Polypharmacy

And I'm only 30.

Here's my current list:

• LDN
• Fish oil
• Vitamin B6
• Vitamin D3
• Calcium/vitamin D
• Prenatal vitamin
• HCG (post-peak)
• Probiotic

Every morning I fill up a little container with all the pills for the day.  DH took one look at my (filled) container and asked, “How old are you??  80??”  Not funny, DH.  Not funny.  ;)

My med list isn't that long, compared to some of you.  But with the latest additions, I am starting to feel a little elderly with the number of pills I'm taking per day.  Yes, most of them are OTC but it still adds up.  I would use a regular pill box that I could fill weekly but I’d have to get a huge one.  That might really reinforce the elderly feeling.  ;)  I am thankful that I don't have to set an alarm to take any of them like I did when I was on antibiotics so I wouldn't miss a dose.  I suppose I shouldn’t speak too soon; I am becoming a patient at the PPVI Institute, which means I may go back on antibiotics and/or T3.  Years ago when I was a patient at PPVI they had me on T3.  And my TEBB refuses to go away so I assume they’ll recommend an antibiotic I haven’t tried already.  Infection and adrenal fatigue are the only two remaining causes for my TEBB that haven’t been fully investigated.  The other (known) causes have been pretty much ruled out or are currently being treated.  I suppose there’s always a chance my TEBB is “unexplained” but let’s not talk about that now.  ;)

I'm going to be doing some traveling soon so I need to stay extra organized with all these pills.  I don't want to bring all the bottles with me...it would take up half of my bag I think!  This will be the first time I’ll have to transport syringes and HCG.  Can't a girl catch a break and have a nice vacation without having to lug along all her injection supplies?  ;)  I guess we'll just do the best we can.

Happy NFP Awareness Week!

Since it's NFP Awareness Week and the anniversary of Humanae Vitae is July 25th, I thought I'd post links to a series of short videos created by a some Catholic seminarians highlighting some of the differences between NFP and contraception.  They're a few years old, so maybe you've seen them already.  Enjoy!  :)

NFP vs. Contraception I

NFP vs. Contraception II

NFP vs. Contraception III

NFP vs. Contraception IV

NFP vs. Contraception V

NFP vs. Contraception VI

NFP vs. Contraception VII

Obviously these are just short sound bites.  If you're interested in digging deeper, here's a link to another favorite of mine:  "Contraception: Why Not?" by Dr. Janet Smith.  It's an older version of the current talk, but the basics are the same (aside from some older research stats).  She also has articles on her website.

My naltrexone isn't dairy-free

It's really not what you want to find out after you've been taking it for a month and a half.  :(

I've been dairy-free (and gluten-free) for over a year and half in the hopes that it would help improve our fertility.  I wrote about the encouraging changes on my chart as a result of that diet change here.  My chart is still more or less the same since then.  I get a couple additional green stamps post-peak in cycles where I use HCG.

Anyway, I had read—just before starting LDN—that sometimes lactose is used as a filler when the drug is prepared.  It didn't concern me at the time because I assumed at least one of the following would be true: 1) perhaps they don't use lactose as often these days since lactose intolerance seems to be fairly common, 2) the pharmacy would ask me if I could tolerate lactose before filling the prescription, or 3) the pill bottle or accompanying info sheet would inform me that lactose was an ingredient.  Food labels are quite good at labeling lactose; why wouldn't a drug label be the same?  I just figured I would find out somehow and didn't give it another thought.

Yesterday I was searching for a website I could send to my NaPro doc explaining how one might compound LDN in her own kitchen in case he had not heard of this possibility.  (I still hadn't asked him for this.)  One website I was reading again mentioned lactose as a filler, which made me start to wonder if my LDN had lactose in it.  I went to check the info sheet that usually comes along with a prescription (listing common side effects, etc.) and realized I never received one.  Thinking I was being paranoid, I thought it wouldn't hurt to call Kub.at's and find out for sure.  Judging by the employee's reaction to my question, I'm guessing not a lot of people ask about this.  He confirmed, yes, there is lactose in my LDN.  :(  I asked if they had lactose-free LDN available.  After some searching, he said that they did have it, but that my doctor would have to specifically order lactose-free LDN for me.  (Really?  I can't just say, "Please send me the lactose-free kind?")

