Tuesday, May 15, 2012

Rolling along...

Its very easy to get sucked into the whirlpool of  TTC anxiety/anticipation, even when you are far away from the actual event. God knows, the months between miscarriage 1 and TTC 2 went in a flurry of mental hand-wringing and hoping that stuff would be ok, and wishing time would just move faster, while not really paying attention to life. Well, things turned out to be decided *not* ok, but something amazing happened- I learned to switch off during the waiting period.  There were an eye-popping 16 months between miscarriage 2 and TTC  3 (which ended in a BFN). And I was mostly ok and relaxed for all of of it, which constituted a minor miracle. Now, there is going to be atleast four more months between TTC 3 and TTC 4 (tentatively planned for July), and I'm fine. I feel ok even when I anticipate delays past July- atleast in the getting pregnant bit.  I totally feel like I need to write somebody in the universe a big thank you note for my newfound Zen.

I've been doing a lot of thinking of how I am on the relationship front.  Its funny how emotionally detached, independent and mostly uninterested in the available fare I am and I can't figure out how I got this way. I became friends with this girl recently, and she is totally the anti-me. She has had a really rough time of it-- her mom died and the guy she had been seeing for 2 years and was totally in love with decides that he has fallen out of love with her & she is skirting depression. It amazes me how all her happiness, everything that is good in her life hinges on this guy and well, he is not delivering. I gave her the spiel on what the stages of grief are and I asked- have  you accepted that its over with this guy (Its been a month)? She said no. She also confessed she was afraid that she might be pregnant, but did not want to take a test to find out. The reason I'm accounting all of this is...its hard for me to get over how different people inhabiting this planet are, and how much better off one would be if one were not at the extreme end of an emotional spectrum.

I'd be a *lot* better off if I was a little bit more emotionally needy like this girl  and she'd do much better if she had some of my detachment and independence. Plus she could do with getting her head out of the sand for a bit- she was contemplating starting anti-depressants while pregnant, she should atleast clarify that question first, and get started on pre-natal nutrition if she is- she confessed she had lost a ton of weight because she had simply lost interest in food. Big ARGH. I may have overstepped many boundaries when I told her like 5 times that she had to find out one way or the other, STAT. I hope she tests.

On the TTC prep front, a source of frustration is my vitamin D levels. Over 2 months ago, my D3 levels were 86 which made me yelp in horror and drop my dosage by more than half. I figured this should bring it down to the 40s, which is where I want them to be. I tested last week- its gone from 86 to 79, which makes absolutely no sense. I have a feeling the levels may be so high that its maxing out the test and both reported values are inaccurate - that or there is some crazy biology at work. Anyway, I'm completely off the D now and the next time, my new wonderfully cooperative and available endocrinogist (I've added a review to my awesome doctors list) has agreed to send my blood off to an alternate lab for the next round.

So life is rolling along, and though on paper, my life does not look that great (single, maybe reproductively- challenged, staring at a possibly very difficult TTCing process as a single mom and I can't even tell which country I'll be in in 6 months), I'm not feeling any of the pain. I'm thankful. 

10 comments:

  1. I think your Zen sounds pretty good, and I'm not sure you'd be a lot better off if you were more emotionally needy. The fact of the matter is that a lot of things happen - or don't - regardless of the angst we put into thinking about them. And while that angst can occasionally light a fire in a motiviational sense, I think to be in a state of panic or anxiety is...well, it's uncomfortable. It doesn't better the quality of life.

    You're a woman with a plan. And you know that the plan may not unfold in the time you want it too, but you still have the plan in front of you. And I still maintain that it's a matter of meeting the right one. And that when you do, the whole playing field might change. 

    (Crazy about the Vitamin D!)

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  2. Hmm, yes, please send some of your independence and detachment over to me, too!   I know what you mean - it's rare people are perfectly balanced in the middle.  I'm glad to hear you're feeling relatively zen right now. :-) 
    p.s. July is actually only two months, versus four, right?  

