P.M.A.

Enjoying the beach in Okinawa

My Dad was my high school soccer coach, which had some perks but also a great many downsides, mostly relating to accusations of favoritism and him being particularly hard on me (because he wanted me to be the best I could be, but still).  In any event, one of his favorite acronyms was P.M.A., for "positive mental attitude."  Having a positive outlook on life is not something I've had trouble with until the last few years.  And a few weeks ago, I made a decision to make a change.

As those of you who have been reading know, I've been feeling terrible about my body lady, I'm been having perimenopausal symptoms, and my mood has been all over the place.  I hate feeling this way, but I wasn't doing much to fix it and I realized I was being whiny and downtrodden and not appreciating what I have.

There was a triggering event for this wake up call that came out of nowhere.  I receive the GOOP newsletter, and while I normally delete it straight away, last week something caught my eye.  There was an article whose subtitle mentioned hormone imbalance and is on the GOOP site here.  Hormone imbalance!  That's me!  I immediately clicked through, read the article, downloaded the Dr. Sara Gottfried's book The Hormone Cure, and read it in one night.  It reminded me of when I read It Starts with the Egg a few years ago and immediately overhauled our house (no BPA, glass containers), my toiletries and cosmetics, and my supplement and vitamin protocol.  I just had this feeling like, "Hey! I want to feel better. I know I'm not doing everything in my power to feel better right now and how lame is that? Just do it."  When I wanted to improve egg quality, I did EVERYTHING I could.  And why am I not doing that now?

In any event, I ordered $350 of supplements and vitamins that will hopefully be waiting for me at the Westin in Tokyo next week before we fly to Amsterdam.  I've signed up for a marathon and started running regularly and using this app I love called SWORKIT (it has workouts that will make you sweat that require no equipment, including yoga and pilates), plus I created an Instagram account where I'm posting about my running, which helps me stay motivated (@rundarcyedenrun if you are interested).  We've been making a point of being in bed at 9:30 PM and lights out at 10:00 PM, which means I feel rested in the morning no matter what time B wakes up.  I'll resume regular acupuncture and massage once we are home (that's tough to do on the road).  I've started keeping a gratitude log in my Bullet Journal.  I've stopped drinking and am reducing carbs/gluten and treats/dessert. I find that on the road it is easy to see all of this travel as "vacation," which means have a drink at night! Have dessert!  Have a mid-afternoon ice cream! The trouble is, that vacation is many months long and not two weeks so it has taken its toll.

I'm two weeks in to making these changes and I feel so much better.  I had this realization that I have been singularly focused on trying to get pregnant, grieving Q, being pregnant and thus anxious, or dealing with a miscarriage for almost FIVE YEARS (it will be five years in October from when we first started trying to have babies).  FIVE YEARS.  I've lost myself in so many ways during this time and I'm ready to get myself back.  I feel like a better Mom, wife, and happier person and I'm so excited to keep this up.

Okay, so I think I sound a little crazy and possibly a little manic, but I really do just feel better.  P.M.A.!

I'll leave you with two things that happened in the last week.

Jizo Statues in Kyoto

First, I found my Jizo for Baby L / Q!  I read this NYT article "The Japanese Art of Grieving a Miscarriage" and knew that when we were in Japan, I wanted to find one of my own to have at home.  In Japan, these small figurines honor the souls of babies who were never born.  I'd been looking since we arrived, but hadn't seen any (I am positive I was just not looking in the right place).  Last week, we finished a lovely day of biking and rode by a shop with lots of figurines on display outside.  We pulled over on our bikes and there in front of the shop next to a fountain were all of these little Jizo statues.  I picked one out and have it carefully wrapped to bring home.

Second, I bought ovulation predictor tests.  This required a great deal of Googling, searching many drug stores, and ultimately showing photos of what I wanted to employees and asking for help.  I finally found them and actually purchasing them requires taking an empty box to the front of the store, someone going to a back room to get them, and then several layers of bags and packaging being wrapped around them (this is standard in Japan and not specific to the OPKs, but still amusing).  I haven't tried to use them yet, but hopefully I can interpret the lines on the tests (they don't have the smily faces like at home).  It was a funny thing to search for in a country where nothing is written in English.  I do very much miss the convenience and anonymity of Amazon Prime.
 

Spring in Japan

We've now been in Japan for 3 weeks and just settled into a home in Kyoto for two weeks. I listened to a podcast while running this week of an interview of a woman who traveled with her family of 5 around the world for 9 months.  She talked about how they had "slow and low" periods where they stayed put for an extended period of time.  2 weeks isn't that long, but it sounds like an eternity right now and I'm thrilled that we can explore Kyoto at our own pace.  We rented a bike with a kid's seat (and have another that came with our airbnb), we have a kitchen and I cooked dinner tonight, and I'm looking forward to having some "normal" days.  Today we found an awesome playground just a 5 minute walk from our house, too.

