Monday, November 30, 2009

Mo's shape up plan collides with Turkey Day and feathers fly: week 2

Here we are, week 2 into the weight loss plan.

It was a tough week in shape-up plan land, with Thanksgiving and the subsequent turkey fest and four-day weekend. Weekends are always more difficult for me when I'm trying to clean up my eating and exercise - when I'm trying to eat less than usual unstructured time is not my friend.

And for whatever reason, I was starving this week. At times, it's been an hour by hour struggle. And although I've kept it pretty healthy, at times I've eaten more than would have been optimal.

My sense was that I did ok. Not great, but ok. I hoped I hadn't gained any weight or plateaued (because I know my motivation gets pretty thin when that happens, and gosh, I'm only on week 2!). But honestly, I wasn't optimistic that things would be looking too good. I mean, geesh, it was THANKSGIVING this week.

So overall, how did I do this week?

Total exercise this week: 7 hours (one extra hour to hopefully make up for Turkey Day, or at least account for a few bites of stuffing!)
1 spinning class
3 hours on elliptical
1 hour run/walk (with Will and puppy)
1 hour run/walk (without Will and puppy)
1 hour running on treadmill (only 4.2 mph, so very slow, but running throughout!)

Diet: Pretty good up until Thanksgiving, then I gave in the siren song of a somewhat large helping of stuffing and an extra piece of pumpkin pie (damn, they were good!), the rest of the week had an extra helping occasionally. So hungry!

Items of clothing earned: 2 (a burgundy knit dress-on sale for $29!- and a costume jewelry necklace so I can be a little sparkley for the holidays)

Weight lost this week: 1.4 lbs

Weight lost overall so far: 3.4 lbs

Will's Weight loss so far: 4 lbs (good job, Will!)

Total body fat lost (based on gizmo on my scale that I only half believe): 1.1 lbs (guess the rest is water?)

All in all, I'm very happy with these results this week! On that note, off to a 6:30AM spinning class. Yikes!


p.s. Thanks for the interest in the new hairdo...I will probably not be sharing a photo of before and after though, sadly. A little too revealing to post my picture here for my tastes.

Sunday, November 29, 2009

The return of Sundays of Grace (#18)

After a long hiatus, I have decided to resurrect Sundays of Grace, a weekly post about the things I am grateful for. This weekly post reflects my conscious attempt to be mindful of the many people, places, and moments in life that fill me with wonder and gratitude. I last posted a Sundays of Grace in August. It's about time I got back to remembering all the things going right, all of the reasons to be thankful.

So without further ado, three things that I am grateful for:

1. Watching my puppy leap around the dogrun like a little deer (a 26 lb. deer!), her ears cocked, her little white socks kicking up dust. She is beautiful!

2. Getting active again and remembering how good it feels to move my body and experience that soreness that comes from working muscles that haven't been pushed to the max in a long time.

3. Taking a risk, getting my hair lopped off at the hairdressers this week. As I was there, thinking how lucky I am to have hair to lop off - remembering back to 10 years ago when I had none and being filled with gratitude.


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Friday, November 27, 2009

Like pulling teeth

Those who read this blog regularly know that I heart my NYC IVF clinic, but lately, as I try to line up everything I need for this upcoming cycle in Denver, they have been less than helpful.

First came trying to get my records to take to the one-day work-up earlier this month. I was able to get most things through a basic records request, but the embryology reports were mysteriously missing.

And I wanted the embryology reports from our five IVF cycles to see what happens with our embryos over time. I love my doctor, but he is awfully vague - so I've never been clear about whether none of my embryos get to blast or just not in good enough shape to freeze or what...

So we emailed my RE directly, and he sent us back to another section of medical records. Who said it would take several days, but that everything should be faxed to Denver in time for the appointment.

Well, I wasn't feeling so confident in them at this point. Fortunately, we have connections and were able to ask (nicely) if someone from patient services could help us get the records we needed. So she did. For hours. We ended up sitting in her office two hours before our flight because she hadn't been successful. And it was at that point we found out that embryology records are usually not released. WHAT?! Our friend in patient services went ballistic, ranting that of course we could get them, they are after all, OURS. She went round and round to various departments, finally tracking down someone in the embryology lab itself, and then it turned out that there was a special "lock" on the file that only my RE could break.

