Show & Tell: Purple Gorilla

This week's Show and Tell will be a little different. I came upon this poem from Beautiful Mess. She posted about it awhile ago, but I never really appreciated her blog until I read her post about her blogoversary. She wrote about how she never expected her blog to be about grief and her mom dying, but that's what ended up happening. I wanted to skip over my blogoversary, which was last Sunday, because I didn't want to dwell on how much pain and grief I had written about over the last year. When I read Beautiful Mess' post, I was glad that someone else was writing about grief too. I didn't feel so alone. I, too, never thought I would write so much about trauma and grief this last year. Heck, I didn't even really know what trauma was, and I never really had to face grief the way I've faced it in the last year and last couple of months.

Beautiful Mess e-mailed me this poem, so I'd like to share it with you too. I cried when I read this.


Grief
by Matthew Dickman May 5, 2008

When grief comes to you as a purple gorilla

you must count yourself lucky.

You must offer her what’s left

of your dinner, the book you were trying to finish

you must put aside,

and make her a place to sit at the foot of your bed,

her eyes moving from the clock

to the television and back again.

I am not afraid. She has been here before

and now I can recognize her gait

as she approaches the house.

Some nights, when I know she’s coming,

I unlock the door, lie down on my back,

and count her steps

from the street to the porch.

Tonight she brings a pencil and a ream of paper,

tells me to write down

everyone I have ever known,

and we separate them between the living and the dead

so she can pick each name at random.

I play her favorite Willie Nelson album

because she misses Texas

but I don’t ask why.

She hums a little,

the way my brother does when he gardens.

We sit for an hour

while she tells me how unreasonable I’ve been,

crying in the checkout line,

refusing to eat, refusing to shower,

all the smoking and all the drinking.

Eventually she puts one of her heavy

purple arms around me, leans

her head against mine,

and all of a sudden things are feeling romantic.

So I tell her,

things are feeling romantic.

She pulls another name, this time

from the dead,

and turns to me in that way that parents do

so you feel embarrassed or ashamed of something.

Romantic? she says,

reading the name out loud, slowly,

so I am aware of each syllable, each vowel

wrapping around the bones like new muscle,

the sound of that person’s body

and how reckless it is,

how careless that his name is in one pile and not the other.


My purple gorilla came to me again Friday night. I was thinking about all the physical things I am doing to get ready for another "mission impossible" IVF cycle. The one thing I haven't been doing is communicating with my spirit baby. I haven't talked here lately about it, because I cry everytime I think about it. I don't want to talk to my spirit baby, because I am afraid. I am afraid of being heartbroken again. The truth is, I'm so sad she didn't come. It's not a guilt trip on her or anything. It's how I feel. I fell in love with her. It's like she died.

When I went to the "Gifts of Grief" movie a couple of weeks ago, I talked about how I didn't think there was anything good about grief. The moviemaker asked me, "who died?" I was dumbstruck. How do you talk about someone dying who never existed? I just said, "it's complicated." I didn't think the moviemaker, or anyone else in the audience, would understand. She experienced the grief of losing her father whom she was very close to. I didn't understand my grief at losing someone I didn't even know. I found that part of me was embarrassed and ashamed.

I checked out a book from my library about grief. Although I had heard this before, it really stuck me when I read the words on the page:

"...love and grief are inextricably intertwined - to love is always to open oneself to the grief of loss"

I loved my spirit baby. She may still be around, but I don't know. I know she has been with me a long time. Years, I think. I've been too afraid to reach out to her. If she's really gone, well, I can't really go there right now. A part of me hopes, but the grief, it still comes like the purple gorilla.

AMH and Adrenals

Ed note 5/30/09: I discovered that I mysteriously lost part of my post, so I added it back in. If you read this post before this date, you might want to read the beginning again.