Since it would be faster to have a new prescription filled locally (as opposed to mailed from Kub.at's), I started to call local pharmacies asking if they had lactose-free naltrexone.  I started with a chain store pharmacy which I've used in the past.  The pharmacist almost chuckled when I said "naltrexone" because he said it's been ages since he has dispensed that drug.  Not a good sign...  He said he could order naltrexone but since he's at a chain store, he can't choose the manufacturer. (The chain store just ships him what they have in stock, which could be from a handful of different manufacturers.)  So there's no way to guarantee that the drug he receives is lactose-free.  I could tell he was frustrated he couldn't help, but he did give me names of two other non-chain pharmacies in town that would have more freedom in ordering.  I called one of them, and the only naltrexone they carry is lactose-free.  :)  And the cost for approximately one year's supply (compounded by me) is less than what I am paying now for one MONTH'S supply (compounded by the pharmacy)!  I know, I know—I should have arranged all of this sooner.

Now I just need to wait to hear back from my NaPro doc that he agrees to let me compound LDN myself...

If only I had known I was going to be ingesting lactose and thus breaking my dairy-free diet, I would have splurged for something much more satisfying like some good chocolate**!!  Or a mocha!  Oh, how I miss mocha...


**Fear not, I am not totally deprived of chocolate.  Our grocery store sells some dairy-free chocolate.  :)

Novena to Sts. Joachim and Anne

The feast of Saints Joachim and Anne, the parents of the Blessed Virgin Mary, is coming up on July 26th, so DH and I decided to pray a novena asking for their intercession for us and for all couples facing IF or miscarriage.

Good parents of the Blessed Virgin Mary,
grandparents of our Savior, Jesus Christ,

When life seems barren,
   help us to trust in God’s mercy.

When we are confused,
   help us to find the way to God.

When we are lost in the desert,
   lead us to those whom God has called us to love.

When our marriage seems lifeless,
   show us the eternal youth of the Lord.

When we are selfish,
   teach us to cling only to that which lasts.

When we are afraid,
   help us to trust in God.

When we are ashamed,
   remind us that we are God’s children.

When we sin,
   lead us to do God’s will.

You who know God’s will for husband and wife,
   help us to live chastely.

You who know God’s will for the family,
   keep all families close to you.

You who suffered without children,
   intercede for all infertile couples.

You who trusted in God’s will,
   help us to respect God’s gift of fertility.

You who gave birth to the Blessed Mother,
   inspire couples to be co-creators with God.

You who taught the Mother of God,
   teach us to nurture children in holy instruction.

You whose hearts trusted in God,
   hear our prayers for . . . (mention your requests here)

Pray with us for the ministry of Catholic family life.
Pray with us for the ministry of Natural Family Planning.
Pray with us for all who give their time, talent and treasure to this good work.

Hail Mary. . . Our Father. . . Glory Be to the Father. . .

God of our fathers, you gave Saints Anne and Joachim the privilege of being the parents of Mary, the mother of your incarnate Son. May their prayers help us to attain the salvation you have promised to your people. We ask this through Christ our Lord. Amen.

Source:  USCCB website

Some PMS drama

I don't need more drama during the post-peak phase; PMS is usually enough for me as it is. This story probably wouldn't be so bad if you took my PMS out of the picture. I thought maybe writing out what happened would make me feel better.

Things are definitely not dull here while DH is away on his business trip. I mentioned before that he put a hold on our mail so I wouldn't have to worry about it while he's gone. It's normally his job to get the mail (we live in an apartment complex) but I don't mind doing it. He just wanted one less thing on my to-do list. The thought was sweet of him. However this meant I didn't get my new meds right away, which were being mailed from the pharmacy. I wanted to get started on the LDN as soon as possible to see if it might help my PMS this cycle, and I would need the HCG for the last injection this cycle; I had some leftover in the fridge from last cycle to get me through part of this cycle.