I'm still feeling all mixed up about pregnancies, babies, siblings, etc.  I have 2 rounds of Clomid with me and I decided to take one round this month because -- why not?  If I don't take it, I'm just toting it around the world for no reason.  I feel fine but it doesn't seem to be working as well this time around (based only on the fact that last time I had a lot of EWCM and I'm not having that as much this time around).  I'm taking COQ10, but not DHEA.  I just don't like how it makes me feel and I worry that I've taken too much of it these past few years.  Honestly, I feel pretty hopeless on the pregnancy front right now and maybe that's okay?  Perhaps I'm coming to grips with reality and acceptance is around the corner?  We'll see.

An aspect of our trip that has been very difficult for me is the utter lack of alone time.  I'm outgoing and enjoy spending time with friends, socializing, etc., but there is part of me that is extremely introverted. I love and need to be alone for some period of time each day and I am just not getting that.  With B not napping and spending every day with R, it's been challenging and I know it i isn't helping how I feel about pregnancy, myself, my body, etc.  I'm getting far afield from wanting another child here, but I have realized that not getting some time to myself is making me a worse wife and mother, making me less patient, and shortening my fuse when it comes to B, well, acting like a toddler!  I've started running every day, which I do alone, so hopefully that helps, and I'm hoping for some solo exploration time in the coming days.  

All of that said, I struggle lately with knowing why I'm feeling a certain way or what is impacting the strength of those emotions.  Is it hormonal imbalance?  Is it lack of alone time?  Is it the inconsistency and lack of routine that comes from travel?  Is it just how I'm feeling?  I don't know.

To end this on a happy note, the days are filled more often with happiness and joy than anything else, so I don't want to sound ungrateful or unhappy - I'm not.  I'm just parsing through what I am feeling, which I don't get to do these days with a girlfriend over coffee or wine, or with a therapist, which is probably what I should be doing...

Also, I wrote before about Sheryl Sandberg's heartbreaking missive after her husband's death.  She just published a book about grief and loss and finding strength in such circumstances called Option B.  I've just downloaded it, but in case you missed the news...

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An Update from the Southern Hemisphere

Wow, I've been terrible about blogging.  I have been writing on my other blog, but I've been preoccupied with traveling and having fun.

Mercifully, the day after my doctor's appointment, my body started to miscarry on its own (I started bleeding).  It was as if my body had known for weeks but my mind was clinging to the pregnancy. Once I let go of it in my head, my body followed.  I took Cytotec anyway and it was a pretty easy process albeit uncomfortable as many of you unfortunately know.

5 weeks later, I have just had my first cycle since the miscarriage.  I haven't had any menopausal symptoms this time around for which I am eternally grateful and I haven't fallen into a depression like I did last spring.   Part of it is certainly that I have learned to manage my expectations a bit but more so I think it is just that I refuse to let this ruin our trip.  We had an incredible time in Hawaii, fell in love with Sydney, and are having the best time exploring New Zealand.  My health is good all things considered and I love spending time with R & B.  Am I incredibly sad and disappointed?  Of course.  But I won't let it swallow me whole this time around.

So, that's the update from here.  My OB did write me another prescription for Clomid before I left Hawaii and I filled it, but I don't plan on taking it right away.  I'm going to see what happens the next few cycles and try not to focus too much on trying to get pregnant.   I feel more resigned than ever to not having another baby.

I did read a fascinating NY Times article today about stillbirth and three tests that can help determine the cause in many cases: placental examination, fetal autopsy, and genetic testing.  We had all three of these done on Q and the placental examination did tell us what happened to her although we still don't know why.  In any event, an interesting read for those of us who have experienced stillbirth (at least I find myself wanting to read and know everything about it).

You all are still very much in my thoughts, I'm just not at a computer very often (which is the whole point of this trip).

August Update & Pregnancy on HRT

Summer is moving along here.  We've taken a few weekend trips in Colorado and have another one coming up next weekend.  It's been so fun to enjoy the beautiful weather, the mountains, swimming, gardening with B, and generally just watching her become a little person.  She has started using two word phrases and is VERY opinionated.  I hear "no" a lot these days, but she is also extra into her Mama, which I secretly love (whenever I find it overwhelming, I remind myself that soon she will be too big to hold and then likely a teenager who hates me).

Miraculously, I just had a normal, 28-day cycle during which I had EWCM and according to the OPKs ovulated.  I didn't get pregnant, but I did feel pretty normal the entire cycle.  I could tell my period was about to arrive because I became insanely irritable... like I knew what was coming out of my mouth was an over-reaction, but there was nothing I could do to stop it.

