Friday, September 27, 2013

Funny Infertility Friday

You don't need to be pregnant for this picture to apply to you. Anyone that can deal with all the trials of infertility and keep your head high daily is such a strong person.

Just remember there will ALWAYS be someone out there wanting to knock you down in your darkest hours and how you handle it truly shows what a fighter you are.

To all the ladies out there still fighting for a baby, don't let anyone ever make you feel that you can't do this because you can.

Hope you all have a great weekend.

FYI: Luckily I have a wonderful friend in ITT and I was able to figure out who was posting nasty comments on my page. As I thought, it was someone I knew from my infertility group. I think over the weekend I am going to change my blog address. I don't mind the mean comments, but I don't really want those kind of people following my journey. Send me an email if you want the new link. It should be up by Sunday!


Thursday, September 26, 2013

Troll Comments

Anonymous Commenter:

At first I wasn't going to give you the pleasure of posting your troll comments. Funny thing is, it didn't upset me, in fact it made me feel sorry for you and your sad pathetic life. I am sorry that you are so miserable you have the need to put mean things on peoples post. Most likely I know you from blogging or a infertility group and you are just to much of a chicken shit to put your real name and leave nasty comments. It is okay though. How about you give me your name and address and I will send you a picture of my beautiful baby? Sorry you didn't win and please feel free to post more comments and show how truly pathetic you really are.



Test Results In

I am going to copy and paste the results from Dr. Kim. Most of this you might not understand unless you have been through the testing.

I highlighted all of the tests that I came up positive for. 



Assessment/Plan
Lab Results and Recommendations
Autoimmune abnormalities are often present in women with recurrent pregnancy losses or implantation failures. Autoimmune screening tests determine the presence of any aberrant reactivity to self-tissue components such as phospholipids, nuclear components and thyroid antigens.

APA (286.53 Autoimmune disease, not elsewhere classified) Tested High Positive
Antiphospholipid antibody test was positive. Women with antiphospholipid antibody have increased risk to develop fetal death, stillbirth, recurrent pregnancy losses, severe pregnancy induced hypertension, intrauterine growth restriction and placental insufficiency even during the latter half of pregnancy.


ANA (710.9 Unspecified diffuse connective tissue disease) Tested High Positive
Antinuclear antibody and autoantibody to nuclear components (such as DNA, nucleotide and histones) were tested. ANA screen was found to be positive with a titer of 1:320 and Centromere pattern. Due to the potential risk of miscarriage with a positive ANA, early re-screening for ANA is recommended with a positive pregnancy test.

Antibodies to nuclear components
Autoantibodies to nuclear components were negative.

ATA 
Anti-thyroid antibody tests including anti-thyroglobulin antibodies and anti-peroxidase antibodies were negative.
Thyroid function testing was normal. TSH was 1.55.

NK Assay (288.8 Other specified disease of white blood cells) Positive
Natural killer cell levels and cytotoxicity have been reported to predict a pregnancy outcome. The NK assay demonstrates normal CD56+ natural killer cell levels with relatively elevated NK killing capacity by flow cytometric analysis. The NK cell in vitro response to immunoglobulin G was adequate. B lymphocytes were measured by flow cytometric immunophenotype study. The patient has normal CD19+ B cell levels with normal CD5+ B-1 cells. These CD5+ B 1 cells are capable of producing autoantibodies that damage the placenta and decrease maternal to fetal blood flow.

TH1/TH2 Cytokine (279.10 Immunodeficiency with predominant T-cell defect, unspecified)
T lymphocytes were investigated based on their cytokine producing capabilities. The patient has increased T helper 1, inflammatory immune responses. T Helper 1/T Helper 2 cytokine producing cell ratio reflects the ratio between two opposing T Helper immune responses. An elevated ratio reflects the dominance of TH-1 cells (represented by secreting TNF-alpha and IFN-gamma), which are cytotoxic and pro-inflammatory; as against the TH-2 cells (represented by secreting IL-10) which are important for implantation and pregnancy.

Anti-inflammatory medication or immune modulators such as steroid and/or intravenous immunoglobulin G infusion treatment is recommended.

Hormonal evaluation
DHEAS level is within normal limits.
DHEA level is within normal limits.
Testosterone Free and Total levels are within normal limits.
Fasting free insulin level was relatively elevated.

