Excuse me while I feel sorry for myself. For some reason something trigger the poor poor pitiful me button tonight.
As Landon approaches two I keep remembering how close we would be to finding out whether we would be having a girl or boy. As much as I wanted a girl I was ready to welcome another boy into this world to snuggle with and play cars with.
I feel awful! I should be happy that I have a sweet healthy little boy that is going to be two! Instead I can only think of my failure of losing his brother or sister. Now you can tell me it wasn't my fault, I know that it was out of my hands but it doesn't keep me from thinking this way.
There are reminders everywhere. The girl who works down the hallway at my new job who is an ultrasound tech with a 20 week protruding belly. She told me (not knowing of course) that when I did get pg she could do my u/s at 12-13 weeks and tell me what I'm having. All I wanted to say was "Yeah I should be 18 1/2 weeks now." :::sigh::: But of course I don't.
I'm reminded by the maternity clothes that still hang in my closet that I washed because I knew my regular clothes soon wouldn't fit.
I'm reminded because we have to be cautious now, not having insurance and all. This wouldn't be the time to get pregnant! I think this is the hardest thing to face. If we had all our answers (blood tests) and were TTC, I think I could throw myself into that and let it in God's hands. But we're not there yet. I don't want to wish summer away because I LOVE summer. I don't want it to be fall yet because my EDD would be right around the corner.
Its just so hard. It sucks so bad. I hate this. Today I feel alone.
Tuesday, May 31, 2011
Monday, May 30, 2011
What Testing Can be Done for RPL? #3
The immune system is a very complex system. When an illness occurs and the body's tissues are attacked by its own immune system, this is known as an autoimmune disorder or disease. Some autoimmune issues include systemic lupus erythematosus (SLE), rheumatoid arthritis, juvenile diabetes (type 1), etc. All of these issues can contribute to infertility or RPL.
The immune system is another complex system. I will do my best to explain how it works but please check this site out "How Your Immune System Works".
-Dr. Alan E. Beer
What are Th1 & Th2? Well these are T-helper cells (CD4) or a type or white blood cells (leukocytes) that are produced in the Thymus (hence the T), the gland next to the heart. Th1 cells are responsible for sending a chemical message called lymphokines. This chemical message is sent to B cells (produced in the bone marrow) telling them to make antibodies. Th2 cells are a second type of T-helper cells that act to restrain antibodies. Th2 cells help the body to accept foreign material or cells. In sense, Th1 cells are the "aggressors" cells and the Th2 cells are the "pacifiers" cells. If the Th1 cells become overly aggressive they can attack the wrong targets causing an autoimmune disorder. However, sometimes Th2 is overly suppressing of the Th1 cells and this can leave the body very vulnerable, susceptible not only to infection but tumors as well.
All this talk about antibodies; so what are they? Antibodies are proteins that destroy antigens aka virus, bacteria, fungi or any harmful substance that enters the body. Every antibody belongs to a group of proteins called immunoglobulins (Ig). Attached to the surface of a B cell is an Ig molecule.
Hopefully this is making some sense and you can now see why the Th1:Th2 ratio is so important now. Moving on to what may also accompany an antibody onslaught. An overproduction of proinflammatory cytokines also known as the cells messenger. Cytokines "interact with cells of the immune system in order to regulate the body's response to disease and infection". They also "mediate normal cellular processes in the body".
These messages in between cells then prompts the NK cells, macrophanges, neutophilis and T cells to go in for the kill. Most commonly they will attack connective tissue (tendons, skin, muscles, etc), joints, nerves, thyroid and pancreas. These particular targets cause some commonly known autoimmune diseases including Arthritis, Lupus, Graves' Disease, Crohns Disease, Rheumatoid Arthritis, Guillain-Barre Disease and psorasis.
There is a test called Th1:Th2 Cytokine Assay that simply counts the number of each Th1 & Th2. While searching for normal lab values I came across this journal article Systemic Th1/Th2 cytokine responses to paternal and vaccination antigens in preeclampsia". Interestingly enough it was thought that a "Th1 shift has been suggested to be involved in the pathogenesis of preeclampsia". Hmm...however, apparently this article proved Th1 to be no different. Anyway, I have had poor results in finding a "normal" lab value for Th1:Th2 Cytokine Assay. If anyone has any insight please do not hesitate to comment below.
One other thing I want to review are ANA's or antinuclear antibodies. These are antibodies designed to go attack a cells nucleus. ANA is another test that can be performed with those who have infertility or RPL issues. Just because one ANA is positive does not indicate a cause of infertility or RPL. The presence of one antibody mayindicate other autoimmune issues. ANA's commonly go hand in hand with hyperactive NK cells.
"ANAs are found in 20-30% of women with RPL."
"7% of women who are unable to conceive naturally produce antibodies to sperm."
Two types of antithyroid antibodies (ATA's) exist: antithyroid peroxidase and antithyroglobulin antibodies. ATA's are also linked to a predisposition to other autoimmune disease. One important factor I want to mention is it is important when testing for ATA's that the lab use the test ELISA. If a less sensitive one is used 1 in 5 women who carry ATA's will go undetected. Women with ATA's should also be tested for elevated levels of CD56+ NK cells, CD19+/5+ cells and activated T cells, according to Dr. Beer.
- 30% of women with RPL will test positive for one or both ATA's and are twice as likely to have a m/c then women without ATA'S.
LAC or Lupus Anticoagulant are antibodies against phospholipids that prevent blood clotting in a test tube. The presence of LAC my be responsible for causing tiny blood clots. Lupus antibodies may be present in those with systemic lupus erythematosus (SLE) or without SLE. Due to temporary side effects of an infection, this test should be repeated in 6-8 weeks.
All this talk about Natural Killer Cells (NK Cells). What are they? They are type of white blood cells or lymphocytes responsible for attacking viruses and/or cancer. According to MILab website a NK cell assay, "tests the killing function of circulating NK cells as well as the ability of interleukin-2 (IL2) to stimulate and intravenous immunoglobulin (IVIg) to suppress that activity. NK activity can be measured as a bioassay that determines the ability of activated NK cells to kill their target (K562 cell line)."
- Approximately 40% of patients undergoing IVF who have been diagnosed with endometriosis display increased NK activity.
The following tests are from Dr. Beer's book, with little side comments about each. You can also find some of this information on his website.
CD3 (Pan T cells) - Normal Range: 63-86% - If CD3 is low this is when the immune system is weak. Typically infertile patients or RPL patients often have high normal range values.
CD4 (T-helper cells) - Normal: 31-53% - Again women with fertility problems are typically in the high normal range value. Those who are low could have a serious health problem.
CD8 (T-Cytotoxic Suppressors) - Normal: 17-35% - These cells moderate the activity of Th-1 lymphocytes. In women with RPL/infertility, CD8 is often low.
CD19 (B-Cells) - Normal: 3-8% - Once again usually women with high normal OR elevated percentages are in women with immune-mediated infertility or RPL.
CD56+/CD16+ (Natural Killer Cells) - Normal: 3-12% - Levels are often elevated in women with infertility or RPL, leading to IVF failure, BO, or CP.
CD56+ (Natural Killer Cells) - Normal: 3-12% - These particular NK cells can be turned on by pregnancy & deteriorates the embryo.
CD3/IL-2R+ Cells - Normal: 0-5% - Women who have an autoimmune disease may also have above-average levels.
CD19+/5+ (B-1 Cells) - Normal: 2-10% - These particular cells can produce antibodies to hormones and neurotransmitters.
Are you confused yet? Yes, this is all very overwhelming and can be very confusing! I hope I've simplified some of this information that you aren't confused right now. I remember the first time I read "Is Your Body Baby-Friendly?" I skipped a lot of it because even coming from a medical background the medical jargon intimidated me. Its ok. This is nothing that you need to understand over night.
The immune system is another complex system. I will do my best to explain how it works but please check this site out "How Your Immune System Works".
"The immune system is balanced between a Th1 (autoimmune) and Th2 (pregnancy or suppressive) response. Most people have a balanced system. Women with implantation failure or RPL are unbalance. They are too Th1 activated with the autoimmune 'bad guys'."
