The sugar monster

November 10, 2015November 10, 201513 Comments

Hello, my name is Dani and I am a sugar addict. Phew. Glad I got that out into the open now :-s

After reading ‘It starts with the egg’ by Rebecca Fett I decided to give up sugar about 2 months prior our 1^st IVF cycle.

Actually what I really gave up was simple/refined carbohydrates. The science behind it all is rather compelling so I thought I’d give it a go. It turns out that women who follow a diet of low-glycemic/slow carbohydrates have a much lower rate of ovulatory infertility. Research shows that high blood sugar and insulin levels significantly decrease egg quality. This in turn reduces the proportion of embryos that can successfully implant in the uterus, reduces IVF success rates, and increases the risk of early pregnancy loss. As we have no clue what causes my infertility, I thought it has got to be worth a shot.

Well fat lot of good that did me! Although, as it was my first time doing both the diet and the IVF, it is difficult to know what would have happened had I not followed the diet. I mean, it was the first time I ever saw two pink lines, so there was definitely something that helped!! Whether it was the IVF or the diet we will never really know. I’m not willing to experiment.

Chris helped me and we made some general food choice changes. We swapped out white rice and pasta with the brown and black stuff. We bought quinoa, lentils and whole wheat cous-cous….all slow release carbohydrates. Our portions also became smaller because we got fuller quicker. I bought a bread machine and we made our own whole wheat breads. We got rid of the chocolate, cookies and other bads and replaced them with nuts, fruits and plain yoghurt.

After the news of our unviable pregnancy the comfort food came out and the diet went out of the window. At first, everything was too sweet and I couldn’t eat much of it! But it soon became easy to eat the bads, and we treated ourselves to whatever we liked.

Today we are back onto the path of a low glycemic diet and exercise. I got a call from my nurse co-ordinator who went through some dates with me for our second round of IVF and we are looking at starting Birth Control Pills around my Birthday (yey! Happy Birthday Me! Have a BCP!!!), starting stimulation injections around about 7th Jan 2016. So that is 2 months of healthy eating (minus Thanksgiving and Christmas holidays).

At the weekend we bought a new book called ‘the sugar free kitchen’ and we have stocked up the cupboards with the good stuff.

Does it seem ironic that there is ice cream on the front cover of this ‘sugar-free’ cook book??!

Our menu for the week looks like this:

Breakfast:

Toasted oats cereal with banana and milk

Lunches:

Chicken salad (no change this is what we usually eat, we just vary the meat and vegetables week to week)

Snacks:

carrots, celery, pistachios, wholewheat cracker bread with butter

Dinners:

Avocado, bacon and chile frittata with peas
Quinoa, squash and pine nut salad
Flat bread pizzas with garlic zucchini ribbons and salad
Squash and chorizo quiche
Italian meat sauce with whole wheat pasta

Homemade Treats:

Raspberry and mascarpone ice cream, frozen yoghurt cups, Ginger and oat no-bake cookies.

Quinoa, squash and pine nut warm salad. Actually pretty darn tasty and easy to make.

We are generally healthy eaters and cook all our own food from scratch anyway, but the biggest change is the treats. I get the sugar-low cravings in the mid-mornings and after coming home from work….this is when I typically snack and eat a lot of sugary things. So for the next week or so my body will hate me as I come off my sugar high. Hopefully it won’t be quite as bad as last time :-s

We are also getting back onto the exercise. I was going to be playing dodgeball this winter season, but the league was cancelled. And our local yoga centre shut down. So we have to motivate our butts to get moving. Chris is still recovering from his sprained ankle earlier in the year so we can’t do anything too energetic like insanity….but we will do some P90X again. We won’t follow the programme religiously, but enough to get a bit fitter than we currently are. So, here we go!

Bodies………………. ready??!?!?! Three….two……one…….*Whistle blows*

(If you ever watched the gladiators you should shout that sentence out loud in a Scottish referee type accent, if you have never watched the gladiators, I am sorry for my randomness but here is a video to help explain it)

In sickness and in health

August 14, 20151 Comment

The day before my egg retrieval we decided to culture ourselves by going to the Chrysler Museum of Art…it is a fabulous free art museum. We have been twice now and still haven’t been round the whole museum. My favourite part is the glass art. I studied art and sculpture at school up to A-Level so I like to think I have a reasonable appreciation for art forms. It was a mini exhibition in the glass section that intrigued me the most – entitled: In Sickness and In Health. Sounds like something from a set of wedding vows, right??! Hmmmm. Here is a peek at the artist’s main exhibit:

Beveryly Fishman: In Sickness and In Health at the Chrysler Museum

I was enamoured by it. Why? Because it represents the world of modern medicine very well. I didn’t take photos of the side exhibits, but they were intriguing too. It is meant to be a ‘playful yet provocative commentary on the world of modern medicine’. As I looked closer at the glass pills I began to understand what she was trying to represent…the bright colours and bold patterns of the pills are supposed to alert us to the complicated relationship between a $500 BILLION pharmaceutical industry and our yearning for good health. The exaggerated sizes of the pills aim to point towards the excess of the industry with aggressive marketing tactics to promote various medications to the sick AND healthy. I realised as I stood there with my big fat bubbling ovaries weighing me down from all the recent injections that looking into the reflection of these giant glass pills, this was part of ME.

