Monthly Archives: January 2015

Missing Menses – The 411

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baby - looking for something

Well today is CD 40 and guess who is MIA?   Aunt Flo !   I think this lil heifer made an early appearance on CD 25  just five days after my hysteroscopy and biopsy and was confused as post surgical bleeding. On that day, the bleeding seemed heavier, with cramping and lots more clotting.  I called the nursing staff to ask if they thought my period had started and they assured me it was just post surgical bleeding which could happen for up to 10 days. Being that I have had NO symptoms, granted I am been popping oxycodone like tic tacs due to the oral surgery I had last week, I have no “pre-period” symptoms.

It appears that I will now be waiting until the 14th or so of February for my period so that I can go in for a baseline/sonogram and then start stimming.

I have, surprisingly, not flipped out nor been upset by this.  I figure my body will do what it will do and I am not willing to rush it or force it to function the way I want it too.  The best thing to do it just wait it out, continue to take supplements, do weekly acupuncture, and stay calm and relaxed.  At the rate I am going I will be having a Christmas baby again next year !

 

 

 

 

 

Oral Surgery Today – CD33- The 411

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baby - tooth pulled

On Tuesday, as I lie on the acupuncture table, my tooth started feeling kinda weird.  I felt this pressure. All day yesterday, it was starting to throb and by the evening,  I was in full out PAIN, despite taking 2600 mg of Motrin throughout the day.  I ended up going to the emergency room to get something for pain.  I was given penicillin and percocet.  The percocet was only taking the edge off the pain but the throbbing was horrific.  I was up all night in tears because my mouth was hurting that bad.  The doctor in the ER was pregnant with a set of twins via donor egg IVF.  She told me that she had had six miscarriages and ten ivf cycles.  After years of trying, they finally decided to do IVF and eventually moved on to donor eggs.  She has a little boy and now pregnant with two girls from the same egg donor. She said it was good that my tooth flared up now before my next cycle so that I did not have infection in my body going into a cycle, which could cause complications.

This morning, my mom called her dentist as soon as they opened and was able to get me a 8:30 am appointment.  I was so twisted from taking 2 percocet every three hours, that my mom and the baby had to drop me off at Dr. Hudgins office.  Dr. Hudgins has seen me before when I lost a filling while visiting my mom.  He took an xray of the tooth and determined that the tooth had cracked and also had a really severe abcess.  He called an oral surgeon colleague and they were able to do oral surgery and get that tooth out.  While there, the nurse told me that she has a 21 year old son who was the result of IVF.

I called my mom to come back to the dentist office and she came and picked me up and dropped me off at Reston Hospital where the oral surgeon’s office is located.  I went in, struggled through filling out the paperwork because I was not only high from the percocet, but also nauseated because I had not had food in 2 days.  I went back, met with the two doctors, who are very nice, and they explained what they were going to do.  I had to have several injections of novacaine and lidocaine to numb me because of the infection.  (the meds and the infected area are both acidic and cancel each other out)  Once I was finally good and numb, they pulled the tooth out.  YAY !   I felt a release of pressure.  The doctor cleaned the area out and got the infected tissue and waste out.

In other news, today is CD 33 (cycle day 33) and my period has not started yet.  I am patiently waiting on my period.  Last month, my period started on CD 37.  I am relieved that my period is taking its time because I had bleeding for a whole 10 days after my hysteroscopy and am glad for the break !

 

 

 

Under The Weather – The 411

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baby - under the weather

For the past few days, I have been miserably sick.  After my surgery on Friday, I woke up in the recovery room with fluid in my lungs, coughing and feeling sleepy.  On Saturday, when I got up, I was still coughing, but also had an extremely sore throat.  I called the doctor on call and was told it should clear up in a couple of days.  All weekend, I coughed up phlegm and nursed my sore throat with sugar free lozenges, hot tea with organic honey and lemon slices, and ate soft foods.

My throat is still very sore and the coughing is subsiding.  I made skillet mac n cheese with a cheddar and provolone bechamel, thinking it would soft and easy to get down… NOPE !  I ate a little bit but my throat was so raw that I felt like butter was coating my throat and it was burning.  I gave up and just made a big mug of tea and added some rum to it for a hot toddy.

