Gluten Free Fridays: Kale & White Bean Soup

If you have "unexplained infertility", you may consider getting tested for celiac disease or gluten sensitivity. One of my favorite websites for a compendium of gluten related diseases is The Gluten File. A couple of years ago when I was trying to get to the bottom of my intestinal and uterine problems, I got to know the author of this website through a forum on neurological diseases related to gluten. When that forum crashed, Cara, the author, lost a lot of her data that she had compiled through many posts. She then decided it was time to create this website, which is a wealth of information.

The Gluten File
Interested in the effects of gluten on fertility? Go to the right menu on the home page of The Gluten File and click on Infertility and Miscarriage. Cara painstakenly searches the PubMed abstracts regularly and links them on her website. Most of her links are from abstracts of published medical literature.

If you think about it, bowel health and reproductive health go hand-in-hand. If you are familiar with your anatomy, the female reproductive organs are sandwiched between the rectum and the bladder. I don't know who thought to put the baby making organs between two septic areas in the body. I think it's a bad design, personally. Take my anatomy for instance. Normally, the uterus lies over the bladder. I'm special in that I have a retroverted uterus, which means it's tipped back more near my rectum. I used to have leaky-gut syndrome, so I can't help but think that all that poo was leaking next to my uterus. This also happens to be the area I tend to get the fibroids, on the back side of my uterus where it's close to my rectum. I know, eww! You can also find information on Leaky Gut Syndrome on The Gluten File.

What's the big deal about Leaky Gut Syndrome? I'm glad you asked. Leaky gut syndrome can lead to gluten sensitivity, as in my case, as well as lots of other food sensitivity issues. Taking lots of antibiotics and NSAIDs (non-steroidal anti-inflammatory drugs), like ibuprofen, can cause leaky gut syndrome. After my laproscopic myomectomy in 2006 to remove uterine fibroids, my intestines were a wreak. I took a lot of ibuprofen, which I thought was safer than the other heavy duty pain killers I was prescribed, but they destroyed my small intestines. I did not know this at the time, and I did stool test after test with my GP to figure out what I had. All the tests came back negative. I think my doctor was beginning to question my sanity. At one point, my doctor had me tested for HIV. I was a bit insulted, but I did the test to humor her. I knew it wasn't all in my head. I just had to find the right doctor to work with.

I finally figured out by doing my own research that my local hospital did not test for all possible intestinal pathogens. I got fed up and went to an acupuncturist who specializes in gastrointestinal disorders. I got the proper testing, and was diagnosed with bacterial dysbiosis, which means I had an imbalance of bad bacteria in my gut. He treated me with Chinese herbs, and the problem was solved. We also did a lot of work on my food sensitivities, and now I have it down to two food groups I can not eat, gluten and most dairy. At one point, I also could not eat corn, soy, and nuts, which made for a very limited diet. I still avoid corn and soy, but eat them occasionally. Most corn and soy in the US is genetically modified anyways, so I don't want to be eating it.

So what does all this have to do with fertility? You are what you eat. When I could not eat gluten or corn, I discovered that these two items are in EVERYTHING, at least all processed foods. I had to start cooking all my own food from whole ingredients, which in the long run was the best thing for my health. Crap in, crap out, I say. If you want to have good egg quality, look at what you are eating. How many times do you eat out a week? Even places like Whole Paycheck Foods do not use their top quality ingredients in their deli. You don't know what crap they are cooking with to save money. Plus, I know many people who are celiac or gluten sensitive who end up getting sick eating from there. If you don't have time to cook for yourself, then ask yourself why? You probably have too much going on in your life and are stressed out. Stress is the fertility killer.

A lot of women freak out when they find out they have high FSH or are told they have bad egg quality. The average lifestyle of a US woman is not conducive to reproductive health. We work too much, we do too much, we don't sleep enough, and we don't take time to relax or cook a good meal for ourselves. Exercise? Who has time for that? Or we do too much of it to fit into some image of a coat hanger skinny model that the media too often pushes off as desirable. Plus, we live in a toxic world. If we took care of ourselves and identified and eliminated the toxins in our lives, our egg quality would be a lot better.