-Dr. Alan E. Beer
What are Th1 & Th2? Well these are T-helper cells (CD4) or a type or white blood cells (leukocytes) that are produced in the Thymus (hence the T), the gland next to the heart. Th1 cells are responsible for sending a chemical message called lymphokines. This chemical message is sent to B cells (produced in the bone marrow) telling them to make antibodies. Th2 cells are a second type of T-helper cells that act to restrain antibodies. Th2 cells help the body to accept foreign material or cells. In sense, Th1 cells are the "aggressors" cells and the Th2 cells are the "pacifiers" cells. If the Th1 cells become overly aggressive they can attack the wrong targets causing an autoimmune disorder. However, sometimes Th2 is overly suppressing of the Th1 cells and this can leave the body very vulnerable, susceptible not only to infection but tumors as well.
All this talk about antibodies; so what are they? Antibodies are proteins that destroy antigens aka virus, bacteria, fungi or any harmful substance that enters the body. Every antibody belongs to a group of proteins called immunoglobulins (Ig). Attached to the surface of a B cell is an Ig molecule.
Hopefully this is making some sense and you can now see why the Th1:Th2 ratio is so important now. Moving on to what may also accompany an antibody onslaught. An overproduction of proinflammatory cytokines also known as the cells messenger. Cytokines "interact with cells of the immune system in order to regulate the body's response to disease and infection". They also "mediate normal cellular processes in the body".
These messages in between cells then prompts the NK cells, macrophanges, neutophilis and T cells to go in for the kill. Most commonly they will attack connective tissue (tendons, skin, muscles, etc), joints, nerves, thyroid and pancreas. These particular targets cause some commonly known autoimmune diseases including Arthritis, Lupus, Graves' Disease, Crohns Disease, Rheumatoid Arthritis, Guillain-Barre Disease and psorasis.
There is a test called Th1:Th2 Cytokine Assay that simply counts the number of each Th1 & Th2. While searching for normal lab values I came across this journal article Systemic Th1/Th2 cytokine responses to paternal and vaccination antigens in preeclampsia". Interestingly enough it was thought that a "Th1 shift has been suggested to be involved in the pathogenesis of preeclampsia". Hmm...however, apparently this article proved Th1 to be no different. Anyway, I have had poor results in finding a "normal" lab value for Th1:Th2 Cytokine Assay. If anyone has any insight please do not hesitate to comment below.
One other thing I want to review are ANA's or antinuclear antibodies. These are antibodies designed to go attack a cells nucleus. ANA is another test that can be performed with those who have infertility or RPL issues. Just because one ANA is positive does not indicate a cause of infertility or RPL. The presence of one antibody mayindicate other autoimmune issues. ANA's commonly go hand in hand with hyperactive NK cells.
"ANAs are found in 20-30% of women with RPL."
"7% of women who are unable to conceive naturally produce antibodies to sperm."
Two types of antithyroid antibodies (ATA's) exist: antithyroid peroxidase and antithyroglobulin antibodies. ATA's are also linked to a predisposition to other autoimmune disease. One important factor I want to mention is it is important when testing for ATA's that the lab use the test ELISA. If a less sensitive one is used 1 in 5 women who carry ATA's will go undetected. Women with ATA's should also be tested for elevated levels of CD56+ NK cells, CD19+/5+ cells and activated T cells, according to Dr. Beer.
- 30% of women with RPL will test positive for one or both ATA's and are twice as likely to have a m/c then women without ATA'S.
LAC or Lupus Anticoagulant are antibodies against phospholipids that prevent blood clotting in a test tube. The presence of LAC my be responsible for causing tiny blood clots. Lupus antibodies may be present in those with systemic lupus erythematosus (SLE) or without SLE. Due to temporary side effects of an infection, this test should be repeated in 6-8 weeks.
All this talk about Natural Killer Cells (NK Cells). What are they? They are type of white blood cells or lymphocytes responsible for attacking viruses and/or cancer. According to MILab website a NK cell assay, "tests the killing function of circulating NK cells as well as the ability of interleukin-2 (IL2) to stimulate and intravenous immunoglobulin (IVIg) to suppress that activity. NK activity can be measured as a bioassay that determines the ability of activated NK cells to kill their target (K562 cell line)."
- Approximately 40% of patients undergoing IVF who have been diagnosed with endometriosis display increased NK activity.
The following tests are from Dr. Beer's book, with little side comments about each. You can also find some of this information on his website.
CD3 (Pan T cells) - Normal Range: 63-86% - If CD3 is low this is when the immune system is weak. Typically infertile patients or RPL patients often have high normal range values.
CD4 (T-helper cells) - Normal: 31-53% - Again women with fertility problems are typically in the high normal range value. Those who are low could have a serious health problem.
CD8 (T-Cytotoxic Suppressors) - Normal: 17-35% - These cells moderate the activity of Th-1 lymphocytes. In women with RPL/infertility, CD8 is often low.
CD19 (B-Cells) - Normal: 3-8% - Once again usually women with high normal OR elevated percentages are in women with immune-mediated infertility or RPL.
CD56+/CD16+ (Natural Killer Cells) - Normal: 3-12% - Levels are often elevated in women with infertility or RPL, leading to IVF failure, BO, or CP.
CD56+ (Natural Killer Cells) - Normal: 3-12% - These particular NK cells can be turned on by pregnancy & deteriorates the embryo.
CD3/IL-2R+ Cells - Normal: 0-5% - Women who have an autoimmune disease may also have above-average levels.
CD19+/5+ (B-1 Cells) - Normal: 2-10% - These particular cells can produce antibodies to hormones and neurotransmitters.
Are you confused yet? Yes, this is all very overwhelming and can be very confusing! I hope I've simplified some of this information that you aren't confused right now. I remember the first time I read "Is Your Body Baby-Friendly?" I skipped a lot of it because even coming from a medical background the medical jargon intimidated me. Its ok. This is nothing that you need to understand over night.
Sunday, May 22, 2011
Another Perspective
I should know better than to ask people what they think of my problems. Unfortunately I require a lot of reassurance but sometimes I don't get that. I get the opposite of that and that for me can make my head spin and spin and spin. Then I'm back to needing reassurance. It is a vicious cycle you see.
Getting on to my story. I recently spoke to a retired Ob/Gyn that I know. I believe he practiced in the 60's - 80's maybe early 90's. However, I've asked for his opinion a few times over the past few months. Back when I was pg we had a conversation about miscarriages. Ever since the 1960's he has been a firm believer in extra folic acid, before there was a big push for folic acid (especially in women w/ RPL). So he always thought folic acid contributed in some way.
Recently I was discussing what has been discovered as far as being MTHFR positive and the treatment that it may require. He was not familiar with MTHFR since (I think) it was discovered in the 90's. After I got done explaining everything he warned me to be careful especially with going the route of Lovenox. Supposedly Lovenox is "too big" to carry over into the placenta but some science debates this original finding. He warned me not to get too caught up in this that it can become dangerous when your grasping for straws. :::sigh:::
[God darn it! I don't care if I'm grasping at damn little strings...I need something. This is ridiculous being 27, having 5 pregnancies and only one child to show for it.]
He also implied that because I have a healthy child that its like you start over and aren't considered to have RPL again until you m/c two or more times. He said you may not be at any greater risk than the average women now. More or less this last m/c could have been a 1 in 4 chance like any other woman. [psychotic tone: WHAT?! Are you kidding me!] Really just because I had a child means I get a fresh start? Too bad my emotions don't.
Getting on to my story. I recently spoke to a retired Ob/Gyn that I know. I believe he practiced in the 60's - 80's maybe early 90's. However, I've asked for his opinion a few times over the past few months. Back when I was pg we had a conversation about miscarriages. Ever since the 1960's he has been a firm believer in extra folic acid, before there was a big push for folic acid (especially in women w/ RPL). So he always thought folic acid contributed in some way.