So I called the post office toll-free number to find out where our mail was being held. I managed to get to that particular post office before it closed on Friday. I waited in a long line only to find out when it was my turn that our mail was being held across town. :( I had 15 minutes to get there before they closed for the weekend. I tried not to panic even though it was rush hour. I arrived with a few minutes to spare and joined several others in line. When I got to the front of the line the clerk took down my info and went in the back to retrieve our mail. She couldn't find it. Neither could another worker. I said I was waiting for a package which would be harder to miss than just an envelope. The second lady said they have problems sometimes with hold requests made online, so she said she'd contact the mail carrier on our route and call me if she found out anything. I left with the sinking feeling I wouldn't be able to get either of the medications in time. I was upset. How ironic is this that PMS rears its ugly head during my hunt for medicines that could help my PMS... The package was either lost or it was in our small mailbox. I had assumed it was too large to fit but maybe I was wrong. If DH were home this wouldn't have been a problem.

However, DH had the only copy of our mailbox key with him on his trip so I couldn't open our mailbox.

My only chance was to catch our mail lady on Saturday while she had the mailboxes open and beg her for the package. I left the window open in case I could hear the mail truck drive by—sometimes I can—and I totally stalked the mailboxes. :)

I heard the truck arrive. Thank you, Jesus. If you haven't gathered that I was desperate for both meds, I was. ;)

I grabbed my driver’s license for ID just in case and ran to the mailboxes. I could see the package in our box! Not wanting to appear desperate, I casually asked if there was a package for me. She said, “Oh, you're the girl looking for her package.” She handed it to me along with the rest of our mail. I ran back to our apartment and tore open the package from the pharmacy. I pulled out two bottles of LDN. To my dismay there was nothing else in there.

No HCG.

It was enough to make me cry. (I'm less than rational while PMSing.)

I don't know why they didn't send the HCG. When ordering it, I made a separate call to ask for the HCG refill--not five minutes after ordering the LDN-- and I knew I had a refill remaining on the prescription. I had even asked if they could mail the two meds in the same package, which the pharmacy employee affirmed. *sigh* It was pointless to call now and ask them again to send it because it would be too late to use it this cycle by the time I'd receive it.

So this meant I would be missing one day's dose of HCG this cycle. I guess that's not the worst thing that could happen. I really wanted to maximize our chances of success this cycle (and every cycle!) just in case... It’s disappointing.

But wait, there's more.

When it was time to do my second-to-last HCG dose, it didn’t look like there was enough medicine left for a full dose. After drawing it up, I learned I was correct. Instead of 2 mL, there was barely 0.5 mL. More disappointment. I guess last cycle we injected a little extra HCG which would explain why I was short this cycle. It’s bad enough having AF arrive when you’re TTC, but when you know you didn’t do everything you could to keep AF away, it feels like a wasted cycle.

Well, at least for next cycle, my list of meds and vitamins will grow noticeably, so that’s something to look forward to. And DH will be back so there won't be a mailbox fiasco. ;)

HCG success

Yay!  My first self-administered HCG shot went well!  I didn't feel it at all.  And, more importantly, I didn't faint or even get dizzy (pre-fainting).  The anticipation while holding the syringe was horrible though.  My skin was red from pinching and then letting go because I would get too nervous and chicken out.  Repeat that times nine or ten…  I had a video playing on the computer for a little mental distraction (not a visual distraction, of course).  I may have closed my eyes for a fraction of a second while shoving the needle into my thigh but then all was well.  I seriously had to double check that the needle was actually in my thigh because I didn't feel it go in.  So, yes, the shot should be painless if done correctly.  I did fire off a few last-minute prayers to a couple saints because I was really nervous.  St. Thomas More was my go-to guy for prayers that it would go okay.  St. Ignatius of Loyola too.  And St. Oswald...DH and I like to ask him for prayers because we figure he's less busy than other saints since his feast day only happens once every four years (February 29th).  ;)  Even if this was a silly request, they came through for me.

