Miscellany

Life is progressing well in NYC. I think at this rate, my liver is going to be pickled (quite a change from the I-don't-touch-alcohol slogan which as the backbone of last year) but I'm slowly settling in and meeting new people.  Loads of fun!

I *finally* had my new RE appointment today (Dr. Licciardi, NYU). I walked out of it fairly pleased, on the whole.

The highlights
Finding out IUIs will be covered (or so I believe at this point)
No forking out 300 odd dollars for a new consult- only a flat small copay!
He agreed right off the bat to genotype me at the FMR1 locus (this is also the fragile X test)

The Plan Forward- do I really have a problem and can it be fixed??
We have no idea why the crapfest that was the last year really occurred.  I think the question to ask is- do lean/ovulatory PCO woman really have problems either conceiving or maintaining a pregnancy? There is a trend to suggest this, but really large, well designed studies have not been done. What I want is the opposite of the studies that are done- I want them to take women who conceive easily and have had multiple healthy pregnancies, and ask if THEY have lean PCO and thyroid autoimmunity and heightened NK cell activation and anti-phospholipid antibodies and all the million other vague problems that plague infertiles.   Sigh. 

Dr. L was willing to go with the theory that I might have lean/ovulatory PCO, but was completely noncommittal (as any sensible person would be) on whether this was the real cause of my losses and whether metformin would help me.  The way he put it- there are two types of PCO patients...The first category, that I fall into, which he referred to as 'New York PCO' (ha) wherein women are thin, are not visibly too hirsute and might even ovulate regularly. Then there is the second class of overweight women with overt glucose metabolism issues and ovulatory problems. In his opinion, metformin really helps the second category, but seems to not do so much for the first. I've read the studies, I've read the reviews discussing the studies, I can't really be sure metformin helps either, but nor can I discount it. There are studies which show it does seem to reduce the antral follicle counts and AMH levels, however bigger and better designed studies are needed IMO. So as it stands- we agreed I would start metformin about 3-4 months prior to my TTC cycle.  I think there would be significant debate about when to end it- I would probably atleast go to the end of the first trimester.

We are also getting my glucose metabolism investigated. I've had fasting glucose tests done and they are excellent- normal sugar levels and actually LOW insulin, indicating insulin sensitivity, not resistance. What we have not done though, is a glucose tolerance test. Given that I love to shock my system with an insanely sharp sugar spike atleast once a day (such a good idea for a girl coming from a family of type 2 diabetics...NOT), it will be interesting to see how my body responds.

More on vitamin D and BBTs and charting and follicle counts to come soon----and I've also got the doctor reviews to put up. Not that I have that many- but- my page is now the FIRST that comes up when you do a google search! Its even pulling up doctors mentioned in the comments- super cool!

Why does miscarriage hurt so much?

I was honestly, given everything, taken aback at how much my two losses have hurt me. I can understand why a woman who has gone through IVF or years of infertility is that shattered by a pregnancy loss: it is not just the the fact that she has lost an incredibly precious promise of the future, its also about the years of emotional investment, of taking nasty drugs that disrupt your body's natural processes. It is almost like the Sisyphus and boulder situation, where you have spent eons pushing that boulder up the hill, only for it to flatten you on its way down.  I can understand their pain and frustration.

In my case, so far, I have paid relatively little money and even that I could comfortably afford. I have had no drugs injected into me (or taken orally for that matter), my conceptions were entirely without any medical intervention other than getting the swimmers into me. I got pregnant both times I tried. My 2 first trimesters were pretty easy.So basically, I went through the entire get-pregnant-and-lose-babies with a minimum of financial and physical liability.

With early pregnancy loss, its not the same as have lost a child you know, it is more like the loss of an infinitely precious promise that had yet to be realized.  From a philosophical standpoint,  I'm pretty darned aware that miscarriage has happened billions of times.  All this has made me wonder, has my soul ever occupied the body of any child that died, at any point, during those 9 months? If the theory of the soul + body is really true, then its highly likely. Maybe after that death, my soul entered the body I occupy now. If I had gone somewhere else, I would'nt be where I am now. I would maybe have different parents (NOT ok with that!), a different identity.  When you think about it in this way, then the grief associated with early pregnancy loss diminishes a little.

Also, one really does not think about this, but sometimes, your situation could be far worse than what it is. If we think early pregnancy loss is hard, then imagine a parent watching their child die of Tay Sachs, or or childhood cancer, or some of those completely horrible premature aging syndromes.  Or imagine a child being born with a disability that would make his or her life difficult forever. If, as Hinduism puts it, that the body is only a garment for the soul, then I wish, above all else, that my child gets a good dress, with no rips or tears or sleeves missing. So if a first trimester miscarriage is really saving me from something worse, then I am okay with that, honestly. I've been in a unique situation, of actually knowing that to be true in the case of my second pregnancy, with the Turner's Syndrome diagnosis.

