5 Stages Of Grief while suffering with Secondary Infertility

Over the years I have come to the realization that trying to conceive with Secondary Infertility has its own set of emotions that are similar to grieving that happen throughout each and every cycle!!!

Hope-usually at the beginning of a cycle, when you feel that maybe, just maybe this might be a month that I will ovulate. Screw a + test at this point, ovulating first is obviously needed to get that Big Fat Positive!!
 
Uncertainty-this occurs as the weeks go by and you're still waiting to see that EWCM or the cervix to move up and start to open.

Denial-"No, this cycles not really a bust, it's just taking a while to happen."

Depression/Anger-This usually happens when you realize the the cycle is a bust, along with the MANY others before it.

Acceptance-When you accept the fact that this cycle is anovulatory and move onto the next. Thus repeats the cycle!

And of course, Envy and Jealousy are underlying feelings that stay throughout all stages of the cycle!!! Some people should know, that too much exposure to things pregnancy related, or some unsettling news from a doctor, can immediately throw you into the Depression/Anger stage and it is much tougher to get back out of that stage.

Revisiting Top Things to NOT Say To Someone Who Is Struggling With Secondary Infertility

This is a compilation of phrases that I have heard over the years of struggling and I really wish at at times I could post a banner of What NOT to Say to Someone Who is Struggling with Secondary Infertility. 

I have decided to revisit this post just as a reminder to those at there who are providing support for a loved one or friend with Secondary Infertility. I have also decided to add a recent one that I feel should make this list.

Added 4/2/12:

A couple more have recently made the list and I feel it is important for them to be recognized.
 
A general good idea if you have no issues getting pregnant would be to NOT publicly offer up an oops baby to someone who is struggling with infertility, secondary or not. If it is meant as a joke, you may need to re-evaluate your humor because I can guarantee you the one struggling will see absolutely NO humor in it.

Unless you plan on becoming a surrogate for the person struggling with infertility (again secondary or primary) do NOT wish your fertility upon someone who is struggling with their own. It only feels like a slap in the face and does nothing to help the situation.

"At least you have two healthy children... be grateful." - This statement brings out all kinds of emotions in me. First off, I interpret this statement as this person feels that I am NOT grateful for my girls. Anyone who knows me and my mothering to my daughters will know that I AM forever grateful. I realize I am BLESSED to have had not one, but two opportunities at being pregnant and birthing and raising children. I get it!! I think that is part of what makes the pain worse is that you KNOW it is possible for your body to do it, it's done it before. Why is it being so difficult now? In MY opinion and experience, this statement is usually said by someone who is struggling with Primary Infertility, and cannot begin to fathom MY magnitude of pain and grief, as I am not able to begin to understand the magnitude of hers either. Nonetheless, it hurts like hell to be told that. My advice, DON'T say that to anyone struggling with Secondary Infertility, you will do nothing for that persons morale, but you WILL succeed in making that person hate you!

"Don't worry, it'll happen when the time is right." ~ Are you kidding me? The time is right right now!

"Everything happens for a reason." ~ Really? What is the reason that I have been struggling for so long for? Is there really a reason behind that one?

"Don't stress." ~ I seriously want to do some major bodily harm when I hear that one. Ok, yeah.....sure.

"I got pregnant on my first try." ~ Well good for you, not all of us are that lucky. But thanks for rubbing it in.

"I did ________________ to get PG, Maybe you should try ____________." ~ Yeah, cause I hadn't tried that trick yet.

"You're trying to hard." ~ Well, judging by my history, I'm not just gonna fall pregnant!

Had to add this one as this was actually told to me just last night. (12/16)  after a vent I posted on what is supposed to be a support site for women strugggling to conceive. I posted (see post I'm Tired...) and actually recieved this response:

"did she say CHILDREN?  She has babies and is complaining"? Just because I have 2 children already does not make my pain any less then someone who is struggling for one. I have pain and heartache as well. I know what it feels like to have that want, that you want more then anything in the world, and it always being out of your reach. I get it! Albeit, it may not be the same heartache as someone who is struggling for one, but it is still painful. It is even more painful to reach out on a place that is supposed to be supportive and receive that type of message. Thanks for the support lady!

The following are ones I have gathered from other women who also are struggling with secondary infertility. (meaning, they had one child just fine, and now are struggling to have another) I have left the names out as to respect their privacy.

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"So, what's the deal? No siblings for XXXX...that's so mean, every boy needs a brother!" -This one made me so sad.

"I bet it's because you are a vegetarian, that's why you can't get pregnant" -Oh Please!

"What are you going to do with that other bedroom now that you know you aren't having more kids" - what, like you want to rent it out? F off!

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"We're pregnant again!!!" announced by my cousin's wife pregnant with her 4th child (1st was born a few months before DS) AT MY BIRTHDAY PARTY.

"I just don't understand the big deal - all the OTHER kids in this class have siblings." when they were asked to write a story about their brother/sister in Kindergarten. He was told he could write about his dog after he told the teacher he didn't have one.

Random fertility articles left on my doorstep - like I don't already realize I'm the town freak with only ONE kid.

"So, have you given up yet?" Uh...no...

"Why did you buy a 6 bedroom house if you only have 1 kid?" Umm....we ARE still planning for more....

"What are you waiting for???" My typical answer is "God."

and my personal favorite...

"How can you possibly homeschool when you only have one child????" Umm...probably more adequately than YOU!!!!

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"Can't you just not think of them as babies yet?" Referring to my MC babies (from my brother!)

"Just relax and it will happen"

"There must have been something wrong with the babies, so you are better off losing them"

"Don't try so hard"

"My husband just looks at me and I get pregnant"

"God has a plan for you"

"The baby you end up with will be the one you are meant to have" (not a mean statement, but it doesn't really help)

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The worst thing I think I have ever heard came from the mouth of a seasoned OR Nurse...I had lost my 2nd at nearly 4+ months (heart malformation) and was giving pills to induce a m/c at home...after being a shut in in my own home for 3 days (waiting for the m/c) my Drs finally scheduled a D&C a week later. It was horrible waiting, looking slighty pregnant and obviously wanting the healing to begin...the D&C was unsuccessful and I had to go in for another a few days later...As the nurse was preping me for surgery, I started to cry. She sighed loudly and said "Why are you crying"...I shrugged and said "I am sad"...she said "It's a routine surgery, it's not like they left an ARM in there or anything!" My mouth just gaped open, I had no response. To this day I think about that cold hearted statement and cringe. Awful thing is, she continued to tell me about her healthy children and how one day, when it was meant, I would be a mother too...awful woman.

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Many people seem to attribute infertility with stress. "try not to think about it/relax" has been said more times than I can count. My sister thought that I should "have a few drinks to relax around THAT time". My dad suggested Valium because apparently, that's how I was conceived. My MIL said not to worry, it took her 9 months to conceive (i.e. #2 and #3 are 18mo apart).

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"Oh you do not know how it is, you do not have kids"

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"Maybe you just tested too early"

Said to us right after our MC, when they found out they were pregnant... "don't tell them our names, they might steal them!"
"no don't worry, we're pregnant first"

Right after my 2nd MC...
"I've had 2 MC also, don't worry 3rd time's a charm!"

And on a somewhat related note, when I told a coworker I was pregnant (she knew about my 2 other MCs), the first thing she asked was "was it planned?" before giving a "congrats"

I don't get that one at all! We had clearly been trying for a long time.