Catching up

Here is everything I meant to post within the past couple weeks but didn't get around to publishing.

TTC cycle #1 after surgery

1.  I took sustained release vitamin B6 and did the HCG injections post peak.  Dr. C thought it couldn't hurt to make my mucus better even though it has always been in the normal range.  (Sometimes it was at the low end of normal...that was his reason for the B6.)  After he recommended it, I read that B6 can also help lower prolactin levels.  When it was checked last year, my prolactin level was borderline high, but not high enough for the doctor to prescribe any medication for it.  I like the idea that the B6 might have a secondary effect on my prolactin.  It didn't end up doing anything to my mucus; my (very good) mucus score with B6 was the same as it was the cycle prior without B6.

HCG is my old friend.  I don't like the injection part, but it's so nice to have relief from PMS.  DH claimed he was out of practice with giving me the injections.  That's not what you want to hear right before being stuck with a needle.  I reminded him it's just a really quick stick.  Like throwing a dart.  Nonetheless, since it had been several months since the last round of HCG, DH was nervous.  Just in case, I turned on the tv so I would have some distraction and hugged a pillow.  This was all unnecessary because I was ready to be pleasantly surprised at how easy the injection would be--like they used to be.  Sadly it didn't go so well.  First, sharp pain.  Then a moment of relief.  Then more sharp pain.  (my worst fear...he didn't inject the needle in far enough the first time so he had to push it in deeper...not fun)  Then I felt liquid running down my skin.  Was I bleeding?  I looked down to see clear liquid on my leg.  Not all the HCG made it where it was supposed to go...too bad it doesn't work topically.  hahaha   DH looked at me apologetically and said, "You can put this on your blog, how your DH* isn't very good at giving these shots."  I tried to reassure him that he did fine.  He did improve after that one; for the next one there was only a tiny bit of HCG dripping down my leg.  ;)

*it's really cute that he knows the lingo that he is referred to as "DH" here

2.  Unfortunately the HCG did not relieve much of my PMS that cycle.  DH was disappointed too.  He knows that the HCG usually makes me a much nicer, happier wife.  I decided I would beg ask Dr. C for naltrexone when I saw him next.

3.  DH's SFA results came back normal.  Praise God that one of us has a correctly functioning reproductive system.  :)  All his numbers were really good except morphology which was borderline but still "normal."  When AF arrived, DH tried to convince me that maybe one of his sperm with abnormal morphology was to blame for the BFN.  I smiled at his attempt to cheer me up, but didn't buy it.  ;)  My body still needs some fixing...

4.  TTC #1 was unsuccessful.  I had high hopes for that cycle.  Unfortunately that meant a harder crash when those hopes weren't fulfilled.  When AF arrived during Mass, I knew a breakdown was inevitable, and I hoped that I could postpone it until we got home or at least had the privacy of being in the car.  I managed to hold off until after Mass, but not before we left the pew.  Thankfully the church was 99% empty by the time the waterworks started, and DH handed me his handkerchief.  (I love that he carries a handkerchief.)  If you're going to have a tearfest, sitting in front of Jesus (and having just received Him in the Eucharist) is my place of choice.  :)   After two days I was able to listen to the voice of reason in my head that this was just the first cycle we tried post-surgery...and not the end of the world.  ;) 

TTC cycle #2 after surgery (in progress)

1.  We're doing the same regimen as last cycle (B6 and HCG).  One day last week when I was preparing for my next appointment with Dr. C, I glanced at my notes from the last appointment.  It was then that I realized I had misread the B6 bottle and was only taking 100 mg per day.  Dr. C had said to take 500 mg per day.  Oops.  No wonder it didn't affect my mucus this cycle, which was not nearly as good as last cycle's mucus. 

