vitamin D levels in your follicular fluid, the higher your chances were of achieving pregnancy in IVF.
My advice to everybody struggling to get or stay pregnant- do a blood test for this vitamin. Its not the most expensive thing and seems like a reasonable thing to check out. Testing your levels before taking vitamin D supplementation would be prudent because you would have to tailor your dosage to your blood level. I was clinically deficient. Granted I had taken my last vitamin D supplement 2 weeks before this blood test, but while I was pregnant, I was consuming around 1500 IU/day, which is about 6 times the daily recommended dosage, and my levels 2 weeks later were still abysmal.
Switching gears now. In my last post I had said none of my theories have been right. I just realized that was not true, I have been proven right in the most horrible way. As my second IUI rolled around, I had become really scared as I had looked at my cycle and realized that it was one with fewest days of peak estrogen ever and I was nervous that egg quality might be compromised. (Prophetic blogpost here)
I went ahead with the insemination because on ultrasound, everything looked decent and nobody knows what parameter really determines egg quality. I did conceive but it was my worst fear realized- a genetically abnormal egg. Its been only a month since that horrible ultrasound, that awful day. I'm doing very well though, all things considered. I guess I should thank god for small mercies.
Subscribe to:
Posts (Atom)