$7700 our IVF medication cost for just one round of treatment. (I know we can buy it a whole lot cheaper…I compared it to the cost in the UK). The artist says that when you look in the reflections of certain glass pills you will see a distorted mirroring ‘evoking the complex connections between chemical substances and our own self-awareness’. I want my own biological child THIS much…I am willing to inject and consume $7700 worth of medication despite the fact that I am not actually SICK. But then again, I have a disease, it’s called infertility, I guess that makes me sick officially, I just don’t feel SICK. But the doctors don’t know what is making me SICK and so we are trying everything possible to overcome it. Do I have a distorted view of our situation?

I put a lot of trust in the doctors and the medication we are using…I mean have you seen the whole list of disclaimers on those medicines???!!! Here in the US there are lots of adverts for drugs on TV and radio, and they have to legally state what possible side effects are, and sometimes these disclaimers go on for 2 whole minutes usually ending up with – may cause every disease under the sun – oh and don’t forget death. We just don’t have this form of advertising in the UK, so it is odd and I always wonder why anyone would ever take the drugs that are being advertised if there is a chance of death. Some of the drugs I am using are known to increase the risk of various cancers, including ovarian and breast cancer. I am willing to accept those (admittedly teeny tiny) risks to have my own child. But to what extent will I keep doing this – pumping chemicals and hormones into my body? How much is too much? When do we stop? When is enough, enough?

The museum critique concludes with a poignant question about the exhibition:

Is this culture of chemistry making us healthy or is it creating an ‘Artificial Paradise’?

When is enough, enough?

Reflections on the future – using someone else’s ten lessons learned on Infertility

June 28, 2015June 28, 20154 Comments

A friend of mine recently sent me a link to a Huffington Post Article “Ten things I would tell my past self about infertility”, written by Kathryn Kefauver Goldberg (she has written other posts too). Not only was it an interesting article, but my friend told me “I can be your number 9”. Number 9 in the list of ten things was:

9. Find one person to whom you can talk uncensored. Check in with yourself about what and who feels good. This might be a friend, a counselor, a support group — anyone who can support you unconditionally and isn’t invested in the outcome.

Well of course, my friend already is my number 9 🙂 I’ve got this one nailed already! So what about the other 9 suggestions in the list of Ms Goldberg’s lessons learned?

1. Recognise that the limbo of infertility puts you in an impossible situation. This is something we are totally dealing with right now, with the added limbo on whether we stay in the US or move back to Europe. Fortunately, one of those limbos has been taken away – I have been offered an indefinite contract, so I don’t have to leave the US in December! We have choices. But we don’t have choices when it comes to whether we get pregnant or not! So we are handling it OK right now, better than last week. We will just take one to two weeks at a time. It’s pretty hard work on the abdominal muscles all this limbo business, but you get a good work out, and your muscles only get stronger as time goes on.

2. Feeling sadness will not define your path. I have had a pretty tough few weeks on this front, and I have questioned my ability at work, if I am coping. I even asked myself if I was depressed. I don’t believe I am depressed, but just sad. Being sad is OK. How do I know I am not depressed? Well I just googled it, and I am not depressed, I don’t fit the descriptions.

3. Define and honor your limits. Here Ms Goldberg talks about pressure to try everything on the medical front. It can be quiet easy to go far without questioning medical treatment, for example agreeing to ICSI, agreeing to freezing embryos, agreeing to participate in research etc. We have made sure we talk about it together, but I am not sure Chris and I have the same feelings on how far we go on our path. I think I will feel what I will feel, in the future and I can’t predict that right now, so I don’t want to put a maximum number of attempts, money or time on our path.

4. Listen to your doctor and trust your gut. I’m not very good at questioning a doctor, after all they are supposed to be the qualified ones, right? But I do get gut feelings about people and I have a positive gut feeling about our doctor, even if she seems a little crazy sometimes.

5. Have rote answers prepared for nosey questioners. I have talked about this on two occasions recently, but I think it depends on the situation. It’s a careful balance. This week I caught up with some friends I haven’t seen for a year, and I totally lied to them about what we are going through (I didn’t lie directly, I just avoided the opportune moment to talk about it) and I wish I had just been honest because I know they would have been great about it.