By this time, it's about an hour until our flight to Denver. The last flight of the day. The RE is in surgery. We've found the file but can't get access to it. Sigh. So the patient services rep calls our doctor in surgery (gulp) and asks for his permission to access the file. And he says ok. And we get the file. And amazingly, we make it through NYC traffic to the airport in time to catch our flight. A minor miracle. And I was grateful. But I was also wondering, gee, RE, if you knew this is what we needed and how hard it would be to get, why just keep sending me back to med records?! Sigh.

The second bit of drama occurred last week when I needed to have day 3 bloods drawn and shipped to Denver. Not sure how to go about this, I called my RE and got turfed to his nurse, who didn't call me back until the end of the day Friday and basically said, No way no how was I going to be able to get blood drawn and sent to Denver. Absolutely not. And by the way, she was leaving the office right then, so I couldn't call her back. And she added to not call the on-call staff either. Hmmmm.... I was peeved at her attitude, as my RE has said he would support me cycling in Denver. So I had Will email him (thought a little M.D. to M.D. email couldn't hurt) and five minutes later he says no problem, just come in the next morning and ask for a specific tech and she'll do it. Done. No problem.

Why does this have to be so hard? Is this what the whole Denver cycle is going to feel like? Geesh!

I should tell them if they make it too hard for me, I might just stick around and do a sixth cycle with them. That should get things moving! I'm sure they think I've tanked their stats quite enough already!!


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Tuesday, November 24, 2009

Hallmark reject #7*

*Another actual statement from a friend, who at age 38 got pregnant for the first and only time. Not even trying. Her son is almost six now.

Made me wistful to think that for many women, just seeing two pink lines fills them with confidence that a child is on the way.

After seeing pink lines five times now, not so much.

Two pink lines for me? Equals Elation + Absolute Dread.

Anyone else?


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Monday, November 23, 2009

A weighty subject

Since this whole infertility project (nightmare?) began, I have watched my weight cycle up and then down and then up, up, and further up.

This has been tough for me because my body and my health are important to me. After being sick with lymphoma, I worked hard to gain my strength back. I used to lie in bed after chemo treatments and think to myself, almost as a mantra, "When I am well, I will never take my body for granted again. I will never take my strength for granted again." And for the most part, I haven't. After I was declared in remission, I started exercising. At the beginning, I was so deconditioned, I could only run a single block before needing to stop to rest. But I kept working at it. After about a year, I joined the Leukemia and Lymphoma Society Team in Training program and raised money for lymphoma research while training for and running two marathons and then completing two Olympic distance triathlons. I felt strong. I felt fit.

And then came infertility.

I've typically gained a little weight each IVF cycle (some combo of all the hormones, the stress, and my clinic's absolute prohibition on any form of exercise, including yoga, swimming, elliptical...). It would seem I'd just have gotten into a good groove with diet/exercise and then it would be time to cycle again and my routine (and then my motivation) would deteriorate and take months to recover. So each IVF saw me packing on approximately five pounds. Each pregnancy too, was accompanied by some increased poundage.

Fortunately (fortunately?! Really, Mo? You're going to try to make a positive out of this?), each miscarriage resulted in weight loss. At least the first three losses or so. I would be so grief-stricken that I would pretty much stop eating and drop five to ten pounds. I had no appetite. Couple that with the fact that running provided one of my only sources of solace during the first two losses and the result was that I became quite slim.

So the weight cycle was something like this: IVF #1 (pork up), pregnancy (porkier), miscarriage at nine weeks (start running, stop eating, weight plummets), IVF #2 (gain weight), BFN, then pregnancy #2 (weight stable), miscarriage (weight plummets)...pregnancy #3 (porkier), miscarriage #3 (weight drops) etc., etc.
Until I got past miscarriage number three.

Then somehow, I stopped grieving in the acute howling animal kind of way I had been and began some kind of chronic grieving. A grieving that involved no running and lots of mindless snacking and comfort eating. And then I started my clinical internship, and dissertation hell (so no time to exercise plus tons of stress - which resulted in more comfort eating), and then just for fun added on IVFs #3, #4, and #5, and pregnancies #4 and #5, and miscarriages #4 and #5 and well...

