Focus on Fertility – eating well, and a breakfast recipe

Not being pregnant for the sixth month in a row has caused me to take a hard look at the things I have been and have not been willing to do in order to get pregnant. I do believe that a person should be able to live a more-or-less healthy lifestyle and continue on as normal, and become pregnant. But I think most people (or maybe I just mean me?) are in a little bit of denial about what a more-or-less healthy lifestyle looks like.

I eat vegetables. I eat probably more of them than many of my friends and extended family. I am not “overweight,” no matter who you ask (unless you ask that asshole who lives in my head and occasionally surfaces when I am jeans shopping or going to the beach with people who have never seen me in a swimsuit). So I was all yeah, I eat basically well. No changes needed. I plowed through the eating chapter in Fully Fertile making one small change – giving up pop – and carried on as I had been.  Also while ignoring the rest of the book, because it told me I had to get more sleep, so I was like, well, here’s where I give up.  

When I wasn’t pregnant last month, I revisited my eating and faced the fact that even though I ate sorta fine, there was definitely room for improvement.  I read the “pregnancy diet” in WTEWYE, and started thinking about nutrients. And, um, I am actually a little short, it seems. I don’t get nearly enough vitamin C or iron, or even calcium. I seem to have become some kind of crazy meat-eater, which is weird because I was a vegetarian for nearly a decade. I probably eat too much salt. And I drink alcohol daily. And (ahem) maybe a bit too much on the weekends.

So for the last few days, I have been diligently trying to get in more fruits and vegetables, and have been drinking milk instead of wine at dinner. I am a LOT more full after dinner now — the milk makes an enormous difference. I am mildly lactose intolerant, so the milk is a bit of a challenge after the fact. The intolerance started when I spent 8 weeks in the UK in college and the cafeteria in my dorm served this horrible super-pasteurized milk that can apparently be left at room temperature. That shit is nasty, and I didn’t drink milk at all for 2 full months, or even put it on my cereal. I came back, and all dairy, even yogurt or cheese, caused issues, and FORGET about putting milk on my cornflakes in the morning. I have gradually worked in all other kinds of dairy and now have no problems with them, so am hoping that my tiny glass of milk each dinner will re-acclimate my digestive system to lactose so that I can eventually grow into the full- sized version of my pre-London years. Even if not, some milk is better for the bones than none, and even though it is animal-derived, at least it is a good non-meat source of protein.

For me, healthier eating was not just a matter of what I added, but also what I subtracted. This meant less processed food, and much less alcohol. Yesterday I was congratulating myself on how little I had been drinking when I realized it had only been four days. Ahem.  But I am carrying on in that regard.

My dinners are almost all home-cooked, thanks to having three growing kids to feed, but I tend to grab both breakfast and lunch out, so this was clearly where I needed to make the effort to eat more home-cooked, nutrient-rich food.  I usually eat some kind of wrap from Dunkin’ Donuts or Subway for breakfast, since they are both in the basement of my office building, and soup, salad, or a sandwich for lunch.  My main challenge with eating breakfast at home was that I never had time to make anything, and I don’t really like cold things or sweet things in the morning. And I don’t really like eggs.  I know, weird. Thus, whatever I was going to eat had to be hot, savory, not too eggy, easy to heat up at work, and had to be made ahead of time.  And so, I present to you, my new breakfast (well, half of it, anyway):

breakfast

 

Spinach-Feta Breakfast Wrap

(makes six)

2 Tbsp. Italian dressing
1 lb. frozen chopped spinach
1 tsp. minced garlic
4-5 eggs
5-6 egg whites (I meant to do 4 eggs and 6 whites, but I broke one of my yolks when separating, so I think I was 5 and 5.  Also I kind of lost count.)
splash of skim milk
a handful of sun-dried tomatoes (not the ones in oil!)
1/2 block of pasteurized feta cheese
6 whole wheat tortillas

Heat the Italian dressing over medium heat, and add the garlic.  Thaw the spinach and press out as much excess water as you can.  Add to the garlic when it’s simmering. Cut up the sun-dried tomatoes into strips with kitchen shears and add to the spinach.  Sautee until heated through and the tomatoes soften a bit. Remove from pan and set aside.*

Meanwhile, mix eggs and milk in a bowl until blended but not totally beaten.  Add to the pan the spinach was in, stirring until cooked but a tiny bit runny.**  Spread out 6 tortillas on the counter, each on a paper towel, and divide the spinach and eggs evenly amongst them.  Crumble/chop the feta cheese and divide evenly.  Add some pepper here if you feel like it.  I was lazy and did not.

