Tuesday, March 27, 2012

Getting Back Into the Game

After sitting on the bench for the past three months, I'm finally going  getting back into the game. In case you are just tuning in, I took off some time to get more tests run and had a hyteroscopy where they removed tons of tiny polyps.

Today is CD3 I had my baseline US apt. My favorite nurse was there so I was able to request her. She is so wonderful and it makes such a difference. She takes her time with me. There are some nurses who are tired of seeing me and rush. She is thorough and respects that I am going natural etc. I have a big history with lufs and cysts. I was worried what crazy stuff my ovaries had been up to since I had not seen them in 3 months.

She took a good look and then did not see any cysts. I was so excited. This is a rare treat for me. YEAH. That probably means I ovulated on my own last month, which is huge since I did not take a trigger.....YEAH. I am so glad that I am starting off right. She checked both ovaries and they both have some small buds. My right ovary that is covered with an endometrioma and only has a sliver of tissue left also had some buds. I cannot express how thrilled I am that my ovaries behaved.

This week I will take antibiotics. I started taking them for my TEBB. Even though it  has not returned in the last 3 months, I decided to take the ab just in case. I start neupogen for my NK cells and lovenox for my 5 blood clotting issues this weekend. So two shots to the belly. ugh. I go back next week for a follicle check. Then we see when I take my trigger.

I can't help getting my hopes up. It is nuts,but this is such a good sign that I have to go with it.

I wanted to schedule a follow up with the fancy reproductive immunologist in NYC. I have had lots of new tests run since last June when I last spoke with him. Since I live hours away, I always did phone consults. He would charge 350  but then only speak to me for 5 min.This time I wanted to get more time to go over them properly. Plus, I would be able to see what he is doing. Is he reading my chart, or staring out the window? I figured I would get better service face to face

I had my DH call bc I cannot stand dealing with his office staff. Well, it seems that this Dr has decided to drop out of network. This means that now I will have to pay the same amount if I go in person or not.  I told my DH that I still want to go face to face to get the most out of my money. Also if I go in person my dh will go with me.

I know it sounds nuts that I would put up with all of his nonsense, but he is brilliant and is up on the newest stuff. He is the one who suggested a lupron trigger which was a huge breakthrough for me. I am at the end of my road here, so I need someone who is willing to try anything. My napro dr found inflammation in my uterus so I need to address that.

Wednesday, March 21, 2012

March is Endometriosis Awareness Month: Pass it on!

What is Endometriosis?
The disease, for which there is no absolute cure, affects nearly 10 million women and girls in the United States alone and another 70 million globally. Endometriosis is a leading cause of female infertility, chronic pelvic pain, immunologic disruption, and pelvic surgery in the United States. In addition, the disease accounts for more than half of the 600,000 hysterectomies performed in the U.S annually.Endometriosis is a reproductive and immunological illness.  Mistakenly stigmatized as merely painful periods, Endometriosis is far more than just "killer cramps".  It occurs when tissue that lines the uterus is found outside the uterus -- usually in the abdomen on the ovaries, fallopian tubes, and ligaments that support the uterus. It can spread to other organs such as the bladder, liver and intestines.  Less commonly they are found in the lung, arm, thigh, diaphragm, and other locations.
This misplaced tissue develops into growths or lesions which respond to the menstrual cycle in the same way that the tissue of the uterine lining does:  The blood and tissue shed from endometrial growths has no way of leaving the body. This results in internal bleeding, breakdown of the blood and tissue from the lesions, and inflammation. It can cause pain, infertility, scar tissue formation, adhesions, and bowel problems.
Yet, despite being one of the most highly prevalent and costly diseases of our time, Endometriosis continues to be mistakenly treated as an insignificant, obscure ailment. Awareness is largely lacking among the lay and medical communities alike.
Is Endometriosis curable?
There is currently no absolute cure for Endometriosis, but there are several methods of treatment, which may alleviate some of the pain and symptoms associated with it. You can have surgery to cut it out. Make sure that you see a dr who specializes in the removal of endometriosis. Many drs do not go deep enough and then it comes back. A surgeon trained in Napro Technology has expert training  in the proper removal of endometriosis.