I was one of those women I'm describing here. My uterine fibroids were a wake up call for me. I had an FSH of almost 18 and was told my eggs were toast two months shy of 39. I changed my lifestyle, cleaned up my diet, and did a lot of Chinese medicine and acupuncture. My FSH dropped and my RE couldn't figure it out. He chalked it up to a faulty lab test. My embryos at age 41 looked like those of a woman 10 years younger than me. One of the key things to turning my health around was getting to the bottom of my intestinal problems and healing my gut. It wasn't easy, and I had to work with a whole team of health care professionals to figure it all out. I'm hoping I can make at least one aspect easy for you by providing recipes for healthy meals. I'm notoriously bad at eating the same things over and over again, which is really bad for leaky gut syndrome. Luckily, I also get bored with what I eat and am constantly looking for new and interesting recipes. Enough talking, let's eat!

Kale and White Bean Soup

This soup became a staple in my house this year. We had an abundance of kale in our garden, and I was looking for new recipes to cook with it. This can be made with sausage or without. I make it both ways, depending on my mood. I will start with the version with sausage. It can be served with rice pasta or spaghetti squash, as pictured above.

1/2 lb. bulk sweet Italian sausage or buy links and take off the casings
2 Tbs. olive oil
1 medium onion, diced
5-8 cloves of garlic, minced
salt and freshly ground black pepper to taste
4 cups chicken broth
one 15oz can of cannellini, white kidney beans, or great white northern beans, drained & rinsed
4 cups packed chopped kale (stems removed)
1 Tbs. fresh lemon juice OR one 15 oz. can of diced tomatoes
1 cube of frozen basil or 2 tsp of dried Italian herbs (can be a mixture of basil, marjoram, thyme, & oregano)

Toppings:
minced fresh parsley (optional)
grated romano cheese

1. If serving with spaghetti squash, bake spaghetti squash by cutting in half, scooping out the middle with the seeds, and placing in a baking dish cut side down with about 1/4" of hot water. Bake at 400 degrees for 45 minutes or until done.
2. Start the soup by browning the sausage first. In a skillet, break the sausage up into bite size pieces and brown. Set aside when done.
3. In a soup pan, saute onions and garlic in olive oil until translucent.
4. Add browned sausage, 3 cups of chicken broth (reserving 1 cup), kale, salt, pepper, Italian herbs, and half the rinsed beans (reserving the other half).
5. With the other 1 cup of chicken broth, put in a blender with the other half of the rinsed beans. Puree until smooth, and add to the soup.
6. Add tomatoes, if desired. Otherwise, add lemon juice at the end.
7. Bring soup to a boil, then reduce heat to a simmer for 15 to 20 minutes. Stir occasionally.
8. If you are not serving with spaghetti squash, cook pasta while you are waiting for the soup to finish.
9. Add lemon juice to the soup at the end if you did not add tomatoes earlier.

Vegetarian version:
Substitute chicken broth with vegetable broth or water.
Instead of sausage, use another can of cannellini beans. Blend one can of beans with 1 cup of water or broth, and put the other can of beans in the soup unblended.

Serve with grated romano cheese and minced parsley. Yum!

Unidentified Uterine Object

A lot has gone on in the last week. I've had my share of poking and prodding and it actually went ok, minus one mini meltdown. I'd pretty much had my fill of injections, detections, inspections, and neglections after the last IVF, so I wasn't in a big rush to have my body messed with for awhile. When I finally got around to getting my teeth cleaned by my sadistic super-anal dental hygienist, I was chastised for not having gone for 10 months. Needless to say, I did not elaborate on the infertility massacre with the four part harmony and the twenty seven three-by-four glossy ultrasound pictures with the circles and arrows and the paragraph on the back of each one. But I didn't come here to write about my dental health today.