Ultrasound Follow Up Appointment

Ok, now that I have had time to marinate on yesterdays doctor's appointment and the news I received, I just might be able to update without breaking down and crying again.

Ok, where to start? My "Bicornuate Uterus" is NOT a Bicornuate but instead it is a Septate Uterus, which means that I am now a VERY, VERY high risk candidate (even more then before) IF I ever get pregnant again. I am now at a VERY high risk for miscarriages, because if a baby implants on the Septum (a piece of tissue that is separating my uterus in two, that does NOT contain blood vessels) it would not support a pregnancy and I would lose it. :( The doctor kept asking me over and over, if I'd ever had a miscarriage and as far as I know, I haven't. I did suspect one cycle I WAS pregnant, judging by extended luteal phase, the flow/severe cramps that followed, I DO suspect that I have, but can't confirm.

THEN, I asked him about the PCOS diagnosis and without a doubt, I have PCOS, with the multiple follicles on my ovaries, them being enlarged, all my other signs/symptoms, etc. So, then I asked him about getting Clomid (an ovulation inducing med) and said that I've been having the hardest time finding a doc to prescribe me Clomid, and his words were, "And you won't find one that will. With you having PCOS AND a Septate Uterus you fall into a class of VERY high risk. High risk for multiples with ovarian stimulation meds, (and my abnormal uterus won't be able to support multiples) high risk for OHSS, (Ovarian Hyperstimulation Syndrome) and high risk due to the Septum. You would have to be monitored VERY closely by a high risk OB/Gyn." :'(

My heart sank into my stomach when he told me that. He said that he works in conjunction with a few local GYN's, one of which is at the last OB/GYN practice I went to while pregnant with Emma. We discussed how expensive all that would be, especially since I am not insured and they have NO discounts for self pay people. But he said he would talk it over with the OB/GYN and see what her take is on it. I don't know if this means he will be referring me to her or if SHE could write the script, I just don't know. So, it looks like my search of a Clomid script is over. :''(

I asked him if I could discontinue the Metformin as it has been messing with my sugars drastically!! I have a feeling this doc didn't have much experience with PCOS as again he is clearing it with the OB/GYN as to if I should stop it or not. With the fact that is is drastically messing with my sugars, and hasn't done anything to help ovulation or weight loss, he thinks I should stop them. He is going to get back to me with all of this info.

He made me nervous and scared because he kept asking about miscarriages and was absolutely FLOORED that I even was able to get pregnant, twice, and carried a pregnancy (Chey was preterm) to term with the Septate Uterus. He did say that any future pregnancies would be compromised and there's a high probability that I would lose them. I really don't know if I could handle a miscarriage after all of my struggles to GET pregnant. Right now, I feel like a lost cause, reproductively. There is nobody that will be willing to take me on, with all of my high risk situations. I don't ovulate on my own, and can't get any assistance in stimulating ovulation. Fuck man, THIS IS NOT FAIR!!!!

I barely made it home before I broke down bawling. Through tears and quivering lips, I told my husband what I was told. He just held me and let me have a good cry. It's not something like this could happen to a crack whore, no, it happens to people who are good people, have stable lives, and WANT to have and love a baby. No, it happened to ME!!

I don't know where to go from here. I cannot afford all of the tests/dr fees/appointment fees/ultra sound fees it's going to take to closely monitor me while I take Clomid. Obviously, I am not/have not been ovulating on my own, so achieving pregnancy without ovulation inducing meds, is most likely not gonna happen. It hit me like a ton of bricks when he told me, "I'm sorry Laura, I don't know what else to do for you. Everyone has already done pretty much everything that CAN be done." Thanks, so now dr's can't even help me. Ugh!!!

Take the Pledge!RESOLVE: The National Infertility Association

Please, show your support, follow the link and take the pledge to help raise awareness for Infertility.

Take the Pledge!RESOLVE: The National Infertility Association

Ultrasounds, Tests and Results...Oh My!!

I know it has been awhile since I have last updated, but between life, dr's appointments, death in the family, computers dying,......sigh, it's been alot!

So, I have had my TSH (Thyroid Stimulating Hormone) tested and even though my symptoms all point to HYPOthyroid, (too MUCH) it came back on the low end of normal, .53, but would indicate HYPERthyroidism. (too LITTLE) So, we're not treating it, but instead will monitor it and have it rechecked in a few months.

My old doctor retired, :'( and I finally got my appointment with the new practice. There are several MD's within this practice and I saw a NP. (Nurse Practioner) WTF?!?! So pretty much all she did is confirm 1) that I don't want to go back to HER, 2)my 5 months waiting to get seen was waste of time. I wanted lab work ran, like all of my hormones, etc. She completely dismissed it as being too expensive. I asked for Clomid, she said it is out of her scope of practice and that I would have to see an OB or a fertility specialist. I DID however get an ultrasound to SEE what is going on inside there and a script for Provera so I can induce AF, instead of going months and months without one.

My ultrasound....very interesting stuff. Kidneys and liver look good. Uterus is tilted, which I already knew. What I didn't know is that I have a Bicornuate Uterus. Which means, instead of my uterus being round and smooth at the top, mine is separated into two chambers and looks like a heart. WTH?!?! All of these years, and I had NO idea that I had that. My right horn (as the radiologist kept calling it) is much bigger then the left, and she said most likely is the one that "homed" both of my girls. Isn't it pretty?

The heart shaped object in the center is my uterus. The right horn is much bigger then the left due to that is where both of my girls hung out during their stays. Notice the deep separation, separating my uterus into two, making it much smaller then a normal uterus.

The scary part about a Bicornuate Unterus is, it can cause miscarriages, if the baby implants on the smaller side. It may not be an early miscarriage either. It could cause growth restriction problems, (due to no space to grow) and cause a late term miscarriage, preterm births and breech babies. Interesting thing is, my oldest daughter was born 8 weeks preemie and was breech and we never had a reason as to why!! She was breech throughout the whole pregnancy, and now I know why!! She didn't have any room to turn head down!! Of course this revelation now makes any future pregnancies high risk and will have to be closely monitored for growth problems and proper placement.

Ovaries are enlarged, but not too much so, and are COVERED in immature follicles. So much so, she didn't even count how many. So, this pretty much confirms it, PCOS (PolyCystic Ovarian Syndrome) it is. There was no fibroids or ovarian cysts, so that is good.

As far as I know, next step in PCOS protocol since I'm already on Metformin (for insulin resistance) is either Birth Control Pills (if NOT Trying To Conceive) to try to shrink the cysts or Clomid to induce ovulation. I feel like I am hitting a brick wall with getting the Clomid though. I have seen 2 different docs in the last 6 months hoping to get a script for Clomid, but both have said it is out of their scope of practice. Why is it so difficult to get a script for it, when it is so obvious it is what I NEED?

I WANT to get in to see a Reproductive Endocrinologist, but the nearest one to me is OVER 3 hours away, one way. That and since I am not insured, everything is out of pocket for me. At this point, we're just not prepared to go into debt to get my body figured out. I did a search the other day for OB's in my area who specialize in infertility and there was 1 that popped up. Coincidentally, it was MY last OB!! :) So, if this doc I'm seeing in August can't help me any further, I guess I will be making an appointment with my old OB.

So the game plan is as follows. I am on CD 84, still no ovulation and on my 9th day of 10, of Provera to induce a period. After AF leaves, on CD 10 I will be taking one dose of Folliculinum, and again waiting (and crossing fingers) for ovulation.