Tomorrow will be day 3 of my cycle. I know it seems like yesterday when I posted on my day 3 results, but since I have the world's shortest luteal phase (a whopping 7 days this time), day 3 has come around again. I will be waiting one more cycle to do my official day 3 testing at BigShotFertilityClinic. You see, I've been holding out on you. I did have my AMH tested after all, and let me tell you, it was grim. BigShotFertilityClinic likes to see a level above 0.6, and I think that is even kinda borderline. Mine was 0.1. At least I didn't get back a result of less than 0.1, so I guess it could have been worse. AMH is used to predict resting follicle levels and sometimes IVF success. The predictive use of AMH for IVF is fairly new. Basically, what this means is that my ovaries need some serious resuscitation! Skip the CPR, and fire up the electro-shock pads!

I immediately consulted Dr. Google when I got the bad news. I wanted to know if the AMH number could change with Chinese medicine and acupuncture. I did find some information that it can change, and that women with low AMH do get pregnant! My acupuncturist EM wants to increase my kidney yin, and thereby AMH, by taking more evening primrose oil. In Chinese medicine, when they talk about an organ, like kidney or spleen or liver, they don't necessarily mean the actual organ. For example, a kidney deficiency, either kidney yin or kidney yang deficiency, usually refers to one's fertility. It can also refer to adrenal function, and the adrenal glands sit on top of the kidneys. I was comforted when EM said, "we treat the patient, not the number."

Part of my strategy of improving my fertility was to have my adrenal glands checked. I have a friend who finally had success getting pregnant at age 42 with her own eggs after battling infertility for seven years. She had one failed IVF with her own eggs and one failed IVF with donor eggs. She never gave up and kept looking for answers. Her success came when she was treated for her adrenals and sub-clinical hypothyroidism. Her thyroid numbers were normal, but she had all the symptoms of hypothyroidism. She gave birth to her daughter at age 43.

I did a test with Dr. F, my other acupuncturist, to test my "Adrenal Stress Index" through Diagnos_Techs lab. I was diagnosed with adrenal fatigue. The good news is that I have a mild case of it, so it will be fairly easy to treat. I dusted off my copy of "Adrenal_Fatigue, The_21st Century Stress Syndrome" by James_Wilson. It had some interesting things to say about taking DHEA and pregnenolone for adrenal fatigue:

"It is my clinical experience that women often do not do well on DHEA unless their adrenals are very fatigued. Levels as low as 10-25 mg have produced symptoms of excess DHEA, such as facial hair and acne. A safer and more successful way of raising DHEA levels in women is to have them take either progesterone or pregnenolone, although some studies of women with chronic fatigue syndrome or lupus have found benefit from using 200 mg of DHEA/day."

I have problems with taking DHEA. It raises my testosterone levels and gives me heart palpatations. I already have high testosterone, as expressed by my "sexy"_Lauren_Bacall voice, and I certainly don't need anymore! I take pregnenolone instead, about 60 mg a day, though I'm experimenting with taking up to 120 mg per day. When I have taken DHEA, I can only tolerate 5 mg a day, and only for about 5 or 6 weeks, before I have to switch back to pregnenolone. BigShotFertilityClinic recommends 75 mg of DHEA twice a day to improve egg quality. I would drop dead if I took this dose, or start growing a beard, neither of which appeals to me. I respond much better to the pregnenolone.

"Progesterone and pregnenolone are hormones that are manufacutred in the adrenal cascade as well as in the ovaries and testicles before they are metabolized into DHEA. Both can be converted into several other adrenal hormones besides DHEA, including the sex hormones, aldosterone and cortisol. Thus, taking replacement hormones like pregnenolone and progesterone that occur early in the adrenal cascade lets your body's wisdom choose which other hormones it will make from them, according to your body's needs. With adrenal fatigue, the sex hormone levels often fall because your adrenal glands are not able to manufacture adequate levels of hormones."

