Another Milestone

Man! Has it really been over a week since I last posted? My humblest apologies for being so delinqent. You see, there really hasn't been much to write about. Since we're going au naturale this time around I haven't had any doctor drama or office visits to complain about. My biggest challenge has been to increase my caloric intake and not offset that by (literally) exercising my ass off.

Although I've been steadily increasing my food, I still am not consuming the 2000+ calories that the nutritioninst is recommending. Yes, you read that correctly...2000+. How the hell am I supposed to consume that much?! I really don't know. I've already gained 5 lbs since we started doing IVF and am now up to 130lbs at 5'6" and have stayed pretty much the same for the past few weeks. I'm scared to death of what may happen if I increase my calorie consumption to 2000. I will say I do love one side effect of gaining weight -- I'm not cold!! I don't have to wear sweaters in the middle of summer. Hallelujah!

I guess I could count the birthday cake that I'll be having tomorrow to my 2000 calories. Yep, I'm turning the big 3-5. I sincerely thought I'd be a mother by now. I even had the gall to think that we might be trying for number 2 around this time. Everytime I think of that, I think of this quote by Woody Allen: "If you want to make God laugh, tell him about your plans." Well, I've learned my lesson and I'm not planning for anything, but I am hoping that this year will be better than last.

And Life Goes On

Wow! Has it really been almost a week since I last posted? Sorry about the delay, but there really hasn't been that much going on in my life. I'm not sure if that's good or bad.

I am excited to report, though, that I had my first meeting with the eating disorder therapist and things went well. I think the most enlightening thing she told me was that 85% of anorexics don't meet the weight criteria of the current anorexia diagnosis. That is, 85% are in the "normal" BMI range, but have all of the other symptoms (psychological and physiologcial) that are associated with anorexia. I guess based on what doctors know now, they are planning on changing the criteria for anorexia and removing the weight criteria.

And for the first time since I've gone off of BCPs, my little ovulation monitor shows that I am ovulating on CD 15!! I've always been a late ovulator, typically on CD18 or later. I'm not sure if it's a fluke or the herbs I've been taking or the fact that I'm eating more, but I have to think that it's a good thing.

So, where do I go from here? Well, I'm meeting with a nutritionist and then with the therapist again. I'm slowly, but surely making progress and I'm hoping that this will help in some way with my IF. I'm not going to hold my breath and assume that this is going to cure everything, but I know it can't hurt.

Back To Square One

I've come full circle and I'm back where I was almost one year ago. Back at my original RE who did my IUIs and my HSG and the one who told me that Doc and I had a 99% chance of getting pregnant through IVF. HA! Yeah right!

I have this love/hate relationship with this doctor (I'll call her Dr. Curt). Love because I think she's very smart and knows her stuff. Hate because she's always in a rush and this makes her curt (hence her name) and I think her nurses/staff are a bunch of dimwits. She works at the same HMO as Doc and I sort of understand her predicament. She's the only RE on staff and so she does everything for everyone who has an infertility issue.

Let me give you some perspective on how overworked these doctors are. Currently, Doc sees 13 patients in the morning and then 13 patients in the afternoon. That's 26 patients in a day -- 20 minutes per patient. That doesn't include having to do all the paperwork, telephone calls and emails. And God forbid if there's a late patient or someone who may require more than 20 minutes. So, I try to give Dr. Curt a break.

Anyway, I met up with Dr. Curt yesterday and she asked me how things were going and I told her I've done 2 IVFs and no pregnancies. Not even a chemical. Her reaction: complete and utter surprise. She insisted that we should have gotten pregnant by now, particularly with the success rates of the 1st IVF center we went to (their success rates are above 50%), and with the fact that I had decent embryos transferred back.

Her thought is that there's something going on with implantation. Maybe my uterus or lining? So, she's scheduled me for a hysteroscopy for next cycle. At that time, I'm also doing a freakin' slew of blood tests...again. She's determined to get me pregnant. Has anyone ever had a hysteroscopy? From what I've read, it sounds very unpleasant to put it mildly.

As for other things going on in my life, I've changed acupuncturists. I'm now going to a Chinese woman who seems very nice and has a wall full of baby pictures and thank yous. She's given me some herbal pills which I googled and seem to be consistent with what's ailing me. I'm also taking the metformin which initially did a number on my stomach, but now seems to be ok.