Meds/Herbals for next cycle: 

Vitamin D, 2,000 iu/day

Calcium, 1,000 mg/day

Metformin, 500 mg/BID

Liquid B Complex 1/day

Kelp, 325 mg/day

Fish Oil, 300 mg/day

Folliculinum, CD 10 only

Provera, *if no Ovulation, CD's 35-45

Happy Birthday to my princess-Emma's Birth Story

I always reminisce on my girls' births on their birthday. I have never written them out, so this will be all from my recollections.

Emma's Birth-May 14th, 2007

Around 1 am I woke up and felt wet down below and thought maybe it was just sweat. Went pee and fell back asleep. My husband was supposed to go to work that day, so when I woke up at 7, feeling wet again, I told him I think my water broke, but I wasn't sure. For whatever reason, I did not believe it, because it was not a steady trickle or a huge gush like it was when Chey's broke. I told him don't worry, go ahead and go to work, I'll be fine. I went and stood in Emma's room staring at her crib all set up and just waiting for a baby to fill it. Then I had another gush, although just a small one. Lance suggested maybe calling my doctor and seeing what they said, as he knew how quick my last labor was (2 hours 22 min.from time water broke to time she was delivered) and didn't want to risk anything. 

I called my doctor and got his nurse, Becky, whom I LOVED, even though week after week she inflicted major pain on me by injecting me with Progesterone shots, in hopes of keeping me from delivering preterm as I did with Chey. It worked apparently!! Becky said she advises all patients who have any sort of wetness like that to go into Triage at the Birthing Center and get checked out. My heart skipped a beat for a minute when I realized that today might be the day that I have our baby. We had had all the bags ready to go since I was 32 weeks, for fear that I would deliver early and I wanted to be prepared. Everything any laboring mother could ever need. 

In my hubby's bag was massage oils, cameras, 1 digital camera, 1 35mm film camera with MANY rolls of film and extra batteries, tennis balls in case I got back labor again and hubby could massage my back with them, snacks in case he got hungry, massaging gadgets, and I believe a change of clothes for him. In my bag was several changes of clothes, all the toiletries I would need, makeup and hair accessories because I knew lots of pictures would be taken and I wanted to look good for them, relaxing cd's to listen to, Chey's PSP for entertainment, sudoku books with plenty of pens, my birth plan, plenty of clean panties and pads for after the birth. Emma's bag was her diaper bag full of diapers, her going home outfit, several outfits, sleepers, her baby book, with a stamp pad because for some reason I thought they would need it to stamp her footprints into her baby book (keep in mind my last delivery was 11 years prior and was VERY traumatic and FAST!!)  and her boppy pillow so I could breast feed comfortably in the hospital. You think we had enough stuff? We (and when I say we, I mean Lance, :)) gathered up all the bags into the car while I did the last minute running around. I had to make sure my hair and makeup were done, teeth were brushed, tea was made and took one last look at Emma's empty crib and thought this will be the last day it will be empty. We headed off to the hospital.

I wasn't really having any contractions, not any that I felt anyways. Since I was high risk for preterm labor and have been having contractions since 28 weeks, I didn't feel anything worse then what I had already been feeling. Part of me was still in denial that my water had broke. Got to triage, and laid down on the bed, allowing amniotic fluid to pool so they could check it and see if it was in fact my water that had broken. I was handed a hospital gown and told to put it on, despite my birth plan which stated that I wanted to labor and birth in my own clothes. I went along with it as she hooked me up to the monitors to check baby's heartbeat and monitor contractions. She left for a while, and came back a bit later to confirm that my water had in fact broken and they would be keeping me. At that time she did a quick ultrasound and we discovered that Emma was sunny side up, which is not an optimum birthing position as they're supposed to be face towards the floor not up facing momma. I knew immediately that with her being sunny side up, that it would mean difficulties in pushing her out. After the nurse left, my mother in law came in. I'm not sure at what point my husband had called her but she was the most excited I have ever seen her. We filled her in on the news that today would be the day. We also asked her if she could go pick Chey up from school as she wanted to there for the birth of her first sibling. She did as we got moved into our labor/birthing room. 

Hanging out waiting for contractions to start.

As we got in the birthing room, I was informed that Pitocin would have to be started since it had been so long since my water had broken and I was still not having any contractions. I immediately felt like dread had taken over. I did not want Pitocin or any other drugs or interventions for that matter. Hell, I didn't even want an IV in my arm but was informed by my doc that they would need to have the heploc in there just in case something came up, so they would not have to fumble around with it while I was in labor. Hesitantly I went along with the IV and Pitocin. It took 4 attempts and a life flight nurse to come in and attempt an IV. I tried telling them that my veins like to roll or collapse, but I guess they needed to find out for themselves. Pitocin was started at 9:23.

Since we had left all the bags in the car, Lance took the time to run down and get them all, as well as my birthing ball. I knew I wanted to labor on it as long as possible to help bring Emma down into the birth canal. Shift change took place and I got a new nurse. I went over my birth plan with her and when she read the part about me wanting to labor in my own clothes she asked me why I was in a hospital gown then. I told her I was told to put it on. She told me that I didn't have to wear it and could wear what I felt comfortable in, so I out my clothes back on. I knew I was gonna like this nurse!! We went over paper work and the whole no pain med paper work. I did not want any and she knew that but informed me that if I signed the paper work declining pain meds that it would also mean IF I had to have a c-section, that it would mean no pain meds for that either. So I stipulated on the paper work, epi only in case of an emergency c-section. 

This nurse knew that Emma was sunny side up and had me get into a position where I was on all fours on the bed with my torso draped over the birth ball, so that Emma could turn and get into prime birthing position. I had my mother in law, my best friend Daleyne, my daughter Cheyenne, and of course my husband all in the room with me. We were all sitting around talking, laughing, watching tv, doing crossword puzzles and just having a good time. We all took guesses at how big Emma would be at birth, I had guessed 6 lbs 7 oz and Lance's guess was 7 lbs 6 oz. I still was not feeling any contractions, despite them showing up on the monitors. I was extremely grateful for Daleyne as she was taking pictures of it all. The nurses pretty much left us alone the whole time only to come in to turn up the Pitocin. Since they had started an IV drip and was giving me extra fluids as well, I was constantly having to pee. So, Lance would help me unhook all the wires, drape them over my neck and help me walk into the bathroom. 

Lance holding the monitors in place so we could still see if I was contracting and how Emma was tolerating them.

Around 3:15, after my latest bathroom trip, I laid down in the bed, kinda bored and started to play Chey's PSP, and at that point I had actually felt my first contraction. Lance had stepped outside to smoke, and I remember thinking man, I wish he was here right now. Lance's mom had gone home earlier to check on her husband and to get a bite to eat. I couldn't concentrate on the game I was playing so I put it down on my lap. Chey asked me if that one was a good one and I told her yes. Then Lance came back in and I had to make yet another bathroom trip. As I got back into the bed, my water started gushing BAD!! I whispered to him, it won't stop pouring out. 

At 3:30 the contractions started for real. The nurse came in and told me baby wasn't tolerating them to well and that I should lay on my right side. When that happened, the contractions came right on top of each other and all I could do was grab a hold of the railing and hold on tight. Lance was behind me and started rubbing my back, in which I asked him to stop, that it was bothering me. He did, without any hard feelings. The nurse was explaining to me me this is what they called coupling contractions where they are right on top of each other. I was getting NO break from them. She started fidgeting with the monitors on my belly which was pissing me off so I slapped her hand away and told her don't touch me. I was profusely sweating at this time and hoping that it would be over soon. 