So- little physical or financial investment and being at ease, mentally, with the theory of the journey of souls---and still this hurts like crazy. I feel like I've been scarred for life, with each loss gouging the cut a bit deeper.  I want to make that hurt go away, because, I might have to go through the process of pregnancy loss yet again. And if it keeps hurting so much each time, I fear I would not have the emotional resources to keep at it multiple times, to find my golden egg.

I've always been an eminently practical person. That practical nature, now, is demanding that I diminish in some way the specter of miscarriage, so even if I have to go through it again, it is a little stumble rather than a giant fall.

Despite all this tough love and merciless laying out of facts, I fear I've made little progress.

Astrology and me

For anybody reading my blog who does not know this already, I’m Indian.  If you have ever heard the stereotype about Indians fervently believing in astrology, it is true.  There are armies of astrologers telling a gullible nation of a billion people when to plan their weddings, when they should start a business, when they should buy a new house, the list is endless.  And they buy it.  They bend over backwards, arrange everything around the prediction. It is bloody incredible. 

Astrology is an ancient practice, with a mathematical system behind it.  Interpretation is drawn from the positioning of the planets and the stars.  Most modern day ‘astrologers’ are charlatans, not knowing anything about this ancient system. There are a few people who actually have made a study of it and apply it properly, though the real question is, is there is any validity to the system?

Courtesy of Google Images

I don’t believe in astrology. However, I cannot sit here and confidently say that it is absolute rubbish either. Its kind of like my position on god, where I’m neither a believer nor an atheist.  My parents, however, believe in it. They have taken my charts, my brother’s charts, various family members’ charts to the astrologers, and occasionally I am surprised that they get interpretations that accurately sum up the situation, since the astrologers have never met the parties in question and do not have the data to make up something that will fit the case.

But still, I am disposed to definitely *NOT* believe in it.  But every now and then, I hear something that just makes me want to tear my hair out in confusion. In the past 2 months, my parents have taken my charts to two separate astrologers. Both have assured my parents that I *will* get married (My response to that…..HAH + rude finger sign). The part that raises my eyebrows is the following

Both parties independently predicted that there is a strong likelihood for me to meet somebody this year . Spooky bit is that both parties independently predicted that the likelihood arises in the same month- July

One of them said there is a huge protective influence, which will make sure nothing really bad happens to me (enough things that have happened in my life so far make me want to agree with this one)

The other (who has no idea of my pregnancies) told my parents that it was really good that I had not been married till now, because my charts indicate that if I did get pregnant before November 2011, there is a strong indication my life would have been in danger.

This last part is truly the one that makes me want to screech in frustration. Why would they make up something like that? Why bring up pregnancy out of nowhere? Why go and name that one month?!?! Because, adding to the weird factor, my tentative date for trying again is December 2011.

I’ve been wondering why my babies died. My brain just keeps buzzing back to this unanswerable question, picking away at it. I’ve always had this sixth sense about things that proves itself right maybe 50 % of the time.  That little annoying voice has been piping up saying that that there was a reason all of this happened, that I just did not know it yet.

Everyday, my brain is so tired from buzzing around endless explanations, the scientific and the philosophical. Then when my parents relate all of this to me, and the buzzing just rises to a bloody crescendo. Ugh.

Do you believe in destiny? Do you think there is a grand plan to things? Would you buy all of this as whacky coincidence? Feel free to not hold back when you answer.  

Reviewing Doctors

Thank you all who have come by from LFCA to the Good/Bad/Ugly post and shared stories of your doctors. Somebody asked whether I was doing a national listing. Another person asked whether I would be willing to put my review up somewhere else.

The main reason why I wrote those reviews, was to harness the power of search engines. The most direct way to find information about anybody, is to google them.  It is the universal  and easiest way of locating anybody. I hence want to create a page that will contain honest, detailed reviews about doctors from everywhere, that has enough tags, and sufficient hits to pop up on the first search page. This last part is really important. You can write a review about somebody, that might be so far behind on the google searches that anybody who looks for the person will never find them, because your review is sitting on page 6 of the search, in a rarely visited website.

It does not matter if the doctor is American or international.  It does not matter even if they are in a small town on the other side of the world. The point is to put their names, with their hospital affiliations and regions on one giant page, which has all these different tags it can be pulled up by.

I would have to consider how to organize the page if I got a lot of material. I think I will stick with having 3 categories (Good/Bad/Ugly), and then further group by region. International is fine.

So this is the format I would prefer

Refer to yourself by any nickname you choose.  Link to your page if you want.
Choose review category (good, bad or ugly)

List full name of doctor with clinic name, region
Specialty: Example OB/ RE/ Perinatologist 
Description of your interaction

It would be easier if you emailed me the information- my address is Justlookingsd30@gmail.com

Once I have enough, I'll enter all reviews in this new format.