Thrombophilia  (289.82)

Testing for inherited blood clotting tendencies or acquired thrombophilia was performed.
Leiden factor V gene was normal.
Prothrombin gene was normal.
Factor XIII gene was heterozygous mutated.
B-Fibrinogen gene was normal.
HPA-1 gene was normal.
PAI-1 gene was heterozygous mutated.
MTHFR (C677T) gene was heterozygous mutated.

Anticoagulants, folic acid, vitamin B6 and B12 supplements are often considered for MTHFR gene mutation.

Serum homocysteine level was normal.
Plasminogen Activator Inhibitor 1 level was normal.
Protein C Activity was normal.
Protein S Activity was normal.

Other evaluations
Vitamin D 25, hydroxy was normal.

The following are recommendations for treatment during conception cycle:
·  Start Metanx once daily, vitamin E 400 i.u once daily and prenatal vitamins once daily.
·  Start Metformin ER 500 mg  twice daily orally as directed.
·  Start coated or buffered aspirin 81 mg. (one baby aspirin) orally, daily the cycle of planned conception and continued throughout pregnancy.
·  Start vitamin D3 1000 unit per day.
·  Recommend to see a rheumatologist prior to next pregnancy attempt. 
·  Start Prednisone 10 mg. once daily 48 hours after ovulation. Increase Prednisone to 10 mg. twice daily at the time of a positive pregnancy test. Since Prednisone can induce gestational diabetes, fasting blood sugar should be monitored monthly at the referring physician’s office with test results forwarded to us. If pregnancy is not achieved after 3 conception cycles on Prednisone, discontinue the medication and contact the office for further recommendations.
·  Start endometrin 100mg twice daily intravaginally twice daily 48 hours after ovulation for 10 days then stop for this cycle.
·  Blood work one day between cycle days 1-3 of conception cycle for NK Assay, TH1/TH2 cytokine, Chemistry panel TFT, ANA, fasting free insulin and testosterone total and free.
·  Start Lovenox 40 mg once daily, this must be injected subcutaneously and initiated cycle day 6 of the cycle of planned conception. It should be stopped if menses begins and pregnancy test is negative.
·  Increase Lovenox 40 mg twice daily with a positive pregnancy test and continue throughout pregnancy until instructed to stop.
·  Uterine Biophysical Profile 5-7 days post initiation of Lovenox treatment.
·  Start Endometrin 100mg intravaginally twice daily and Prometrium 200 mg. orally, once daily the cycle of planned conception, 48 hours after ovulation or within 48 hours of embryo transfer and continue throughout pregnancy until instructed to stop. Discontinue the Endometrin and Prometrium if the pregnancy test is negative.
·  Start supplementary Calcium Caltrate 600 mg with vitamin D 200-400 IU twice daily when taking Lovenox and/or Prednisone therapy.
·  Start Intravenous Immune Globulin (IVIg) as follows: Immunoglobulin G 400mg/Kg/day for one day between days 6-14 of conception cycle, at time of positive pregnancy test and repeated every 2 to 3 weeks as indicated by follow-up laboratory testing.
PLEASE NOTE FIRST DOSE NEEDS TO BE DONE AT RFUHS
·  NK assay, cytokine ratio and ANA study should be done 5-7 days after each IVIg infusion.
·  Pregnancy test 10 days after ovulation (Blood testing for b-hCG, serum E2 and P4 level).

The following are recommended as follow-up tests during pregnancy.

1. We recommend an APTT, Chemistry panel and a CBC with platelet count every month while on Lovenox. These tests should be done at the referring physician’s office with test results forwarded to us.
2. We recommend TSH, Free T-4 and Free T-3 weekly to monthly as needed. These tests should be done at the referring physician's office with test results forwarded to us.
3. Antiphospholipid antibody, anti-DNA/histone antibody, ANA, NK assay, PAI-1 and TH1/TH2 cytokine testing starting with positive pregnancy testing then as needed. Patients must schedule this test with our office.
4. A β-hCG should be drawn every two days until a heartbeat is established per ultrasound.
5. Progesterone and Estradiol levels should be performed at the time of a positive pregnancy test and weekly during pregnancy until instructed to stop.
6. Blood pressure monitoring should be done monthly while patient is on prednisone.
7. A Triple Test (AFP, ß-hCG, unconjugated estriol) is recommended at approximately 16 weeks of gestation. The Triple Test screens for open neural tube defects and aids in assessing the risk for fetal chromosome abnormalities. Abnormal Triple Test results should be followed up by genetic counseling, high-resolution ultrasound evaluation and amniocentesis, if necessary.
8. Ultrasounds using gray-scale and Doppler techniques to assess the pregnancy development should be done every week beginning at 5-6 weeks of gestation through the first trimester and then monthly.
9. At 28-30 weeks, weekly Non Stress Tests and biophysical profile exams should be done.
 