When I was in triage I was dilated to 2 and had not had any cervical checks after that so I had no clue where I was at at that point. All of a sudden I felt the overwhelming urge to push and made it loud and clear that I was pushing. The nurse and Lance both said, no don't push!! I said I can't help it, I have to push!! Then everything became so rushed!!! Cheyenne and Daleyne stepped outside as I didn't feel comfortable with my daughter seeing that side of me. The doctor came in and quickly gowned up, and him and Lance rolled me over onto my back and took off my pants. Dr Weeks, kept telling me not to push. I could hear that frantic sound in Lance's voice as he cradled my head in his arms and whispered in my ear, "Baby, PLEASE don't push!" His voice settled me a bit but the urge was still there. I was given the ok to go ahead and push, but was then told to slow it down as he didn't want me to tear. I gave one more steady push, a very loud scream and Emma was delivered. Time of birth, 4:00pm, just 30 minutes after contractions started. 

No tears, no epsiotomy, and a very healthy baby girl who weighed....6 lbs 7 oz, and 19 inches long!!! Momma knows best!! Part of my birth plan was to let the cord stop pulsing before clamping and cutting but since everything happened so quick at the end, the dr was not informed of that request of mine and immediately clamped the cord and had Lance cut it. It was such an amazing sight to see Lance bonding with Emma. Chey and Daleyne came back in and we all took turns holding her and ooh'ing and ahh'ing over her. Chey helped out with the bath but was so scared to touch her for fear she would hurt her. The nurse was great in helping her overcome her fears. Nana missed the birth but came back in time to shed a few tears and cuddle with her newest granddaughter.

Hard to believe this was three years ago today. I relive it every year on her birthday and cannot be more proud to have Emma as my daughter.

I HATE MY BODY!!!

That title pretty much says it all. Cycle day 27, still no ovulation, and spotting/bleeding has been taking place since cycle day 15. I am so frustrated at my body, but what is new right? Why can my body not do the ONE thing it was designed to do? My ovaries must've missed the memo or something. It doesn't seem fair to not have a fair chance at trying to conceive when you don't even ovulate!!! More and more I am wanting to try Clomid to make my body ovulate, if it even will then. I feel like I am almost at my wits end as far as where to turn next. I feel defeated, tired, fed up, lost, and unsure of myself and all the work I have done in the last 2 years to conceive our next child. I just want to scream, cry and go hide until my body can get it right. It's just not fair!!!!!!!!!!!! I.Hate.My.Body!!!!!!

The Challenge and Cycle Updates

I cannot believe I never posted about our challenge the hubby and I worked out. I approached him at the beginning of my cycle and challenged him that he couldn't do the deed with me every other day until 3 days AFTER ovulation. I thought this was a no-brainer challenge as that would guarantee him nookie every other day throughout the month!! Well he decided to come back at me with if he holds up his end of the deal then he gets his fishing license early. I thought, why not? He won't be able to keep up for that long, works for me. So, deal is, do the deed every other day until 3 days after O, if he misses one day, then our agreement is null and void and he must wait until Father's Day for his fishing license. 

Just recently we have had some modifications on both parts. He has decided to give up the fishing license quest and instead work for beer!! LOL So on days that we're scheduled to DTD, he gets a beer or two and I get laid!! SCORE!! Since he got to modify his end of the bargain I did too. I know my body is gearing up to ovulate now and have requested that we DTD every day until 3 days after O. Which would sound like alot of pressure for my dear husband, but really, it's another win-win for him. He gets beer and laid EVERY DAY until I O!!! How can he turn that down??

Now for a cycle update. I had 6 days of spotting this cycle with it ending yesterday. Which is one day more then last cycle. The very shitty and breath holding part is that I ran out of NPC!!!! I am so holding my breath to see what will happen. I saw I was running out, as did DH, so he had me order more and I thought it'd be here in time, but nope! So, I have 2 old empty bottles of NPC, that if you take apart the pump mechanism, there is about 1/2-1 tsp of NPC in there. I seriously look like a feign tearing apart NPC bottles to scrape out that last remnants of NPC!! LOL

I had my usual temp drop this morning that usually happens just 2 days before O, so all is lining up nicely now. Now if my NPC will just get here and DH will give up the nookie every day til here til after O, I think we might just have a chance at catching my egg!!!

Why are some doctors so damn smug??

I have to share this reply I got from a reputable IVF specialist b/c I can't seem to shake it. I know how my body responds to NPC. Since this doctor might know WHY, I asked him about it, and this is the response that I got. Top part is obviously my question to him, bottom part is his response.

Question:
Hi,

I have long cycles and was recently diagnosed with PCOS. Prior to my diagnosis I have tried everything under the sun to regulate them and help me to ovulate. Vitex, Evening Primrose Oil, Dr John Lee's Shutdown, (in which Natural Progesterone Cream is applied for CD's 5-26, then stopped) a couple unmedicated cycles, soy isoflavones, currently on 1000mg/day of Metformin and the ONLY cycles I had "normal" cycle length with ovulation, is when I took NPC (25mg/BID) from CD's 5-26 (or til Aunt Flow) I know normally NPC should suppress ovulation, but instead for me it helps me ovulate. Why would that be? I cannot make sense of it at all, but am impressed that this is all it took.

I recently had an appointment with my dr, who actually told me that the NPC would do me no good in the beginning of my cycle and I should stop the NPC and start BCP's for a while to help get my cycles regulated again.

Thank you,
L. from Oregon


Answer:

Hello L. from Oregon,

Natural progesterone cream (NPC) will NOT get you to ovulate, but will help to keep you regular. In fact, you don't need to take it as many days as you are taking if all you want is to have a period on a regular basis. All you have to do is use it on CD#16-25 (10 days). When you withdraw the progesterone, you will have a period, because that is what happens in the luteal phase of the cycle. The progesterone is working directly on the endometrial lining and causing it to "luteinize" which is why withdrawal of the hormone causes it to breakdown and bleed. We use other forms of "natural" progesterone such as prometrium, Crinone, Procheive, Endometrin and Provera to accomplish the same task. But the progesterone does nothing to the ovary so ovulation does not occur. In large enough doses of progesterone, as that contained in birth control pills, it will cause a suppression of ovarian function.

The birth control pill is only a treatment to regulate your cycles. If a woman with PCOS is not intending to become pregnant, then the treatment of choice is to use the birth control pill. On the other hand, if your goal is to start ovulating, because you want to get pregnant, then as a woman with PCOS you need to use a medication that will induce the ovaries to ovulate such as Clomid, Femara or injectable medications.

I hope this helps to explain things."

Now the part that got my blood boiling is when he posted this on his blog AND his IVF blog to be tweeted on his twitter site.

"#PCOS Patient on natural progesterone #NP, thinks she is ovulating w/cycle but she is mistaken." 

Really? I'm mistaken?? Out of all of my TTC cycles NPC has been THE only thing to make me O, and I'm mistaking that??? Oh, he can so bite me!!!! I bet the jackass didn't even take a look at my charts I sent him. Really though, why did I expect a doctor who specializes in IVF to remotely understand a damn thing about alternative medicine anyways??? 

Now I am wishing will all of my being that I ovulate soon, because you can bet your ass he will be getting a follow up email from me!!!

