Tales of a new doctor

I am officially a patient of Dr. K at the PPVI Institute. Yay! Since I was a patient there a few years ago, the process to become an active patient again was straightforward: fill out a few forms and have copies of my medical records sent to them. I would say it was a “quick” process except that the medical records department at the hospital where I had my laparoscopy took their sweet time in sending my records to Dr. K. Apparently they have up to a month to complete the record request, and they barely made that deadline. ;) (For new patients, there’s an extra step in the process: you have to wait for one of the PPVI physicians to review your case and make an initial written recommendation, which is mailed to you.)

Dr. K’s first two recommendations were to have an ultrasound series and endometrial cultures done. The cultures I had done a year ago were not thorough enough. Dr. K wanted to test for six different types of organisms which might be taking up residence in my uterus: aerobes, anaerobes, mycoplasma, ureaplasma, Chlamydia, and fungus. The cultures could be done locally, but the ultrasounds would have to be done by a NaPro-trained ultrasound tech. Knowing that a trip to Omaha probably isn’t feasible for me in the near future, I asked if I could have them done locally as well (assuming there was a 99% chance they would say no). They said no. I had heard of cases where a non-NaPro ultrasound tech is given written directions on how to do the NaPro ultrasound, so that’s why I inquired. Obviously that is far from ideal, but I figured it would be better than no ultrasound at all.

DH and I have been discussing it, and he is really supportive of getting the ultrasounds series done. If he had said it’s too much hassle to make the trip, I would have gone along with that and not pushed the idea. It makes you feel really good when your husband is on board. :) DH is trying to plan how he could take a week off, which is even more encouraging because normally it’s hard for him to even take one day off, let alone a week. Dr. K said if it’s at all possible, DH should come along so we can TTC the cycle of the ultrasounds. The bigger issue now is that I don’t have enough vacation days to use; I used them up during the trip to visit DH’s family. So I’d either need special permission to work from the hotel, which is not out of the question—except I’d rather not have to fill my boss in on the details of my IF and the reason for this trip—or we’ll have to wait until January at the earliest. We may have to wait until January anyway since I estimate that my ultrasound week would fall during both Thanksgiving and Christmas. I honestly wouldn’t mind doing the series over Thanksgiving, but I don’t know that the clinic would be open or that the ultrasound tech would be too excited about the idea. ;)

To have the endometrial cultures done, I made an appointment with an ob/gyn in town whom I had never met. I needed a new ob/gyn anyway for pap smears (and maybe, hopefully, God-willing someday for the ob aspect). Armed with a prescription script from Dr. K listing the required tests, I was mentally resigned to face any reaction on the spectrum from indifference to hostility. You just never know how a mainstream doctor is going to react to NaPro.

Before the doctor even came into the exam room, I could hear the conversation just outside the door between the nurse and doctor. Walls and doors don't block any sound in this office apparently. The doctor wanted the nurse to call PPVI to ask how the sample was to be collected. She was transferred a few times before she actually got a PPVI doctor on the phone. I breathed a sigh of relief. Who knows where the doctor might be—with a patient, in the middle of surgery, on vacation—especially on a Friday afternoon...

In the meantime the doctor came in to meet me and take my history. He wanted to know what kind of tests had been done for our IF and why these cultures were being requested. I described the hormone profile, surgery, and why it was suspected that I had an endometrial infection. No doctor can argue that periods lasting up to 13 days including a week of brown bleeding are normal. At least I had that evidence going for me! Most mainstream doctors would not suspect infection as a cause of brown bleeding, however.

He asked if we'd done ovulation stimulation or ovulation predictor kits to see if I'm ovulating or IVF. I said no to all of the above. I mentioned that I was charting to know the time of fertility and that the next thing PPVI wants to investigate is whether I'm ovulating...by doing ultrasounds. He looked like he was about ready to roll his eyes. He said that what I've had done so far is not usually how most doctors handle IF pts. Really? I had no idea! ;) I wonder if he thought I'd been shortchanged out of the usual IF offerings: Clomid, ovulation kits, and then IVF?

One of the first things I had said to him was that the approach my (NaPro) doctors were using was not mainstream. at. all. It might have made a tad more sense why we were taking this “unusual” route if I had explained that IVF and any other ART are not options for us morally and that we’d like to actually fix what’s wrong with my body, but there wasn't an opportunity to interject that information. You can only cover so much at the first appointment.

He also said that this unconventional approach was expensive.

Yes, but since when is IVF cheap? And it’s this “unconventional approach” that is responsible for finding and fixing the first two of my IF-related problems—endometriosis and a luteal phase defect—neither of which mainstream medicine would have found nor fixed. Why is it so hard for mainstream doctors to understand this? It’s frustrating...

He stopped short of saying NaPro is "silly" or "a waste of money" but I don't think those thoughts were far from his mind.

He left the room when the nurse had a PPVI doctor on the phone. Again I could hear every word he said loud and clear. I heard him express his skepticism about everything that had been done to me so far. I'm sure the PPVI staff gets this all the time.