Recently I was discussing what has been discovered as far as being MTHFR positive and the treatment that it may require. He was not familiar with MTHFR since (I think) it was discovered in the 90's. After I got done explaining everything he warned me to be careful especially with going the route of Lovenox. Supposedly Lovenox is "too big" to carry over into the placenta but some science debates this original finding. He warned me not to get too caught up in this that it can become dangerous when your grasping for straws. :::sigh:::
[God darn it! I don't care if I'm grasping at damn little strings...I need something. This is ridiculous being 27, having 5 pregnancies and only one child to show for it.]
He also implied that because I have a healthy child that its like you start over and aren't considered to have RPL again until you m/c two or more times. He said you may not be at any greater risk than the average women now. More or less this last m/c could have been a 1 in 4 chance like any other woman. [psychotic tone: WHAT?! Are you kidding me!] Really just because I had a child means I get a fresh start? Too bad my emotions don't.
Saturday, May 21, 2011
Could it be?
No I'm not pregnant. BUT after TTC since Oct 2007, changing Ob/Gyns not once but twice, changing from a local RE to an out of state RI, after 4 m/c and one live birth...I have a answer and possibly more to come.
I finally got my blood tests back that I had done at the end of April. And drum roll please..............one test came back POSITIVE!!! Seriously?! After 4 m/c? It infuriates me BUT at the same time I'm thrilled to no end to have an answer if not more to come.
So I'm positive for MTHFR. Not only am I positive for the gene mutation A1298c I carry T-W-O! Yes, that makes me homozygous. From my understanding, homozygous is worse then if I only had 1 copy or heterozygous. So let's review a little. MTHFR puts people more at risk for blood clots, in this case usually in very small and tiniest blood vessels. Guess where tiny blood vessels exisit? Yup, your uterus among other places.
So why does this put you more at risk for blood clots? Well when the mutation exists your body does not absorb Folic Acid properly possibly due to a lack of Vitamin B complex (B6 & B12, I think). So not ony will I be taking extra folic acid I will also be taking extra Viamin B6 & B12. There is a possibility since I'm homozygous that they may recommend taking Lovenox as soon as I get a bfp. Obviously there are pro's and con's to Lovenox but we'll cross that bridge when we get there.
There is another MTHFR mutation, C677T that is worse then A1298C. And a compound meaning a carrier of each mutation is just as bad.
I have some questions as to whether DH & Landon should be tested. Why did I have such a normal pregnancy with Landon? Thank GOD I did! I'm curious if DH is a carrier of the mutation or not. Is it possible if he is at least heterozygous that all the babies we lost were homozygous and Landon was not? Would that affect anything or have nothing to do with it? I DON'T KNOW. If you know anything about me...I HATE NOT KNOWING!!!!!
Or is it possible after being on extra folic acid since my 1st baby, my body was getting enough and Landon was a result of 10 months extra folic acid? Not sure.
Having MTHFR will not only affect you during your childbearing years; it will put you at higher risk for thrombosis (blood clots), arteriosclerosis (hardening of arteries), Alzheimer's, stroke, heart attack, Fibromyalgia, migraines (especially with "Aura" migraines), osteoporotic fractures, bone marrow disorders and for those of child bearing years, it has found to be connected to higher incidences of down's syndrome, spina bifida, other neural tube defects, trisomy, miscarriage, stillbirth, implantation failure, placental abruption, preeclampsia, higher incidences of autism, among others.
So expect to see some new resources in the upcoming weeks about MTHFR.
I finally got my blood tests back that I had done at the end of April. And drum roll please..............one test came back POSITIVE!!! Seriously?! After 4 m/c? It infuriates me BUT at the same time I'm thrilled to no end to have an answer if not more to come.
So I'm positive for MTHFR. Not only am I positive for the gene mutation A1298c I carry T-W-O! Yes, that makes me homozygous. From my understanding, homozygous is worse then if I only had 1 copy or heterozygous. So let's review a little. MTHFR puts people more at risk for blood clots, in this case usually in very small and tiniest blood vessels. Guess where tiny blood vessels exisit? Yup, your uterus among other places.
So why does this put you more at risk for blood clots? Well when the mutation exists your body does not absorb Folic Acid properly possibly due to a lack of Vitamin B complex (B6 & B12, I think). So not ony will I be taking extra folic acid I will also be taking extra Viamin B6 & B12. There is a possibility since I'm homozygous that they may recommend taking Lovenox as soon as I get a bfp. Obviously there are pro's and con's to Lovenox but we'll cross that bridge when we get there.
There is another MTHFR mutation, C677T that is worse then A1298C. And a compound meaning a carrier of each mutation is just as bad.
I have some questions as to whether DH & Landon should be tested. Why did I have such a normal pregnancy with Landon? Thank GOD I did! I'm curious if DH is a carrier of the mutation or not. Is it possible if he is at least heterozygous that all the babies we lost were homozygous and Landon was not? Would that affect anything or have nothing to do with it? I DON'T KNOW. If you know anything about me...I HATE NOT KNOWING!!!!!
Or is it possible after being on extra folic acid since my 1st baby, my body was getting enough and Landon was a result of 10 months extra folic acid? Not sure.
Having MTHFR will not only affect you during your childbearing years; it will put you at higher risk for thrombosis (blood clots), arteriosclerosis (hardening of arteries), Alzheimer's, stroke, heart attack, Fibromyalgia, migraines (especially with "Aura" migraines), osteoporotic fractures, bone marrow disorders and for those of child bearing years, it has found to be connected to higher incidences of down's syndrome, spina bifida, other neural tube defects, trisomy, miscarriage, stillbirth, implantation failure, placental abruption, preeclampsia, higher incidences of autism, among others.
So expect to see some new resources in the upcoming weeks about MTHFR.
Wednesday, May 18, 2011
What Testing Can be Done for RPL? #2
Moving onto homronal imbalances, such as FSH, LH, Estradiol, Progesterone, TSH, T4, Prolactin, (Fasting) Glucose and Insulin and Inhibin B.
FSH stands for Follicle-Stimulating Hormone. FSH is secreted from the pituitary gland and is responsible for stimulating the production of eggs and producing a hormone called Estradiol (E2), better known as estrogen, during the pre-ovulatory phase of the menstrual cycle. FSH & E2 are tested on cycle day 3 because typically this is when FSH peaks. If the FSH is below 12 and E2 is below 35 a fertile cycle is likely to occur. However, if the levels of FSH are above 12 and E2 is above 35 an unsuccessful cycle most likely will occur. This can be a good indicator antibodies are at play too.
LH or lutenizing hormone is responsible for giving us positive OPK's. This is because E2 reaches its peak around the day of ovulation which sends a signal to the pituitary gland to secrete LH. LH is responsible for triggering the ovary to release an egg. Normal results vary between 6-30 U/L. Typically LH tests are performed when a woman is going through IVF to determine when ovulation would occur but this could also determine: anovulation, ovarian failure, PCOS (polycystic ovarian syndrome), pituitary disorders and chromosomal abnormalities.
Progesterone (P4) should be low during preovulatory phase and increase post-ovulation. The corpus luteum is responsible for the progesterone after ovulation. The production of progesterone helps in aiding a blastocyte to implant to the uterine wall. Normal P4 values at cycle day 3 should be < 1.5 ng/ml and at 7 dpo should be > then 10-15. Low progesterone may indicate a luteal phase defect, meaning there are too few days between ovulation and menstruation.
Prolactin as many of us know is the milk secreting hormone. Elevated levels when not breastfeeding may interfere with ovulation and conception. Hyperprolactinemia is commonly associated with PCOS. Normal levels at cycle day 3 are <24 ng/ml.
Another important hormone test is thyroid testing which includes TSH (thyroid stimulating hormone) and T4 (thyroxine). TSH & T4 will help determine if hypothyroid (lack TSH &/or T4) or hyperthyroid (produce too much TSH &/or T4) conditions are present. TSH is produced by the pituitary gland and signals the thyroid to make hormones.