Trying Not to Get Excited

As of today I am on CD 15, and I started spotting this morning. Normally this would get me down and totally upset thinking my chances for a normal cycle are out. However, looking back on my last cycle, I had spotting on CD 14-18, with ovulation occurring on CD 19. The odd thing is that the Nabothian cyst that I have on the right side of cervical OS, disappeared the same day spotting started. The same has happened this cycle as well. Since this cycle seems to be mirroring last cycle to a T, theoretically, ovulation should take place the day after spotting stops. Which again if it's mirroring last cycle, should be CD 21. I can't help but to get excited with hope that my body just might be a normal cycle length again.

What IF?

What IF? A Portrait of Infertility from Keiko Zoll on Vimeo.

There's not a whole lot of explanation needed for this video. It really touched me as I could relate to ALOT of it!! Thought I'd share with others.

Pregnant Women are Smug by Garfunkel and Oates

When Infertility StrikesRESOLVE: The National Infertility Association

I know the following article is REALLY long, but it has so much helpful information in it, I couldn't help but to share it.  I especially like the end part "For Family Members" and how to be supportive to someone in the family who is suffering with infertility.

When Infertility StrikesRESOLVE: The National Infertility Association
  

When Infertility Strikes

Although infertility is widely acknowledged as a crisis for individuals and couples, it is less recognized as a trauma that impacts their families. Yet, involuntary childlessness is an intergenerational crisis that has the ability to strain, even damage, family relationships over time by impairing communications and interactions. Invisible losses, such as miscarriages, failed medical treatments, or adoptions gone awry, may highlight a family's inadequate means of dealing with problems. Old family issues, jealousies and resentments may resurface or other family struggles, such as parental illness or the pregnancy of a sibling, may take priority over reproductive difficulties, leaving the infertile couple feeling isolated and abandoned. The lack of acknowledgment of the losses associated with infertility may damage family interactions, particularly if family members use negative coping techniques such as blaming, side-taking, denial or avoidance. However, the family experience of infertility also has the potential to bring out the best in the family system, promoting growth and well-being for the members. This article will examine family dynamics impacting infertility and discuss ways to help deal with the demands infertility places on the family system.

Family Systems

Some families faced with infertility grow closer and find ways to provide support, compassion, and understanding in the midst of the maelstrom of profound loss and despair. These families are able to handle the myriad of negative emotions of infertility, and weather the pain of its many losses. They acknowledge the despair of this unique loss and its impact on the family as a whole, not simply on the individual or couple. Family members listen, openly communicate warmth and compassion, and ask for what the couple wants or needs during the infertility journey. And, they are willing to provide support in a variety of ways, including participation in rituals for commemorating losses as a family (e. g., attendance of service after a miscarriage) and a willingness to adjust family life to accommodate the realities of the infertile couple's situation (e.g., adapt gatherings to meet treatment plans or emotional needs). However, even strong, healthy families can find the challenges of infertility daunting and draining, particularly the pain of being an observer in a drama in which your loved one is suffering and there is little one can do to relieve that suffering.

Involuntary childlessness is an interruption of the family life cycle. Family building is a developmental stage that represents generativity or fostering the next generation. It is a life cycle stage in which each and every member of the family transitions from one developmental stage to another, and in the process assumes new roles and new role responsibilities: couples move from being spouses to parents; their parents become grandparents; their siblings become aunts or uncles; nieces and nephews become cousins, and so on. Infertility is the obstacle blocking these normal transitions and preventing family members from assuming new developmental roles.

Interruption of normal life cycle transitions can highlight a family's unique flaws, precipitating negative behaviors such as; parental favoritism; poor communication; and/or unhealthy coping strategies. Infertility may also require family members to re-examine some long-held family beliefs if they cause increased distress. For example, the belief that an offspring is not an adult until he/she is also a parent, or children owe parents grandchildren. In short, infertility has the ability to distress not only infertile couples but also, also, their families, resulting in 'collateral damage' that lingers long after the problem of childlessness has been resolved.

Interfamily Relationships

Very often parents of an infertile couple feel caught between their infertile child and their 'fertile', sometimes pregnant, child(ren). Naturally, both offspring may expect to rely on their parents for emotional support at this significant time in their lives. While this is a realistic expectation, many parents may, for a variety of reasons, end up providing more support to the 'pregnant' child than the infertile couple. Sometimes this happens when a parent is more knowledgeable about providing support around pregnancy and parenthood issues than about infertility. Other times, it may be that pregnancy and grandparenthood is a happier, more enjoyable experience, while infertility brings sadness, loss, and a variety of negative emotions. In addition, the infertile offspring may not have asked for parental help, keeping infertility a secret, or may have asked for assistance that is impossible to provide. Many parents become paralyzed by their child's pain and feel helpless to know what to do. Sometimes they feel trapped in the middle-or worse, their children demand they declare a specific loyalty or that they take sides. It is important to remember that parents still set the tone for family interactions and values, even in adulthood, and must refuse to take sides.

A significant challenge to parents of adult children is knowing when and how to provide feedback-particularly when it may not be wanted or appreciated. How does a parent say, "Telling me to support you by asking that I reject your sibling is inappropriate. I will support you in any way I can, but not by being hurtful to your sibling." Or "While it is wonderful that you are overjoyed with your new baby, I expect you to be compassionate of your sibling's feelings while they struggle to have children." Parents must be aware that watching a sibling move through the stages of pregnancy is typically most difficult for the infertile couple.

Parents faced with their children's infertility are often baffled by this crisis. It is an 'invisible' loss that involves private marital issues, complex medical treatments, and a rollercoaster of emotions. They may know how to support a fertile child, because of their own experience, and may be less clear about their role of support for infertile child. As with other experiences in parenting, they may have difficulty dealing with different children, with different needs, and coming from two very different life experiences.

Families dealing with infertility must find ways to help each member feel respected and acknowledge, despite their differences. It is important to define goals for strengthening the family which help to keep the group intact, communication open, and strengthening the functioning of all members.

The following suggestions are advice for family members and couples struggling with infertility and is based, in part, on Patricia Irwin Johnston's Understanding Infertility:Insights for Family and Friends:

For Family Members:

• Acknowledge infertility as a medical and emotional crisis with a wide variety of losses, disappointments and 'costs': physical, financial, social, marital. Do not attempt to deny or minimize involuntary childlessness either by avoiding the topic or offering empty platitudes like, "Everything will be fine" or "Just relax". Avoid offering unsolicited advice and never interfere by taking sides, blaming, or imposing rigid expectations or limitations.
• Be sensitive to the pain, stress, and emotional pressure of childlessness or the inability to expand one's family as desired. If it is difficult to know what to say, tell the couple rather than saying nothing. Ask them what you might say or do that would be helpful. Try to frequently convey care and compassion and do not 'forget' the couple over time as the months and years of the infertility struggle drag on. Be cognizant that some junctures in the journey may be more difficult than others such as after a miscarriage, failed in vitro fertilization cycle, or surgery that fails to produce the hoped for results. Remembering the couple with a card, phone call, donation in their names, flowers, or some other kind gesture can make the journey less difficult.
• Be supportive. Do not assume you know what supportive means to your loved one but, instead, ask how you can be supportive: what would they find most helpful and useful? If you are able, consider ways in which you can assist emotionally (listening during a 'good cry') and functionally (offering financial assistance). Offer to simply listen and be ready to listen when called upon.
• Emphasize the importance and value of the couple (and each partner) in the family. Encourage and welcome their involvement as a couple or individually in family events and activities. Once it occurs, infertility becomes a part of the family's history; how a family adapts and copes with the events and stress will be forever part of the family's past. Like any stressor, infertility can strain family functioning or improve it. Families need to be sensitive about the needs of the infertile couple, particularly around child centered family gatherings. It is important that they understand the infertile couple's decision not to come may be important.
• Always keep the lines of communications open. Stress the importance of honesty, candor, tact, and diplomacy in family interactions. It is not a good idea to hide pregnancies 'out of kindness' or not invite the infertile couple to child-centered family events; or keep secrets out of fear of upsetting the couple. Always think about how things are told as much as what is being told: tact, kindness, and privacy can go a long way to soften the blow of difficult news. Open communication also means being able to express concern if there is evidence of significant emotional distress. When expressing concern always offer suggestions for help, such as seeking support and counseling through RESOLVE or an infertility counselor.
• Respect the boundaries the infertile couple sets regarding their infertility. Some couples prefer a high level of privacy about infertility. Other choose a more open approach. When in doubt, ask the couple their preference.