I went to the big-shot fertility clinic yesterday to get more inspections, detections, and neglections. I got the ultrasound, the 3-D ultrasound, the uterine artery blood flow check, and the antral follicle count. I hadn't had three out of four of these last things for my last cycle at the "clinic-across-the-tracks", and it didn't seem to matter as neither my uterus nor my eggs were the problem. I passed the uterine-artery-blood-flow-whosiecallsit, failed the antral follicle count, though they were nice enough not to say it in those terms, and found a mystery blob in my uterus, though it's "so far away that it won't be a problem for pregnancy". So somewhere out there in the universe of my uterus is an Unidentified Uterine Object. The baby-faced Dr. G, who looks like he just graduated from college, couldn't tell me for sure if it was a fibroid or what. At least he gave me the same answer as Dr. W did two months ago and yesterday's ultrasound tech, who I think was also in the Class of 2008 along with Dr. G. It hasn't gotten any bigger in the last two months, so I guess I'll keep doing what I've been doing.

In defense of my ovaries, I'd like to clarify that I personally don't think I failed the antral follicle count. I'm 42, and I think seven is a very respectable resting follicle count for my age, thank you very much. Oh, they would want me to do a clomid-challenge-test for them, to which I'll probably reply something eloquent like, "up yours," or calmly point out that I think we have enough information about my ovaries after one clomid challange test, one IUI cycle with clomid, and two IVF cycles with different protocols. Besides, clomid makes me crazy, and you don't want to see me crazy do you??!! That's already caused enough problems.

Anyways, let's not put the cart before the horse, shall we? I still have frozen embryos that I need to decide what to do with. I won't be making any decisions before December 12th. That's the date I find out if the buyer for my house gets their loan, and the same date I have the reading with the baby psychic. Do not attempt to adjust your computer screen. You read that right. I'll be having a phone reading with Walter Maki.chen author of the book "Spirit Babies". I need specific information and I believe he can give it to me.

Testing the Waters

I began my speech with, "I don't know how much of my story I can tell because I might start crying".

After I had made some progress with my last trauma therapy session, I decided I was ready to try again. My first plan of action was to make an appointment with the big time fertility clinic in my area. Everybody knows which one it is because, I will give you a hint, it's number one in the nation. It's only a 15 minute drive to their office branch near my house. You might wonder why I did not do my IVF cycles there before. I had consulted with one of their REs previously, but I did not have a good experience with her. They have a relatively new RE who I have heard good reviews about. I couldn't believe how quickly I got an appointment with him, which could have been the next day, but I stretched it to the day after that. It's a good thing, because I had a hangover yesterday morning. My main reason for going to the appointment was to get an update on my uterus in terms of any fibroids that might be lurking there, and to check out this new RE, Dr. G, in case I decide to switch clinics.

Most of the details of my first appointment with Dr. G can be read about on my private blog. If you have access to my private blog, you can click here to read more.

I'll go back in about two weeks for another ultrasound to see what the status of my fibroids are. Dr. G did say that the size and location of what appears to be a fibroid that Dr. Wonderful saw two months ago would not be a problem for future pregnancy at this point.

As it usually seems to go with doctor's appointments at fertility clinics, the information I got from Dr. G did not clarify my decisions. If anything, it seemed to make them that much more complicated.

RESOLVE's Resolve on Amendment 48

If y'all don't live in Colorado, then you might not be aware of this potentially historic making amendment that Colorado voters will have to grapple with, along with a long list of other issues to mull over. Amendment 48 would define "personhood" at the point of fertilization. This is one scary piece of legislation that has only one agenda, to outlaw abortion. In that process, it would likely take away fertility treatments and IVF.