I am bigger than I have ever been in my entire life.

A lot bigger.

THREE clothing sizes bigger, if you want to know.

This is a fact I have been avoiding. Or that I have been acknowledging but not feeling able (willing?) to do anything about.

But then two weekends ago, we went shopping. To some of my favorite outlet shops (Banana Republic and Ann Taylor and Nine West. Sigh). Previous shopping trips have included me not buying anything because my usual size doesn't fit, nor does the size above that. But this time I really needed some work clothes and I just sucked it up and told myself I deserve to have clothes that aren't cutting me in two because they are so tight, and I bought clothes that fit, beautiful clothes that I'm really excited about, but that are much bigger than my pre-IVF size.

During the trying on of all these clothes, and the acknowledgement that my size has skyrocketed, I hit a limit. I "got" it. I realized I can't keep going on like this. I decided that I am going to take action. During that weekend, I outlined a plan.

I'm a psychologist, so I'm well versed in positive reinforcement. I decided to implement some contingency plans for myself. I could purchase clothes that fit, but I would have to "earn" them to actually get to wear them. When I've tried to reinforce myself in the past, I have rewarded an outcome (example: "for every five pounds I lose, I can get a massage"). This sounds good, but has never worked so well for me. THIS time, I decided to reward the process. So here's the plan:

For every three days that I (1) Exercise for at least 60 minutes / day AND (2) Eat according to healthy limits (three meals, two snacks, approx. 1,500 calories), I "earn" one of the items that I purchased.
I'm keeping a food diary with every morsel put in my mouth recorded, which research shows by itself is an effective technique to fuel weight loss.

So here we are, one week into the Mo shape-up plan. Would you guys be willing to follow along with me as I hopefully progress?

Total exercise this week: 6 hours
2 spinning classes
2 hours on elliptical
1 hour run with puppy
1 hour on treadmill

Diet: According to plan all days

Items of clothing earned: 2

Weight lost this week: 2 lbs!!!

When I think of how much I have to lose, it feels daunting and I want to give up. And I'm a little bit nervous that it's the holidays coming up, starting with the American bingefest known as Thanksgiving this week. I'll loosen things up a little that day (and obviously it won't count as a day toward "earning" any clothing), but plan to not get too far off track.

Overall, I'm hoping that by focusing on short-term goals of three days at a time of exercise and diet, I will find myself off to a good start and getting there before I know it. By my calculations, if all goes according to plan, it should take approximately 3-4 months to get back to a weight and fitness level I'll feel very happy with. We'll see. I really want to wear these cool new clothes!

Stay tuned for weekly updates.

In other news, Will and I attended an awesome adoption conference in Brooklyn this weekend and day 3 bloods have been drawn and are on their way to Denver (yes, apparently only their lab can analyze day 3 blood samples...). Posts on these topics coming soon...
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Tuesday, November 17, 2009

Move over Baby On Board! IF signs for every occasion

Prompted by you commenters pointing out the annoying "Baby On Board" signs (most frequently endured apparently by international bloggers), Will and I decided to create a line of "On Board" signs for the infertile driver.

Because every situation is unique, we've created a range of signs to fit several unfortunately common situations. Sure to warm the hearts of infertile drivers everywhere, as well as create discomfort and fear in the drivers around them.

So read through and enjoy. I'm sure there are many we haven't thought of, so let us know what we should add to the "On Board" line. We are always open to suggestions.

First off, there is just the general retort to the "Baby" signs. You've got a Baby on Board? Yeah?! Well, over here in this car we've got exactly:

But maybe that's too general. Maybe that makes it sound like you just don't want a baby or something, which isn't really quite right...

So we decided to be more specific...

For the infertile who's cycling, and needs to caution drivers that her medications may make her, how shall we say, a raving lunatic b*tch...there's this specific sign, both an announcement and a warning. Yes, Sprogblogger, we made this one just for you. Not that you're raving, but you are on this particularly yucky medication at the moment : ) Smart drivers should know to GET OUT OF YOUR WAY before you haul off and slam your car into them just because it's so sucky to take lupron.

