Naturally Getting Pregnant

Studies show that psychotherapy alleviates anxiety and depression for women going through infertility – probably something a lot of us could benefit from. But to be totally honest, this wasn’t reason enough for me to go out and join a support group and become one of  ‘those’ people.

That is until I did the in-depth research for the Stress Reduction Page and came across numerous studies that gave me the all powerful motivation: psychotherapy seems to improve fertility.

I’ve done crazier things to try and get pregnant – like sit in the mud, drink olive oil, become a human pin cushion – but somehow going to a support group wasn’t something I saw myself doing. We go to the dentist when our teeth hurt but going to get help when we need support emotionally is something that so many of us resist. The possibility that it may boost my fertility, though, was enough to tip the scale.

I found a support group near me and after filing the info away for several months I finally did it: I called. I showed up. I became one of ‘those’ people – whatever that means.

Telling my infertility story to a group of women that know exactly what it’s like was so, well, therapeutic. They knew. I didn’t have to explain why I had an overwhelming feeling of sadness at the announcement of a friend’s pregnancy. I didn’t need to justify myself – I could see it in their eyes – they knew. The knot in my stomach started to dissolve and quite honestly, I felt relieved.

When I left, I was surprised how much better I felt.

In hindsight, I have no idea why I was so surprised. It’s certainly not new that women need and rely on one another. We have issues that men just don’t have and sometimes there’s just no substitute for sharing an experience with women who know exactly what you’re going through. They also have good advice including how to deal with and help with your partner’s emotional needs – advice that your partner can’t give you.

RESOLVE, the not-for-profit national infertility association, lists on its website several benefits for participation in a support group like enhanced self-esteem and decreased sense of isolation. I can say that I’ve experienced both of these. Now, if I could just experience the ultimate benefit that is showing up in the studies I’ve researched and is also mentioned on the RESOLVE website, “… a 2000 study found that attendees of RESOLVE support groups had higher pregnancy rates than women who didn’t attend a support group” (1).

Until then, I’m going to enjoy the fact that going to an infertility support group makes me feel better.

Sources:
Benefits of Joining a Support Group. RESOLVE: The National Infertility Association. www.resolve.org accessed on 25, April 2009.

I was at the dentist this week.

Exciting?

No.

But while I was sitting in that oh-so-comfortable dentist’s chair I was confronted with the fact that I have been trying to conceive for over three and a half years. Let me repeat that in case you skimmed: over three and a half years. All I could think about was the fact that three and a half years is a long time – almost ten percent of my lifetime so far.

So why did this dismal thought come to me while a guy in a white coat was trying to see how many sharp objects and mirrors could fit in my mouth at once? Because the fact that I am trying to conceive weaseled its way into the discussion I had with my dentist and now I was sitting back with nothing but my thoughts to distract me from the poking, pushing and drilling that was taking place in my mouth – which I consider a very small place for all that activity.

The discussion my dentist and I had started out simply. He informed me that one of my two amalgam fillings had to be replaced and that a few of my other teeth will probably develop cavities if they are not sealed soon. So replace it and seal em’ up, right? Not quite so fast.

For someone who’s trying to conceive the decision to replace an amalgam filling is a bit more involved. I wrote about this in my blog last fall: Dental Fillings with Mercury: In or Out.

In a nutshell: mercury is toxic and although organizations such as the U.S. Food and Drug Administration, the World Health Organization, and the Center for Disease Control currently agree that there is not enough evidence to show that the fillings are a health risk, the FDA states on their website, “Dental amalgams contain mercury, which may have neurotoxic effects on the nervous systems of developing children and fetuses.”

The greatest exposure to the mercury in these fillings comes when the fillings are placed or removed. And since the body needs months to eliminate mercury, women trying to conceive could have elevated mercury levels at conception which presents a potential danger to the fetus. This is why I decided last fall to leave them in.

Now it’s different. One of them has to come out. Does this mean I should postpone trying to conceive even longer than the two cycle wait I’m in right now from my miscarriage to allow my body to eliminate mercury? After talking to my dentist I decided no.

He said the fact that the filling is so tiny combined with the special equipment he uses to remove the filling means there will be virtually no mercury exposure to my body. Sounds good. Sounded so good that I thought while he is in there he might as well remove the other amalgam filling. Because while there are no studies that show these fillings cause infertility there are some anecdotal stories out there from women who attribute the removal of their amalgam fillings to becoming pregnant. Totally weak to base a decision on anecdotal stories but it was somehow enough to tip the scale. I mean, I have to get one of them replaced anyways so why not wipe the whole issue from the table by replacing the other one too?