1. POLYCYSTIC OVARIES (256.4)
·        METFORMIN ER 500 MG TABLET,EXTENDED RELEASE 24 HR -
Take 2 tablet(s) every day by oral route in the evening for 30 days.     Qty: 60 tablet(s)     Refills: 3     Pharmacy: WALGREENS DRUG STORE 12027     Note to Pharmacy: Start one pill every other day for 3 times, then one pill every day for 7 days, then 2 pills per day.

2. SECONDARY HYPERCOAGULABLE STATE (289.82)
·        METANX (ALGAL OIL) 3 MG-35 MG-2 MG-90.314 MG CAPSULE -
Take 1 capsule(s) every day by oral route for 90 days.     Qty: 90 capsule(s)     Refills: 3     Pharmacy: WALGREENS DRUG STORE 12027

3. RECURRENT PREGNANCY LOSS WITHOUT CURRENT PREGNANCY (629.81)
·        PROMETRIUM 200 MG CAPSULE -
Take 1 capsule(s) every day by oral route for 30 days.     Qty: 30 capsule(s)     Refills: 1     Pharmacy: WALGREENS DRUG STORE 12027

4. LEIOMYOMA OF UTERUS, UNSPECIFIED (218.9)

5. UNSPECIFIED DIFFUSE CONNECTIVE TISSUE DISEASE (710.9)
·        PREDNISONE 10 MG TABLET -
1 tab daily     Qty: 30 tablet(s)     Refills: 3     Pharmacy: WALGREENS DRUG STORE 12027

6. ANTIPHOSPHOLIPID ANTIBODY WITH HEMORRHAGIC DISORDER (286.53)
·        ENOXAPARIN 40 MG/0.4 ML SUBCUTANEOUS SYRINGE -
Inject 0.4 mL every day by subcutaneous route for 30 days.     Qty: 12 mL     Refills: 0     Pharmacy: WALGREENS DRUG STORE 12027

Discussion: All test results were reviewed with the patient and a treatment plan was established. Pros and cons of treatment and possible side effects of medications were thoroughly reviewed. Patient was recommended to read the educational booklet that was given for further information regarding medications.

Patient was informed to check insurance for IVIg coverage.

Patient was instructed to contact her infertility specialist and establish a plan for next conception cycle.

Patient is planning to have ART with/without IUI cycle as next cycle.


Any of you that have seen Dr. Kim or have any experiencing with this testing, I would love some feedback!

Moving Forward

I won't lie, yesterday we were totally overwhelmed with all the information Dr. Kim gave us. I have always thought I had an underlying immune issue and after all the tests ran, it is now confirmed. I went through most of the day in a fog just trying to digest off of this and honestly I am still working on processing it this morning. Al and I sat down last night and had a very long talk. We have decided if insurance doesn't cover IVIG and we can't get it done here in Oklahoma then we are moving past that specific treatment. We don't have the finances to fly to Chicago and also pay thousands of dollars out of pocket for this treatment. I told Dr. Kim yesterday that without insurance coverage we would not be able to do the IVIG and asked if we should move forward with the other treatments or just move past trying to have a child. She said that with the blood thinners, steroids and other medications that we will had a pretty good chance of keeping a pregnancy. Of course the IVIG does help chances even more, but I was happy to know that we can keep going even without it. I am still waiting on the offical report to come through and will know all of the immune issues I have. I also asked her about doing TI verses IUI and she said that the IUI would only give us a small chance over the TI and the "delivery" of the sperm and egg was not the issue. The issue is my body attacking the embryos and the blood clotting issues I have keeping them from implanting. So at this point, Al and I have decided to hold off on IUI for at least a few months, start our new medication protocol and do Follistim/Femara TI for at least 3 months. At that point if we haven't succeeded on getting pregnant, we will re-examine and maybe move to IUI again.