Symptoms of Hypothyroidism:
- Fatigue
- Weakness
- Weight gain or increased difficulty losing weight
- Coarse, dry hair
- Dry, rough pale skin
- Hair loss
- Cold intolerance (you can't tolerate cold temperatures like those around you)
- Muscle cramps and frequent muscle aches
- Constipation
- Depression
- Irritability
- Memory loss
- Abnormal menstrual cycles
- Decreased libido
Symptoms of Hyperthyroidism:
- Palpitations
- Heat intolerance
- Nervousness
- Insomnia
- Breathlessness
- Increased bowel movements
- Light or absent menstrual periods
- Fatigue
- Fast heart rate
- Trembling hands
- Weight loss
- Muscle weakness
- Warm moist skin
- Hair loss
- Staring gaze
Signs and symptoms vary due to severity and are different for everyone.
- 10 million AMERICANS have hypothyroidism.
- Approximately 10% of women suffer from some type of thyroid hormone deficiency.
A great resource I found while researching thyroid conditions; www.endocrineweb.com.
The fasting insulin and glucose is a test for diabetes. There are 2 types; Type 1 & Type 2. Type 1 Diabetes typically comes on gradually but symptoms develop quickly. With Type 1 Diabetes your body loses its ability to produce insulin. This increases glucose levels.
Signs & Symptoms of Diabetes Type 1 include:
- Extreme weakness and/or tiredness
- Extreme thirst—dehydration
- Increased urination
- Abdominal pain
- Nausea and/or vomiting
- Blurry vision
- Wounds that don’t heal well
- Irritability or quick mood changes
- Changes to (or loss of) menstruation
- Weight loss—despite eating more
- Rapid heart rate
- Reduced blood pressure (falling below 90/60)
- Low body temperature (below 97ยบ F)
There are actually two types of Type 2 Diabetes; insulin resistant and not insulin resistant. Insulin resistant means your body does not use insulin properly. If you are not insulin resistant it means your body does not produce enough insulin to break down glucose.
Signs & Symptoms of Diabetes Type 2 include:
- Fatigue
- Extreme thirst
- Frequent urination
- Extreme hunger
- Weight loss
- Infections
- Slow wound healing
- Blurry vision
Inhibin B is a protein hormone that is secreted by your follicles once FSH has worked hard to develop those follicles. Inhibin B inhibits the pituitary from secreting FSH and will reach a peak in early-mid follicle phase and then a second peak at ovulation. The test is performed on cycle day 3 as well. This test is a newer test for predicting ovarian reserve or quantity and quality of eggs. This seems to be a more reliable for predicting ovarian reserve over FSH.
- Millenova Lab
Stay tuned for more tests.
FSH stands for Follicle-Stimulating Hormone. FSH is secreted from the pituitary gland and is responsible for stimulating the production of eggs and producing a hormone called Estradiol (E2), better known as estrogen, during the pre-ovulatory phase of the menstrual cycle. FSH & E2 are tested on cycle day 3 because typically this is when FSH peaks. If the FSH is below 12 and E2 is below 35 a fertile cycle is likely to occur. However, if the levels of FSH are above 12 and E2 is above 35 an unsuccessful cycle most likely will occur. This can be a good indicator antibodies are at play too.
LH or lutenizing hormone is responsible for giving us positive OPK's. This is because E2 reaches its peak around the day of ovulation which sends a signal to the pituitary gland to secrete LH. LH is responsible for triggering the ovary to release an egg. Normal results vary between 6-30 U/L. Typically LH tests are performed when a woman is going through IVF to determine when ovulation would occur but this could also determine: anovulation, ovarian failure, PCOS (polycystic ovarian syndrome), pituitary disorders and chromosomal abnormalities.
Progesterone (P4) should be low during preovulatory phase and increase post-ovulation. The corpus luteum is responsible for the progesterone after ovulation. The production of progesterone helps in aiding a blastocyte to implant to the uterine wall. Normal P4 values at cycle day 3 should be < 1.5 ng/ml and at 7 dpo should be > then 10-15. Low progesterone may indicate a luteal phase defect, meaning there are too few days between ovulation and menstruation.
Prolactin as many of us know is the milk secreting hormone. Elevated levels when not breastfeeding may interfere with ovulation and conception. Hyperprolactinemia is commonly associated with PCOS. Normal levels at cycle day 3 are <24 ng/ml.
Another important hormone test is thyroid testing which includes TSH (thyroid stimulating hormone) and T4 (thyroxine). TSH & T4 will help determine if hypothyroid (lack TSH &/or T4) or hyperthyroid (produce too much TSH &/or T4) conditions are present. TSH is produced by the pituitary gland and signals the thyroid to make hormones.
Symptoms of Hypothyroidism:
- Fatigue
- Weakness
- Weight gain or increased difficulty losing weight
- Coarse, dry hair
- Dry, rough pale skin
- Hair loss
- Cold intolerance (you can't tolerate cold temperatures like those around you)
- Muscle cramps and frequent muscle aches
- Constipation
- Depression
- Irritability
- Memory loss
- Abnormal menstrual cycles
- Decreased libido
Symptoms of Hyperthyroidism:
- Palpitations
- Heat intolerance
- Nervousness
- Insomnia
- Breathlessness
- Increased bowel movements
- Light or absent menstrual periods
- Fatigue
- Fast heart rate
- Trembling hands
- Weight loss
- Muscle weakness
- Warm moist skin
- Hair loss
- Staring gaze
Signs and symptoms vary due to severity and are different for everyone.
- 10 million AMERICANS have hypothyroidism.
- Approximately 10% of women suffer from some type of thyroid hormone deficiency.
A great resource I found while researching thyroid conditions; www.endocrineweb.com.
The fasting insulin and glucose is a test for diabetes. There are 2 types; Type 1 & Type 2. Type 1 Diabetes typically comes on gradually but symptoms develop quickly. With Type 1 Diabetes your body loses its ability to produce insulin. This increases glucose levels.
Signs & Symptoms of Diabetes Type 1 include:
- Extreme weakness and/or tiredness
- Extreme thirst—dehydration
- Increased urination
- Abdominal pain
- Nausea and/or vomiting
- Blurry vision
- Wounds that don’t heal well
- Irritability or quick mood changes
- Changes to (or loss of) menstruation
- Weight loss—despite eating more
- Rapid heart rate
- Reduced blood pressure (falling below 90/60)
- Low body temperature (below 97ยบ F)
There are actually two types of Type 2 Diabetes; insulin resistant and not insulin resistant. Insulin resistant means your body does not use insulin properly. If you are not insulin resistant it means your body does not produce enough insulin to break down glucose.
Signs & Symptoms of Diabetes Type 2 include:
- Fatigue
- Extreme thirst
- Frequent urination
- Extreme hunger
- Weight loss
- Infections
- Slow wound healing
- Blurry vision
Inhibin B is a protein hormone that is secreted by your follicles once FSH has worked hard to develop those follicles. Inhibin B inhibits the pituitary from secreting FSH and will reach a peak in early-mid follicle phase and then a second peak at ovulation. The test is performed on cycle day 3 as well. This test is a newer test for predicting ovarian reserve or quantity and quality of eggs. This seems to be a more reliable for predicting ovarian reserve over FSH.
The mean value of Inhibin B for normal women on day 3 of the menstrual cycle is 40 pg/ml and the 95% confidence interval of the mean is 33 to 45 pg/ml. Women undergoing IVF with day 3 Inhibin B concentrations less than 45 pg/ml have a pregnancy rate 70% less than women with day 3 Inhibin B concentrations greater that 45 pg/ml.
- Millenova Lab
Stay tuned for more tests.
Sunday, May 15, 2011
Seriously?!
I'm beyond fed up at this point! Why do things continue to go downhill when I thought I was seeing a light at the end of the tunnel?
As the time gets nearer for me to change jobs, I'm becoming more and more anxious. I HATE that we cannot move forward with any type of testing until August. And this puts TTC off until fall. I am, however, waiting for the results of my blood work that I had done after I came back from Holland. These include my Thrombophilia labs: Antithrombin III, Protein C &C activity, MTHFR, Homocysteine, Factor II and TSH, T4, Antithyroid antibodies, Prolactin, (Fasting) Glucose and Insulin. I'm hoping to have the results this week.