National Infertility Awareness Week

1 in 8 people are dealing with or have dealt with infertility, such as myself. It's a crisis not often understood or discussed, but has a huge impact on that person's life. During National Infertility Awareness Week (NIAW), (April 24th-May1st) please take a moment to learn a little more. If you have been effected or know someone who has, please repost this to spread awareness!

WWW.RESOLVE.ORG 

http://abcnews.go.com/Health/video/infertility-awareness-10480319

Menstrual Cups and Devices

Since I don't have a whole lot to report today, I figured today would be a good day to discuss menstrual cups and devices. We all have grown up hearing about tampons and pads, but up until about a year ago, I'd never heard anything about sea sponges, cloth pads, menstrual cups or anything of the sort.

Sea sponges are exactly what it sounds like. Sponges from the sea that are used to soak up menstrual blood. Cloth pads, also very self-explanatory, pads that are cloth that can be washed and re-used each cycle. Menstrual cups, now this is where things get interesting, for me at least.

There are many types of menstrual cups out there and it's not a one size fits all type of thing. I highly recommend doing your homework before shelling out the money on a cup only to find it's not that comfy for you. So, the basics of a menstrual cup are, it's a device that is shaped like a small cup, usually with a stem on the bottom of the cup for easy removal. It does exactly what it sounds like it does. It fits comfortably inside the vagina, around the cervix and catches the menstrual flow. You remove and empty the cup, as needed, and insert it again. It is VERY comfortable and very eco-friendly.

Perks to a menstrual cup:

Environmentally friendly

No waste-there is nothing to throw away with a menstrual cup, it is reusable.

Most menstrual cups last for 10 YEARS

No bulky tampons to fish out of your purse. You know you all have had at least one embarrassing moment trying to be discreet fishing a tampon out of the purse and have knocked a tampon out, of course in front of people.

The COST!!! This to me is a HUGE perk, being the cheapskate that I am. I spent $35 on my Diva Cup, that will last me 10 YEARS. So break that down. A normal woman will have a cycle every 30 days, (I am not one of said "normal" women though) so 12 cycles a year, $2.91 per year. Break that down over 10 years and the cost each cycle is $.29 each cycle. Now tell me, how many of you all can say you spend $.29 on feminine supplies for a cycle? I can!!! I was easily spending $35 every 2 MONTHS on tampons for me. (and my daughter) And was having garbage cans full of used tampon applicators only to fill the landfill.

I did have some problems with my Diva Cup in the beginning, mainly due to the fit and my anatomy. This is why it's important to do your homework before impulse buying one. I bought a Diva Cup model 2, that is meant for women over 30 OR who have had children already. Model 1 is meant for women under 30 years of age and who have NOT had children. The difference I have found in them is the length. The length of mine was a bit long, especially with the stem. You can cut the stem off for comfort which I did. I was still having problems with it, feeling like it was falling out anytime I peed. I have since learned that if one is experiencing that discomfort, simply flip the cup inside out, and wear it that way. It makes the cup a bit shorter, and I have not had a problem with it since. I love that I can wear it on days that I am spotting, bleeding heavily, passing clots, etc! It doesn't make a difference and there is no risk of TSS (Toxic Shock Syndrome) as there is with tampons. I used to have horrid cramps with tampons, and after removing the tampon, I would feel instant relief. Since wearing my cup, I have no cramps associated with the cup, only the common AF cramps.

For more info or to buy a Diva Cup here is the website's link.

http://www.divacup.com/

And a picture so you all can get a better idea of what I have been talking about.

This Cycle's Game Plan

Well AF showed shortly after my last post and I have never been so excited for her arrival in my life!!! Even though I didn't end up with my BFP, it did confirm that I had O'd this cycle. That is huge for me, especially considering I have not O'd since November!! I have decided to not change what is actually working for me and I'm going to do another cycle of the NPC and see if I O again. So, I will be starting the NPC tomorrow, applying 1/4 tsp, which works out to be about 25mg. I will apply it morning and night from CD 5-26, then stop. I will be continuing to take the Metformin 1000mg/day, Vitamin D 2,000IU/day, Calicum Citrate 1000mg, and Liquid B Complex throughout my cycle. I'm hoping to get DH on board to BD every other day, as soon as AF leaves, until after O. With as much as I have neglected him over the last few weeks, I'm sure he'll be game!! ;)

How Fitting

"Today, and to some degree the entire Mercury retrograde period, is about the willingness to try and try again, Libra. It seems that, scientist or not, your life right now is about trial and error learning. This could have something to do with programming code you cannot find the correct reference for, or trying to get someone to understand you. Whatever it is that you're trying to accomplish is likely to be something you've attempted before and are attempting again with a fresh approach. Success may come in a way you don't expect."

Could this horoscope not be anymore fitting for today?

Mystery Solved

Looks like I won't need a HPT afterall, BUT it also means that I DID in fact O!!!!!! My temp plummeted to the coverline this morning. I guess I should expect AF any time now. This makes me excited to know that I O'd, but now leaves me feeling confused as far as which way to turn next. If the NPC made me O (which is the only thing in the past that has worked) do I dare start the BCP's, once AF starts, or take another cycle of NPC? I was never really WANTING to go on them anyways, just felt I had exhausted my options and didn't know where else to turn. I certainly do not want to change something that I know works for me.

On a side note. We had company over last night for poker, and one of the couples has a newborn baby. She was quite inconsolable, as she has colic. She had been passed around to each adult trying to get her soothed. I busted out my Moby wrap (the one thing that Lance let me keep when he said I had to get rid of all of Emma's belongings) and I showed the Dad how it works. She still wasn't having it and was quite upset. So, I held her while Dad took off the Moby. Instantly, she was quiet, and within seconds, she was fast asleep in my arms. I held her for almost 2 hours, and honestly, I was in heaven!!! I cannot wait until I get to be holding our baby in my arms again.

O or No O? That is the question

So, not sure if I should say anything, for fear that I just might jinx myself, but I'm about 75% sure that I Ovulated. Early on in my cycle (Cycle day 7) I got my tattoo, and was in extreme amounts of pain. So much so that it affected my sleep. During that week, my temps were sky high. Lately, my temps have been super high, and the only time they're EVER that high is during my Luteal Phase. So, knowing that sleep disturbances can affect temps, I disturbed those temps, (CD 7-14) and got my egg on my chart!!! It would totally explain why Aunt Flo is STILL not here after 7 days of stopping the NPC (Natural Progesterone Cream) sore nips still, no more attempts at Ovulation, etc. IF I did O, (and not Pregnant) temp should drop tomorrow and Aunt Flo should show shortly after. Part of me is wishing and hoping that I DID O, as it would show me that my body IS needing the extra progesterone to function normally. So, until then, still waiting.