For my next appointment he’ll finish sealing the rest of my teeth and replace the other amalgam filling. When I’m reclining in the dental chair next time, I plan on thinking about the fact that I’ll be mercury free instead of dwelling on the three and a half years that I’ve been trying to conceive.

Mercury free. I like it. 

Sources
Food and Drug Administration Consumer Information on Amalgam:
http://www.fda.gov/cdrh/consumer/amalgams.html

To say the least, things have been bumpy lately.

I moved across town. I’m totally excited about the move but whether I’m happy about it or not, moving is considered to be a major life event – or in stress terms: a major external stressor (not to mention that it was postponed by a week due to my miscarriage). On the day we moved things also got a bit hectic – can moving day go any other way? I tried to eat well and stay relaxed. But, no, it did not work.

For lunch I threw some chicken in the oven to go with the potato salad my mother-in-law made. Being in the hectic mode I was in, I forgot to ask what was in the potato salad. Well, it turns out she put in some sunflower seeds – seems harmless but, they are the bag of sunflower seeds I gave her because I couldn’t eat them with a clear allergy warning on the back that they may contain gluten. Yes, I told her they contained gluten when I gave them to her. But apparently, she forgot, and fed them to me.

After we finished hauling in the last boxes, we stood in our new kitchen with friends and toasted with our Champagne glasses bubbling with…water. No, water just didn’t seem to represent celebration, so, I raised my glass full of Champagne just like everyone else.

Stress, gluten and alcohol. These things have never equated to fun for my body. Why should now be any different? I got my acne back, my hair started falling out again, I lost weight that I didn’t want to loose, and I’ve been pretty exhausted. I finally started feeling better last week (the move was over four weeks ago). All I can do is hope that this episode is coming to an end and that I’m recovering.

So what about the probiotic bacteria?

Well, in the same haphazard fashion of the move: I didn’t stick to my plan. The plan was to first introduce probiotic bacteria naturally with fermented foods and then, if necessary, add probiotic supplements.

That’s not what I did. Instead it was like this: I’m standing in my new kitchen with my body totally peeved (acne, tired etc.) and I saw the gluten free probiotic supplements sitting in the middle of the otherwise empty fridge. I thought, “Oh, what the hell.”

I took them for two weeks every morning with my mid-morning snack and except for a little bit of a butterfly feeling in my stomach sometimes, there’s not much to report. My bowels were actually a little slower during that period but since everything was out of whack it’s really hard to say how my body reacted specifically to the probiotics.

I’ve stopped taking the probiotics and I am also feeling better. Connection? No idea. My head is on straight now, though (I think) and I am going back to food sources to get my probiotic bacteria. Here’s what I’ve chosen:

Probiotic Food I’m including:

• Organic Raw Sauerkraut – I sprinkle this on my salads.
• Organic Vinegar – I use vinegar to make a simple but yummy salad dressing (2 Tbs olive oil , 2 Tbs vinegar, 1 crushed garlic clove, ½ tsp Dijon mustard, salt and pepper: shake in a jar and enjoy).
• Miso Paste – I found some that’s gluten free and I use it to make miso soup. Yes, this is a product made from soy, which I avoid because several studies suggest that too much soy can lead to infertility. So why do I eat miso if I’m avoiding soy products? Fermented soy products offer the benefits without the drawbacks of non-fermented soy. Soybeans are high in phytates and enzyme inhibitors which cause gastric distress and can bind to minerals like zinc, calcium, and iron in the digestive tract and prevent their absorption. Fermented soy contains only low levels of these culprits.
• Tamari Sauce – This is like soy sauce but is gluten free. I use this sauce along with ginger and olive oil to bake my chicken. I also add it to steamed vegetables. Yes, this is a soy product that I allow because it is fermented – see Miso Paste above for why I allow fermented soy products in my diet.
• Organic Pickles – I eat this as a snack but I’m careful to buy the truly fermented ones: not in vinegar but listed on the package as fermented.

Probiotic Food I’m not including and why:

• Fermented Dairy Products like cottage cheese, kefir and yogurt – dairy products remain controversial in their role in infertility and most experts recommend keeping them to a minimum, add on to that I don’t digest them well.
• Tofu – several studies suggest that too much soy can lead to infertility
• Soy sauce – contains gluten
• Tempeh – again, several studies suggest that too much soy can lead to infertility
• Beer & Wine – some studies suggest it may not be good for fertility and it’s dangerous to a developing fetus, not to mention that it throws off my digestive system.