That fact that I have to vote on this crap makes me sick. It leaves a lot of gray room for what is legal and what isn't. We had another well intentioned but vaguely worded amendment pass in Colorado a couple of years ago. Amendment 41 prohibits government workers and their beneficiaries from accepting gifts. This amendment was intended on preventing lobbyist from giving gifts to lawmakers. However, when it first was passed, it was unclear if a child of a government employee could accept a college scholarship. As a government employee myself, it was even unclear if I could accept gifts of value over $50 from my husband!! It took two years for an independent ethics committee to deem that this was ok. That's the mess that can be caused by vague and broadly worded amendments.

I asked Magic if we would have to get social security numbers for our frozen embryos, and he said yes. We would probably also have to get birth certificates for them. This makes my brain go *tilt*. What a mind game it plays with all infertility patients. If all of our fertilized eggs instantly became children, then we could all breath a lot easier, eh? When one of our embryos doesn't take, do we have to get a death certificate too?! In short, this amendment would be a nightmare if passed.

RESOLVE put out their statement on the amendment a couple of months ago. It's worth reading, because the same type of legislation may be coming to a state near you soon! One statement in particular got my attention:

"Would women with fibroids or other uterine abnormalities be forbidden to try to have babies because the problems with their uteruses reduce the chances that an embryo will successfully implant after IVF or an insemination?"

Seriously?

And other gotcha:

"If a Colorado woman travels to another state for IVF, would her eggs still be defined by Colorado law such that doctors in no other states would offer her treatment? Would she be forbidden to move any currently frozen embryos to another state to continue her treatment?"

This one got me worried. I never thought that Amendment 48 might prevent me from transferring my frozen embryos.

Amendment 48 was initiated by a 21 year old woman Kristi Burton who was homeschooled. She isn't old enough to know if she even has fertility issues. I'm sure she isn't aware of all the other sticky issues that this amendment would create. For example, what if a woman has an etopic pregnancy? Who do you save then?

All those of you who think CCRM, the #1 fertility clinic in the US, is your last chance for success with IVF, forget it with this amendment. So, if you are thinking of cycling at CCRM in the near future, you better call all your friends and relatives in Colorado and tell them to vote No on this one.

As much as I think this one is a no-brainer, you never know in Colorado how people are going to vote. After all, it got 130,000 signatures to get on the ballot. In the case that it does pass, it might push the issue of when I do my FET. I think I would have until January 1 before the law went into effect. I couldn't wait for the years it's going to take to untangle the legal mess this amendment will create to get pregnant. I hope I'm not pushed to make that decision!

Show & Tell: My Garden

This is my sanctuary, my garden. The kale you see on the far right, lower part of the garden was planted while I was pregnant. This is the best garden I've had since moving in with Magic five years ago. The first year, I completely dug up the garden that had been neglected since Magic's divorce five years earlier. My stepson, who was eight at the time, helped me remove a gigantic rock that probably weighed close to 100 pounds out of the garden. Two of those years, I didn't have a garden. One year was because of how busy I was with planning my wedding and the next year I didn't have a garden because of my fibroid surgery. I have an interesting story to tell about my garden and my fibroids.

My babyquest started in earnest after I was married in the summer of 2005. The first RE visit was the revelation of my "huge" fibroids and my (failed) attempts at getting rid of them naturally. Although I ended up having surgery, I learned a lot in the process. Shortly after my first devastating RE visit, I was fortunate to be able to attend a workshop in my home town by Rosita Arvigo to learn about Maya abdominal massage. The workshop really wasn't so much about Maya abdominal massage, as it was a fascinating anatomy lesson about the uterus and all the ligaments that hold it in place, and it's health. All the women in the workshop were midwives except for myself and another woman who had been dealing with infertility for five years. I asked Rosita about why she thought fibroids formed. She answered that fibroids are basically confused creative energy manifesting in the uterus. The uterus is an organ of creation, and not just for babies. One of her examples was of a gardener who doesn't garden. This hit home for me as I did not have a garden that year because of all my wedding and other summer activity planning, and my exhaustion afterwards. At some point during the workshop, I came home for lunch, and I saw my patronus sitting in my backyard. That was the first time I'd ever seen that happen. I knew that it was a good sign and I was on the right track. Unfortunately, the next year I was not able to work on my garden either because of my surgery to remove my fibroids and the complications I had afterwards. Ever since then, I have tried to express my creative energy, the garden being one of them.