Wrap each into a burrito, then wrap in the paper towel and then in parchment paper.  Stuff them all into a gallon-sized ziplock and freeze.  This whole process took me about 15 minutes on a Sunday night.  In the morning grab one and stick it in your lunchbox.  I put mine in a sandwich bag in case it thaws, but it’s so freaking cold in New York right now that it never has.  

To heat, pop the whole thing in the microwave for 2-3 minutes.  The water from the spinach will soak the paper towel a bit and it will steam inside the parchment paper.  For your trouble, you get:

1/2 serving of protein
1 serving of calcium
1 serving of iron
1 serving of leafy greens
1 serving of whole grain

I purposely made sure this was pregnant-lady friendly, so that I don’t have to think too hard about how to change it if I am pregnant.  I also plan to try some variations on this, with maybe some soy-breakfast sausage, different cheeses, different veggies, etc.  I think bell peppers, sausage, hot sauce, and pepper-jack cheese would be a nice combo to mix it up a bit.

*  Next time, I plan to try mixing the eggs and spinach together. I am thinking it will be less “one bite spinach, one bite egg” and more blended.  We shall see.

** I left the eggs a tiny bit runny because they cook up when you’re re-heating and can get a little spongy.  If you’re worried about food safety, I am sure you can cook them through without it being a huge deal.

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one pink line, and the problem with maybe

This weekend, I got my period.  Again.

Friday, I was sure I was pregnant.  I planned to test on Saturday morning, because then we would have some time to revel in it before getting back into real life. How could I not be pregnant?  We used a different donor, the donor that we thought we were meant to have been using all along, but originally had not chosen because he was an open donor.  His numbers were much better!  I had the HSG test, and my tubes were clear.  My prolactin levels were down (still not in the normal range, but very close).  We timed it right, finally, for our two back-to-back inseminations.  I would surely be pregnant this time, lucky try number six.

There are lots of women who feel nothing, less than nothing, no pregnancy symptoms at all, before they are late.  So I could be one of them.

When I woke up Saturday, I knew I was not pregnant.  “Are you going to test?” my wife whispered.

“It’s going to say no. Give me just one more minute to hope.”  But I had to go to the bathroom, and eventually I couldn’t put it off any longer.  I set the test on the nightstand and put my head on my wife’s shoulder for three more minutes.  I was right.  It was negative.  I stared for a while at that blank, white space next to the one pink line before I got up and threw the test in the garbage. I crawled back into bed and cried, for kind of a long time.

This was the worst loss.  The other times, I knew it might not work.  I really, really thought this time would work.  I let myself read week 3 on Amalah’s zero-to-forty pregnancy calendar (and week 4, and 5).  I had a dream that I had a baby, and it was a boy, and BT was happy about it.  I avoided brie, and smoked salmon, and drank sparkling water, just in case.  I hoped.

On Sunday, I had the worst fucking cramps I have had in a decade, and got my period. I spent a good portion of the afternoon sitting on the couch with a heating pad, feeling sorry for myself.  I discussed Clomid with my wife and my sister, who is a consultant that works with pharm companies and knows things about drugs.  I talked with my wife about how long we would do this, and how hard it is on me emotionally.  We talked about Clomid, we talked about IVF.

The thing about not being pregnant, month after month, is that you start to think that it’s you.  I am starting to lose faith in my body’s ability to become pregnant without some further assistance.  I look at my lifestyle, and I think, maybe it’s because I refused to give up drinking.  Or even drinking coffee.  Maybe I should do more yoga.  Maybe I should not have skipped acupuncture. Maybe it’s all the late nights of work.  Maybe it was staying home to care for my son, and catching his cold.  And you know what? Maybe it is.  Or maybe it’s not.  I don’t really know.  I don’t know why I’m not pregnant yet.