I know that all of this is a total crap shoot on what is going to work and what isn't. She really wants us to make another trip to Chicago for an u/s after I start blood thinners to see if it is helping with the blood flow and then another after we get pregnant to see. I explained to her that we are tapped out after all the ivfs, medications, surgeries and trips for our infertility. Al and I do live comfortable, but we don't have anymore money to spare for this. We are still paying off a 401K loan for our two ivfs last year. And we made a promise to each other that we would not go in to debt anymore, as hard as that is, we have to be responsible for our finances and family as it is already. We might be able to squeeze one more trip to Chicago to see how the blood thinners are working, but that would be it. She said she totally understood and wish people had better coverage for infertility. She is such a caring woman and I highly recommend anyone going through multiple losses to see her. Especially if your doctor keeps telling you it is egg quality. I was so tired of hearing the generic ass "egg quality" excuse with nothing to prove it. 

Also for anyone considering seeing her, I wanted to let you know that we don't have infertility coverage on our insurance and was very scared on how much the labs were going to cost. I got a bill yesterday and my insurance covered all but $35.01 out of $2,000.00 in labs. Since this is immune testing and not "infertility" it was covered. Dr. Kim also allows you to make payments to her and does not expect all the money up front. I will continue to keep her as a doctor along with my current RE. Dr. Kim will oversee all of my medications and care for the most part. Let me stress again that if you are having these issues, please call her and see if she can help you. Although I did get a lot of  "not so great" news yesterday, at least I now know what exactly I do need to get pregnant and stay pregnant. If we wouldn't have seen Dr. Kim I would be having recurrent loss after loss and not know how to fix the problem.

To end this very long and draw out post, Al and I have decided that this is the end, the last of treatment. We will give this protocol a fair shot for a while (1 year) and if there is no pregnancy out of this, we are moving on to the next phase in our lives. We are almost at the 4 year mark of treatment and it tends to wear a person out emotionally, physically and financially. I wouldn't trade our struggle for anything though. I have learned so much about myself throughout all of this and I know that I can handle anything thrown in my path. Many people can't say that.................. Struggles in our lives are put there for a reason. Even though it is not apparent to us at the time.

Wednesday, September 25, 2013

Follow Up with Dr. Kim

First of all, please excuse my absolute ignorance on the following. We spoke with Dr. Kim for well over an hour and it was a lot of information to take in. She is suppose to send me a summary of all my tests, but I will go ahead and tell you the things I do remember.
I have high and/or elevated Natural Killer Cells, T Helper 1 &2, ANA, Pie 1 gene mutation, Antiphospholipid Antibody , IGAA
There is no way that without treatment I can keep a pregnant. I was told by Dr. Kim that my chances of heart disease are 5 times more likely, and if we do get pregnant my chances of pre-clampsia and pre term labor also go up pretty drastically.
She has suggested the dreaded IVIG and I am waiting to see if my insurance covers this medication. It is about $3,000 per infusion and we would also have to fly to Chicago to have it done the first time.
Lovenox starting on cd6 through positive pregnancy test or period.
prednisone- starting after ovulation and not sure how long
Metanex- Prescription Folic Acid, b6, b12
Metformin- 500mg every other day and then 500mg twice a day
D3-1000mg daily
Fish oil
Vitamin E -400mg daily
Aspirin 81mg daily
Endometrium for 10 days after ovulation
She said that I am one of her more severe cases and recommends the IVIG. Without insurance coverage we just can't do it. Have a lot of thinking right now and need to decide where to go from here. I will share test results on my blog when I receive them from her.

I am definitely down in the dumps this afternoon. I need some time to process and make the best out of this situation. 

Thursday, September 19, 2013

Tuesday, September 17, 2013

Good Day Gone Bad

Have you ever had a day start off good and then take a fast track down hill? This is my day today.

I've been having issues with my new implant. It has been very sore for weeks. Today when I was flossing after lunch, the floss was covered in blood. I called and they wanted me to come in. This was my xray:
As you can see, there is cement that was left in the gum and tooth area. My dentist said I should play the lottery because this usually only happens once, maybe twice a year. We started with floss and it hurt. They numbed me up with a short lasting anesthetic and it didn't work. He had to go ahead and numb me with the other stuff. Between all the digging spraying etc. it took over an  hour to get the cement loose from the tooth and remove it . Needless to say I am hurting like a &(*&(&*()$#*()& insert whatever nasty word you would like.