And in my diet I also include the following foods that contain prebiotics (food for the probiotic bacteria):

• Asparagus
• Chicory
• Chinese chive
• Eggplant
• Garlic
• Fruit – I only eat fruit in small amounts so that I don’t spike my sugar / insulin levels
• Jerusalem artichokes
• Leeks
• Legumes
• Onions
• Tomatoes

Here are the prebiotic food items I don’t eat and why:

• Burdock root –  I have no idea what this is or where to get it
• Peas – never really liked these little green pellets
• Soybeans – several studies suggest that too much soy can lead to infertility
• Sugar maple – can spike sugar levels / insulin

So, I’ll keep eating my probiotic foods and I’m even thinking about making some of my own sauerkraut. We’ll see in the next few weeks how my body likes the new critters in my digestive system.

For more info on probiotics and fertility see:

Probiotics and Fertility - Part 1
Probiotics and Fertility - Part 2

Helpful Resources:
For great recipes on how to make ferment foods and recipes including fermented foods:
Nourishing Traditions: The Cookbook that Challenges Politically Correct Nutrition and the Diet Dictocrats by Sally Fallon
Interesting resource of information on fermented foods and healing through nutrition: Linda Page’s Healthy Healing: A Guide to Self-Healing for Everyone by Linda Page.

If you haven’t read part 1 of this blog yet, you might want to start there (it covers the basics and the potential connection to fertility): Probiotics and Fertility Diet – Part 1

Otherwise more on those critters in our gut…

Create a Healthy Digestive System with Probiotic Bacteria

The importance of probiotic bacteria in our bodies is uncontested but how – and to what extent – we can influence this delicate balance is still being researched.

The research results are very encouraging though and, so, many experts recommend we ‘cultivate the garden within’ for a healthy body by adopting the right diet, reducing stress, avoiding antibiotics whenever possible, and in some cases supplementing with probiotics and prebiotics (which are food for the probiotic bacteria) (1, 2).

Foods that Contain Probiotic Bacteria and Prebiotics
We may be able to influence the balance of bacteria in our bodies with food in two ways: by eating foods that contain the good bacteria and by eating the types of food that good bacteria feed off of (prebiotics).

Choose Carefully: not all traditionally fermented foods contain these helpful bacteria. Industrialization of fermentation has lead to efficiency in production and more consistent tasting products but, it ruins some of the healthful benefits by killing the probiotic bacteria. Pasteurizing, for example, effectively kills all the healthful bacteria.

Foods that naturally contain probiotic bacteria are cultured/fermented foods.
 
Foods with Probiotic Bacteria

• Raw Sauerkraut
• Kimchi
• Cottage cheese
• Kefir
• Yogurt
• Tofu
• Miso
• Tamari sauce
• Soy sauce
• Tempeh
• Pickles (made with brine not vinegar)
• Pickled ginger
• Beer
• Wine
• Vinegar

Interestingly, cultured foods have long been recognized as an integral part of a healthy diet like Miso in Japan, Lassi drinks in India, Kimchi in Asia and sauerkraut in Europe – just to name a few.

The second way to boost probiotic bacteria is to eat foods that provide prebiotics. Two well documented prebiotics are FOS and inulin, which are naturally occurring carbohydrates found in the following foods (2, 3).

Foods that Contain Prebiotics

• Asparagus
• Chicory
• Chinese chive
• Burdock root
• Eggplant
• Fruit (especially bananas)
• Garlic
• Jerusalem artichokes
• Leeks
• Legumes
• Onions
• Peas
• Soybeans
• Sugar maple
• Tomatoes

Probiotic Supplements

Probiotic supplements are high doses of specific strains of beneficial bacteria in an easy to take form (liquid, power, or capsule). Initial studies are encouraging and suggest that probiotic supplements can be used to treat various health issues. Numerous doctors, naturopaths and nutritionalists recommend probiotics for this reason but, the extent of the claims being made has not yet been rigorously proven through research.

Elizabeth Lipski, author of Digestive Wellness, recommends that already healthy people can maintain their healthy bacteria by eating cultured foods but says supplements are necessary when disease producing microbes have colonized (2).

Dr. Haas makes a similar recommendation in his book, Staying Healthy with Nutrition, by recommending probiotics for use after a course of antibiotics or to treat yeast overgrowth, otherwise, he says, “I recommend them for one to two weeks once or twice a year…” (4).