In the end, we decided that we are going to try one more “natural cycle,” and I am going to really give it a go doing all the shit they tell you to do in books about fertility.  I am not going to eat crap that’s bad for me.  I am going to cut down to the four drinks a week they recommend when you are trying to conceive.  I am going to re-give up the second cup of coffee and the diet coke that has been sneaking back into my hands on the weekends.  I am going to do better with remembering both the prenatal vitamins and the B-6.  I am going to diligently try to get to bed earlier, even if that means no Downton Abbey for me.  If it works, so much the better.  If it doesn’t, then there are worse things than being super healthy for a month, and it will give baby a little head start on having a healthy mama, when I start the Clomid in March.

if we wanted Chlamydia, we’d ask for it

I have spent a lot of time over the past few days fretting about how my doctor proposed maybe considering Clomid for the next cycle if this one doesn’t work.  I think this one will work, right? There are a lot of variables that have changed:  new donor, HSG test, two inseminations this month (one today, one tomorrow, yay!), and ever-lowering prolactin levels.  Good for pregnancy odds, not so good for a controlled study, I guess.  Nonetheless, I feel like “considering Clomid” is hanging over my head like a dark cloud.

Yesterday, I confessed to my wife that I was worried about this.  I don’t want to try medication, yet, I told her.  It made the already-awful HSG test worse to have it popped on me while I was still bleeding on the x-ray table that we had to start thinking about fertility meds.

“Well, honestly.  I don’t think she needs to keep bringing it up.  If we wanted Chlamydia, we’d ask for it, right?” my wife said.

“Clomid.”

“What? What’s that?  What’s Clomid?”

“That’s the medication.  The medication is Clomid.  Chlamydia is an STD.”

“Oh, right.  Clomid, then.  Whatever, the logic still stands.”  The woman has a good point.

peesticks and dignity

Here is a picture of my peestick (not surging).  It is resting on top of the toilet seat protector thingy dispenser in a stall in my office restroom.

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My dignity was apparently flushed down the toilet.  It’s hard for me to think of something as degrading as testing your ovulation in a public restroom at work, while other women come and go.  I have learned that there are a few times one should never, ever test one’s ovulation in the work ladies’ room.

1) 4:49 pm – 5:15 pm.  This is the time that hoards of secretaries come to brush their teeth and reapply makeup before leaving for the day.  Let me tell you, if they did a study of dental hygiene habits, I am willing to be that legal secretaries would be in the 99th percentile.

2) Immediately after lunch.  For the same reason.

3) 10:00 am.  This is when the attorneys roll in, and they are likely to go to the bathroom on their way to their desks.  Also, someone will be pooping, and if you stay in the stall for 3 minutes so as not to jiggle your precious peestick, people will almost certainly assume it’s you.  And, I, for one, have memorized most of the shoes on my floor, so you can bet I know who’s in what stall.

The emotional turmoil of trying to get pregnant should be enough.  It should not also be required that I remember not to pee for some four-hour stretch in the middle of my workday, the end of which will not coincide with one of the time periods described above.

the hsg test – ow, and nooooooo

Today, I had the HSG test.  I had to take a pregnancy test before I could have the HSG test, so I went to my ordinary doctor’s office about an hour and a half before my appointment to find out if I was knocked up already.  I failed one test, and passed the other — I’ll give you one guess which is which.

I had been advised by the nurse to take ibuprofen an hour or so before the test, but of course, because I was so insanely early for the HSG test, I instead sat in the sandwich shop, eating broccoli soup and reading my book until my frantic and late-as-usual wife showed up to hustle me down to radiology.

The test itself was painful.  More painful, actually, than I thought it would be.  I think this is because my doctor had some difficulty getting the catheter in deep enough, so she used some horrible sword-like device that “would cause considerable cramping.”  That’s an understatement, when someone is shoving a sword into your cervix.  The one upside is that it was fast — about 2 minutes, once they wrangled that catheter through my apparently maze-like cervix.

And, I guess the other up-side is that my tubes are clear.  Totally clear. So now there’s just some dye swimming around in my abdominal cavity and some residual bleeding from the sword fight to deal with.  And a free and clear path for this month’s lucky gentlemen (the sperm, I mean).