What are some symptoms of Endometriosis?
The amount of pain associated with the disease is not related to the extent or size of the implants. Some women with Endo have no symptoms, others have debilitating pain and even infertility. Some fairly common signs that may lead you to suspect Endo can be found here http://hope2endure.org/endo-faq

How is it diagnosed?
The only way a positive diagnosis of Endo can be made currently is via surgery, either a laparoscopy or the more invasive laparotomy, where biopsies are taken from suspected sites.  It can also be visualized during surgery if the surgeon knows what to look for.  Ultrasounds, MRIs, CT Scans and other diagnostic tests are not conclusive.  The ERC does not support “medical diagnoses,” such as administering GnRH therapy prior to a surgical diagnosis.

Why does endometriosis cause infertility?
It has been found that between 30 to 40 percent of women undergoing laparoscopy as part of an infertility evaluation are found to have Endometriosis.There appears to be a number of mechanisms by which Endometriosis impacts fertility. Scarring or adhesions in the pelvis, for example, may cause infertility. The fallopian tubes and ovaries may adhere to the lining of the pelvis or to each other, restricting their movement. The scarring and adhesions that takes place with Endometrisois may mean that the ovaries and fallopian tubes are not in the right position, so the transfer of the egg to the fallopian tubes cannot take place. Similarly, Endometriosis can cause damage and/or blockage to the inside of the fallopian tube, impeding the journey of the egg down the fallopian tube to the uterus. Another factor which could cause infertility for women with Endometriosis, may be the over-production of prostaglandins. These are hormones which play and important role in the fertilization and implantation of the embryo. An excess of prostaglandins may interfere with these processes.
Some women also have an immune response that will cause infertility. This can  cause implantation failure and poor egg quality. You will need to see a reproductive immunologist to get tested and treated.

Can Endometriosis be prevented?
There is no current manner of preventing Endometriosis, and it is not a disease which is “contracted” or “caused” by anything the patient did – nor is it contagious.  It is, however, highly suspected to be genetic.
The World Endometriosis Society Produced it's first educational video

Saturday, March 17, 2012

Traffic Ticket and Blood Tests Results

My speeding ticket:
I got a speeding ticket at the end of December. I had to go to court this week to speak to the ADA to see if I could get it reduced.  When I got there and saw that the room was already full of people I knew it would be a long night. You sign in and then they call you up to speak to the ADA for like a min in the corner but it was still in front of everyone. I sat there and watched everyone go up and listened to see what kind of deal they got. It seemed that everyone got a large reduction on their pts but had to pay $150 fine. Then it was my turn. I got up there and I was all set to plead my case but he already had a deal without hearing any info from me. He reduced it from 6 pts to 2 pts. Then I had to also pay a fine of $150 plus the state surcharge of 85. So for my first offense I had to pay a large fine and also get two pts. I am not complaining bc it could have been 6 pts plus at least $300. So this is ok with me. I am just glad that this two month drama is finally over. I can go to a defensive driving course and remove my pts.

My blood tests came back. I have to speak to the dr but I have some ideas on the results thanks to the Internet and my past experiences.

I tested positive for another blood clotting disorder.  That puts my total up to five  which includes  PAI-1 4G/5G that is mentioned below. I think I have been tested for 9 or ten, so I have about half of them. Sometimes it amazes me that I even walk around. It seems that I really need the blood thinners. My hematologist upped my dose to 40mg once a day. It is hard to know if this is enough, bc she said I am her only IF patient. Her others are all pg women with RPL and she wants to give me the same dose as them.

 My natural Killer cells were high, but about the same as usual. This was what I expected to see. When I start TTC again, I will go back on the med to lower this. My  TNF was a little higher than my usual but still in the normal range.

My Vitamin D level is getting better each time. I am very pleased to report that it is now up to 46. It is so great when something works correctly. 1,000 equals 10 pts and that is what has been happening with me. I have been taking 3,000 so now I am going to add another  1,000.

My ferritin level was low. It was 37 which seems normal  in the lab's range, but everything I read online stated that under 40 caused fertility issues. Some sites mentioned wanting a level near 60. So I am going to slowly ease in some supplements in order to prevent GI distress.

My folate level is still really high but it came down a lot since the last time I was tested. A few months back, I was taking  a high dose folate supplement for my MTHFR. I reduced the dose after the test came back much higher than the range. Since it is still outside of the normal range, I am going to reduce it some more. I eat a lot of salad so I guess I do not need to supplement that much.