It’s important to note that probiotics do not all have the same quality. Some guidelines for choosing probiotics are: probiotics requiring refrigeration at the store and at home tend to be the best, probiotics that contain prebiotics may be more effective since they provide food for the bacteria once they get there, probiotics that include several strains are helpful (2).

Elizabeth Lipski also emphasizes in her book, Digestive Wellness (2):

Different combinations will work for different people and to a greater or lesser effect. You’ll have to experiment with different brands and see which are most helpful. Remember to begin with a small dosage and increase slowly. You are changing your gut ecology and you want to do it gradually.

Another important aspect to taking probiotics that Elizabeth Lipski points out is that it’s not necessarily a bad sign if the supplements cause a sudden bloating, diarrhea, gas, or worsening of symptoms. She says that as the bad bacteria and fungus die, they release chemicals that aggravate symptoms. If this happens, she recommends beginning again and building up slowly (2).

Naturopath Linda Page suggests that probiotic supplements are not for everyone because each person’s digestive system is highly individual (5). She recommends getting probiotic bacteria from food and by supplementing with prebiotics instead.

The good side to this new dietary supplement is that probiotics have no toxic effects (1) and the American Cancer Society addresses the safety of one of the more popular probiotics strains, Lactobacillus acidophilus, by stating that except in rare cases acidophilus is safe (6).

Although, I haven’t covered them in detail here prebiotics are also available in supplemental form.

For my next blog I’ll be writing about how I’m getting probiotics and prebiotics, how my body likes/dislikes them along with a list of some helpful resources. Until then, happy bacteria consumption.

Sources

1. McDougall, John A. Digestive Tune-Up. Summertown, Tennessee: Healthy Living Publications, 2006.
2. Lipski, Elizabeth. Digestive Wellness. McGraw-Hill, 2005
3. Lininger, S.W., Gaby, A.R., Austin, S., Brown, D.J., Wright, J.V., Duncan, A.D. The Natural Pharmacy: Complete Home Reference to Natural Medicine. New York: Healthnotes, 1999.
4. Haas, Elson M. Staying Healthy with Nutrition. Berkeley, California: Celestial Arts, 1992.
5. Page, Linda Ph.D. Healthy Healing: A Guide to Self-Healing for Everyone. Healthy Healing Inc., 2006.
6. “Acidophilus.” American Cancer Society. American Cancer Society, 2007. http://www.cancer.org/docroot/ETO/content/ETO_5_3X_Acidophilus.asp?sitearea=ETO accessed on 27,  March 2009.

Life is returning to normal, so I’m back to upgrading my fertility diet. I mentioned in my blog, Upgrading My Fertility Diet that I’ll be adding two critical – and missing – components to my fertility diet: probiotic bacteria and enzymes.

As you may have guessed by the title, for this blog I’ll be covering the little critters that live in our gut.

What are Probiotic Bacteria?

Probiotic bacteria are the friendly bacteria that live in our digestive systems. Doctors and nutritionists agree that these bacteria are one of the most important aspects to our overall health and well being.

Dr. McDougall refers to them in his book, Digestive Tune-up, as “so important to our health and survival that they should be thought of as a vital organ” (1). In her book, Allergies, Carolee Bateson-Koch writes that the cultivation of these bacteria “can mean the difference between radiant health and chronic debilitating conditions” (2).

It’s not a surprise that these little inhibitors are so important to us given the slew of responsibilities they have. The probiotic bacteria break down our food, manufacture vitamins like biotin, niacin, folic acid and B-6, increase the absorption of minerals, normalize bowel transit time and produce antibiotics that prevent colonization of the harmful bacteria – just to name a few of the things they do for us.

Interestingly, this micro flora isn’t just a few bacteria scattered throughout our digestive tract. Trillions of bacteria inhabit our digestive system. The bacteria weigh a total of about four pounds and account for half of the volume of the contents of our large intestine (3).

These bacteria begin to colonize our bodies at birth; finding their way into our system through the air we breathe, the breast milk we drink and the things we put in our mouths. We need to continuously replenish these bacteria, though, because they don’t set up camp permanently. They regularly exit our digestive systems – making up over half of the dry weight of feces – many of which are still living (for those of you who weren’t grossed out enough).