Surprisingly, I am still experiencing some bleeding.  I thought it would have stopped the same day as the surgery as it did before.  The last time I had a D&C in June, I was pregnant… well, I was carrying an expired eight week old fetus.  After the D&C, the bleeding stopped the next morning.   Today is day 3 after the procedure and I am still having off and on bleeding.   I am mad because I want to go to the gym and start lifting again, but I am not going to as long as I am bleeding.

I did go out to a birthday party on Saturday night for about four hours.  I was sore and tired, but I promised my friend I would be there and I would bake a bourbon red velvet cake and a rum infused guava jelly cake.  I baked the cakes, boxed them up, picked up my best friend, then went to the party in DC.  We have a great time.  I sat most of the party.  I am still feeling a bit of pulling in my abdomen.

I stayed in bed most of yesterday, with the exception of the time I spent making the mac n cheese.  I have rested today as well.  I am so tired of this bed rest stuff ! If you know much about me, I am not the sit still and do nothing kinda girl.  After watching everything I had on Tivo and several hours of Law & Order SVU and Criminal Minds, I have had enough of tv for a while. (well, until tonight when Major Crimes comes on lol).

Tomorrow, I will work on my book outline.  I am trying to find busy work I can do from my laptop on my bed or the couch.  I hope to return to the gym on Wednesday.  I have dropped 24 pounds so far and I hope to continue to work out even after getting pregnant.  I just do not want to overtax my body.

I hope all is going well for the rest of you ladies !!

 

 

IVF #4 Underway – Hysteroscopy with Biopsy – The 411

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baby - sick

Yesterday, I arrived at Lenox Hill Hospital at 5 am, an hour before I was to report.  I sat in the waiting room and watch Law and Order until it was time to go upstairs to the 10th floor to the same day surgery center.  I went up and checked in and was quickly taken to my pre-op room and met with the intake nurse.  I was given my gown, robe, and socks to change into and then the nurse brought me a warm blanket.  My nurse came by to ask me the same questions I had already been asked by the intake nurse and another nurse.  I then met with the Anesthesiologist and he asked me the same questions then explained what he would be doing.  I asked what meds he would be administering and I was getting propofol and toradol if needed for pain.

Next, the surgical resident came and asked me again the same questions and introduced herself and shortly after Dr. Moisa came in to introduce herself and ask me about my IVF journey and other questions, as she was filling in for my OB, Dr. Karamitsos.  Soon, I was taken to the OR, removed my robe, adjusted the silly cap they gave me to cover my hair, laid on the table and was freezing while they got me warm blankets, hooked up a monitor, put in my IV and then gave me an oxygen mask.  I remember the propofol going in because it burns, starting in the vajayjay and then quickly coming up.  The last thing I remember is the Anesthesiologist telling me I was going to sleep now and feeling the burning in my chest.  I woke up at 9 am in the recovery room and was coughing up phlegm.  I asked for pain meds and then I went back to sleep until 10 am.

I was ready to get up out of there at 10:30 or so and my make up artist had to come sign me out and take me to Penn Station because the hospital would not release me on my own.  One of my producers was supposed to be in the city awaiting a call from the hospital, but he did not show up due to a sprained ankle.

I got to Penn Station and waiting on my train the DC (which was 5 mins late !) I slept all the way to DC on the Acela and then got off and my mom came to get me.  I got to my mom’s house, and went straight to bed.

This morning, I awoke to a very sore throat and chest congestion.  I called the doctor on call and he said as long as I did not have a fever, the irritation from the tubes they put down my throat should clear up in two days max.  I explained to him that I have a history of pneumonia and I can not afford to get sick going into an IVF cycle.  He assured me that it is just irritation and a little fluid from the moist oxygen.  Hopefully this does clear up and if not, I will go to the emergency room here tomorrow evening for antibiotics.

Thanks for all of your well wishes and support and SpiritBaby, thanks for texting to wish me well just before my procedure!  I was so touched !  🙂    I was in surgery and my mom was in Northern VA undergoing chemo.  What a day !

 

 

IVF #4 – Hysteroscopy with Biopsy Tomorrow – The 411

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baby - surgery

This morning I went to LabCorp on my way to the gym to have six tubes of blood drawn for presurgery prep for my surgery tomorrow.  I had to have a CBC,  Complete Metabolic Panel, HIV, TSH, HCG, and some other test I have never heard of.  I am so sick of them always sticking me in my left arm.  Thank goodness that arm and vein have healed since it has had a little rest since October.