Once my insurance kicks in we will proceed with the immune testing & the cycle day #3 labs: FSH, LH, Estradiol. We may pursue the immune testing while on Cobra since this will probably be an OOP expense either way. The other testing that is on hold is the SHG and semen analysis.
On top of this we are still dealing with DH's endocrine issues. I don't think I've mentioned this before. The short story on that is DH was diagnosed about 6-8 months ago with hypothyroid and low testosterone (Low T) by his PCP. He has since gone to an endocrinologist. Despite being on Synthroid he was still not feeling all that better. The endocrinologist, Dr. P (I'll call him), was not happy with his hormone levels and wants to increase his synthroid as well as put him on Androgel to increase his testosterone. Dr. P seemed certain that these issues have nothing to due with my RPL. However, Dr. Corley was pretty adamant that this is not the case unless a semen analysis was performed to determine this. Why is no one ever on the same page?
So the WTF news of the week, is DH called Dr. P because we are having trouble getting the Androgel approved by insurance. Dr. P mentioned we may want to consider freezing DH's sperm because Androgel may decrease his sperm count. Excuse me? Why was this not mentioned before?! He damn well knows our history of RPL and wanting to conceive. DH thinks its just to cover his tail, which I understand but this is a HUGE deal in my book. And I'm disgusted that he hasn't ordered a sperm analysis at least a comparative one before and after Androgel to see if this does affect his count.
So at this point I have emailed Dr. Corley and his nurse Lisa to let them know where we stand and to acquire his opinion on whether we should do a sperm analysis before starting the Androgel.
It is important to DH that we do something and soon. His symptoms continue to get worse and both the hypothyroid and Low T are most likely related. The hypothyroid and Low T have affected his sleeping, increased fatigue, inability to lose weight, loss of hair, mood swings, weakness, occasional ED, and muscle cramping.
Any other monkey wrenches?
As the time gets nearer for me to change jobs, I'm becoming more and more anxious. I HATE that we cannot move forward with any type of testing until August. And this puts TTC off until fall. I am, however, waiting for the results of my blood work that I had done after I came back from Holland. These include my Thrombophilia labs: Antithrombin III, Protein C &C activity, MTHFR, Homocysteine, Factor II and TSH, T4, Antithyroid antibodies, Prolactin, (Fasting) Glucose and Insulin. I'm hoping to have the results this week.
Once my insurance kicks in we will proceed with the immune testing & the cycle day #3 labs: FSH, LH, Estradiol. We may pursue the immune testing while on Cobra since this will probably be an OOP expense either way. The other testing that is on hold is the SHG and semen analysis.
On top of this we are still dealing with DH's endocrine issues. I don't think I've mentioned this before. The short story on that is DH was diagnosed about 6-8 months ago with hypothyroid and low testosterone (Low T) by his PCP. He has since gone to an endocrinologist. Despite being on Synthroid he was still not feeling all that better. The endocrinologist, Dr. P (I'll call him), was not happy with his hormone levels and wants to increase his synthroid as well as put him on Androgel to increase his testosterone. Dr. P seemed certain that these issues have nothing to due with my RPL. However, Dr. Corley was pretty adamant that this is not the case unless a semen analysis was performed to determine this. Why is no one ever on the same page?
So the WTF news of the week, is DH called Dr. P because we are having trouble getting the Androgel approved by insurance. Dr. P mentioned we may want to consider freezing DH's sperm because Androgel may decrease his sperm count. Excuse me? Why was this not mentioned before?! He damn well knows our history of RPL and wanting to conceive. DH thinks its just to cover his tail, which I understand but this is a HUGE deal in my book. And I'm disgusted that he hasn't ordered a sperm analysis at least a comparative one before and after Androgel to see if this does affect his count.
So at this point I have emailed Dr. Corley and his nurse Lisa to let them know where we stand and to acquire his opinion on whether we should do a sperm analysis before starting the Androgel.
It is important to DH that we do something and soon. His symptoms continue to get worse and both the hypothyroid and Low T are most likely related. The hypothyroid and Low T have affected his sleeping, increased fatigue, inability to lose weight, loss of hair, mood swings, weakness, occasional ED, and muscle cramping.
Any other monkey wrenches?
Sunday, May 8, 2011
What Testing Can be Done for RPL?
Doctors have many different opinions on what types of testing are necessary for RPL. This post is for those who are unsure if they are being "cheated" by their RE or Ob/Gyn and not getting the care that they deserve. I've been there and want to make you aware of what is available. I am NOT a doctor and I am not a know it all. I do this in my free time, reading & researching RPL. Researching the possibilities of why I lost my 4 angels. If no one else is going to give me answers I have to research to hold on to my hope, faith and sanity. This is what I have found and there very well could be more out there. If something is incorrect please leave me a message. If you are looking for more about a particular diagnosis leave me a message and I'll be glad to try and help you.
Let's start with thrombophilia for this post. Approximately 40% of those who have thrombophilia have inherited it. Thrombophilia means a person is prone to develop blood clots due to defect in the process of coagulation. Some interesting facts about thrombophilia related to RPL:
~ Found on the Millenova Lab website
Thrombophilia labs include Antithrombin III, Protein C & S activity, MTHFR, Homocysteine, Factor II and Factor V Leiden.
So what are these tests and what are the tests testing for?
Antithrombin III test is to determine how the amount of AT III in the blood, a protein that assists in blood clotting. When you have an AT III deficiency often times these things may appear:
1) Increased risk of venous thrombosis and pulmonary embolism. Venous thrombosis occurs most frequently in the deep veins of the lower extremities.
2) Thrombotic events begin in mid-late teenage years.
3) Mesenteric veins, inferior vena cava, renal veins are all susceptible.
4) Cerebral vein thrombosis can occur.
5) Events occur with AT activity at 40-60% of normal. Homozygosity is fatal in utero.
6) May be precipitated by provocations such as surgery, trauma, pregnancy, oral contraceptive (OCP) use, or infection.
Protein C & S activity is another blood test that examines the function (activity) or quantity (antigen) of both proteins. The lack of one or the other protein or possibly both (highly unlikely) indicates that you do not produce this substance to help prevent blood clots.
- 1 out of every 300 people has one normal gene and one faulty gene for protein C deficiency.
- Protein S deficiency is less likely and only occurs in about 1 in 20,000 people.
- 20-40% of women who have had two or more consecutive m/c have an incidence of Protein C deficiency.
Next, MTHFR. The full name Methylenetetrahydrofolate reductase. From my understanding a blood test helps to identify a mutated gene. This can be heterozygous (inherited by one parent) or homozygous (inherited by both parents). A defective MTHFR gene cannot process folic acid and B12 properly. As we all know folic acid is very important for a developing fetus.
- The incidence of a heterozygous MTHFR condition in women with RPL is about 25-30%.
- Where as the homozygous MTHFR condition is found in 14% of women with RPL.
- MTHFR is the most common abnormality in women with thrombophilia.
High homocysteine levels are usually found in those who are carriers of a MTHFR mutation. Not all the time is there a connection. People who are deficient in folic acid, B6 & B12 may have high homocysteine levels as well.
Factor II deficiency is is present when there is a lack of Prothrombin in the blood, this creates a blood clotting/coagulation problem. Both parents must be carriers of Factor II to pass it along to their children. Factor II deficiency is most commonly caused by lack of Vitamin K. Some babies are born with a Vitamin K deficiency which explains why a Vitamin K shot is given shortly after birth.
- 8% of women who experience fetal loss have this mutation.
People with Factor V Leiden not only have a higher chance of developing blood clots but have a high chance of the blood clot breaking away from the original site. Some history about Factor V Leiden, it was named after a Dutch professor who discovered it in 1994. I find that interesting since I'm half Dutch. ;-)
- Between 3% and 10% of Caucasian people are heterozygous for Factor V Leiden, and a much smaller percentage are homozygous.
- In Sweden the rate of heterozygous mutation may be as high as 15%.