Better day tomorrow? I think so :)
Today is CD1. I called the clinic yesterday to get a prescription for Femara. My idea was to start it on CD3 and on my follow up consult with Dr. Kim, ask her whether we could actively try this month. Therefore I would feel completely prepared in case she said yes. On the way home last night I told me husband of what I thought was a completely brilliant idea that no one understood but me. I could totally tell in his face that he didn't think my idea was in fact that brilliant at all. He said he didn't want us to mess up anything and be put in the waiting stage even longer. The first thing I wanted to do was be defensive and try to prove that I knew better and was right. The thing is, I don't know better and I'm not right. I am just tired of this waiting game. Al is tired of waiting. We are so close now and I can't let my emotions over take common sense. The prescription is already called into the pharmacy. I will pick it up today and put it in the medicine cabinet until next month. I did come into work today and email Dr. Kim. I let her know that today is my CD1 and our follow up with her will be on CD8. I asked if we could actively try this month or if I needed to sit out again for another month. In my heart I know the answer already. I know that it is her job to give me the very best care with her knowledge and in the end it will pay off. So I am waiting for a response and I guess as of today I can start counting down to a new cycle with Femara/Follistim and IUI..... T minus around 28 days and counting!!

We are taking a much needed camping trip this weekend. It has been planned for a few months now. Unfortunately I found out on Sunday that my ex MIL only has a few days to live. She was diagnosed with colon cancer 3 months ago. She went through surgery to remove the cancer, but they found out it spread into her liver and other major organs. Sunday I took Cierra to the hospital and said my good-bye to her. Cierra wants to be with her grandmother until she passes, so tonight I am meeting her dad and she will be with them until early next week.  I have mixed feelings about all of this and feel guilty that we are going camping this weekend while she is with her dad waiting on her grandmother to pass. It is a very hard situation and I told Cierra if she needs me, I will be there in a flat second. I think they want to share this within her dad's family and use this time to reconnect with each other. So I am stepping back and seeing what happens. She packed some fingernail polish last night so she could paint her grandmothers finger nails. The one thing that does help me feel better, one of the family members of her grandmothers husband is a Army Chaplin and he has promised me that he will talk to Cierra extensively and help her while she is there.  Why do I feel like a bad mother? 

Better get to work and finish packing boxes for our move.


Friday, September 13, 2013

Funny Infertility Friday




Well my new lifestyle change is going amazing so far. Only two weeks in though and have a long road ahead of me.

The Body By Vi Shakes didn't work out. I couldn't get past the sweet nasty taste of them. Luckily I have a friend who is getting amazing results from them and she is going to take the shakes!

I have cut my carbs down by 90%. In the mornings I am eating two eggs (sometimes with cheese and other yummy toppings). I snack on raw veggies through the day at work and eat a nice lunch, usually a lettuce wrap with tuna or lunch meat and cheese. My dinners aren't really carb free, but I am eating in moderation and then going for a mile walk in evenings or bike rides. I am very happy to say that I have a already lost 8lbs. Seeing that weight come off is enough to keep me motivated. I also love that the weather will be turning cool so I can hopefully start walking longer distances and then maybe and that is a BIG maybe, try incorporating running? Yes this coming from a girl that has always said I would NEVER run unless a bear was chasing me :) I still have some time to process that whole idea. So instead of jumping on the diet craze of the month, my main goal is watching my food, moderation of food and exercise. I think I can be successful at this.

Goal weight is 150 lbs and I am at 172 lbs right now.


State Fair this weekend! I saw last night on the news that the fair had a cripsy creme hamburger. I was set that I was going to eat one this weekend and then changed my mind. Think I will stick with a turkey leg or something just a "little" healthier than a hamburger enclosed in two donuts :) now the Wisconsin fried jalapeno cheese is a totally different story!

Tuesday, September 10, 2013

Standing Still

Well I had my blood work finished yesterday and tomorrow is my thyroid u/s. We are currently on  hold from ttc until our follow consult with Dr. Kim on September 25th. I am really happy that we will have answers and also have the best possible treatment going forward, but I can't help but feeling down in the dumps right now. This whole year has been such a loss. Just itching to get back into treatments. I miss the shots, the pee sticks, the u/s etc. Yeah it does sound weird that I miss all of that, but to me, all of that meant we were actually doing something to get pregnant. 

You know, maybe it is the whole not having control that truly bothers me. I mean we have waited over 3 1/2 years to get pregnant. That has not really bothered me as much as doing nothing. Just keep reminding myself that it is only one more cycle that I'm out and then it is on like Donkey Kong!
I can do this, I can do this....................................