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  3. Jay, can you please look at this link: 
    http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(12)60710-7/fulltext?version=printerFriendly
    I really understand your frustration. Testing everything is not so good. Vitamin D story is not yet confirmed. I think at this point  the pharmaceutical companies are earning a lot of benefit from Vitamin D sales (from 40 million dollars in 2001 to 285 million dollars in 2010) and nothing else. Try to read your body. It will give you the necessary clue. If you feel fine everything else will be fine, at least some things need not have to be tested . Think about your TSH level too! ( I agree that you should stay on thyroxine because of your antibody titre, on the other hand I feel a TSH of 0.65 is too closer to being hyperthyroid!) You should realize that there are no proper studies conducted to determine the apt Vitamin D level for Indian population. http://mpkb.org/home/pathogenesis/vitamind

    I do not know why I am writing all this to you. Might be I just want to prove I am right :) But if I think about it deeply the truth is not so. Two people with two different world-views can be good friends too :) Might be we can learn from each other! I wish you lots of good luck! Take care.

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  4. I'm glad you're feeling Zen. July will be here before you know it. As someone said to me just this morning, "It's already halfway thru MAY!!"

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  5. Thank you for your concern, I  truly appreciate it. I think you need scientific education/perspective to look at all of this the way I do, below is my 2 cents on this subject and what you bring up here.

    -The Lancet article you showed basically said they need better assays, and I'm not arguing there. I've now started investigating which lab does what sort of assay- that is the way to tackle it, IMO, not by saying, well, since the tests suck, I'm going to sit here and ignore all the literature that links vitamin D deficiency to various adversities.

    -the second article was written by somebody with an agenda, and they make piss-poor arguments, forgive my french. They make a super strong case for vitamin D being anti-inflammatory which would make  most women here desperate to be replete on it during pregnancy (where an anti-inflammatory effect is  VERY good), and ditto autoimmunity. As an immunologist- vitamin D is about regulating the immune system. Too little is bad, too much is bad, you need to find a good balance.

    -Also, I have to comment on this:  vitamin D is not a big moneymaker for the pharmaceutical industry!  First thing, its not even MADE by the pharmaceutical industry, and moreover, even the cheaper drugs made by big pharma (from advil to metformin) retail for a lot more than vitamin D. Vitamin D on the other hand, is sold by independent unregulated companies(atleast in the US) that make  health supplements.  One years supply (if you take 2000 IU/day) is around 15$ off Amazon.com. Its a laughably small amount .

    -on a TSH level of 0.65 being hyperthyroid- no its not.  its in the normal range, as were my test values of the thyroid hormones themselves, and the most telling sign of course  (and is this the one place where I do agree with you) is your own body.

    Perspective on vitamin D deficiency:

     All the giant body of studies show is not a confirmation of vitamin D
    deficiency as the supreme cause of many ailments, but a very significant
    association of risk for various diseases with low levels of this
    hormone, which may have manifested because we do not spend even one
    tenth of the time nature intended us to be out in the sun.  11 % of the perfectly healthy population are vitamin D deficient people-- ie, their deficiency has no effect on their health.  
    But if you have certain genetic pre-dispositions towards diseases, a vitamin D
    deficiency might amplify whatever genetic risk you carry to start with, for example, type 2 diabetes in the indian population. In a Scottish population, it may amplify the risk for multiple sclerosis and so on and so forth.



    Indians are very commonly deficient in vitamin D. We also have an incredibly
    high risk of type 2 diabetes, and I think the  amplification effect of
    vitamin D  deficiency for diabetes development begins when we growing in the womb.  Right now, this is just a hypothesis, backed by quite a
    bit of studies which shows that children of  vitamin D deficient mothers have a much higher risk for developing both asthama and diabetes, and schizopherenia, etc.  I'm not surprising that most RCTs are not showing too much of an effect, unless it an autoimmune disease or maybe a mental health (for ex: depression) RCT.  In most of these cases, its like trying to close the barn door after the horse has bolted.  IMO, in many cases, correcting vit D deficiency would be more effective for prevention of disease states, not as a cure. And THAT, is highly relevant for pregnancy, while you are creating new life.