Pregnenolone is a precursor to DHEA, as you can see in the flow chart below. Pregnenolone is also a precursor to other hormones, and that's why it's safer than DHEA. Your body can determine where you need it the most. Maybe your adrenal glands have to heal before you can produce more of the sex hormones. We all know how stressful infertility can be!



I am also taking a cortisol supplement called Iso_Cort, though I have already had to cut back on that after taking it for a couple of weeks as I'm starting to get symptoms that I am getting too much cortisol, such as rapid heartbeat and anxiety.

Another strategy for me to improve my adrenal health is to go to bed by 10:00pm. This is very hard for me, and I have had to set limits on my internet use at night. In fact, I am already past my "internet bedtime"! Couple this with my busy schedule at work, and I've been a pretty lame commenter this week for ICLW. I will post more about the other supplements I have been taking to improve egg quality and to improve my mental health.

Show & Tell: Fire it Up!

I always love metaphors of transformation into something beautiful after going through fire. It's the theme of this blog, if you haven't noticed.

A while back, I was inspired by Lori's pottery pals, and did my own creation. Never having done this before, I didn't know what I was getting into when I chose a pasta bowl. I've always loved colorful pasta bowls, so I thought I would paint one for myself. Little did I know that it would take me three days to do this!! Since you have to coat everything two or three times, it takes a long time to finish a big piece with lots of colors, like I did.

Before firing.

By the last day, I wanted to join the family at the table that brought their own Margaritas!

The wait was worth it.

After firing.

Edge detail.

The sunflowers look like a third grader did them. I traced them from a photo of a real sunflower. Otherwise, I don't have any drawing talent. But I really like how the edge turned out!

This bowl was a nice distraction for me during my FET cycle. I left it on the island in my kitchen, and it's bright colors distracted me from potential trauma triggers. During the doldrums of winter, it was nice to have a splash of color around the house. It has yet to see a bowl of pasta, though!

You can see what everyone else is showing off at Mel's Show and Tell.

Gluten-Free Fridays: Jonesing for Pesto

For those just joining my blog for ICLW, there are a few key things you need to know about me. I'm of Italian heritage, which means I have olive colored skin (when I tan), which I'm pretty sure has to do with the olive oil running through my veins. I cook almost exclusively with olive oil. My parents used to buy it in gallon tins when I was a kid. I also subsist on garlic, basil, and tomatoes.

However, the one thing that my Italian genes do not like is gluten. I am gluten-intolerant, which is the protein in wheat, barley, rye, and spelt that makes dough sticky. Dairy doesn't agree with me either. One would think that all of Italian culture would crumble if wheat and dairy could not be put into Italian recipes, but luckily, exceptions can be made! Wheat is also considered bad for fertility. Most grains, including the gluten containing ones, are acid forming. An alkaline diet is considered healthier for the body and fertility. All my recipes exclude gluten grains and dairy, but not meat. It would be pretty grim if I couldn't eat meat either.

Part of eating a healthier diet for me, and in theory to improve my egg quality, is to grow my own food. I've been working like crazy in my spare time preparing my garden. I just transplanted ten basil plants. I'm wondering what I'm getting into planting them all at once, but I decided not to mess around this year. My best basil plants last year were the ones I put in first. My frozen pesto from last year's ten basil plants lasted until March this year! But what am I do do between the months of April and June while I'm waiting for the basil to grow?

The solution is arugula.

rocket arugula

Arugula is an early spring green in the mustard family. It has a spicy taste, kinda like basil. You can substitute arugula for basil in pesto recipes. You can buy 20 times the amount of arugula for the same amount of money you would spend on basil in the grocery store. Arugula is always the first green sold at the farmer's market.

Arugula is instant gratification, well, as instant as it gets when it comes to growing your own. It comes and goes quickly, so you have to successively seed it, meaning seeding every two or three weeks. My first seeding of arugula from March 22nd is almost spent already. I've gotten three cuttings off it and it bolted after the second cutting. I planted rocket arugula this year, which has nice big leaves. I also planted another variety called "Sputnik" from Seeds_of_Change, which is slightly less spicy. It's still small, so I'll see how I like it once I can get a harvest off it.