And, finally, next week is my first appointment with the eating therapist. I'm actually dreading this. I've had therapist appointments in the past and they didn't go so well because I'm absolutely terrible at talking about feelings and emotions. This has sometimes been an issue of contention between Doc and I because when I get upset, he wants to talk about it immediately and address the issue. I just want to get control of my emotions, mull over them, and then once I feel like I can handle a discussion, then I'll discuss. I just hate being emotionally poked and prodded. Ugh...

Trials and Tribulations

I'm not sure if this is national news or if it's just been a local preoccupation, but in the Bay Area we're on high alert because of the Johannes Mehserle trial.

Doc was on-call until 11pm last night at the ER and he'll be on-call for most of the weekend. Our office sent out an email yesterday telling everyone to go home early and avoid Oakland. Everyone has been avoiding downtown Oakland and a lot of people who usually take BART (which is the "subway" system for the Bay Area) have opted to either not go to work or to take an alternative mode of transport.

It'll be a tense weekend and I'll probably skip my usual jaunt down to the Oakland Farmer's Market. I feel bad for the store owners and other businesses that will suffer due to the unnecessary violence.

On another note, I met with SI.RM yesterday and had a long discussion with Dr. G. He had a different perspective on my situation. He's of the opinion that my issue is a hormonal problem and not necessarily a protocol problem and that I need to address/treat the underlying hormonal problem. He basically said that with a good lab and maybe some changes in protocol, I could possibly get a few more mature eggs, however it wouldn't address the uterine issue (i.e., thin lining) which is also probably related to the underlying hormonal issue and probably causing implantation problems.

When I asked about donor eggs, his opinion was that it was far too soon to do donor eggs and even if I did do donor eggs, seeing as I may have a uterine problem, there's no guarantee that they would implant. He really thinks I should take some time to do additionally testing and find out if/what my underlying hormonal issues are.

So, that being said, I did a bit more research and it appears that a lot of my symptoms are related to eating disorders and nutrition. Adding to that list, I'm now including low DHEA. I just got my tests back and I'm on the borderline/low end of normal. Low DHEA, low estrogen, low libido, fatigue, insulin resistance, bloating, constipation, light/no periods, low heart rate (my resting heart rate is below 50), very low blood pressure, always cold...It's all there.

Amazingly and strangely enough, I've actually LOST weight since I've stopped exercising and eating more. It's seems so counterintuitive, but the scale shows a loss of 4 lbs! It's really hard to believe. I've been making a conscious effort to eat when my body says it's hungry and not ignore the hunger pains. Prior to this, I would just drink a ton of water or go exercise and typically that would suppress the hunger.

Unfortunately, I think there's still a lot of work to be done because I still have this mindset of what/how much I can eat. It's just so hard to overcome and even though I've increased my food intake, I'm still not sure if it is enough. Am I full or am I just "mentally" full? I know that may sound strange, but I'm really having difficulties with it. I've led a certain lifestyle for so long, I think it's going to take a long time to undo the damage.

Tests Results

Sorry, I couldn't think of a more interesting post title, although I was going to put "Going Insane." That about sums up what I'm feeling...

So I requested a bunch of tests from my ob/gyn and because I'm so impatient, I requested them done now instead of waiting a month and waiting for my hormones to normalize after this IVF cycle. What news did I get?

LH: 5.7
Estradiol: 36
Testosterone: still waiting

But the kicker...My FSH came out to be 23!! WTF! I have to imagine (hope) that this is because my hormones still haven't calmed down after all the injections. I've done the FSH test twice and the results have been 7 and 6. I can't believe that out of the blue it could skyrocket to 23!

And now for the encore kicker...my oral glucose tolerance testing level: 147! It should be below 120. My fasting glucose levels are normal, this shows diabetic levels. WTF?!

Sometimes it's just better off not knowing anything.

Something To Chew On

I just finished talking to NO.VA in Palo Alto. They're a very small IVF shop, but people had pretty good things to say about the docs and about the level of service and personal attention.

I have to say that the doctor was very nice and I heard a few very interesting things. First off, he thinks that I can get pregnant with my own eggs. And second, he's seen this immature egg issue before several times and interestingly enough it's only been in asian women. He even said that as soon as he saw my paperwork and my IVF results, he assumed that I was of asian decent.