- Approximately 1 in 100 women who have FVL will have a serious deep vein thrombosis (DVT) during pregnancy.
While researching Factor V Leiden, I came across an informative website for those who have been diagnosed with Factor V Leiden. I also came across this article, "Pregnancy, Clotting, and Factor V Leiden: An Overview"
Stay tuned! More info to follow on immune and hormonal blood tests.
Let's start with thrombophilia for this post. Approximately 40% of those who have thrombophilia have inherited it. Thrombophilia means a person is prone to develop blood clots due to defect in the process of coagulation. Some interesting facts about thrombophilia related to RPL:
"Inherited thrombophilias have been associated with early and late recurrent pregnancy loss as a result of uteroplacental microvascular thrombosis and hypoperfusion. Obstetrical complications such as intrauterine growth retardation, placental abruption as well as preeclampsia have also been related to abnormal placental vasculature. Genetic thrombophilia are suspected to account for about 30% of these obstetrical complications. Poor pregnancy outcomes are associated with maternal thrombophilia but may also be associated with fetal thrombophilia by inheritance of maternal and paternal thrombophilic genes."
~ Found on the Millenova Lab website
Thrombophilia labs include Antithrombin III, Protein C & S activity, MTHFR, Homocysteine, Factor II and Factor V Leiden.
So what are these tests and what are the tests testing for?
Antithrombin III test is to determine how the amount of AT III in the blood, a protein that assists in blood clotting. When you have an AT III deficiency often times these things may appear:
1) Increased risk of venous thrombosis and pulmonary embolism. Venous thrombosis occurs most frequently in the deep veins of the lower extremities.
2) Thrombotic events begin in mid-late teenage years.
3) Mesenteric veins, inferior vena cava, renal veins are all susceptible.
4) Cerebral vein thrombosis can occur.
5) Events occur with AT activity at 40-60% of normal. Homozygosity is fatal in utero.
6) May be precipitated by provocations such as surgery, trauma, pregnancy, oral contraceptive (OCP) use, or infection.
Protein C & S activity is another blood test that examines the function (activity) or quantity (antigen) of both proteins. The lack of one or the other protein or possibly both (highly unlikely) indicates that you do not produce this substance to help prevent blood clots.
- 1 out of every 300 people has one normal gene and one faulty gene for protein C deficiency.
- Protein S deficiency is less likely and only occurs in about 1 in 20,000 people.
- 20-40% of women who have had two or more consecutive m/c have an incidence of Protein C deficiency.
Next, MTHFR. The full name Methylenetetrahydrofolate reductase. From my understanding a blood test helps to identify a mutated gene. This can be heterozygous (inherited by one parent) or homozygous (inherited by both parents). A defective MTHFR gene cannot process folic acid and B12 properly. As we all know folic acid is very important for a developing fetus.
- The incidence of a heterozygous MTHFR condition in women with RPL is about 25-30%.
- Where as the homozygous MTHFR condition is found in 14% of women with RPL.
- MTHFR is the most common abnormality in women with thrombophilia.
High homocysteine levels are usually found in those who are carriers of a MTHFR mutation. Not all the time is there a connection. People who are deficient in folic acid, B6 & B12 may have high homocysteine levels as well.
Factor II deficiency is is present when there is a lack of Prothrombin in the blood, this creates a blood clotting/coagulation problem. Both parents must be carriers of Factor II to pass it along to their children. Factor II deficiency is most commonly caused by lack of Vitamin K. Some babies are born with a Vitamin K deficiency which explains why a Vitamin K shot is given shortly after birth.
- 8% of women who experience fetal loss have this mutation.
People with Factor V Leiden not only have a higher chance of developing blood clots but have a high chance of the blood clot breaking away from the original site. Some history about Factor V Leiden, it was named after a Dutch professor who discovered it in 1994. I find that interesting since I'm half Dutch. ;-)
"The factor V Leiden mutation is associated with a slightly increased risk of pregnancy loss (miscarriage). Women with this mutation are two to three times more likely to have multiple (recurrent) miscarriages or a pregnancy loss during the second or third trimester. Some research suggests that the factor V Leiden mutation may also increase the risk of other complications during pregnancy, including pregnancy-induced high blood pressure (preeclampsia), slow fetal growth, and early separation of the placenta from the uterine wall (placental abruption). However, the association between the factor V Leiden mutation and these complications has not been confirmed. Most women with factor V Leiden thrombophilia have normal pregnancies."
- Between 3% and 10% of Caucasian people are heterozygous for Factor V Leiden, and a much smaller percentage are homozygous.
- In Sweden the rate of heterozygous mutation may be as high as 15%.
- Approximately 1 in 100 women who have FVL will have a serious deep vein thrombosis (DVT) during pregnancy.
While researching Factor V Leiden, I came across an informative website for those who have been diagnosed with Factor V Leiden. I also came across this article, "Pregnancy, Clotting, and Factor V Leiden: An Overview"
Stay tuned! More info to follow on immune and hormonal blood tests.
NaPro - Private Session
I had my first NaPro private session last night with Erin. I have to admit that I was a bad student and did not read the book/manual that was included. I just haven't had the time between Easter, Holland trip, accepting a new job, etc. I do consider this to be a downfall of the NaPro system. In all honesty a private session should be first, instead of being handed a book IMO (in my opinion). It turns out its quite different then how I'm use to checking for CM. So I learned a lot from our $50 private session.
With the Creighton Model you do not temp or do internal exams as other systems have you do. Its based solely on your CM; sensation (when you wipe with flat layers of tissue), observation (on the tissue) and finger testing (between thumb and forefinger). Acronym: SOFT
So let's start with sensation: When you wipe is it dry, damp, wet or lubricative?
Observation: Is there a discharge present? If so, you finger test.
Finger Testing: Is it sticky, tacky or stretchy? Is it shiny, brown, cloudy, cloudy/clear, gummy, clear, lubricative, pasty (creamy) or yellow?
Now you may ask, when do I check for this? Well, before and after urinating or BM (including in the middle of the night), before bathing or showering, before and after swimming and before bedtime. NaPro definitely changes your bathroom habits.
Here are some pictures I took of my chart for those who are curious.
This is a picture of my chart so far this month.
One thing Erin pointed out is a I had 3 days of brown spotting at the end of my period which I can't say is normal for me. Maybe two but she said this can indicate low progesterone the prior cycle. Hmm...interesting! I'm looking forward to our next session in two or so weeks to see if there are any other indicators.
With the Creighton Model you do not temp or do internal exams as other systems have you do. Its based solely on your CM; sensation (when you wipe with flat layers of tissue), observation (on the tissue) and finger testing (between thumb and forefinger). Acronym: SOFT
So let's start with sensation: When you wipe is it dry, damp, wet or lubricative?
Observation: Is there a discharge present? If so, you finger test.
Finger Testing: Is it sticky, tacky or stretchy? Is it shiny, brown, cloudy, cloudy/clear, gummy, clear, lubricative, pasty (creamy) or yellow?
Now you may ask, when do I check for this? Well, before and after urinating or BM (including in the middle of the night), before bathing or showering, before and after swimming and before bedtime. NaPro definitely changes your bathroom habits.
Here are some pictures I took of my chart for those who are curious.
This is a picture of my chart so far this month.
One thing Erin pointed out is a I had 3 days of brown spotting at the end of my period which I can't say is normal for me. Maybe two but she said this can indicate low progesterone the prior cycle. Hmm...interesting! I'm looking forward to our next session in two or so weeks to see if there are any other indicators.
Saturday, May 7, 2011
"To Full Term"
I've almost completed reading this book, "To Full Term: A Mother's Triumph Over Miscarriage" by Darci Klein, that I want to rave about. This book is geared towards those who have experienced RPL, stillbirth and pregnancy complications. This woman spent nearly 30+ weeks on bed rest, fighting to save her child's life and maintain her sanity. In this book, she encourages women to take part in their own health care, to trust their instincts and not let doctors dictate their care. In fact, this is the best book I've read that is a story telling book, supportive, inspiring and combines factual information.