Following transfer you may want to let people know that it might look like it's just you and your partner in the car, but in fact, you are not have:

Ever mindful of the guys, woefully neglected in the infertility world:

And for the man with azoospermia:

Or for those of us who unfortunately experience pregnancy loss, and for the really unlucky, multiple losses, this special sign:

And finally, this sign, for the infertile who's fed up with it all, after multiple cycles, heartbreak, angst, and financial hardship:

I think I'll pick the last one. You?

Surely someone will let us in if we've got this one stuck on our back window, right?


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Monday, November 16, 2009

Oh my God! I had no idea THAT could happen!

Remember how I've mentioned that at the Denver clinic, they are incredibly attentive to detail?

Well, I wanted to make it clear just what level of detail we're talking about.

The consent for IVF/embryo transfer was a whopping 21 pages long. And within it, in addition to the usual risks of the stimulating meds and the retrieval procedure, this consent includes the following risk information:

GENERAL WELL BEING Pregnancy affects women in different ways. While some women feel fine during pregnancy, others have complaints of nausea, fatigue, loss of energy and may develop various discomforts (i.e., back pain).... These symptoms and others may affect a woman's sense of well-being and ability to function at home or at work...

Hmmm....I don't know about this....I could have back pain? or fatigue?

TIME COMMITMENT Pregnancy lasts an average of 280 days.... During the pregnancy, the woman will make frequent visits to her obstetrician to monitor the pregnancy. It may be necessary to remain in the vicinity of your local obstetritian during all or part of the pregnancy...

What?! 280 days?! That's what I'm signing up for? And I might have to be near my OB for part of my pregnancy?! Horrors! That's more of a "time commitment" than I was planning!

Will and I kept laughing as we were reading through this form, imagining some poor uninformed couple not realizing that pregnancy might require some medical monitoring or thinking that gestation only lasts 6 months or something. Thank goodness for this detailed consent to let them know that they might experience - gasp - pregnancy for 9 months and maybe even some nausea to boot!!!

Geez, Denver clinic, we sure hope you can get us pregnant for nine full months. No complaints here. I understand the risks as I have read them and sign right here on the dotted line!

One thing's for sure, you can't say they aren't thorough.


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Friday, November 13, 2009

Sticking it to infertiles with stick family stickers

I'm going to admit to a pet peeve of mine - Stick Figure Family Car Window Stickers.

Do you know the stickers I mean? The ones people plaster on their car rear windows for all the world to see? (International bloggers, is this a solely American phenomenon?)

Since I live in Manhattan and fewer people drive cars here, I have been somewhat more insulated from this annoying fad than I would be if I lived in the suburbs, but it's something that bothers me all the same.

What is the purpose of these decals? They strike me as slightly self-aggrandizing, not to mention potentially unsafe. (Broadcasting your children's names on your car - brilliant idea!)

And perhaps needless to say, but there seem to be no family stickers for those without children. Oh wait, since we're childless, maybe we don't even qualify as a, I family here - just Mo and Will. Nothing to see here, folks, just keep on moving.

So maybe these stickers are a somewhat dim-witted idea that amounts to shameless bragging, but so what? Usually I don't get riled up about other people's business. I'm generally a live-and-let-live sort of gal.

So I had to ask myself, Why do these stickers irk me so?

Honestly, it's because they seem to be yet another unintended sucker punch from the fertile world. Another proclamation of fertile people's normality, their damn irritating fecundity. And another reminder of my defectiveness, my barreness, my pronounced child-killing abilities.

I realize my skin is thin on this. I know it is not the world's fault that it seems most everyone else can have sex and get (and stay) knocked up, whereas we've spent an obscene amount of money and endured a ridiculous number of procedures to get pregnant, and be pregnant, and then to get unpregnant again with nothing to show for it but a depleted bank account, a larger dress size, two laparoscopy scars, and an increasingly caustic sense of humor.

I know it's not the fertile world's fault. Hey, maybe if I could successfully reproduce I'd want to brag about it on the back end of my newly purchased minivan too (bought to shuttle my large family around in, to our many happy family events).

What bothers me probably most is that it is socially acceptable to put up self-congratulatory stickers of your family on your rear window, but it is not acceptable for us infertiles to discuss our reproductive struggles - and it is downright taboo to even mention pregnancy loss.