His protocol change recommendations were to switch to microdose HCG, regular lupron protocol, no menopur until the very end of the stims, and lastly stim for an additional 1-2 days past the typical day that they would do the HCG shot. He said that some women just have eggs that need to be stimmed a little longer.

Now, I'm not sure that I would end up going to this clinic, but talking to the doctor really put my mind at ease. As of now, I have 2 docs saying that there's still hope and only 1 doc saying it's time for DE. I have two more appointments to go, one with SIRM and another with CCRM, so I'm hoping that I'll hear good things back from them.

As for my other issue...I definitely ate more this weekend! For example, yesterday I ate a bowl of cereal for breakfast and then for lunch/dinner I ate 5 ribs, some grilled veggies, half a cup of macaroni salad, some cherries, and a few cheese and crackers. That's a lot of food! :)

Thank you!

I'm doing ok...Well, as good as can be considering the results. But as with all bad things, I realize that I can't dwell on this and I have to move on.

And I will move on, thanks to all of you and your kind words. When I started this blog, I had no idea what a huge part of my life it would become and all the wonderful, fabulous women I would meet. Sometimes I'm amazed how we even make it through each day. If I could, I'd go visit each and everyone of you and give you a huge, gigantic hug.

My next step will be to address my eating disorder (it feels so weird to write/say that). I've lived this way for so long, I don't know any other way to live. Every media outlet tells you, eat more veggies and fruit, eat less carbs and fat and exercise more. That's what I did. I just don't understand how they can say that and then tell me what I'm doing is wrong. I guess this is where the nutritionist and counselor come in to play.

I'll also be doing acupuncture and taking herbs. I'm meeting with a new TCM(traditional chinese medicine) doctor next week and I'm sure she'll have a lot to tell me.

And then lastly, I'll have to deal with my mother. She's coming back from Korea next week and I'll have an earful to deal with. Not only will I get to hear her opinion, but I'll also get to hear the opinion of all my Korean relatives (which she will tell me in detail) and all the anecdotal stories about so-and-so's daughter and how she got pregnant by obeying her Korean mom and eating tons of miyuk gook (seaweed soup). Patience is a virtue...

BFFN

There's not much more I can say...

Food for Thought

I'm still waiting on the results of my beta, but I'm 99.9% sure that it's going to come back negative.

In the meantime, I've been doing a lot of research and a whole lot of soul-searching. I've mentioned in my previous posts that I think I have an eating disorder. It's always been in the back of my mind, but I never addressed it because I didn't fit the "typical" profile of being bulimic or anorexic.

For the past 8+ years, I have restricted my daily calorie intake to be between 1,000-1,200 calories. If I knew I was going to be having dinner with friends, I'd skip lunch so that I could eat "normally" at dinner or do an extra few miles on the treadmill. I would go to bed hungry, sometimes 4-5 nights/week. Up until about 8 months ago, my daily meals would be: one small bowl of fiber cereal (150 calories); salad with only veggies and no dressing (300 calories); small dinner usually chicken, veggies, brown rice (500-600 calories). In addition, I would exercise for a minimum of 1-2 hours 5 days/week.

After doing research on the internet, I realized that you don't have to be 5'5" and 100lbs to have an eating disorder AND that I had many of the symptoms associated with it. I have incredibly scant periods, low estrogen, bloating, brittle nails (for awhile my toe nails were falling off), thinning hair/hair loss, dark undereye circles, joint pain and chronic fatigue.

What's amazing is that no one has ever noticed...After eight years and two years of being married to a doctor, you would think that someone might take notice, but I guess I was pretty good at hiding it. Most of my meals are eaten at work and no one ever questioned my eating habits.

After the results of my last IVF retrieval and information from the internet, I finally decided to talk to Doc about it. It completely caught him by surprise and it was incredibly difficult for us. I'm such a terrible communicator and all I wanted to do was curl-up and disappear, but I made it through. Doc asked a lot of questions and we had a long, in-depth talk. He told me that there are many fully-functioning women with eating disorders. He also recommended that I talk to a nutritionist and a counselor.

The counselor is actually a good friend of Docs and when he spoke to her about me, she said that 25% of unexplained infertility cases are related to eating disorders and most of these women never disclose this to their REs! There are several studies that show the exact same thing.

The reason I'm writing all of this is because if there are other women out there with similar issues, please get help. Your RE will probably never ask if you have an eating disorder, so it's up to you to be your own advocate and make things happen for you.