Here is something I found online. 

While the role of inherited thrombophilia has been accepted as a cause of recurrent late pregnancy complications, the contribution of mutated thrombophilic genes to implantation failure has not been studied. Proteins involved in fibrinolysis are necessary for trophoblast invasion into the endometrium. This study compared the prevalence of 10 thrombophilic gene mutations among 42 women with a history of recurrent implantation failure after IVF–embryo transfer with 20 fertile control women. Buccal swabs were taken from all of the women for DNA analyses. Women with a history of implantation failure after IVF–embryo transfer displayed a higher prevalence of PAI-1 4G/5G mutations than controls (P = 0.007). No differences in the frequency of the other specific gene mutations were detected. However, the prevalence of total gene mutations among patients with implantation failure was significantly higher than among controls. More than three gene mutations among the 10 genes studied were observed in 74% of women with implantation failure and 20% of controls (P = 0.0004). 

It is concluded that inherited thrombophilias are associated with implantation failure. This association is manifest by total number of mutations as well as with PAI-1 mutations.

Friday, March 9, 2012

Lots of Blood Tests

This is the time of year that school budgets get discussed. It is so sad that schools have to make so many cuts. Everyone is sad at work. I cannot believe that the president would make huge education reforms, make teacher evaluation tied to the test scores at the same time that  most schools are cutting tons of teachers and increasing class sizes. Nothing is set in stone yet. It is just so stressful and I try not to think about it. The other day they mentioned that the music teachers might get  cut. One of them has a small baby with major health issues. She is having trouble paying her bills and now she may lose her job. I started to wonder if I should be so greedy and want kids and a job. I have been blessed with a job when many do not. I started to feel guilty about it.ugh. My dh said to keep trying and not give up.

I am getting closer and closer to going back into the fight. It has be awesome these past few months not doing any shots. I have to admit that I still had TTC on the brain, but that is less painful than injections to the belly. I spoke to the hematologist last week. She upped my dose of blood thinners to 40mg. I waited all week to get a call from the mail order pharmacy. When I called today, the guy told me that my prescription came in and started to set up the order. I went through almost the whole thing and even paid for the medicine. He does the recap and mentioned 30mg.I said oh no she raised it to 40mg and then my cell phone died. Ugh so I panicked and ran to find a phone. I called back and got a different rep. She said that my prescription did not come in. She said that my last script was from December and that must have been what he saw. HMMM I told her that he set up the whole order. She was able to fix it and then said she would fax my Dr to get the script. One of the many lessons I have learned is to start setting up the meds a month or two before you want them. If they get the script  then they can mail it to me on Thursday.

I also got some more blood drawn for immune tests. Two of them are repeats since I have not had them done in 6 months and there is one new one. I had 9 vials of blood drawn. Thankfully I got a great nurse and it did not hurt when she swapped the vials. I was able to go down there on my break and get back on time. Those tests will take about a week to come in. One test was sent out to Colorado to be tested and the others went to Illinois.

I also requested to have some tests run locally and I hope to get those done tomorrow. So in about a week, I should have lots of test results to go over, and some medicine. The last part of the puzzle is to speak to the Reproductive Immunologist. I have not spoken to him in months. I do not like talking to him bc he charges and arm and a leg, is  two hours late for the apt and then he hurries you along. I know that he is very intelligent and I just have to deal with him so I can make a plan. I want to get all my test results in before I speak to him.

Sunday, March 4, 2012

Vitamin D

Have you had your level tested?
I was only tested for the first time about 6 months ago because I read that a deficiency could cause infertility.  My level was only 24 which is deficient. I was shocked bc that was during the summer when I was going outside. I started taking 2,000 units a day and got retested 3 months later. My level went up 10 points. At this point, the lab said it was normal. The Vitamin D council says it is still deficient so I added another 1,000. I am now up to 3,000 a day. I got retested 3 months later and it is now 46.  I have been learning so much about Vitamin D and how it is so important to your overall health. I  signed up to get the Vitamin D council's newsletter. I also decided it was time to give vitamin D its own page. 