He returned to my exam room with good news, bad news, and interesting news. The good news was they would be able to do the cultures. The bad news was that they were going to do an endometrial biopsy, and it was going to hurt. I know what you're thinking. Noooo! Not a biopsy! Those are horrible! I would agree. Last year’s biopsy was no fun. But I pretty much expected that was going to be the case, so I consented.

And the interesting news? He knew the PPVI doctor with whom he had just spoken. In other words, he was personally acquainted with her, and she had explained NaPro to him in the past multiple times. Talk about a small world! Perhaps it was Providence? :) That connection I think may be a substantial reason why he turned out to be so cooperative.

The doctor left to get the necessary supplies. The two nurses in the hall were having a tough time figuring out what kind of swabs were needed for the six different cultures that Dr. K wanted. I heard them make a couple phone calls—presumably to their lab. I heard them pull out the instruction manual for the swabs they had on hand. I heard them say they don't have the all the right ones. I heard them on the phone again. This went on for a while. Meanwhile I decided to make myself comfortable and lie back on the exam table.

The doctor returned briefly to say they were working on it and promised they wouldn't close up the office for the weekend with me covered with a sheet on the exam table. I was glad he was so good-natured about the whole thing.

Finally he returned, ready to go. He said PPVI had called back and changed their instructions: no biopsy needed. Just use the swabs. That meant no scary metal objects through my cervix, just a long q-tip-like stick. Yay! They had to take 3 or 4 samples but it did not hurt at all. I'd almost say a pap smear is worse. I highly recommend this method over the biopsy. Afterward the doctor gave me the (half-joking) disclaimer that it wasn't his fault if it turns out PPVI really needed a biopsy and I end up having to come back. He was just following orders. ;)

Now as much as this doctor was clearly skeptical of the NaPro approach, he was and is remarkably cooperative. He said he will do whatever PPVI asks, as if he's the local arm of their clinic. Wow! I was stunned. I was definitely not expecting that. His only request was that PPVI send him a summary of their approach to treating me so he understands the bigger picture. Seems reasonable to me. Hopefully PPVI already has such a document. He also wants all PPVI orders faxed to his office to ensure legitimacy and so he can follow along what is being done. Not a problem, I assume. I bet this will be a bit eye-opening for him. But to be honest I'm not sure how many more orders for tests and things there will be, other than the monthly Peak+7 blood draws. Since I just go to the hospital lab for that, it doesn't really involve him, unless for some reason the lab stopped accepting the paper order that I bring along and needed an order from a local doctor. I guess I'll just have PPVI fax him orders when they need him to do something—pelvic exam, other test, etc.

They said the fungal culture could take up to three weeks because it grows slowly. Nothing with IF is ever quick, is it? ;)

Visiting the in-laws

Here I am crawling out from under my rock to post an update. :)

We had a pretty nice vacation visiting DH's family. They live far away so I've only seen them a few times since we’ve been married. One particular day we spent the entire day with DH’s parents in a nearby town—visiting a garden, strolling through cute shops, etc. The following day my MIL handed us her camera so we could see the pictures she had taken of her grandson (our nephew) whom I had yet to meet. We flipped through lots of pictures of the baby. Then we came to a picture from our outing together the day before. There was one picture of the garden and that was it. They had spent the entire day with us in some rather picturesque areas and had not taken a single picture of us. Did I mention it had been two years since they last saw me? DH just shrugged it off. Maybe it only strikes a girl as odd if she's PMSing and is more prone to feel sorry for herself. Of course babies are much cuter to photograph—I know that—especially if that baby is the one and only grandchild who visits once a week (meaning lots of opportunities for photo shoots). It still hurt though because I felt like DH and I were second class because we don't have kids. It didn't help that I heard my MIL rave about her wonderful grandson fairly often during our visit. I doubt she meant to rub it in our faces. I mean, she never asked us when we were going to have kids, but it got old after a while.

DH's parents know we're infertile. Or at least they know that we've been TTC for a long time, and it obviously hasn't worked yet. DH doesn't give them updates, and they don't ask. I guess I don't mind that that's how it is. I greatly prefer it to constant questions and other random comments.

I met my nephew a couple days later. I admit he was pretty cute. There's something about a baby smiling at me that just melts my IF heart. I couldn't bring myself to hold him though. Just to keep myself from completely breaking down in tears (I was still PMSing), I had to put my IF sadness in a little “box” and shove it to the back of my mind. That was the only way I could put on a happy face. I didn't think I could pull it off while holding him. I did play with him a little so as not to appear that I completely dislike babies. ;)

I also met my SIL for the first time. The more I got to know her, the more I liked her. She is still kind of overwhelmed by the events of the last year—pregnancy, moving several hours away from her friends to live with my BIL, birth, wedding, and now raising their son.

During our trip we were also able to do a mini pilgrimage, visiting two beautiful cathedrals and a basilica. At each church we lit a candle and prayed for all those still waiting, especially my prayer buddy and all those in the IF blogging community. I prayed for as many of you by name as I could remember.

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.")