To make arugula pesto, just substitute the arugula for the basil! It's that simple. I have reprinted the recipe below from this original post. Remember that you need a food processor for this recipe. You can do it in a blender, but it will be very slimey tasting if you do. We learned this the hard way when Magic recently tried to make pesto. Serve the pesto over your favorite gluten-free pasta. I personally think the Tinkyada_brand is THE best gluten-free pasta, hands down. We had this last night for dinner and ate it before I had a chance to take a picture! Enjoy

Ingredients for Pesto
lots of arugula (roughly one store bought package
1-2 cloves of garlic pine nuts, about 1/4 to 1/3 cup
romano cheese (optional), about 1/4 to 1/3 cup or to taste
salt
about 1/4 to 1/2 tsp olive oil

A lot of making pesto is relative to how much you like of each ingredient.

The How to of Pesto Making
I make pesto in a food processor. First, fill the food processor with arugula leaves. Grind them down. Put more arugula leaves and grind them down again. Continue this process until all of your arugula is finely chopped

Next, add a clove or two of garlic. I don't like a lot of fresh garlic in my pesto, even though it would seem that you can't have enough garlic. A little fresh garlic goes a long way. There are many different types of garlic too, but that's a whole 'nother discussion that I'm not really qualified to get into. I like a mild garlic, which is usually the standard grocery store type.

Then, add the pine nuts. Add the romano cheese at this point if you too, if you can have dairy. I have never found a good substitute for pine nuts. You just have to bite the bullet and spend the money on them. You can use walnuts, but I think they are too bitter. Process the pine nuts enough that it chops up the nuts, but not enough to make pine nut butter. Pulse the processor if you have to. When it's starts to stick together, stop processing! Ideally, you would want to stop before it starts to stick together, because that's when it tastes like pine nut butter. You'll know what I mean once you've made this mistake. I've done it more often than I'd like to admit.

For cheese, I prefer romano to parmesan. Again, it's what I grew up with. We always had a jar of fresh grated romano cheese in the frig for sprinkling on all our Italian dishes. Romano has more flavor than parmesan, in my opinion, but use what you prefer. Since I can not eat dairy, I leave it out. The pesto will taste just fine without cheese.

Lastly, add the olive oil and a little bit of salt to taste. Try adding the salt in at 1/4 tsp at a time and taste it as you go. The romano will make the pesto salty tasting, but I like more salt than that. I don't measure the olive oil. I just keep adding it until I get it to a consistency I like. You can pulse or run the food processor each time you add the olive oil. In the end, it should look like the regular basil pesto, but with a more vibrant green color!

Grappling with Grief

I saw grief drinking a cup
of sorrow and called out,
"It tastes sweet, does it not?"
"You've caught me," grief answered,
"and you've ruined my business.
How can I sell sorrow,
when you know it's a blessing?"
- Rumi

Grief is not a popular subject. It is exactly what the counselor and I talked about last Thursday at BigShotFertilityClinic. To their credit, they finally figured out that those of us who live near the satellite office were in need of counseling services. I signed up for the first slot. I liked the counselor. We talked about how I deal with grief. I do feel it. I do not try to cover it up, in general, with things like alcohol, TV, or food, though I have to admit, chocolate is my friend at times. But there is only so much grief I can stand. We talked about how I feel isolated by my grief. I notice that many people, including my DH, have a hard time staying with my sadness or anger.

Tonight, I went to see a movie called, "The Gifts of Grief". The documentary highlighted seven people who had lost loved ones in many different ways. I was moved to tears many times, but I could not feel that I have had any of my own gifts from grief. Perhaps I am still too sad and angry.

What have I learned from grief?