I've always had some flowers in the vegetable garden. Usually, it's been marigolds, but I got bored with them this year and these flowers were on sale. I bought the "Lady in Red" salvia and the Black and Blue salvia for the hummingbirds, and they do love them! I was working in the garden yesterday, and had a hummingbird about two feet from my face, hovering above these flowers and checking me out. I look out my window in the morning to watch the hummingbirds feed on these flowers and chase each other. I love going out to my garden everyday to see what's new. There is always an interesting variety of insects visiting my plants.

What's growing in your garden?

He's Leaving

I received a "Dear Jane" letter the night I got home from enlightenment training. He's leaving, Dr. Wonderful, my surgeon savior. The letter had no forwarding address for him. It was a bad sign. I knew he must be leaving the state.

I had been meaning to see Dr. Wonderful, but it didn't materialize before I left on retreat. I promised myself I would do it right after the retreat. I just didn't want his leaving to be the motivation.

I was worried about seeing Dr. Wonderful. I didn't know what I was going to say to him. I was nervous about how he would take the news. It's too bad he didn't deliver babies, or I would have picked him for my OB when I was pregnant. Now, I needed to know if I had any new fibroids. My uterus has felt different since being pregnant, and I've worried that it's been a big fat fibroid lurking underneath my belly fat.

I immediately broke down in tears when I told Dr. Wonderful the story of my failed pregnancy. It's the first time I've done that in front of a doctor. Usually, I can keep it together long enough to have my breakdown in the car or later at home, but my story is just too sad. Then, the words came out of my mouth. I didn't know what I was going to say when he asked me what I was going to do next. I said, "I want to try again, but I'm not ready... emotionally." That was clear to me after seeing him. I was pretty shook up, and this was after seeing a doctor I love! I'm not ready, but this is my first step towards getting there.

Dr. Wonderful is leaving because he can't make it financially here. He's a progressive surgeon who does minimally invasive gynecological surgery. I had my laparoscopic myomectomy (fibroid removal) with him, but this was after seeing three reproductive endocrinologists, the first two who adamantly told me I couldn't have my fibroids removed laparoscopically. Not only could Dr. Wonderful do it, he didn't even bat an eye when I asked him if he could handle my "difficult" case. My first RE who manhandled me in a "pre-surgical exam" lectured me about how he couldn't do my surgery laparoscopically because of the location of my largest fibroid, on the posterior side of my uterus. I couldn't fathom having my uterus completely removed outside of my body, after moving the bladder and intestines to the side, then shoving it all back in again and in hopes that it would work. Lots of women have abdominal myomectomies, but I didn't want to have my abdomen sliced open if I could prevent it. Unfortunately, doctors aren't progressive enough around here to refer their patients to Dr. Wonderful for minimally invasive surgery, even though in the long run, it would be better for their fertility and certainly a lot less painful for the patient. If you live in the Tuscon area, Dr. Wonderful is coming to a new hospital near you very soon!

We did the exam without fan fare. He said, "you've had this done a thousand times". I said, "sadly, yes, it's true". I couldn't see the ultrasound monitor very well with the glare from the sun, but Dr. Wonderful explained how I had this small thing that he didn't even know if it was a fibroid at this point. It's a little less than a centimeter in diameter, probably about the size of a marble, if it's even a fibroid. It's in the same area where I had my large 8cm x 4cm fibroid, and luckily it is on the outside of my uterus (subserosal). I'm going to treat it as if it were a fibroid, and not ignore it. I've kept them at bay for two years since my surgery, but I stopped doing some of the things I was doing to prevent them from coming back, like weekly acupuncture and Chinese herbs, and I had started eating dairy and a lot of chocolate again. Oh, and I haven't been working out on a regular basis since January. I don't know if I can put the effort into everything I had to do to keep the fibroids away. It's a big effort, but it's for my overall health in the long run, not just the health of my uterus.