Still waiting...

Not a whole lot to report, except that I'm still waiting for AF's arrival. I've never had to wait for her to show up after stopping NPC. Actually the 2 times that I did the shutdown, I O'd and AF showed up at the end of my LP, right on time. I really don't know when to expect her arrival, but got to thinking maybe I O'd and am in my TWW and that's why AF hasn't shown? IF I O'd, I didn't get a clear thermal shift. But, if you were to take out CD's 8-14 temps, it really DOES look like I've O'd, Which would make sense as to why 1) AF hasn't shown yet, 2) why my body hasn't attempted to O again, 3) explains the sore nips I only get in my TWW. I just don't know though. If that theory is correct, AF should show up in 2-3 days. Again IF I O'd, we covered it with Bd'ing the day of (suspected) O and the day after. So, I would still be in the running of a BFP this cycle...again IF I actually O'd.

Oh where, oh where can she be??

Well, I stopped the NPC 3 days ago, and am still waiting for AF to arrive. Usually AF shows the day after stopping the NPC, so I'm in the continual waiting game now. Something kind of odd though, I have had tender nips for the last 3 days! Odd b/c I usually do not get tender nips, and if I do, only in the TWW. I don't think I've O'd, let alone be IN a TWW. Not sure if it could be tied in, but this all started a day after starting calcium supplements. Odd?

I have to say I am still soooo torn about taking BCP's again!! I DON'T WANT TO!!! I know about the waiting game for them to get out of your system, I know they can sometimes be more harm then good and mess a body up more. BUT, part of me remembers that it helped me get my Emma. I was using the Nuvaring for 2 cycles b/c of irregular cycles, but DH made me stop d/t MASSIVE mood swings. That very next cycle, I got my BFP! That part of me is holding out hope that this will be the missing link. But, I'm still so torn! I don't have much more time to think about it, as after AF shows, I am supposed to be starting them.

Benefits of Vitamin D - Vitamin D3 Supplements

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Benefits of Vitamin D - Vitamin D3 Supplements

There is a vast body of science showing the many health benefits of vitamin D. You may be surprised to learn the important role that vitamin D plays in your health.

Maintains Your Calcium Balance

Maintenance of blood calcium levels within a narrow range is vital for normal functioning of the nervous system, as well as for bone growth, and maintenance of bone density. Vitamin D is essential for the efficient utilization of calcium by the body.¹

Aids Your Cell Differentiation

Cellular differentiation results in the specialization of cells for specific functions in your body. In general, differentiation of cells leads to a decrease in proliferation. While cellular proliferation is essential for growth and wound healing, uncontrolled proliferation of cells with certain mutations may lead to diseases like cancer. The active form of vitamin D, inhibits proliferation and stimulates the differentiation of cells.¹

Boosts Your Immunity

Active vitamin D is a potent immune system modulator. There is plenty of scientific evidence that vitamin D has several different effects on immune system function that may enhance your immunity and inhibit the development of autoimmunity.⁸

Has a Role in Insulin Secretion

The active form of vitamin D plays a role in insulin secretion under conditions of increased insulin demand.⁹ Limited data in humans suggests that insufficient vitamin D levels may have an adverse effect on insulin secretion and glucose tolerance in type 2 diabetes.^10-12 More studies are needed on the role of vitamin D and diabetes.

Blood Pressure Regulation

Adequate vitamin D levels may be important for decreasing the risk of high blood pressure.^13-15 Again, more studies on vitamin D and hypertension are necessary.

Vitamin D and Diseases

According to the National Institutes of Health, vitamin D may play a role in the following diseases.

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Vitamin D and Osteoporosis

Osteoporosis is most often associated with inadequate calcium intake. However, a deficiency of vitamin D also contributes to osteoporosis by reducing calcium absorption.³³ While rickets and osteomalacia are extreme examples of vitamin D deficiency, osteopororsis is an example of a long-term effect of vitamin D insufficiency.³⁴ Adequate storage levels of vitamin D help keep bones strong and may help prevent osteoporosis in older adults, in those who have difficulty walking and exercising, in post-menopausal women, and in individuals on chronic steroid therapy.³⁵
Vitamin D deficiency, which is often seen in post-menopausal women and older Americans, has been associated with greater incidence of hip fractures.^39-41 In a review of women with osteoporosis hospitalized for hip fractures, 50 percent were found to have signs of vitamin D deficiency.³⁵ Daily supplementation with 20 800 IU of vitamin D may reduce the risk of osteoporotic fractures in elderly populations with low blood levels of vitamin D.⁴² The Decalyos II study examined the effect of combined calcium and vitamin D supplementation in a group of elderly women who were able to walk indoors with a cane or walker. The women were studied for two years, and results suggested that such supplementation could reduce the risk of hip fractures in this population.⁴³

Vitamin D and Cancer

Laboratory, animal, and some preliminary human studies suggests that vitamin D may be protective against some cancers. Several studies suggest that a higher dietary intake of calcium and vitamin D correlates with lower incidence of cancer.^44-51 In fact, for over 60 years researchers have observed that greater sun exposure reduces cancer deaths.³³ The inverse relationship between higher vitamin D levels in blood and lower cancer risk in humans is best documented for colon and colorectal cancers.^44-50 Vitamin D emerged as a protective factor in a study of over 3,000 adults who underwent a colonoscopy to look for polyps or lesions in the colon. There was a significantly lower risk of advanced cancerous lesions among those with the highest vitamin D intake.⁵²
Additional clinical trials need to be conducted to determine whether vitamin D deficiency increases cancer risk, or if an increased intake of vitamin D is protective against some cancers. Until such trials are conducted, it is premature to conclude you should take vitamin D supplements for cancer prevention.
Read more about the latest studies involving calcium and vitamin D reducing the risk of cancer

Vitamin D and Alzheimer's Disease

Alzheimer's disease is associated with an increased risk of hip fractures because many Alzheimer's patients are homebound, frequently sunlight deprived, and older.⁵⁶ With aging, less vitamin D is converted to its active form. One study of women with Alzheimer's disease found that decreased bone mineral density was associated with a low intake of vitamin D and inadequate sunlight exposure.⁵⁷ More investigation on vitamin D and Alzheimers Disease is necessary.

Other Diseases Vitamin D Deficiency May Affect

Autoimmune Diseases - Diabetes, Multiple Sclerosis and Rheumatoid Arthritis

Diabetes mellitus, multiple sclerosis, and rheumatoid arthritis, are each examples of autoimmune disease. Autoimmune diseases occur when the body launches an immune response to its own tissue, rather than a foreign pathogen. Treatment with vitamin D has beneficial effects in animal models of all of the above mentioned diseases. Studies have found that the prevalence of diabetes, multiple sclerosis, and rheumatoid arthritis increases as latitude increases, suggesting that lower exposure to sun light and associated decreases in vitamin D synthesis may play a role in the development of these diseases.
The results of several studies also suggest that adequate vitamin D intake may decrease the risk of autoimmune diseases. Evidence from animal models and human studies suggests that maintaining sufficient vitamin D levels may help decrease the risk of several autoimmune diseases, but more studies are needed to draw any solid conclusions.