To cut out the BS of life: I don't have time for people who claim to want to help me, but just say that to soothe themselves. In the discussion after the movie, one woman talked about how she wanted to write a book on how to deal with a grieving person. She said that telling someone who is grieving, "just call me if you need anything," was not helpful to her. She described how the responsibility was then put on her to do something at a time when she was not functioning. This wisdom could be applied to anyone going through a crisis or trauma. I felt like this completely during my time of crisis while pregnant. I can't tell you how many people told me this, but who never really showed up in a real way to take action or to sit with me. I got lots of advice on what I should have been doing, but I was not functioning and could not do those things that were talked at me about. I didn't know what I needed, so how could I call someone to ask? Or I didn't believe that someone could really give me what I needed, so why bother asking. There were plenty of jealous women who were not pregnant or who had never been pregnant that avoided me, or worse yet, said hurtful things, acting out their own pain. There were the doctors and the healthcare providers who didn't see me, even though I was telling them of my difficulties. It was as if they all had this image of "you'll be fine" instead of seeing the truth. It was as if I was invisible. If they believed someone else was taking care of me, there was not a problem. I feel this way about grieving as well. As long as I'm functioning, people don't really see how much I'm hurting. It's easy to hide the sadness and anger by withdrawing, but I don't really feel like I'm living much of the time.

I don't really know of any resources out there that deal with the grief of going through infertility treatments, regardless of their outcome. If you know of those resources (i.e. have read the book, not just heard about it), please pass them on.

Someday, I may appreciate the blessing of grief. I know I have much more compassion for those going through infertility than I had before, so that is one gift. Can we be there for each other as we grieve day after day, month after month, year after year with each loss related to fertility treatments? Or does it feel better to cheer those on who continue to do treatment after treatment? I want to hear from those women who are in the trenches, dealing with these losses. I am guilty of not writing about how I feel, for fear I will turn off my readers or be viewed as a negative person, but the reality is that I am grieving still from the failure of our FET and from last year's loss as well.

We all have a story to tell about our grief around infertility. I'd love to hear yours. Do you have any gifts from your grief to share?

The Baskin Robbins of Grief

Today, I learned I have a new flavor of grief. Anniversary grief. I guess it's kinda nice to have a name for it. It's not the same grief as the grief I had last year grief. I'm not big on talking about this anniversary, but yeah, it's been kicking my ass, especially because of how close it is to Mother's Day. I lived, but I think I'd just rather be in another country where they don't celebrate Mother's Day on that actual day. I actually feel much better, emotionally, since Sunday passed. I holed up in my house, but that wasn't enough. I also could not turn on the TV or read the newspaper lest I be reminded of what day it was. Really, it was hopeless.

I did get a nice Mother's Day gift. I talked with my mother for half an hour! For those who have not been following my story, my mother has this thing about talking on the phone, as in, she won't do it. I haven't talked with my Mom since I visited her last December. My Dad will talk a blue streak with you, but my Mom refuses to get on the phone. The love didn't last long. I got an off "joke" e-mail from my Mom two days later that went like this:

A man boarded a plane with 6 kids. After they got settled in their seats, a woman sitting across the aisle from him leaned over to him and asked, "Are all of those kids yours?"

He replied, "No...I work for a condom company. These are customer complaints."

I'm the youngest of six and my oldest sibling is seven years older than me. It's no mistake that my Mom found this funny, but to me, I just felt sad. Who would want to be thought of as a customer complaint? Thanks for making me feel wanted, Mom. If she had actually used some birth control, which I think would have been the best thing for her sanity and all of us in our family, I wouldn't be here, which is really ok by me.

Age is Just a Number

Dara_Torres became my instant hero when I learned she was competing in the 2008_Olympics at age 41. I have since discovered that we have more in common than I first thought. First, my post title is the same title of her new book, which is featured in the April issue of More_magazine. Second, we are both 42. Third, we have both done IVF. The similarities end there.