After the procedure, when the doctor told me my tubes are clear, she dropped the bomb — she thinks that if this cycle doesn’t work, I should consider Clomid for next time.  My desire to go on Clomid ranks somewhere between “root canal” and “brain removed through nasal passages using a hook.”  Not to mention the risk! of! multiples!  Maybe she wasn’t paying attention when we told her we already have a shit-ton of kids, and we would like to up the ante one at a time.  When she said this, I wanted to say to my wife “See!  It’s really abnormal that it’s taking this long!  And therefore breaking down the bedroom door was a totally normal reaction to the frustration and disappointment!”  Unfortunately, she wasn’t allowed in the x-ray room with me, and I was still lying prostrate on an x-ray table with god only knows what on display for the rest of the room to see, so I just nodded and told her we would think about it.

I’m done thinking about it.  No.  No Clomid.  Maybe I’ll just go ahead and get pregnant this month, instead.

the hsg test and taking charge

Tomorrow, I am scheduled for an HSG Test, also known as the dye test.  This is where they squirt dye into your uterus and fallopian tubes, then look at it under some kind of machine (x-ray? MRI? something?) to make sure nothing is blocked, because it’s taking you a long-ass time to become pregnant.  My doctor recommended that I try this last month, but I didn’t want to because ew.  I don’t particularly want them poking around in there, squirting fluids where they don’t belong, and even though I occasionally (i.e., every month when I am not pregnant) am wracked with fear that there is something wrong with me, in general I have a hard time thinking that there could possibly be any real issue here.  I think, in most of my saner moments, that sometimes it just takes a while.  And that is heartbreaking, and annoying, and expensive, but it just is.

That said, I would rather have tests than medications.  In general, I am a root-cause medical person, not a symptom-treating medical person.  In other words, I am all about investigating, testing, monitoring, to find out if there is an actual issue somewhere, and what it is.  I am resistant, however, to medicating “unexplained infertility” with Clomid (especially when there is very good evidence that I am, in fact, ovulating), or even taking Advil for a headache before I have tried to rule out root causes, by drinking a glass of water, having a snack, or taking a nap.

So, when the options are Clomid or dye test, I went for dye test.  Nothing is also always an option, but I kind of want to feel like I am moving forward or escalating this in some way.  In reality, I think it will show nothing, but at least I will have a day off of work, and anecdotally I have heard that conception rates are higher the month of a dye-test — something about it washing out the uterus, or something.

One positive effect of all this annoying medical stuff is that I have learned much more effectively to advocate for myself when it comes to my own healthcare.  Last month, they recommended I do the dye test, and I said no thanks — we’ll try again without it, thankyouverymuch.  This month, I scheduled the test and took notes when they described the procedure, so that I realized earlier this week they had not prescribed the antibiotics they said I would be taking starting the day before the test.  So, I called and got the prescription.  All of this makes me feel like I am doing this, I am in charge.  Earlier in the process, it would have annoyed me that they didn’t think to call in my antibiotics when they scheduled the procedure, but whatever. No one is as concerned about my own body as I am, and that’s fine with me.  In fact, I generally prefer it that way — my body, my choice, right?  My dye test.

The other thing I have learned is the power of dealing with nurses.  They often know much more about how things work than the doctor does.  Now, every time I have a question, I call and ask to talk to a nurse.  At least nine times out of ten, they can answer it and handle whatever I need.

So, tomorrow, dye test.  I am nervous, because it’s supposed to hurt (like sudden, bad cramps) and also because any time I have to do a new medical procedure, it’s a little scary. But the wife will be there to hold my hand, and my regular doctor is going to be doing the test, so I think ultimately, it will be fine.

feelings, and stuff

Obviously, I am not pregnant, or you would have already had 13 posts between the end of the two week wait and now, with me gleefully holding positive pregnancy tests and over analyzing all the goings-on in my body.  No news is bad news, I guess.

December was our fifth try.  I realize in the world of trying to conceive, that is not technically a long time.  But we aren’t in the ordinary trying to conceive world.  We are in the fertility clinic world.  And five months is a long time, in that world.  I know that statistics are thrown around, which say that a normal, healthy, heterosexual couple can take a year to conceive.  But I can’t help but feel like those normal, healthy, heterosexual couples aren’t really trying all that hard for the first few months.  Like, I am sure, for example, that they are not getting ultrasounds to make sure they are ovulating, they haven’t had their hormones checked, they aren’t even necessarily peeing on sticks.  They’re just sort of having sex on day 14 and hoping for the best. We’ve really stepped it up a notch from there since day one.  You know?  Which makes the five months a long time.