    Finally- I do listen to my body. After I got vitamin D replete, this is the best I've ever felt or looked in my whole life :) Of course, I have no desire to overdo it either, which is why I have to find the right balance. And thankfully, I have the financial and practical means to achieve that easily.

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  6. Zen is a mindset that so many people could benefit from and so very few actually find.  Embrace it sister!  And just a little side note FYI, I am also a very independent gal.  I knew I wanted to find someone but it took me a lot longer to find someone that LOVED my independence and fostered it.  Just because you're comfortable alone doesn't mean that the perfect guy isn't out there...he's just harder to find because he's in the minority of guys who love strong ladies.  :)

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  7.  haha yeah and thank god for that :)

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  8.  You have an incredibly simplistic worldview on things and of of course you are welcome to your own views.

    However, let me correct you on a few points

    Vitamin D IS measurable. Some labs may have more faulty techniques than others, and the method of testing appears to be a work in progress, with earlier used methods appearing more faulty, but there IS value to a vitamin D blood test. You may disagree, but that is YOUR opinion.

    The amount of vitamin D you get through food is utterly negligible, except for a few fatty fish, and even that you would have to consume lots of.

    Uncontrolled inflammation is very, very bad. Let me give you that as an immunologist, who studies this for a living. Its bad in autoimmune disease, its bad in pregnancy, its linked to endometriosis,  and a really long list of esoteric problems and you seem to be interested in its anti-cancer poperties- let me educate you, increased inflammation can actually be LINKED to cancer formation and many
    See this review
    http://www.ncbi.nlm.nih.gov/pubmed/22391222

    Finally- you utterly missed the point I was making- it is logical that a lot of RCTs (for example, the diabetes RCTs) exploring the effects of vitamin D do NOT work, because a vitamin D deficiency is possibly one of the many dominoes to fall in the causation of a disease state, like diabetes, or fibromyalgia or schizophrenia. Once all the dominoes have fallen and disease gets established, just correcting your vitamin D state  [probably cannot fix the issue, unless the disease propagation involves active inflammation.

     I am well aware that vitamin D is a hormone and effects over 3000 in the body- all of this is taken into account when I've said everything that I have

    Finally, while you definately do not deserve this explanation, I'll give it anyway, because it may be useful to other people reading- I used to take over 1000 IU vitamin D 2 years ago, when I was trying to conceive. With this dose, my blood levels were revealed to be slightly below 20 (which is deficient according to the experts). I had 2 pregnancy losses, certain symptoms of PCOS and a short luteal phase. I had to increase my dose largely to bring my levels to over 30 ng/ml, at which point the PCOS and the luteal phase issues went away, my skin looked amazing and I put on some much needed weight.  But  probably because I took too much (and a recent week spent running aroiund in a bikini in the carribean) my levels went too high, to above 75, if the testing lab is to be believed.

    Where the ideal levels should be is a matter of debate. I don't believe in too  high levels, just because its a hormone as you stated, and I've very well aware that whats good at a certain level can have different effects at others. But where we strongly differ is what the 'good' level is .

    If I took your advice (of 1000 IU/day, with no testing), I'd be deficient like I was, with all the issues I had then. But what I was doing went to the far end, so I have to find a good balance, which I am capable of doing, after trial and error, which I can do without your dubious input. You seem to be utterly hung up on your own 'wisdom'. You are welcome to your own views- please do not try imposing it on me any further, you are wasting your time.

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  9. FertilitygoddessMay 18, 2012 at 10:35 PM

    Good Wishes Jay!!!

    Just a good debate and will be helpful for people who read it. Did not have any idea to hurt you and I did learn a lot about Vitamin D. Ofcourse my view is not changed and ofcourse it is very wrong on my part if I expect you to change :) Take care. I did appreciate who you are !

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  10. Glad for your Zen.  Especially in the face of a friend with a potential unexpected pregnancy.    (Also, I promise to send you a review of my former RE shortly.) -M

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