Dara is married to a fertility doctor (!) and had a daughter from IVF at age 38. It's interesting what she writes, though brief, about her infertility experience. She says that infertility was the one thing that she could not control. I was so inspired by Dara's wins at the 2008_Olympics and her drive to compete even more today, but is it really true that we have no control over our fertility as we age? I would like to think we do.

I have let my age get the best of me these last few days and weeks. How at age 42-and-less-than-six-months-away-from-43 can I even consider cycling with my own eggs? I thought for sure that I was doomed and my Day 3 FSH would come back sky high. I had a meltdown yesterday morning, letting these negative thoughts get the best of me, though I still had not seen my Day 3 results yet.

The truth is not so bad. My numbers are not spectacular, but they are pretty damn good considering my age. I was unsuccessful in getting the AMH test, but I did get FSH and estradiol:

FSH = 4.4
Estradiol, Serum = 61

The first number rocks, but the second number is the one I'm concerned about. I believe that BigShotFertilityClinic likes to see this number below 50 on Day 3. Those of you who also go to BigShotFertilityClinic (there can only be one in the US, you know), please chime in about what you know. The theory goes that if you have a low FSH and "advanced maternal age", you also have to look at estradiol because a high estradiol can mask a low FSH. I'm not exactly sure what is considered a high estradiol, and I think it depends on where your labs were run. Dr._Liccardi says 50 is the cut off. This fertility clinic puts the cut off around 70-80, with the caveat that the number really depends on the lab where your bloodwork is done. The one number I am missing that I needed was the anti_mullerian_hormone (AMH), which I thought was ordered.

The other theory about high estradiol on day 3 is that your follicles start growing and producing estrogen early, which is basically interpreted as bad egg quality. One reason I am not entirely concerned about my sketchy E2 level is that my last cycle was long for me, 28 days. A "normal" cycle for me is 24 days and has been that way all my life. My sister is the same way, and she has three children, one who was conceived at 40 years old, no problem. My cycle was so long, that I actually peed on a stick the morning of the 29th day, but of course, it was negative and AF showed up shortly thereafter. I would not be surprised if my follicles did start growing a bit early, as they might have been confused by this seemingly long cycle for me.

Consider too, that the last time my antral (resting) follicles were counted, I had seven, which I thought rocked for my age, but again, this fertility clinic shows that the numbers were sketchy. Ten or over is the acceptable number. I'm figuring, a little estrogen_priming_protocol and a lot of ovarian stimulants will get that number higher for me. I'm not in it for the quantity. I would be happy with one good embryo out of the whole lot.

Having taken graduate statistics, I'm all too aware of how statistics do not tell the whole story. I am not doing IVF because it has been proven that I have egg quality/fertility issues. I'm sure that if my husband had swimmers, we would have been knocked up a long time ago. Not to say that we couldn't use IVF now at my age, but still, I don't have the double whammy of age and fertility problems. Most of the women doing IVF at my age do have fertility problems, so I believe that could skew the statistics. If I am going to plunk down $20-$25K that I don't have on another IVF cycle, I want to know that I have more than a snowball's chance in hell of success. I think my recent numbers show that hell just got a little colder. I feel comfortable going ahead with my plan of improving my egg quality as much as possible in the coming months to go forward with another IVF cycle. As comfortable as one can get with doing IVF again, that is.

Anticipation

I got Dr. F, my acupuncturist, to order Day 3 testing for me, and that means Dr. BloSunMyCha never has to see it. But since Dr. F knows squat about IVF, he and his staff don't understand that I'm dying that I can't see my results. I'll have to wait until tomorrow afternoon to know if I have a snowball's chance in hell or not. It's not like I'm going to do an IVF cycle anytime soon. In fact, it might not be until September, which means I might actually be able to enjoy my summer. It also means I'll be 43 by then. I hate to think I'll be 43 when I do my next IVF cycle, three years almost to the day of when I did my first IVF cycle. Crap. I was old back then. Three years later? I don't feel that much different, except for the weight I never lost from my pregnancy. But still...