 

Friday, September 6, 2013

Making my body baby friendly & Funny Infertility Friday

I am sure most of you know how I feel about exercising and eating healthy. I come from a family full of morbidly obese people. Not sure how it happened but I was lucky enough to stay a consistent 115 lbs until the birth of my daughter. After that I only gained about 20 pounds and stayed at that weight for years. Four years ago when I quit smoking I put on another 10 pounds and was still under 150 for being 5'7 so I was okay with that number. Then we started fertility treatments and from there depression and now I am the biggest I have ever been. As of today I weigh right at 179 lbs and have a BMI of 28 which is Overweight = 25–29. After talking to Dr. K and discussing how PCOS and thyroid truly effects fertility, I have decided to get off my lazy ass and do something about this. I have let my body go down hill for years now and kept telling myself that I would get into shape after a baby. Well I don't have a crystal ball and have no idea when the baby part is coming, but I do know I can't keep gaining weight like I am. I feel horrible, not only physically, but I can't stand looking at my body in the mirror. I am beyond grossed out on what I see. Now going back to the fact that I come from an obese family, I know what fad diets and and exercise do. I don't want to jump into this fast and furious and then end up being burned out in no time. I have decided to start slow and steady. Yesterday was my first day of changes. I am cutting out as many carbs as possible. Mainly no bread, pop, rice, or chips. I am eating more raw veggies ( I actually love veggies). I also started walking last night. After dinner I went for a mile walk. It took my over 20 minutes, but I did it. The girl who always said she wouldn't run, walk etc. unless a bear was chasing me. Well there was no bear, only me taking pride and walking my mile. Now will I walk a mile daily? Right now my goal is to walk a mile 3 days a week. If I do more that is great, but my baseline is 3 days a week. I also decided to start body by vi shakes and will do those at least once a day for breakfast. I don't want to jump in to fast on that one either. If I feel okay then I will start having a shake for lunch also. It is just a matter of finding what works for me and trying to push myself and stay focused on the main goal. 

My goal is a baby friendly body....... So hopefully with diet, exercise, meds, and Dr. Kim's help I can go on to get pregnant within the next year.  I think that is definitely a reachable goal. So wish me luck everyone because this lady is going into the unknown!


Almost forgot Funny Infertility Friday!

 I know I have stood on my head more than once, LOL!

Thursday, September 5, 2013

Chicago Part 2

This post is going to be about our trip and sightseeing in Chicago. I took about 100 pictures while we were there. It is going to be very hard to narrow it down and not totally fill this blog with that many pictures. Before this appointment I never thought of Chicago as a city that I would be interested in visiting, ever. Boy did this place prove me wrong and I am so glad it did. Chicago has to be on my top three list of places I have visited now. To say it was absolutely an amazing city would be a total understatement. I plan on going back. I did find out there are a few things you absolutely have to do while there; visit The Sears Tower ( even though I am not from Chicago, I will no longer refer to it as the Willis Tower). Chicago totally got ripped off on that deal. It has always been the Sears Tower until  the Willis Company from London turned out to be the biggest owners in the building (owning biggest %). They wanted the building named after them. It really pissed me off that not only were they not from Chicago, they weren't even from the U.S. Total rip off and douche move ( in my opinion). The tower is absolutely amazing though: The first day we went, it was around 11:00 in the morning and the wait time was 3 1/2 hours to get in. So Al and I woke up very early on Monday morning (Labor Day) and were there right when it opened at 8:30. The wait was about 45 minutes. After going up to the top I realized that if necessary I would have waited three hours. WOW! You may ask, "Tonisha did you go out in the boxes off of the 103rd floor"?  Yes I did :) Scared shitless but felt so liberating after I did it. I was on a high all day after. Here are a few pictures from the Sears Tower..








Next we went on a river tour throughout the city and the canal of Lake Michigan:






Our visit to the Navy Pier:







Random pictures of Chicago:



State Park Beach:


Deep Dish Pizza!

We ended up eating at two different places, but only got a picture of the first.

This was our pizza from Giordano's downtown. We also had a wonderful pizza from Lou Malnatis north of Chicago.

So here was the majority of my pictures. Hope you guys enjoy them.

Wednesday, September 4, 2013

Chicago Part 1

I am back from Chicago. Let me first start off by saying, wow what an absolutely amazing and beautiful city! I will get to our actual sightseeing in another post. Today I want to stick with my appointment with Dr. KK.