As I mentioned before, having Landon this time around has greatly distracted me. Whether this is a good or bad thing, I'm unsure. I'm not convinced I have grieved entirely over this last loss. Maybe, I have come to accept this as the norm and deal with it by throwing myself into research and books over RPL. Don't get me wrong I think about my latest lost on a daily basis. It pains me that I'm not 15 weeks pg, that I'm not a month away from finding out if I'm carrying a girl or boy in my newly protruding baby belly. I would be close to feeling little drum like taps as my developing baby stretches his or her arms or legs. I am use to this disappointment. Should anyone be use to this?
These days I'm having difficulty facing the sea of PGR (pg related) posts on my private board. It stings, it stings a lot. There was a huge bfp (big fat positive) explosion on the board the time of my bfp. I'm finding it harder this time around to be happy for those who are due in the fall. As October approaches I'm sure it won't get any easier. It's funny how different I am reacting this time around. It has definitely flip flopped. I don't find myself being bitter as women walk by with big baby bellies. I actually find myself smiling at them and yearning to be pregnant once again with a healthy baby. Prior to Landon I was not happy for these people that I didn't "know". These people who were naive to the fact that 1 in 4 pg end in m/c. I never went through a pg not worrying, I have no concept of this feeling--it was stolen a week after I found out I was pregnant the first time.
Now I know what pregnancy feels like. I can appreciate being a mother to a happy & healthy little boy. I'm not that girl any more who just yearned to be pregnant to experience the joys (as well as the uncomfortable times). And because I know this; I know how easy it is to get caught in the joy of pregnancy and forget. I know my sisters have been through the same tragedy of m/c but only a hand full have gone through RPL. In fact, only 5% will go on to have a 2nd consecutive miscarriage and 1% will have 3 or more consecutive miscarriages. I can't say ever forgot the pain that my m/c caused but the joy of pregnancy triumphs that pain and pushes the devastating memories far away as you reach new milestones. Week by week that fear dissipates and turns into appreciation, love and joy.
As I mentioned before, having Landon this time around has greatly distracted me. Whether this is a good or bad thing, I'm unsure. I'm not convinced I have grieved entirely over this last loss. Maybe, I have come to accept this as the norm and deal with it by throwing myself into research and books over RPL. Don't get me wrong I think about my latest lost on a daily basis. It pains me that I'm not 15 weeks pg, that I'm not a month away from finding out if I'm carrying a girl or boy in my newly protruding baby belly. I would be close to feeling little drum like taps as my developing baby stretches his or her arms or legs. I am use to this disappointment. Should anyone be use to this?
These days I'm having difficulty facing the sea of PGR (pg related) posts on my private board. It stings, it stings a lot. There was a huge bfp (big fat positive) explosion on the board the time of my bfp. I'm finding it harder this time around to be happy for those who are due in the fall. As October approaches I'm sure it won't get any easier. It's funny how different I am reacting this time around. It has definitely flip flopped. I don't find myself being bitter as women walk by with big baby bellies. I actually find myself smiling at them and yearning to be pregnant once again with a healthy baby. Prior to Landon I was not happy for these people that I didn't "know". These people who were naive to the fact that 1 in 4 pg end in m/c. I never went through a pg not worrying, I have no concept of this feeling--it was stolen a week after I found out I was pregnant the first time.
Now I know what pregnancy feels like. I can appreciate being a mother to a happy & healthy little boy. I'm not that girl any more who just yearned to be pregnant to experience the joys (as well as the uncomfortable times). And because I know this; I know how easy it is to get caught in the joy of pregnancy and forget. I know my sisters have been through the same tragedy of m/c but only a hand full have gone through RPL. In fact, only 5% will go on to have a 2nd consecutive miscarriage and 1% will have 3 or more consecutive miscarriages. I can't say ever forgot the pain that my m/c caused but the joy of pregnancy triumphs that pain and pushes the devastating memories far away as you reach new milestones. Week by week that fear dissipates and turns into appreciation, love and joy.
Tuesday, May 3, 2011
SIRM
I recently found the Sher Institute for Reproductive Medicine also known as SIRM. I first came across SIRM after my 2nd m/c. I read a book named "Is Your Body Baby Friendly?" that mentioned SIRM briefly. I never further investigated them at the time. Shortly there after I became pg for the 3rd time and then for the 4th time.
A dear "sister" of mine kindly returned some books that she had borrowed from me, right before my 4th m/c. Little did I know that I would yet again turn to "Is Your Body Baby Friendly?". It was one of my favorite m/c books that I've read. It explores all medical avenues. Now I do have to worn that it can be a bit over the top especially if you do not have any medical knowledge. I remember reading it the first time and skipping over parts because I had a hard time following it and I'm in the medical field. With that being said, it provides excellent material. The author, Dr. Beer was certainly ahead of his time in his field.
Anyways, my "sister" Amy and I met on a public chat board and later we became part of a private chat board. I believe I talked about her and shared her blog in a previous entry. I call her my "sister" because we are part of a family and consider all of the 150 posters on there to be my sisters. This has become a huge support system in my life. These women have helped me to grieve, listened to me when I needed an ear, reassured me that my feelings were/are normal, swapped information, talked about IRL (in real life) issues other then pregnancy loss and so forth. They have allowed me to vent and most importantly they understood me when the closest people (DH, family, co-workers) to me could not.
Getting back on track...I'm not quite sure how it came about. I don't think I really realized at the time Amy was going to SIRM. I recall asking her questions about what she thought of the books, etc and then she shared her story about going to SIRM. Shortly after I started investigating SIRM myself and what they were all about. I decided that this was something I wanted to pursue.
I filled out a Request a Consultation with a SIRM Physician. I also filled out a Patient Questionnaire. The very next day I got a call from SIRM and scheduled a FREE phone consultation with Dr. Corley. I faxed over my questionnaire and records. I couldn't believe how quick they were able to get me in and accommodate me.
I had my appt with Dr. Corley on April 21. The appt lasted about 45 minutes and was a little overwhelming with all the information he had given me. The nice thing is the next day he emailed me and reiterated all the information that he had covered the day before. He was very nice and the things that stick out in my mind is he was just as unhappy with the lack testing that my RE & Ob have performed (including NOT testing the tissue from my last D&E). He almost sounded shocked that no one has followed up with very simple blood tests.
In 2008, my RE, Dr. Dodson ordered some Coagulation panels; Factor V Leiden, Lupus Anticoagulant & DRVV. He ordered Homocysteine levels which were inconclusive and never repeated (most likely the lab messed up and never drew my blood for this particular test). He ordered some endocine testing; HbA1c, TSH and Free T4. He also ordered some rheumatology labs; AnticardA, CardiolipIgG, CardiolipIgM & B2Microglb. We also had a chromosome analysis of DH & I. All the tests at the time came back within normal limits, WNL.
Dr. Corley has ordered the following:
1) Cycle day #3 labs FSH, LH, Estradiol, TSH, T4, Antithyroid antibodies, Prolactin, (Fasting) Glucose and Insulin.
2) Immune testing APA and NKa. If Nka is positive we will check DQalpha when you are pregnant.
3) The rest of the Thrombophilia labs: Antithrombin III, Protein C &C activity, MTHFR, Homocysteine, Factor II.
After my quick trip to Holland recently, I came back and was able to complete most of the labs except the cycle day #3 FSH, LH, Estradiol & I did not have the immune testing done yet.
The immune testing, I have to call MILabs tomorrow and they should send me a kit. The kit will include everything I need including the tubes. All I have to do is find a phlebotomist and then fed-ex over night to MILabs, located in Chicago. These two tests will most likely be out of pocket (OOP) expenses (around $400 to be exact) because most insurance companies consider these "experimental tests". :::flicking off insurance company::: :-D What do you guys know anyway?! ;-)These immune tests are only performed at special laboratories across the US.