After my labs, I ran to the grocers to get chicken breast, fresh mushrooms (to make garlic mushroom chicken) and fish fillets.  I had fish and hushpuppies for breakfast after I got back from the my morning weight training.  Today was leg, glutes and abs day. Note, I have lost 22 lbs thus far !!

I am going through mental withdrawals since cutting out beef and pork from my diet.  In doing research, I learned that pork, beef, and lamb are carnivores which produce a sugar that human bodies do not.  By eating it, our immune systems inflame and go into attack mode.  It is advised that we consume no more than two grams per day.  Since I have autoimmune issues and I need to keep my immune system at bay, I have temporarily cut those meats from my diet.  I will eat chicken, turkey and fish from here on out.

So, I am trying to figure out what to wear tonight ! I am in DC area at my moms and the temperature has plummeted.  It is NEGATIVE SIX outside with the wind chill !  UGH.  It is going to be snowing in NYC tomorrow.  I will arrive in NYC tomorrow morning at 5 am and have to report to the hospital at 6 am for my procedure.  I will be on the table at 7:30 am so please send up some prayers and well wishes for me at that time.  The procedure should be thirty minutes tops.  I am nervous because my OB is not on call tomorrow and one of the female doctors in the practice, whom I have never met, is doing my procedure.  For those who know me, I research the HELL out of doctors and staff that I deal with and do not like change at all !  I wish Dr. K were able to do my surgery, but it is what it is…

How MTHFR and A1298C May Be Contributing to Infertility – The 411

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baby - MTHFR

What is the official name of the MTHFR gene?

The official name of this gene is “methylenetetrahydrofolate reductase (NAD(P)H).”

MTHFR is the gene’s official symbol.

What is the normal function of the MTHFR gene?

The MTHFR gene provides instructions for making an enzyme called methylenetetrahydrofolate reductase. This enzyme plays a role in processing amino acids, the building blocks of proteins. Methylenetetrahydrofolate reductase is important for a chemical reaction involving forms of the vitamin folate (also called vitamin B9). Specifically, this enzyme converts a molecule called 5,10-methylenetetrahydrofolate to a molecule called 5-methyltetrahydrofolate. This reaction is required for the multistep process that converts the amino acid homocysteine to another amino acid, methionine. The body uses methionine to make proteins and other important compounds.

Defective MTHFR Gene Linked to Fertility and Pregnancy Struggles

The B vitamin Folic Acid has been touted as the most important vitamin for the proper development of a baby in pregnancy. This is especially true for the first few weeks of pregnancy, when the spinal column is developing. Research shows that folic acid plays a critical role in preventing the neural tube defect, spina bifida. It is considered so important, that the March of Dimes has an entire campaign focused on educating the public about the importance of women in their childbearing years, getting the right amount of this vitamin daily.

What if your body has a genetic defect that makes it extremely difficult for your body to utilize folic acid properly, though? And how would you even know? For 1 in 4 people this is a serious reality and if left undiagnosed, may lead to a variety of pregnancy related issues including difficulties conceiving, unexplained infertility, elevated homocysteine levels, recurrent miscarriages, child with Down Syndrome, development of Autism, preeclampsia, postpartum depression, or even the development of chronic depression.

The Role of MTHFR in Utilizing Folic Acid and Folate

To begin, it is important to know that the MTHFR gene resides in each and every cell in the body. It is responsible for utilizing folic acid and producing the most active form of folate called methylfolate. People with the variant MTHFR C667T have a 40 – 60% decreased ability to produce methylfolate.

Why is Methylfolate so Important?
In the body, methylfolate starts an innumerable amount of critical enzymatic reactions. This impacts the body’s ability to produce a compound known as s-adenosylmethionine, SAMe for short. The body needs SAMe to produce CoQ10, carnitine and creatine, all of which play a critical role in the body’s ability to reproduce, not to mention maintain a variety of other body systems.

MTHFR C677T gene defect contributes to elevated homocysteine levels, which are commonly linked to recurrent miscarriages, as well as the other pregnancy related risks I spoke of previously.

How does MTHFR gene defect cause elevated homocysteine levels?
One by-product of SAMe is homocysteine. Methylfolate and methylcobalamin help to convert harmful homocysteine into the beneficial methionine, which in turn helps to produce SAMe, in a cycle that is never ending, as long at the body is producing methylfolate. In the case of MTHFR gene defect, homocysteine levels may rise to harmful levels due to the impaired ability to produce adequate amounts of methylfolate; impacting your ability to conceive, or harming an otherwise healthy pregnancy.