When we first got there I had to have about 16 vials of blood drawn.  I was so nervous about making sure my bladder was full that I forgot I wasn't suppose to eat breakfast. Luckily the nurse was fantastic and told me it wasn't a big deal. The three test that I was able to get yesterday is mainly sugar levels, insulin etc. and I have a script to get them here this week. 

Our second appointment was the ultrasound. Let me tell you how amazing this machine was. Please forgive me if I don't get all the information 100% accurate, but I promise to get it very close. Anyone else who has seen Dr. KK could probably help me out with all this technical stuff. Here are some of the things found and discussed while having the ultrasound done:

  • I was on cd 17 and still haven't ovulated. I had one 14 mm follicle on my left ovary. 
  • She found many cysts on both ovaries and especially the left. I was asked how long has it been since I did a medicated cycle. My answer was over two months. Right away she asked if I had ever been diagnosed with PCOS. (If you remember I asked my RE last year and he said that there wasn't enough to diagnose me and if he did, it would be a "soft" diagnosis). Well she was 100% certain that I had PCOS. The amount of cyst they found on my ovaries should only be seen when you are having a medicated cycle for a larger amount of follicles. 
  • I was then asked about my thyroid. (If you remember my blood test came back within normal ranges). Well here is the problem with a "random" thyroid test, it is not accurate. 30% of woman who have a thyroid problem will test negative on the blood test. You need to have a scan of your thyroid to really know. So that was suggested by her at the time.
  • Good blood flow to both ovaries
  • Thin Endometrium lining. She told me that most doctors will measure the thickest part of your lining and therefore most patients have good numbers. Your lining goes from think to thick and thin again. Therefore you should measure and get an average on the lining. She said that some woman will have a polyp or something behind the lining making it seem to be thick, but in reality it is thick in a bad way instead of good. My lining yesterday was 8. This was " okay".
  • The blood flow to my uterus was very bad. On a scale of 1-5 with 5 being what they like to see, mine was a 2. (I will go into the effect of this later).
  • The actual new blood vessel development that is suppose to happen each month in the uterus to supply filtered blood for an embryo was also way under pare.

This is a wrap up of the ultrasound.

Next was the physical exam and questions by the Gyn before seeing Dr. KK.

  • She felt my thyroid and said it was bulky. Suggested a thyroid scan when we get home. 
  • Breast exam went fine
  • Basically asked me more questions about all the miscarriages, immune issue symptoms I have etc.
The consult with Dr. KK and let me say what a amazing woman she is. So kind and caring. She also knew her stuff!

She basically explained to me the three reasons for my miscarriages:
1.Underlying Immune Issues
2. Blood Flow Issues
3. Was Immune related with T-Cells etc.

She told me that the chances of a woman with multiple miscarriages having a genetic disorder that causes the wrong amount of chromosomes are MUCH lower then an average woman. That studies have shown the recurrent miscarriages are usually because one the listed above. She did explain that the PCOS is messing up my hormones and causing to much male hormones. The blood flow to my uterus is probably the biggest thing right now. Because of this, it will be merely impossible for implantation  or even supplying a growing embryo with the filtered blood needed to grow. So without medications, the chances are very low. She also went on to draw diagrams of how important the blood is to a embryo until the 20th week when they can start going without all the new blood of a mother. She also talked to my about the thyroid and told me to get my scan  as soon as possible here.  Basically that is all we know as of this point. We have a follow up phone consult with her on September 25th at 1:00pm. At this time she will give me my blood work results and create a plan from there. I was told that until we start on medications, she doesn't want us trying to get pregnant. As she feels it will result in another loss.

A lot of information and a lot of answers! Like I said, this woman is amazing and I would recommend her to anyone in our position with the miscarriages. Anyone who's doctor has given up on them. As much as this field of medicine is under scrutiny, it works for many people who couldn't get pregnant through other treatments. Oh and before I forget, we talked about ivf and Al and I didn't even need ivf. Dr. K told us that the main reason to go the ivf route is DOR, sperm issues, or for woman who can't ovulate and/or have no tubes. Otherwise it is a matter of finding out what the underlying problem is and treating it. 

I won't sit here and play the blame game. It has been years full of many emotions and treatments. I know that after our last miscarriage, my doctor knew there was nothing further he could do for us and therefore referred us out to CCRM. I researched and went with my heart knowing that ivf was not the route to take again and decided on a different approach. For me it was the right decision and I feel very confident that there will be a baby Rapp within the next year or so.