Then I think about the months leading up to our first try, and I realize that we were meeting with the RE nearly a year ago.  And suddenly, the heart-wrenching devastation each time it doesn’t work seems a little more normal.  It’s sort of agony.

Also, as one of my friends pointed out, what kind of cruel trick of nature makes you find out you are not pregnant and HAVE YOUR PERIOD AT THE SAME TIME?  I am already an irrational, weepy mess when I get my period.  Then nature was like, I know, this is the totally perfect time to let this person know she is not pregnant.  When she’s a fucking walking train wreck and has house guests.  Good idea, nature.  Although, technically, nature did not force me to have house guests when I got my period, but still.  Nature knew they were there, and let me not be pregnant anyway.  So I had like 15 minutes to silently weep in my room before getting dressed, blowing out my hair and going to Cafe Wha with what felt like 900 in-laws.

Which, I guess, is what led to the New Year’s Day Explosion, where I broke down the door of our bedroom.  I hate New Year’s in general, but everyone was finally gone, and the kids were at their father’s for the day.  So, I was all “YAY, we have a day to ourselves, let’s watch football on TV and order pizza and stay in pajamas all day.”  And the Wife was all, “We can’t, it’s our friend’s birthday and we said we would shower ourselves and go to her house for a party.”  Why, why, why do we have to have friends at times like these? Friends with birthdays even. Ugh.

So we decided that, since we were getting out of bed anyway, we might as well clean up some of the Christmas that was all over our house, and my wife let me know that she did not like the Christmas presents I got her.  Not any of them.  The sweaters were too casual, and also like one she already had, etc., etc. with all the other presents too.  She didn’t hate the presents, she just didn’t like them.  So could she exchange them, please?  Which is totally rational, but anyway caused me to flip the fuck out.  It was like some kind of angry animal was unleashed in our house.  I was a screaming, sobbing, mess of feelings.  All wild and negative feelings, like angry and sad and miserable.

Wife was kind of, shall we say, overwhelmed by the strength of my reaction to a request to exchange a sweater at the Gap, and went into our room.  In all honesty, she was pretty pissed at me.  You’re supposed to be gracious, I guess, when someone wants to exchange a present you got them, which I decidedly was not.  So she went into our room, and she locked the door.  Now, this is against the fighting rules.  Every couple has fighting rules, I think, and this is one of ours: We aren’t allowed to lock another person out of a shared space during a fight.  Partly because it’s so totally infuriating to be locked out of your own room, and tends to cause the fight to escalate.  Also, one of the loathed presents was in the room and I needed to get in there so I could examine it.  When I tried the knob and it was locked, I could have done any number of things; for example:  (a) asked her to let me in, (b) gone to sob on the couch some more instead, or (c) put my shoulder into the door as hard as I could and try to break it down.  I went with (c). I just football-style rammed my shoulder into the door, which, yes, got me into the room, but was also a totally insane thing to do.  I popped the trim off and split the doorjamb in half.  Shards of drywall went flying.  Without a word, I walked in and got the present, and just sat on the floor and stared at it.  “Um, you broke our house,” a small voice said from the other side of the room.

It was like the splitting doorjamb split open something inside of me, and all the real feelings came out.  Why couldn’t we have a baby?  And why did there always have to be so many people around that I didn’t even have one second to be sad about that, before I had to bop off to hear a cover band and make small talk?  And why, why, why on our one day at home, did we have to go to our friend’s house for her birthday, where there were going to be a bunch of other suburban women that totally intimidate me and make me feel weird for wearing a hooded sweatshirt that I have had since I was 16 instead of grownup people clothes?  It’s New Year’s Day!  I don’t want to wear grownup people clothes.  I am tired of being grownup people.  I am mostly, though, tired of putting on an act, and pretending I am fine when I am so totally not fine.

I don’t really know how to cope with the not being pregnant thing.  It’s not a concrete loss, that people understand.  I didn’t lose a baby, no one died.  It’s just a slow, slogging, low-grade kind of stress and misery.

So, then, I did what I had to do.  I cried for like 2 more minutes, then I pushed our non-baby out of my head, got in the shower, got dressed, and went off to my friend’s party and acted like a grownup.  Although I did wear the hooded sweatshirt from when I was 16 and drink Bud Light, so not a total grownup.  She is my friend, after all, and knew what she was getting into when she asked me to come.