Vitamin D and Hypertension (High Blood Pressure)

The results of epidemiological and clinical studies suggest an inverse relationship between serum vitamin D levels and blood pressure. Data from epidemiological studies suggest that conditions that decrease vitamin D synthesis in the skin, such as having dark skin and living in temperate latitudes, are associated with increased prevalence of hypertension.⁷¹ In randomized controlled trials of vitamin D supplementation, a combination of 1,600 IU/day of vitamin D and 800 mg/day of calcium for eight weeks significantly decreased systolic blood pressure in elderly women by 9% compared to calcium alone,⁷³ but supplementation with 400 IU/day or a single dose of 100,000 IU of vitamin D did not significantly lower blood pressure in elderly men and women over the next two months.^{74, 75} At present, data from controlled clinical trials are too limited to determine whether vitamin D supplementation will be effective in lowering blood pressure or preventing hypertension.

Vitamin D Toxicity

It is very rare to have a vitamin D overdose. Vitamin D toxicity induces abnormally high serum calcium levels (hypercalcemia), which could result in bone loss, kidney stones, and calcification of organs like the heart and kidneys if untreated over a long period of time. When the Food and Nutrition Board of the Institute of Medicine established the tolerable upper intake level (UL) for vitamin D, published studies that adequately documented the lowest intake levels of vitamin D that induced hypercalcemia were very limited. Because the consequences of hypercalcemia are severe, the Food and Nutrition Board established a very conservative UL of 2,000 IU/day (50 mcg/day) for children and adults.²⁸ (see table below)
Research published since 1997 suggests that the UL for adults is overly conservative and that vitamin D toxicity is very unlikely in healthy people at intake levels lower than 10,000 IU/day.^{36, 76, 77} Vitamin D toxicity has not been observed to result from sun exposure.
Certain medical conditions can increase the risk of hypercalcemia in response to vitamin D, including primary hyperparathyroidism, sarcoidosis, tuberculosis, and lymphoma.³⁶ People with these conditions may develop hypercalcemia in response to any increase in vitamin D nutrition and should consult a qualified health care provider regarding any increase in vitamin D intake.

Tolerable Upper Intake Level (UL) for Vitamin D

Infants 0-12 months- 1000 IU
Children 1-18 years- 2000 IU
Adults 19 years and older- 2000 IU

Vitamin D Drug Interactions

The following medications increase the metabolism of vitamin D and may decrease serum D levels:

Phenytoin (Dilantin), fosphenytoin (Cerebyx), phenobarbital (Luminal), carbamazepine (Tegretol), and rifampin (Rimactane).

The following medications should not be taken at the same time as vitamin D because they can decrease the intestinal absorption of vitamin D:

Cholestyramine (Questran), colestipol (Colestid), orlistat (Xenical), mineral oil, and the fat substitute Olestra. The oral anti-fungal medication, ketoconazole, inhibits the 25(OH)D3-1-hydroxylase enzyme and has been found to reduce serum levels of 1,25(OH)D in healthy men . The induction of hypercalcemia by toxic levels of vitamin D may precipitate cardiac arrhythmia in patients on digitalis (Digoxin).^{78, 79}

Vitamin D3 Supplements

It is not always practical to get your vitamin D from sunshine, and quite difficult to get adequate amounts from your diet so for many people, a vitamin D supplement is a practical way to ensure adequate levels of this important protector are always available in your bloodstream.
Since a large body of science shows vitamin D works closely with calcium and magnesium, it is best to take your vitamin D in combination with calcium and magnesium to maintain a proper balance. Recent literature also shows most calcium supplements have too little vitamin D to be effective. And some of them use synthetic vitamin D2. A much better form is natural vitamin D3 which stays in your system longer and with more effect.

One More Day To Go

When your struggling to TTC, countdowns become a very crucial part of your existence. The countdown to O, the countdown during the TWW when you can POAS next, then comes the countdown to when AF is gonna show. Throw in supplements into the mix, then it becomes the countdown to when you can stop a supplement and move on with your cycle or the next supplement. This is where I am now. I've been doing Dr John Lee's shutdown in which you take NPC (natural progesterone cream) twice a day for 21 days, (CD's 5-26) then stop and let AF come. During this time, the goal is to suppress O so that the hormones can get a break to "reset" and level back out to where they need to be. I only have one more to day to go before I will stop the NPC and let the countdown begin for waiting for AF's arrival.

Dr Appointment-Follow Up

Had my follow up appointment yesterday and it went very well!! I cannot say enough how much I love this doctor and am so sad that my next appointment, in 3 months, will be my last with her. It's gonna be a long one, so get comfy. :D

We're keeping my Metformin dosage where it is at since my body is still having a hard time getting adjusted to it. (ie., gastric upset) She asked me if I had taken the P.O.P BCP's that she gave me last time, which I had not. I wanted to do one cycle with just the Met to see what it would do to my cycle. Since I didn't O, I brought on AF with NPC (which she is VERY supportive of doing) and did NPC throughout this cycle. I wasn't keen on putting synthetic hormones on my body, which again she was very supportive of. She did explain to me that just the progesterone will not help me in my situation.

We discussed how women with PCOS have too little amounts of estrogen. The estrogen levels slowly increase at the beginning of the cycle, until they reach a peak. During that peak, is when an egg is released. It made soooooooo much sense for my situation, despite the fact that I have always read that women with PCOS have estrogen dominance, aka too much estrogen. I told her that I seem to be stuck at the stage where a follie grows (I can feel it taking place) but it never releases, hence all my fake out O's. She agreed even more once I told her that, that my estrogen levels are too low, and suggested that I go on a estrogen/progesterone combo pill. I am reluctant just b/c I am TTC. She took one look at my charts and confirmed the low estrogen, with all the waves of my body trying to O, but never being successful.

Then, we got to talking about Vit D and bone health. Estrogen also plays a role in good bone health. Top that off with low calcium and low Vit D levels (which she said that most ALL people who live in the NW are, so much so, they quit testing for it, and just tell everybody to take 2,000IU/day of Vit D/day, which I've been doing for the last 2 weeks) that it is a recipe for osteoporosis. My mom was diagnosed with osteoporosis at the age of 35 after she twisted her ankle and shattered it into tiny little pieces!! So, she wants me to get in the estrogen BCPs if nothing else for my bone health.

I was more receptive to taking the BCP's, b/c of what she said about my bone health and how well she explained the PCOS/O connection. It made so much sense. I was on the Nuvaring for 2 cycles prior to getting PG with Em. So, something (most likely the estrogen) helped reset my body, and now that I know what I know about too little of estrogen, it makes sense!!

So, gonna finish out this cycle with the NPC, only have 2 more days of taking it, and will stop to let AF come. Then I will start the BCP's while continuing the Metformin, Vit D and now starting on a calcium supplement. I go back for a follow up in 3 months, which will be my last appointment with her, since she is retiring. I'm still on the new patient waiting list at the place she referred me to. I will continue my care there, once I can get an appointment.

Again, she told me that I need to teach others all my knowledge of FAM/NFP and charting. She mentioned the local Christian church teaches NFP, and I should look into doing that. Then after finding out that I'm not religious, she figured it might not work with the church. SO she suggested instead to hold a conference type meeting, charging 35-$40 per person and teaching a FAM/NFP course. That made my wheels start turning!! (and my DH's after I told him) That would definitely be something I would LOVE to do!!