Excretion isn’t the only factor affecting the bacteria balance in our gut. Bacterial infections, hormones, antibiotics (which kill the good and the bad bacteria), high stress levels, steroid drugs, excessive alcohol intake, poor diet, and a number of other factors can throw the beneficial bacteria out of balance.
This improper balance of flora can cause the following symptoms (2):

• Acne
• Arthritis
• Asthma
• Ear infection
• Fatigue
• Headaches
• Hormonal disturbances
• Intestinal symptoms
• Irregular heartbeat
• Low back pain
• Nervousness
• Rashes

So, probiotic bacteria are important to our health but what do they have to do with fertility?

Can Probiotic Bacteria Boost Fertility?

There don’t seem to be any studies yet that directly link probiotic bacteria to fertility but there are two aspects that make it very likely that these bacteria play a role.

1. Probiotic bacteria influence our hormones (1,2,3). They break down and rebuild, for example, hormones such as estrogen (3). Knowing that an imbalance of estrogen can make getting pregnant harder it seems quit likely that a healthy bacteria balance will create a more fertile body.
2. Probiotic bacteria manufacture important vitamins like biotin, niacin, folic acid and B-6. And not that it’s a surprise, but a recent study (4) shows that vitamins may play an important role in getting pregnant (not to mention that folic acid is important for a healthy baby – reducing the chances of having a baby with neural tube defects).

To find out how and to what extent we can influence our gut flora through food that contain probiotic bacteria and probiotic supplements check back for my next blog Probiotics and Fertility Diet – Part 2 .

Sources

1. McDougall, John A. Digestive Tune-Up. Summertown, Tennessee: Healthy Living Publications, 2006.
2. Bateson-Koch, Carolee. Allergies: Disease in Disguise. British Columbia: Alive Books, 2002.
3. Lipski, Elizabeth. Digestive Wellness. McGraw-Hill, 2005.
4. Chavarro Jorge E., Rich-Edwards, Janet W., Rosner, Bernard A., and Willett, Walter C. “Use of multivitamins, intake of B vitamins, and risk of ovulatory infertility.” Fertility and Sterility 89.3 (2008): 668-676.

How hard can it be to take a little break from the whole fertility topic?

Pretty damn hard if you have a post miscarriage check-up scheduled in which your gynecologist wants to discuss your fertility planning.

Originally I thought, I have to be there anyway so what’s a twenty minute fertility chat?

Oh, the ramifications.

I was on the ever so comfortable chair with my feet in the air looking at an ultrasound image hanging from the ceiling. She was maneuvering the wand around to get a look at my ovaries, my uterus, and my notorious fallopian tubes when she noticed that my left fallopian tube was slightly swollen. Not that I could identify it on the monitor but she went on explain that this could be the remnants of an ectopic pregnancy that my body is still recovering from. And then she opened the conversation, “You need to give your body a chance to heal before you begin trying again to conceive.”

I could see she thought she was going to meet some resistance from me but I already knew we had to wait out this cycle – no big deal.

Not quite.

She stopped looking at the ultrasound monitor, looked me straight in the eye, and said, “You need to wait three months before trying again.”

I protested immediately.

“What? That seems extreme. That’s how long we waited after my ectopic pregnancy surgery and this is certainly much less for my body to recover from.”

She went on to explain that my body needs one normal healthy cycle before we begin trying again. “The current cycle is your miscarriage cycle, the next one isn’t going to be normal so after the third cycle you can try again,” she said with a stern compassion. Given my long cycles though, it could be June before we can try again to conceive.

She could tell: I was not on the same page.

After a little more explaining she moved right on to the next topic. My fallopian tubes. She said it would be pointless to keep trying if in-fact my tubes are blocked or compromised and recommended that I have them checked to see if they are clear.

Oh boy. Now, I’m really not with her. Not on a different page – I’m in an entirely different book.

I already had my tubes checked (a few months before I had my ectopic pregnancy, actually) and they came out clear. So while the surgery could have created a blocked right tube, it does not seem like the test is any indication that they are going to function properly. I supposed if it turned up that both my tubes were blocked it would be good to know but I just got pregnant so, obviously, they’re not.

I started to get up and she asked me when my last breast exam was. With this infertility issue dominating my visits I had to say I couldn’t remember so I moved over to the table and she began the breast exam and continued the fertility planning conversation. Oh, joy.

She got right to the point, “You need to think about how long you are going to try on your own. I would give it six months and then consider going right to IVF.” This hit me like a ton of bricks. Basically, she’s not rooting for my body anymore; she thinks it’s time to jump ship. So to emphasize her point she then added what no one with infertility likes to hear, “The clock is ticking.”