The Vitamin D Council

The Vitamin D Council is a nonprofit, tax-exempt 501(c)(3) educational corporation in the State of California, founded in 2003 by Executive Director John J. Cannell, M.D., on the conviction that humans all over the world are needlessly suffering from vitamin D deficiency. Their mission is to end the worldwide vitamin D deficiency epidemic by means of outreach and awareness, treatment, research and activism.
 The Vitamin D Council produces summaries on a wide range of health conditions. 
Vitamin D and infertility 
Vitamin D and pregnancy
World's Healthiest Foods Vitamin D Information

The following info below comes from Dr.  Donald Miller who is a cardiac surgeon and Professor of Surgery at the University of Washington in Seattle. He is a member of Doctors for Disaster Preparedness

Vitamin D regulates the expression of more than 1,000 genes throughout the body.  Vitamin D switches on genes in macrophages that make antimicrobial peptides, antibiotics the body produces.

Vitamin D also expresses genes that stop macrophages from overreacting to an infection and releasing too many inflammatory agents — cytokines — that can damage infected tissue. Vitamin D, for example, down regulates genes that produce interleukin-2 and interferon gamma, two cytokines that prime macrophages and cytotoxic T cells to attack the body's tissues.

A growing body of evidence indicates that rickets in children and osteomalacia in adults  are just the tip of a vitamin D-deficiency iceberg. Tuberculosis and various autoimmune diseases, such as multiple sclerosis, lupus, and type I diabetes have a causal association with low vitamin D blood levels. Vitamin D deficiency plays a causal role in hypertension, coronary artery disease, congestive heart failure, peripheral vascular disease, and stroke. It is also a risk factor for metabolic syndrome and type II diabetes, chronic fatigue, seasonal affective disorder, depression, cataracts, infertility, and osteoporosis. 

Experts reckon that an optimum blood level of vitamin D  is 50—99 ng/ml. (Children need a blood level >8 ng/ml to prevent rickets. It takes a concentration >20 to maintain parathyroid hormone levels in a normal range. A level >34 is needed for peak intestinal calcium absorption. And in elderly people neuromuscular performance steadily improves as vitamin D blood levels rise to 50 ng/ml.) 

The government's recommended daily allowance (RDA) for vitamin D is 400 IU (international units) a day, an amount sufficient to prevent rickets and osteomalacia but not vitamin D's other gene-regulating benefits. To achieve all of vitamin D's benefits one has to take an amount ten times the government's RDA — 4,000 to 5,000 IU a day.  

Food contains very little vitamin D. Federal regulations now require that some foods, like milk, be fortified with vitamin D. But one would have to drink 200 glasses of milk to obtain the amount of vitamin D a light-skinned person can make in 20 minutes sunbathing. 

The majority of Americans are vitamin D deficient, with a  blood level <20 ng/ml,  Vitamin D supplements (D3, ) provide the only way most of us can maintain a year-round vitamin D blood levels greater than 50 ng/ml. That requires taking 4—5,000 IU of vitamin D a day 

Thursday, March 1, 2012

Snow Day

In my region we have had barely any snow this year. We had a small storm near Halloween and that was it. Since then we have only had a few dustings that just melt the next day. Yesterday morning the kids told me that it would snow.  Kids have a snow radar. All of a sudden they noticed it had started and yelled out "its snowing" then they tried to flock to the window. I  have to close the shades in order to get their attention back. They get so excited when it snows.

Today is the first snow day of this school year. This is one of the perks of being a teacher. Yippee  I am so excited. It is still snowing and the forecast says it will continue all day. Being that I am the one home, I am responsible for clearing the driveway and making sure to remove snow from any bushes that are slumped over, but that is a small price to pay.

In other news:
TPT: I have had a lot of sales from Teachers Pay Teachers. Thank you to all my loyal customers. I love making stuff for my class, but when I can sell it to others it makes me happy. I am just honored that someone liked my stuff. Making some extra money is great too.

Family: I was so upset that I emailed my dad and said that this was out of control. He spoke to my Aunts. One of them got on FB and wrote a whole page. She is awesome.She mentioned how we should treat each other and that we have to come to an agreement peacefully or we are going to cancel it. I spoke to some of my cousins. It became clear that this is a battle of those with kids against those without. We spoke to them about what they really wanted. They said they wanted to put the kids to bed at night and then have time for adults. OK so now that the real issue is out, we started to look for places to make them happy. We are getting very close to an agreement. We are thinking about renting a house so the kids could sleep while we would have the living room. FX that we can find a place that is affordable.