6. For every medical procedure you go through, find a soothing activity for your body. Ahhh a couple of massages I think might be scheduled. Maybe we need to think about this more.

7. Take care of your heart. This is more about protecting yourself from emotional overload moments, like going to baby showers. Well I have decided to tackle these head on. Infertility doesn’t define the me and the type of friend I want to be to my friends. I won’t let it, and it’s worked so far. I will take care of my heart, but I know Chris has got me on this one too. He’s like my cod liver oil or what ever is good for your heart – he is my added protection layer for my heart.

8. Invent a project. Well I have decided to take another online course starting in a week. This will be my project. It will be a useful distraction, I hope, rather than be an added stress.

…

10. It will be OK, though your definition of OK will change. I tell myself this a lot. Everything is going to be OK. And if I ever doubt this, all I need to do is listen to Chris’s playlist of movie’s all time greatest dramatic soundtracks, like the one below. And everything is going to be OK again. This is my future.

You might be upside down, but you’re gorgeous to me dear Uterus

May 27, 2015May 27, 20154 Comments

I have been told by several doctors that I have a beautiful cervix, and today I discovered that my uterus is just as “gorgeous”. Well these were the exact words of my Reproductive Endocrinologist (RE)!!!

Today was my hydrosonogram (also known as a Saline Infusion Sonogram). This procedure was the final test I required prior to our IVF treatment. The hydrosonogram is a procedure where the doctor inserts a catheter into the uterus and injects saline into the uterine cavity whilst performing a transvaginal ultrasound. The water shows up as dark black on the ultrasound against the white endometrial lining. This allows the doctor to look for smooth edges of the uterine cavity. If the ultrasound shows an edge that is not smooth then these rough and lumpy edges maybe polyps, fibroids or scar tissue which could be a possible problem for embryo implantation.

The procedure in itself was an interesting experience. Greedily, I had three doctors in the room as well as the nurse! The three doctors were: my RE, the doctor whose name I can’t pronounce and performed two of my IUIs, and one of the male student doctors Chris conversed with at our last IUI. I wasn’t quite sure if my RE was overseeing the procedure, or she had called in the other doctor because she was more familiar with my cervix and therefore inserting the catheter. Either way, there were a lot of people clambering around my vagina in this one tiny examination room. It was rather amusing.

First the doctor with the unpronounceable name inserted the speculum, and then peered up from between my legs and showed me the ‘flexible’ catheter and said, “remember this? Was it this one we used before?”. Ummmm….. “I think so??!!!” I replied. How am I supposed to know these things???! When she inserted the catheter I could hardly feel it at all. The speculum was removed with the catheter still in, and then she inserted the vaginal ultrasound ‘wand’. We could see the catheter on the screen, there was a lot of excitement amongst the doctors. The nurse was tying to hold something in whilst the two female doctors discussed tactics of why it wasn’t distending with the saline, perhaps the catheter was up against something, my uterus wall…or perhaps it was bent somehow. Either way, when they removed the magic wand, the catheter came out. They apologised and said they would try again. So back in the speculum went (this was only the painful part, no different to a pap smear), the catheter went back in, speculum was removed, magic wand went back in. And there was a gaggle of excitement as this time it had clearly succeeded; the saline filled the uterine cavity and I could quickly see there was a nice oval shape, with no rough edges on the screen. My RE told me my uterus was “gorgeous!”. She took a few shots on the screen, and showed me in 3D my uterus. With this image it actually looked more like a normal shaped uterus that you see in biology books rather than what I saw on the screen during my HSG x-ray. You can see from the image from my HSG below that it was upside down. Today’s ultrasound, it was the right way round and looked almost perfect. Text book.

My HSG X-ray with my retroverted uterus (it’s hard to see because it’s hiding behind the catheter)

I don’t have a copy of images from my ultrasound from today, but I have found a link that shows the difference between a normal and abnormal result from a hydrosonogram.

After all the excitement and the nurse had cleared everything up, suddenly my RE exclaimed! “Wait! I need to see her ovaries so I can calculate her dosages!” So back in the stirrups I went and the nurse re-prepared everything for another peek inside using the magic wand. We had a very quick look at my ovaries to count the number of follicles. As today is Cycle Day 7 I had about 5 or 6 follicles in the right ovary and then a dominant one in my left. She seemed pleased with this. I mentioned that I knew it was going to ovulate from the left his month because I could feel it. I can always feel pain in my ovary on the left side when I’m ovulating from this side. I’m not sure why. The doctor who’s name I cannot pronounce seemed very interested in this fact. I left wondering why.