I hate to be so critical because, if my gynecologist isn’t going to be frank and inform me about the factors influencing my fertility then who will? The thing is: I already know all this information.

I’m what one might call over-informed. I know the role age plays in my fertility. I know that IVF works best before age 35. I know that the more miscarriages I have the more bleak the statistics look for me. But – and this is a big but – if I’m listening to my body and making lifestyle changes and doing therapies that cause positive changes in my body then I feel there’s still a chance. So until the progress plateaus: I won’t be turning to invasive methods.

Before I was even out of the building I called my husband, “I need lots of hugs and some soul food.” We cooked up some fajitas – with extra guacamole and without the shells. And I got lots of hugs. But it was inevitable; we talked about our fertility planning. I couldn’t stuff my feelings and frustration away. One thing became clear; we don’t plan on waiting a full three cycles until we try again. We plan on waiting one full cycle after my miscarriage cycle. I don’t think my body needs three cycles and I know too many women that have had their first healthy child immediately after a miscarriage – one of these women is my mother.
 
Well, so much for that break from the infertility topic and thank god for hugs and fajitas.

Sometimes you just need a break.

Now is one of those times for me.

My hormone values fell last week, meaning that my miscarriage is probably not another ectopic pregnancy. Saying that I’m relieved doesn’t seem to cover it. I mean, to think that I’m sitting here typing away on my computer instead of lying in a hospital bed in pain from a surgery to remove an ectopic pregnancy absolutely overwhelms me with feelings of gratitude.

Except for a few more visits to the doctor – to make sure my hCG values return to zero – I consider this miscarriage to be behind me.

So why take a break from the whole infertility topic and trying to conceive?

Well, first of all, we aren’t allowed to try and conceive this cycle. Yes, after three and a half years of infertility we are supposed to use a condom. The irony. But OK, my doctor said that it’s important because a fertilized egg wouldn’t find the right kind of environment in my uterus right now. Makes sense.

So we have to wait until my next cycle (whenever that is) to try and conceive. But I also have to say that I don’t feel like diving into the infertility books right now to read or do research. I need a break. I plan to read and write about digestive health (enzymes and probiotics) – not how they directly relate to fertility but how they relate to overall health.

This isn’t just a decision that my body and soul wants but my life needs some serious organization at the moment since we just moved last Saturday (it would have been two weeks ago but the miscarriage delayed it). I love the new place, but the whole which-box-is-it-in phase is not one I want to be in permanently.

Today, I have a check-up appointment with my gynecologist for an ultrasound and to surrender my arm again to the prick of a needle. She said she wanted to discuss some infertility issues and procedures like checking again to see if my tubes are clear. This doesn’t really fit into my taking a break from the topic plan, but I have to be there for the check-up anyway so what’s an extra ten to twenty minutes?

Last week was a week like no other.

Monday started off with mid-cycle mystery cramps and bleeding that sent me straight to the gynecologist. Turns out I was pregnant and this was a miscarriage. Strangely enough this was all OK with me. A miscarriage stinks, yes, but emotionally, I was relieved to know what was wrong (since I didn’t even know I was pregnant) and happy that my body was showing it could get pregnant again.

That was Monday.
 
Being completely naive about how a miscarriage can be, I planned my week with all the work and fun I usually plan. I mean, I’ve heard about women who hardly even noticed that they miscarried. And except for the sporadic cramping phases, I was feeling OK. I mean why would it be any different for me?

Ha ha. Because my body is special that’s why.

On Tuesday night I woke up with terrible cramps that left me in tears and rendered my husband feeling helpless. He brought me a heating pad and sat down on the bedroom floor while I moaned in pain and sprawled catty-corner across the bed in the most contorted maybe-this-will-help position. The next morning I was listening. OK maybe this isn’t going to be easy process. I called my gynecologist and headed back in.

She prepared the ultrasound. But before I crawled up onto the chair she asked me why I seemed so stressed? She’s a very competent doctor and I like her. But what the hell kind of question is that?

I was too tired to reiterate all the pain that I had last night and to explain that the idea of having another ectopic pregnancy scares me and that being in her office for a miscarriage instead of a pregnancy sucks. I’m such a chicken. I just want her to do her job. I don’t need her for emotional support; I need her to solve my physical problem. OK a few supportive words would be nice but, you can’t have everything. She’s a totally career orientated woman – which I used to be – so I wasn’t about to explain my desire for children or my feelings, instead I tried to relax and gave her the short version, “I had a lot of pain last night, which concerns me.”