I'm seriously considering starting a very low dose of estrogen (0.1 mg/day) even though my menopausal symptoms have all but ceased.  I still feel emotionally a bit on edge and I think the estrogen will help.  The dose is so low that it wouldn't prevent me from getting pregnant.  I've read this post over and over and my doctor said the same thing - you can absolutely still get pregnant on HRT.  I've read this study and this one, too.  Does anyone have experience with HRT, whether just in general or getting pregnant while doing HRT?  Any thoughts, advice from a doctor, etc.?  I'm desperate for more information on this topic and it doesn't seem to exist. What I'm really wondering is whether your odds are better trying to get pregnant while on HRT if you still have some ovarian function or whether it is better to not be on the estrogen if you are still ovulating?  I suppose it is time to make an appointment with my OB again...

Happy end of summer to everyone!

What the what?

First of all, Happy 4th of July!  We spent a long weekend (5 days) in Seattle visiting a bunch of friends and had a blast.  The weather was cooler, there is tons of water (obviously), and we enjoyed delicious oysters and great craft beer.  Oh, and Blythe rocked some seriously cute red, white, and blue!

So much attitude these days. I love it (I know I won't when she is 16).

Second, my body is doing some crazy things lately.  I have been feeling better (as I said in my last post). I saw my OB to talk HRT on 6/28.  We developed a plan, talked next steps, and I promptly came back to work and got my period.  She also re-ran my FSH since I was feeling better and it was 7.7.

7.7!  From 59.

This swing fits with what every doctor has said to me - DOR/POF is unpredictable.  I could have these swings regularly, it could have been the miscarriage, they just don't know.  So, we'll see. In the meantime, I feel better.  I'm less irritable, I feel positive again, I'm less snappy (poor R), and I just feel like me.  I can't ask for much more than that.  For now, we will hold off on HRT and see what happens.

Chin Up!

I'm not sure what has changed since my last two posts, but I'm happy to report that I'm feeling much better. The malaise that has been hanging over me since my miscarriage has, for the most part, lifted.  I've decided that despite the horrible test results I got, I'm not giving up on my body.  I refuse to believe that I can go from regular cycles to menopause with one miscarriage, even if that makes me a fool.

So, I'm back on all of my supplements, the herbs recommended by my acupuncturist, and I'm going to see my OB next week about hormone replacement therapy (HRT).  I'm also going to see a local NP who specializes in natural HRT.  If I'm going to start pumping my body full of hormones, I'm going to do some research first.

Whether it is the shift in my attitude or an actual change in my body or the herbs/supplements, I haven't had a hot flash in two weeks and my other symptoms have gone away.  Like writing in the early days of pregnancy, I feel like a fool for publishing this post in some ways.  I know what my numbers are.  I know what the odds are of ever getting pregnant.  And I know that I'm in perimenopause.  But I'm not giving up.

In the meantime, how could I stay sad too long with this sassy, adorable one in my life? 

I also ran another marathon last weekend.  While I have always enjoyed running and have never had an issue with mental toughness, in the two races I've done this year, I've had absolute mental collapses around mile 18.  I become really negative, I've shed tears (crying and running do not go well together), and I've questioned whether I can finish (even though there is no doubt than I can physically).  I've concluded that marathoning is something I am really not enjoying right now, so I'm taking a break.  I'm still going to run, but I'm going to do more pilates and swimming and mountain biking and things that I'm actually enjoying.

So, that's the update.  Call me crazy for not just throwing in the towel, but I'm just trying to keep things real and honest on this blog.  So there it is.

The "M" Word

I've known this day was coming since my dreaded diagnosis in early 2013 of premature ovarian failure / diminished ovarian reserve.  I'm 10 weeks out from my miscarriage and still no sign of my period.  I gave in and had a blood test run last week to check Estradiol levels and FSH.  Given the recent hot flashes I've been experiencing, the results are not surprising:

Estradiol: undetectable
FSH: 59

I'm officially in perimenopause.

How I can go from being pregnant to menopause in one cycle is completely baffling (especially since I'd had 3 normal cycles prior to the pregnancy).  But I have.  As explained by my OB, this doesn't mean I won't have cycles again as hormone levels tend to fluctuate, but I should assume that my baby-making days are over.  I'm going to start hormone replacement therapy.

Menopause.  This is something that my Mom talks about.  That women in their 50s deal with. How am I here?

Nevertheless, I am.  Please don't think for one second that I don't count myself lucky every time I look at Blythe, think about Blythe, kiss her cheeks, hug my husband, etc.  Over the past three years we have faced infertility, failed infertility treatments, a stillborn daughter, me almost dying from a blood clot in pregnancy, a miscarriage, a myriad of health concerns, and, most importantly, the birth of our living daughter.  She is a miracle and I count my lucky stars every day for her life.

But does that change the fact that I dream of having another living child?  Not at all.

I'm an only child and I loved my childhood. I think we can give B a wonderful upbringing on her own. But I really would have liked her status as our solo living little one to have been our choice.  I'm resenting the fact that this decision has been made for me, and frankly in such a cruel way.

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I have the impression that most of my readers are here because we share the common experience of losing a baby, but if any of you out there have experience with POF/DOR. I'd love to hear your thoughts/experiences.  Have you had wild fluctuations in hormone levels?  Any advice/guidance?