We also have a new issue. I am taking a new job for a few different reasons that I won't bore you with. Less then a month ago I found out at my current job that we would be going to a new insurance plan and have a family deductible of $4k. Did I stutter?! Yes I said...$4000! So this is one of the reasons I wanted to find a new job. We don't have the option of taking Mike's insurance because its over $1k OOP and $5k deductible. :::choke me::: So I took a new job and my insurance will not kick in until after 90 days. So cobra we go to. :::sigh::: But I will only have a $500 deductible with the new insurance plane. Remember there are many reasons I took this new job but it just throws a monkey wrench into the whole thing and puts many things on hold, including TTC any time soon.
So overall I am very pleased with where things are going except for the new monkey wrench. I have an appt schedule with Center for Women's Health, June 28th. I'm looking forward to hearing from Dr. Corley soon regarding my labs. Hopefully we will get some answers.
A dear "sister" of mine kindly returned some books that she had borrowed from me, right before my 4th m/c. Little did I know that I would yet again turn to "Is Your Body Baby Friendly?". It was one of my favorite m/c books that I've read. It explores all medical avenues. Now I do have to worn that it can be a bit over the top especially if you do not have any medical knowledge. I remember reading it the first time and skipping over parts because I had a hard time following it and I'm in the medical field. With that being said, it provides excellent material. The author, Dr. Beer was certainly ahead of his time in his field.
Anyways, my "sister" Amy and I met on a public chat board and later we became part of a private chat board. I believe I talked about her and shared her blog in a previous entry. I call her my "sister" because we are part of a family and consider all of the 150 posters on there to be my sisters. This has become a huge support system in my life. These women have helped me to grieve, listened to me when I needed an ear, reassured me that my feelings were/are normal, swapped information, talked about IRL (in real life) issues other then pregnancy loss and so forth. They have allowed me to vent and most importantly they understood me when the closest people (DH, family, co-workers) to me could not.
Getting back on track...I'm not quite sure how it came about. I don't think I really realized at the time Amy was going to SIRM. I recall asking her questions about what she thought of the books, etc and then she shared her story about going to SIRM. Shortly after I started investigating SIRM myself and what they were all about. I decided that this was something I wanted to pursue.
I filled out a Request a Consultation with a SIRM Physician. I also filled out a Patient Questionnaire. The very next day I got a call from SIRM and scheduled a FREE phone consultation with Dr. Corley. I faxed over my questionnaire and records. I couldn't believe how quick they were able to get me in and accommodate me.
I had my appt with Dr. Corley on April 21. The appt lasted about 45 minutes and was a little overwhelming with all the information he had given me. The nice thing is the next day he emailed me and reiterated all the information that he had covered the day before. He was very nice and the things that stick out in my mind is he was just as unhappy with the lack testing that my RE & Ob have performed (including NOT testing the tissue from my last D&E). He almost sounded shocked that no one has followed up with very simple blood tests.
In 2008, my RE, Dr. Dodson ordered some Coagulation panels; Factor V Leiden, Lupus Anticoagulant & DRVV. He ordered Homocysteine levels which were inconclusive and never repeated (most likely the lab messed up and never drew my blood for this particular test). He ordered some endocine testing; HbA1c, TSH and Free T4. He also ordered some rheumatology labs; AnticardA, CardiolipIgG, CardiolipIgM & B2Microglb. We also had a chromosome analysis of DH & I. All the tests at the time came back within normal limits, WNL.
Dr. Corley has ordered the following:
1) Cycle day #3 labs FSH, LH, Estradiol, TSH, T4, Antithyroid antibodies, Prolactin, (Fasting) Glucose and Insulin.
2) Immune testing APA and NKa. If Nka is positive we will check DQalpha when you are pregnant.
3) The rest of the Thrombophilia labs: Antithrombin III, Protein C &C activity, MTHFR, Homocysteine, Factor II.
After my quick trip to Holland recently, I came back and was able to complete most of the labs except the cycle day #3 FSH, LH, Estradiol & I did not have the immune testing done yet.
The immune testing, I have to call MILabs tomorrow and they should send me a kit. The kit will include everything I need including the tubes. All I have to do is find a phlebotomist and then fed-ex over night to MILabs, located in Chicago. These two tests will most likely be out of pocket (OOP) expenses (around $400 to be exact) because most insurance companies consider these "experimental tests". :::flicking off insurance company::: :-D What do you guys know anyway?! ;-)These immune tests are only performed at special laboratories across the US.
We also have a new issue. I am taking a new job for a few different reasons that I won't bore you with. Less then a month ago I found out at my current job that we would be going to a new insurance plan and have a family deductible of $4k. Did I stutter?! Yes I said...$4000! So this is one of the reasons I wanted to find a new job. We don't have the option of taking Mike's insurance because its over $1k OOP and $5k deductible. :::choke me::: So I took a new job and my insurance will not kick in until after 90 days. So cobra we go to. :::sigh::: But I will only have a $500 deductible with the new insurance plane. Remember there are many reasons I took this new job but it just throws a monkey wrench into the whole thing and puts many things on hold, including TTC any time soon.
So overall I am very pleased with where things are going except for the new monkey wrench. I have an appt schedule with Center for Women's Health, June 28th. I'm looking forward to hearing from Dr. Corley soon regarding my labs. Hopefully we will get some answers.
Sunday, May 1, 2011
What is NaPro?
I have to say I've been very hopeful about the two avenues that I've researched, NaPro & SIRM. I'm only going to talk about NaPro today.
So I signed up for a group session (for free) at Holy Spirit Hospital in Camp Hill, PA. Mike and I went Tuesday evening. The session was put on by Erin, a CRNP from a local Ob/Gyn office, Center for Women's Health. It turned out to be informative for the average Joe who doesn't know a whole lot about charting, getting pregnant, CM, etc. A lot of it was reviewed in our natural family planning class before we got married. However, what I did really really like about the session was we got to ask Erin individual questions at the end and in private. She was super helpful. She listened to my story and said she could understand how frustrated I must be that no one is listening to me. :::DING DING DING::: WE GOT A WINNER!!! She told me that their practice would be willing to work with SIRM and try to get to the bottom of this, unlike my current RE & Ob/Gyn. Needless to say, my current Ob/Gyn & RE have been fired! She also told me that she really thinks the NaPro could help me figure things out and if not that SIRM would be very thourogh.
So I'm charting now based on my CM which should be fun since I always have a discharge. I know already that my luteal phase (LP) is shorter then average but I've never put it down on paper. I've already made an appt but unfortantly they will not see me until after 2 months of charting which is frustrating as well.
So at least, I have hopefully found a new Ob/Gyn. Check one. Complete.
"NaProTECHNOLOGY works cooperatively with the procreative and gynecologic systems. When these systems function abnormally, NaProTECHNOLOGY identifies the problems and cooperates with the menstrual and fertility cycles that correct the condition, maintain the human ecology, and sustain the procreative potential.."To me? Its natural family planning and charting based soley on cervical mucous (CM). So you can use it to avoid pregnancy or achieve a pregnancy. Another great website to visit is Pope Paul VI to learn more about FertilityCare & NaPro.
So I signed up for a group session (for free) at Holy Spirit Hospital in Camp Hill, PA. Mike and I went Tuesday evening. The session was put on by Erin, a CRNP from a local Ob/Gyn office, Center for Women's Health. It turned out to be informative for the average Joe who doesn't know a whole lot about charting, getting pregnant, CM, etc. A lot of it was reviewed in our natural family planning class before we got married. However, what I did really really like about the session was we got to ask Erin individual questions at the end and in private. She was super helpful. She listened to my story and said she could understand how frustrated I must be that no one is listening to me. :::DING DING DING::: WE GOT A WINNER!!! She told me that their practice would be willing to work with SIRM and try to get to the bottom of this, unlike my current RE & Ob/Gyn. Needless to say, my current Ob/Gyn & RE have been fired! She also told me that she really thinks the NaPro could help me figure things out and if not that SIRM would be very thourogh.
So I'm charting now based on my CM which should be fun since I always have a discharge. I know already that my luteal phase (LP) is shorter then average but I've never put it down on paper. I've already made an appt but unfortantly they will not see me until after 2 months of charting which is frustrating as well.
So at least, I have hopefully found a new Ob/Gyn. Check one. Complete.
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