On the ultrasound there was an empty uterus and something in the right tube. “Nothing to be alarmed about at this point,” she said with certainty. But something she said she’ll be watching. I headed home with a prescription for some pain medication and was told that I should rest.

I really didn’t have another option at this point. My body was tired. Each little task I tried to do became more and more exhausting. So, I found my place on the couch and wasn’t able to keep my eyes open for more than ten pages at a time of my good book.

The cramps were on some kind of schedule because each night around 9:30 they kicked in. They were muffled by the painkillers but the longer I stayed awake the more obnoxious they got. So, my husband forced me to go from the couch to the bed and placed a hot water bottle under the covers with me, which was amazingly therapeutic.

By Friday, though, the bleeding had become bright red. Where is the blood coming from anyway, my uterus is empty? My gynecologist had given me her cell phone number for the weekend in case, “The blood is red or the pain is constant.” Crap. I called her office to report the red blood.

She decided to have the lab go back and check my progesterone values from the two blood tests she had done earlier in the week. Turns out they fell, which is good for a miscarriage, meaning the ectopic pregnancy scenario is less likely. She told me to call her over the weekend if the bleeding exceeds how much I would bleed during a normal period or if the pain is constant.

On Saturday the climax came. Not the good kind of climax, but the bad kind. After breakfast, I was totally and utterly exhausted. I could do nothing more than lie on the couch. Before long I started bleeding heavily. I turned to my husband and asked, “Should I call her?” But before he could answer I thought aloud, “What’s she going to do about it?”

The only thing I could think of is that she’d decide to go ahead with a D&C. But I felt for some reason like my body wasn’t failing me but doing what it needed to do. The cramps in my abdomen had disappeared and instead I had a pain near the lymph nodes of my groin – the same pain that I had after the surgery for my ectopic pregnancy and endometriosis. I decided to ride it out.

I have almost no recollection of Saturday. I slept almost the whole day waking up occasionally in tears from the throbbing pain in my groin. I was bleeding a lot. But as the evening turned into night the bleeding began to slow and the painful abdominal cramps that came every night during the week never arrived. All I kept thinking is: Is this the end of the miscarriage?

On Sunday, I was back on my feet. My husband and I even went on a long winter walk – not to give the impression that it was an enjoyable Sunday though.

My emotions were completely out of whack.

I didn’t ponder the miscarriage, I was just irritated by everything: the fact that the snow was melting, the brown leaves on my house plants, the grey sky. You name it, it was irritating. Perhaps these were just my hormones settling back down, maybe it was my way of being frustrated about a miscarriage and a lost week of my life, or maybe brown leaves and grey skies merit complete irritation. I’m going with hormones on this one.

My emotions are a bit better today – even though the skies haven’t turned blue. Tomorrow I’ll be getting my HCG values tested again to make sure they are going down so we can turn off the ectopic pregnancy alarm. But I think it’s over. My body thinks it’s over. And I am ready to go back to my life. What is that again exactly?

I find myself here…again.

I’m having a miscarriage, but it may be worse – yes, there is a worse – it could be another ectopic pregnancy.

My HCG values which should be going down since I am miscarrying have decided instead to stay the same. On Monday the value was 125 and on Wednesday it was 142. So actually it went up slightly but my gynecologist said that she considers the values to be the same since HCG is normally measured in the thousands and the slight difference in the hundreds is outside the measurement’s precision.

Originally, I was scheduled to have my HCG values tested on Thursday but the terrible cramps that woke me up in the middle of the night on Tuesday prompted me to reschedule my appointment for Wednesday.

Wednesday’s visit didn’t provide me with any new answers though, just a prescription for pain medication. Since then I’ve been bleeding and each night I have terrible cramps. The pain medication certainly helps but could this please just come to an end. My frustration is building and my sense of relief that I spoke about in my last blog is dwindling.

My next appointment is set for Tuesday. She’ll be checking my HCG values and probably doing another ultrasound.

I hope my body figures this out on its own. Luckily, I have a gynecologist that also wants to give my system a chance to short this out. Until then I have a winter wonderland to look out the window at and two cats that think it’s cool I’m lying on the couch. Friends have invited us over for an evening of cooking and a movie this weekend. Hopefully, I feel up to it because an evening with friends couldn’t sound any better than right now.

Last week in my blog about upgrading my fertility diet, I wrote about the “occasional bout of fatigue” that I still had. Well it turns out that those occasional bouts of fatigue were due to the fact that I was pregnant and had a miscarriage.