All in all, I left with a sense of relief. But my feelings were mixed. I was relieved that we can still proceed with IVF and there was nothing seriously wrong that would require surgery, but I had the feeling of frustration. In the back of my mind, we still don’t have an explanation for why we have not been successful in conceiving so far. Unexplained infertility can really niggle away at your mind.

On a side note, today I have experienced two more pregnancy ‘announcements’. One whilst I was at the fertility clinic, a lady found out she was being released from the fertility clinic to her OB/GYN. She kept asking the nurse if she was sure, then she cried a lot (tears of happiness of course) which made pretty much everyone else around cry too. Including myself. And secondly another of my colleagues who recently married is pregnant. Soooo all I’m thinking is – who is the third? They usually come in threes, right??!

Work in Progress…ARTApp

April 3, 2015April 3, 20154 Comments

I successfully completed another module in my Data Science course! Woohoo!! Eight modules down, one to go. Now I have one week off of study, then onto the home straight. I can’t wait to finish it.

Part of my final project was to develop an online web App; I decided to develop an App that uses the data provided by the CDC on Assisted Reproductive Technology and presents the data in more user friendly way. I bit off more than I could chew for this project because the data the CDC provides is a bit messy and required some cleaning up in order that I could manipulate it easily. Now I have ‘cleaned’ the data, I need to spend a bit more time making the visualisation useful. I got 100% for my project so I passed with flying colours, but I have a lot more to do before I share it with a wider online community. You can have a sneak preview!

You can see my ARTapp here. It was supposed to look a bit more like this…

Screen shot of my ARTApp so far

My idea is that someone can select a state they are interested in, it shows all the fertility clinics in that given state, then the user can select a fertility statistic they are interested in comparing their clinic against the state wide average. There is also a map of the states that shows the statistic average for each state. This is just a prototype for now, I will keep working at it and include all data available from CDC, not just data for fresh embryos. Also add in some more interactive charts for looking at ART data over time.

Now, wouldn’t it be good to know what the IUI stats are like too?

Statistics statistics – infertility and treatment – who to believe?

February 9, 20152 Comments

Did you know?? Over 1% of all infants born in the US are conceived using Assisted Reproductive Technology*.

Luckily I am an analyst by trade, so I am quite aware of the lies, damn lies and statistics. I am quite skeptical when it comes to stats that don’t explain the data source. A lot of websites quote stats and don’t tell you either where the data originated, how it was collected or how it was analysed. So which stats can you believe?

I am undertaking a small project for an online course in data science – part of my project is to develop an online app. The app can be anything I like, but it has to be an interactive tool using data. Seeing as I have been looking at lots of statistics online about fertility treatments, I thought, why not design my own web app that allows a user to interact with all that data out there? Hmmmm perhaps I am being ambitious. But I have a couple of weeks to complete it – so lets see! In the mean time, I have been doing some research on potential data sources…

The most up to date fertility treatment data I have found so far is from the Centers for Disease Control and Prevention (CDC). (Ha! I didn’t expect to find the data here!!) Apparently there is an Act that mandates all clinics performing Assisted Reproductive Technology to provide annual data to the CDC. I think this data is THE most comprehensive (or certainly largest) source of data to understand the factors that contribute to a successful birth when using Assisted Reproductive Technology*. The CDC has been collecting data since 1995. All their data is freely available to download along with reports and interactive tables. The most recent data released is from 2012, collected from 256 clinics with in the US.

When I was reading the CDC 2012 report that was published in 2014 I found an interesting stat that surprised me – In 2010 about 7.4 million women aged 15-44 received infertility services at some time in their lives. That makes it about one in ten women of that age group. If I look at all my friends and family on my facebook in that age group, that could be 12 of my friends affected somehow. Woah.

Anyway, the data provided by the CDC gives stats on almost 98% of clinics in the US. The link below (provided by the CDC website) takes you to an interactive tool that allows you to see the data for your fertility clinic – they probably report it on their website. But you have to be careful when you look at the numbers and what they all mean. I’d highly recommend reading the whole report to help understand it all. I did not see this data before we decided which clinic to use. To be honest the number of choices for us weren’t particularly big, but we did have a choice.

The data looks good for my project, I just need some ideas on how to make a useful app out of it. If anyone has any suggestions on what they think would be a useful way to see the data I’d be interested to hear from you. I’ll keep you updated on my stats research as I come across it…

Ps. Hope this post wasn’t too geeky!! I can be quite geeky sometimes.

*Note. The CDC define Artificial Reproductive technology as a procedure that involves surgically removing eggs from a woman’s ovaries, combining them with sperm in the laboratory, and returning then to the woman’s body or donating them to another woman. They do NOT include treatments in which only sperm are handled (ie. IUI) or procedures in which woman takes drugs only to stimulate egg production without the intention of having eggs surgically retrieved.