I'm tired of it all, I tell you. So today, I decided to make my own stick family sticker. Unfortunately, I don't have a car to put it on, and probably (but I'm not promising anything), I wouldn't be outrageous enough to stick it on my car even if I did have one. Because that would just make people uncomfortable and that's not really my aim.

But a little part of me thinks it would be awesome to get the conversation started, to not have so much of all our suffering be silent, not to mention how cool it would be to pull up behind someone else's car and see that she too struggles with infertility and loss - for a moment to cut through the isolation of it all.

So herewith I present Mo and Will's New Stick Figure Family Car Window Sticker, coming to you courtesy of this website:

Me, my husband, five miscarried babies, and our dog. What do you think? Isn't my family cute?

If I did stick this decal on my car, here's what I would secretly want to say:

Fertile world, here's my family. It's not the way I hoped it would be but this is how it is, so far, at least. Deal with it, OK? I have to deal with you - and the reminders of our heartbreak - every day.

Grumble grumble, grouse, grumble.


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Wednesday, November 11, 2009

The Colorado genetic counselor rocks

Thanks for all of your blogoversary wishes. We are ready to look forward to the coming year - and hope that there are fewer disappointments and more successes - please! Loved your comments reminding us to focus on what's important - our love for each other, and to be mindful of the accomplishments the last year has contained. We're with you guys - may this be the last year that this is an infertility blog!
So, finally, to fill you all in on the rest of the Colorado visit...
Our last meeting of the day was with Danielle, the genetics counselor. I'll be honest - I really didn't want to go to this. I mean, I spent an hour and a half with an M.D. geneticist in New York just a couple of months ago. What could this counselor possibly add? That said, once we met Danielle, I liked her immediately. And what she had to say perked up my ears rather quickly as well. We were drawn to Colorado because of their microarray technology. She said, however, that after reviewing our files, she'd spent the day meeting with the scientific director and making calls on our behalf because she felt that microarray wouldn't be enough for us, given my cancer treatment history and the fact that our losses have included both trisomies and polyploidies (overachievers, us!).
Basically, she said that microarray can only detect trisomies. Apparently, the way the technology works, microarray looks for alterations in the patterns of chromosomes - so one more or one less of a particular chromosome, a heterogenous problem. Microarray does not pick up polyploidy - because in this situation, there is an extra set (or sets) of every chromosome. And so the test reads it as normal, since it's a homologous defect across the entire set.
Who knew?
But surely, we're not the first couple to ever cross the Colorado Clinic's threshhold who's had a polyploidy plus a trisomy? I asked this, and Danielle assured me that although it is unusual, we are not.
But she said in our case (lucky us!), they were worried the polyploidy problem (usually a 1 in 1,000 occurrence) might have a tendency to repeat.
Hearing this, part of me was like YES! Finally, someone agrees with us that there is something unusual here - that these silly population statistics may not apply to us! This part of the information was super validating and welcomed. At the same time, I also had a Oh no, we are so f*cked up sort of reaction.
Bottom line, according to Danielle, we will need to do both microarray and FISH screening (the type of screening they use in PGD) to look for both trisomies and polyploidies. Because they do not want me to transfer embryos back thinking they are normal and then find out that they aren't normal after all. So they want to do a single biopsy of each blast (should we be so lucky to get blasts), split the tissue from each blast and send half of it for FISH and half of it for microarray.
Sounds good, right? The only problem is that each of these tests costs approximately $5,000. So it would add an additional $10k on top of the usual ridiculous IVF fees.
Ha. Ha. Ha.
Before we both fainted, Danielle quickly said that the Colorado clinic would never expect us to carry all of this cost and that they were already negotiating with the labs involved to waive fees so that we could have both tests run for no additional cost. In fact, she waived her $150 fee that day to get us started down the road of savings and said they were going to figure out how to shave $5,000 out of things somewhere so we don't foot the bill.
This was our final appointment of the day and we after we finished speaking with Danielle, we got into our rental car and drove directly to the airport to catch our flight home. What a way to finish out the day.
Our final impression was Wow. They are really thorough and have thought about our specific situation and what would be best for us. They are really looking out for us. Needless to say, we were impressed.
We'll keep you posted on what they're able to work out for us.
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