How could someone who is trying so hard to conceive not know she’s pregnant?

Quite easily: with a negative pregnancy test and my period.

OK let’s start from the beginning.

My last cycle was 36 days. I was taking my temperature each morning so I know I ovulated around cycle day 26 (yes, this is very late). And since my luteal phase seems to be around 10 days long right now, I took a pregnancy test on cycle day 36. The test was negative and my period started the next day.

File away another cycle. Or so I thought.

My period was not the usual five days of bleeding. It was eight days and I had a few bouts of fatigue during this never ending period. I thought this was a bit strange but I’m so used to randomness with my renegade cycle. So I noted the difference and chalked it up as to be observed. Over the next week, though, I experienced some spotting. I never spot around mid cycle. This was officially out of the ordinary. But things got really strange last Sunday (cycle day 15).

With new powder on the ground, I got up early, grabbed my skis and headed off with my husband and some friends to the mountains. For me, the day ended before it even got started.

I made two turns in the deep powder and sat down. I was too tired to ski.

What the #*@! ?

I was appalled. This fatigue thing is going too far. I can’t ski one powder run? I wasn’t out of breath; I just didn’t have the strength. Somehow I got down the powder run – more rolling than skiing but, hey, you do what you gotta do. When I reached the lift, I announced that I’d be sticking to the groomed trails for the next few runs. But this wasn’t working either. Before the lunch break I had to part with my new friend that joined me on the groomed runs and say, “Well, I can’t ski anymore, I’m too tired.” I had no explanation. I didn’t feel sick. I just couldn’t find an ounce of strength.

After lunch, I thought maybe I’d be energized and be able to head back out.

Nope.

Instead I waved goodbye as they all headed out of the ski hut. I played a little Sudoku on my cell phone, stared out the window at the beautiful mountains and then laid my head on the table and slept – for over an hour.

I tried not to be frustrated, but when we got home the frustration oozed out and I cried to my husband, “What’s going on?” Neither of us had an answer but, tomorrow would shed a whole new light on the situation.

I woke up on Monday and headed down to my yoga matt – like I always do. Halfway into the Sun Salutation posture series, I found myself lying on the floor – in pain. I pulled the nearest blanket over me and moaned in pain until my husband got up.

“What’s happening?” he asked with concern and his eyes barely opened.

“I need to call my gynecologist as soon as the office opens. I’m having cramps.”

My husband covered me with a big blanket and curled up next to me on my yoga matt.

The cramps began to subside after what seemed like an eternity – but was probably more like thirty minutes. I then called my gynecologist’s office and explained that I needed an appointment today – not tomorrow – today.

My appointment was set for 1:15. By late morning I recovered but, the spotting had increased. Anxiously, I headed downtown to my gynecologist’s office and kept myself quite distracted from any what if scenarios.

She did the usual exam and ultrasound and found nothing. No cysts. No fluid. No visible ectopic pregnancy. No signs of anything. The only thing she discovered was that my uterus was very tender – the yelp I let out and the tears streaming out of my eyes where apparently a dead giveaway. She told me to go home and rest and she’d call me later with the results from the blood work.

It was 5:30 in the evening and my cell rang. It was my gynecologist. She cleared her throat and said it straight away, “It turns out you were pregnant, but you miscarried.”

Scared. Sad. Happy. These were my emotions; in that order. At about the speed with which you read them – I had them.

Scared because what if this is another ectopic. Sad because I just miscarried. Happy because I had gotten pregnant.

She talked to me for about 15 minutes answering my onslaught of questions. And then she had me do what I knew was inevitable: make an appointment to get my HCG values checked to make sure they return to zero – indicating that the pregnancy is not ectopic. The chances of this being an ectopic pregnancy are slim since I have bled so much but apparently they aren’t zero and, as my gynecologist said, “since you’ve had an ectopic before we need to be sure.” So I’ll be going in on Thursday afternoon to “double-check.” Right now I’m hopeful that this is not an ectopic pregnancy but, since we need to double-check, I can’t say I’m worry free.

Strangely, my predominant emotion now is relief. Yes, I still cried last night and had a couple of “why did I miscarry?” episodes. But I am truly relieved. I now know where my bouts of fatigue were coming from. I know why my cycle was so strange. And I know my body is once again capable. And certainly it helps that I found out I miscarried before I knew I was pregnant.

What’s next? My first pregnancy was ectopic. My second pregnancy a miscarriage. The next one could be the one where my body gets it right.