Dr. Wonderful is the only regular type doctor I know that I hug. We hugged each other at the beginning of my visit and we hugged again when we said goodbye. I hope he will come back when all the old fart OBs retire or die off around here. It's sad, but he's a doctor before his time, at least in these conservative parts of the west.

Show & Tell Sunday: Honeymoon

I was going to Show and Tell our wedding in honor of our anniversary (still a good read), but this would now be our anniversary of our "mini" honeymoon. The picture above is the view from our balcony of our honeymoon condo. I specifically went and checked out rooms at this place ahead of time and requested this one because I knew Magic would love the view of one of his favorite climbing spots. And climb here we did! I think we climbed the smaller triangular looking slab of rock that is about a third of the way in from the left in the photo towards the bottom of this ridge. Can you find it? Of course, Magic wanted to climb the route named "Magical Chrome Plated Semi-Automatic Enema Syringe". Don't you love the name of climbing routes? Although it sounds hard from the name of it, it's actually quite an easy climb, which was good since I was exhausted from planning our wedding. If you can name this mountain ridge (no cheating, i.e. no googling), I'll take you climbing there, or at least take you out to lunch!

We actually took two honeymoons. One right after our wedding for a few days close to home, the mini-honeymoon, and one to Thailand later. Both involved rock climbing, amongst other things!! But first, let's flash back to the day after our wedding.


The honeymoon begins! If you haven't read the story of our wedding (really, you don't want to miss it), you might want to go check that out first. This is the view from my sister-in-law's backyard where we got married. You can kind of see the view of the Rocky Mountains in the distance from the clouds. In the foreground is the remains of our chuppah (pronounced like "hoop-ah"). I like how the top of the chuppah looks like clouds, which is kind of hard to see in the picture since they blend in so well. I'm not Jewish, but I loved having a chuppah. Ours was made from aspen poles that a friend had cut down for us, and was decorated with flowers. Instead of a wedding party, we had "The Chuppah Groupa". Magic and I each picked a man and woman friend who meant a lot to us to hold the poles. The meaning of the chuppah for me symbolized a sacred space to hold our new relationship in marriage, supported by our dear friends. It was also a symbol of Magic and I creating a life together, as in the Jewish tradition, it symbolizes the bride and groom's new home.


This was before I ever went to an RE or found out I would have to have surgery to remove multiple uterine fibroids before they would even touch me for fertility treatments. We took our "official" honeymoon to Thailand eight months later. By this time, I had had five opinions on my uterus, one of which I flew across the country to New York City to get. That was pretty much the clincher for me, and I decided on the surgery. I was waiting until after our honeymoon for the knife, but regardless, the glow of our wedding had vanished and the looming reality of uterine surgery and my declining fertility was already weighing heavy on my mind.


In Thailand, we visited one of the primo climbing scenes at Tonsai beach. We met throngs of climbers from all over the world; Japan, Isreal, France, Sweden, Holland, Germany, Slovenia, New Zealand, Australia, Canada, the US, and of course, Thailand. Magic even ran into an old climbing buddy there.


I'm not much into scenes, but the climbing was outrageous. Pulling down on stalactites and trying to smear on greasy limestone while sweating buckets - exciting to say the least. I wanted to climb the route that this woman below is doing the split on, but sadly, we didn't have time. The long grey phallic looking thing to the left of the cave is a giant stalactite. Outrageous!

Flashback to the last stop on our mini-honeymoon after our wedding (below). You guessed it, another climbing spot! This one required a hike through an area that had been burned in a wildfire and was now spectacular with blooming penstemons and other wildflowers. I didn't realize it until later, but I had visited this area when it was barren and charred. It looked so completely different now, that I didn't recognize it at first.


Reflecting back on this now, I see the analogy of something beautiful arising from the ashes, something that I wish has yet to be for my life.