2.  I saw Dr. C last week, and he's adding low dose naltrexone and fish oil to my daily regimen.  He decided against adding T3—though he would have if I twisted his arm.  My thyroid labs and the symptom questionnaire I filled out would support adding T3, but my temps were only borderline low.  The fish oil is supposed to be "instead" of the T3, although I forget what its function is exactly.  I know many other NaPro patients are on fish oil so I was happy when he suggested it.  He recommended the Nordi.c Natu.rals brand but didn't say how much to take daily.  I will scour various blog archives and my notes from Dr. Boyle's presentations (the Irish NaPro doc)to find a dosage unless someone wants to tell me how much I should take.  :) 

The naltrexone I asked for by name.  I really don't like asking a doctor for specific drugs—I prefer the doctor to be the doctor—but with IF I guess I've become a little (okay, a lot) more proactive than I normally am.  (Case in point:  The first time I met Dr. C when he asked why I was there, I said I wanted surgery.  That raised his eyebrows.  It was direct, but there's no need to mess around when you're IF.)  I explained that the HCG used to take away my PMS symptoms nicely but it doesn't work as well anymore.  Last cycle my PMS was nearly as bad as during unmedicated cycles.  I also mentioned that Dr. Hilgers has great success with using HCG and naltrexone together when HCG alone doesn't cut it.  Before the appointment I had looked up my notes from the lectures Dr. Hilgers gave during my CrMS practitioner training where I had written down that 98% of women find relief with the HCG and naltrexone combo.  I also mentioned that I have quite a few symptoms of an endorphin deficiency which would be a second reason to try naltrexone.  Dr. C went on to explain a bit about low dose naltrexone and how it works.  He said he prefers Dr. Boyle's dosage schedule because it gets to the maximum dose faster which sounded good to me.  He said he'd call in a prescription to Ku.bat's where it would be compounded.  I completely forgot to ask about the significantly cheaper possibility of compounding it in my kitchen.  I'm getting a two-month supply, so I will ask when I'm due for a refill.  I doubt the naltrexone will do me any good this cycle because I still haven't received it.  (Long story...DH was trying to do me a favor and put a hold on the mail while he's away on a business trip but he forgot that my prescriptions—HCG and naltrexone—were coming.  He didn't save the hold confirmation number, so I have to visit the post office sometime before it closes to hunt down the box.  Hopefully I can do that soon...)

3.  My vitamin D level came back at 29.  Normal is 30-100.  I can't find my notes from the talk on vitamin D from the conference last year for what a good level is fertility-wise.  I want to say it was >80...but don't quote me.  Dr. C wasn't aware of a recommended level for fertility (other than the range the lab provided).  Regardless, I need to spend some time in the sun.

4.  Dr. C said that NaPro is getting noticed, at least in his city.  A local practitioner told him this story:  A new client attended an intro session.  The FCP asked the couple how they heard about NaPro.  The woman said that her ob/gyn mentioned it (!) as an infertility treatment option along with artificial means and names of various REs.  When describing NaPro, the ob/gyn, who is not affiliated with CrMS or NaPro at all, said that all her patients who had done NaPro became pregnant.  The couple read the NaPro website and decided to do it.  (my jaw is on the floor...I don't know about yours)  It's about time other doctors noticed!!

5.  This cycle DH is getting a break from giving the HCG shots because he's out of town.  Lucky for him.  Not so lucky for me.  That means I have to give myself the shots.  (Tips would be appreciated if any of you have self-administered shots before...)  I don't know how I'm going to pull that off.  The thought of it makes me want to run from the room screaming.  hahaha  I need to toughen up.  Is there a patron saint that would be good to ask for prayers in this situation?  Maybe one of the ones known for mortification would be appropriate...  ;)  Somehow I don't think it would be a good idea to close my eyes while sticking myself with a needle, but I admit that is my first instinct.  What if I just looked out of the corner of my eye?  Or squinted?  Maybe that would be enough to ensure that I inject my thigh and not my hand.  ;)  I'm really not sure I can psychologically handle injecting myself in the belly.  I think I'd have to work up to that by practicing elsewhere first.