Other concerns with this wheel are that the body will poorly convert homocysteine to the powerful antioxidant glutathione, which helps protect the body from free radical damage. People with compromised antioxidant levels are more susceptible to oxidative damage due to stress and environmental toxins, thus increasing the risk for toxin build-up. In addition, people with MTHFR gene defect may have lower levels of SAMe, which has been shown to increase the development of depression and postpartum depression. SAMe is also plays an important role in immune system function, growth, repair and maintenance of cells, and is anti-inflammatory. All of these play a role in reproductive function and proper development of a baby in pregnancy.

Testing is Easy!

If you have been struggling to get pregnant, have experienced recurrent miscarriages or any of the other pregnancy related issues I mentioned previously, schedule an appointment with your doctor for a MTHFR genetic test and blood homocysteine level. This should be done before you try to get pregnant again.

Results Matter – Heterozygous or Homozygous?
There are different variations of the MTHFR gene defect. There are people with heterozygous (1 copy of C677T, passed on from one parent) and homozygous (2 copies of C677T, passed on from both parents) MTHFR mutations. Those with homozygous MTHFR C677T are often advised to take their folate requirements more seriously. Homozygous individuals need to avoid synthetic folic acid (see below for more info on this), they require more methylfolate supplementation than heterozygous individuals do, and their blood thinning requirements are greater, especially where a woman’s ability to get pregnant and carry to term is concerned. Before a successful pregnancy can be achieved, these considerations must be addressed.

What You Can Do if You Test Positive for MTHFR C677T

Although at first it feels quite scary and hopeless to be diagnosed with a genetic defect, this one is quite common. Fortunately there are things you can do at home to increase your chances of natural conception, carrying a healthy pregnancy to term, preventing postpartum depression and protecting your health overall, since MTHFR gene defect impacts many areas of health.

  • Eat organic, this will help reduce overall toxic load.
  • Avoid supplementing with synthetic folic acid, choose a whole food preconception multivitamin like Fertile Woman One Daily while trying to conceive and then switch to a whole food prenatal multivitamin like Baby and Me Multivitamin through pregnancy and breastfeeding. You may also want to ask your doctor about special prenatal vitamins that contain methylated folate or folinic acid.
  • Eat a diet rich in naturally occurring folate, such as uncooked dark leafy green vegetables, lentils, beans, liver, and avocado.
  • Take ONLY L-methylated folate, as the body will not absorb methylated folate.  (Amazon.com is a great resource)
  • Avoid processed foods that are fortified with synthetic folic acid (homozygous), or strictly limit them (heterozygous).
  • Consider supplementing with carnitine, CoQ10 Ubiquinol, cod liver oil, probiotics and an antioxidant blend.
  • At each meal, eat a variety of whole foods and be sure to include a protein.
  • Make sure all the B vitamins you supplement are from a whole food source and provide the methylated form (active). For vitamin B6 this would be Pyridoxal 5-Phosphate or P5P; for Vitamin B12 this is methylcobalamin.
  • Avoid regularly consuming both black and green tea, as they may inhibit folic acid absorption.
  • Avoid antacids, these inhibit folic acid absorption as well.
  • According to Dr. Ben Lynch, an expert on MTHFR gene mutation, it is best to avoid birth control use, as this can block folate absorption.
  • For vegans, it is important to speak with your doctor about supplementing with the following, in addition to the above; methylcobalamin (active form of vitamin B12) and choline.
  • Find a good OB/Gyn or midwife to work with that is well educated in MTHFR gene mutation if you plan on getting pregnant. This will help you to maintain the continued support you need through pregnancy and lactation.

A1298C:

“The A1298C gene variant is found in the MTHFR gene. This gene produces an enzyme that is important in the metabolism of homocysteine, an amino acid.

We all have two copies of the MTHFR gene, one from each parent. People with two copies of the A1289C gene variant are referred to as homozygous. Having two variants/mutations, such as A1298C, can cause elevated homocysteine levels.

MTHFR deficiency, in the presence of elevated homocysteine levels, has been associated with a variety of health issues including an increased risk for venous thromboembolism (the formation of a blood clot in a vein), early onset cardiovascular disease, and adverse pregnancy outcome including fetal growth restriction, preeclampsia, miscarriage and placental abruption. However, these risks may not be increased in the presence of normal homocysteine levels. A blood test can be performed that measures plasma homocysteine levels.