Eine kleine Blogmusik

I hope you weren't expecting Mozart...  :)

The song below has been a source of comfort for me, especially on the hard days when the sadness of IF feels extra heavy (like CD1 yesterday, for example).  I randomly found it one day a few months ago among DH's music collection and was surprised I had never listened to the CD before.  Listening to it makes me long for Heaven.  :)

Be Still My Soul - Jean Sibelius

Be still, my soul: the Lord is on thy side.
Bear patiently the cross of grief or pain.
Leave to thy God to order and provide;
In every change, He faithful will remain.
Be still, my soul: thy best, thy heavenly Friend
Through thorny ways leads to a joyful end.

Be still, my soul: when dearest friends depart,
And all is darkened in the vale of tears,
Then shalt thou better know His love, His heart,
Who comes to soothe thy sorrow and thy fears.
Be still, my soul: thy Jesus can repay
From His own fullness all He takes away.

Be still, my soul: the hour is hastening on
When we shall be forever with the Lord.
When disappointment, grief, and fear are gone,
Sorrow forgot, love’s purest joys restored.
Be still, my soul: when change and tears are past
All safe and blessed we shall meet at last.

(I took some creative liberties with the post title; it means "a little blog music.")

Relief. It's done.

I could just make this a super short post and say we managed to do the SFA collection, which went horribly, and are waiting for the results, but that is not my style.  :)

First a little recap...  Before my surgery Dr. C wanted to do a SFA.  After finding out that the only lab in town that does SFA requires an appointment and those appointments are offered two days a week, we knew it would have to wait until after surgery.  We finally got around to scheduling it for this cycle.  (read: DH stopped protesting and said I could schedule it. He was trying to put it off as long as possible.)  When I called for the appointment I was informed they only offer morning appointments one day each week.  Well, that pretty much limited our choice to one day this cycle because I wanted to do it during the infertile post-peak phase.  (gotta save all the sperm pre-peak for our primary goal here...hahaha)  The receptionist asked where the SF sample would be collected--at home or at the clinic.  I was surprised at the question because I assumed we were in a tiny minority wanting to collect the sample at home through a normal act of intercourse.  I am guessing we still are in the minority...

Anyway we couldn't get an appointment first thing in the morning to our disappointment.  DH was considering going into work early and then meeting me at home for the collection. Then he decided to just stay home before the appointment because he thought he'd be more relaxed that way.  I agreed.

He told me the last few days that it was a lot of pressure for him.  I knew this was not going to be easy.

I should have asked all you veteran SFA ladies ahead of time about how to make the necessary hole in the collection device.  I thought when I had spoken to the lady at the PPVI Institute when ordering the kit ($20 plus shipping FYI) that she had said to use a pin.  So I grabbed my smallest stick pin from my sewing box and did my best to disinfect it (with alcohol).  That was the best we could come up with.  Is that what everyone else does?

The rest, well, I don't think I should describe here but it did not go well.  I really, really hope we never have to do this again.  If we do, we will do it while traveling this summer, and I will find a lab that allows you to drop off the sample during business hours without an appointment.

The one (and only) funny part was when we arrived at the lab. After signing some forms at the counter, DH held the container out in front of him to give to the receptionist.  She was seated such that he was holding it directly in front of her face.  She said to keep it in his pocket until he saw the nurse.  I had to suppress a laugh.  :)

The "appointment" turned out to be signing a spouse release form and telling the nurse he wasn't taking any meds.  He was out in five minutes.   All this "appointment" trouble for that?  Ah, well.  It is over now.  What a relief.  Now we just wait for the results.

Ever wish you had an IF t-shirt?

Some days it would just be easier if we could wear our IF on our sleeve...literally.  :)  For the days you're just not in the mood to face the questions, perhaps one of these might work.

It isn't related to IF, but I had to make this one too:

What other phrases would you put on a t-shirt?