the best drugs

Started watching "The Business of Drugs" on Netflix last night. All that talk of dopamine and serotonin made me think of my baby.

Yes. Baby smells delicious. I have even found my husband's smell more delicious lately. Like when I lay on his pillow, I love the smell of it. Like sugar cookies or freshly baked sweet bread. I wonder if it is due to oxytocin. Causing our nuclear family to bond even more tightly. That would be advantageous, no? For survival. And maybe my husband is making different aroma, maybe my nose receptors are rearranged or maybe my brain is perceiving it differently. Anyhow on the flip side, my own body is producing extreme BO. Or maybe that's just my perception. I have yet to get outside confirmation. Too scared to ask my husband, and due to COVID, I don't see anyone else in person.

Last week was another hormonal rollercoaster. I was super weepy on Thursday and Friday then had a migraine on Sunday. I am kind of trying to track when these bumps in the road occur to predict if my period is coming back.

I swear I have never been so present in the here and now of my life since getting pregnant and having this baby. Starting in pregnancy, I did a lot of monotasking. Being really aware of my surroundings to protect the baby. Not doing too many things at once. Like not "carrying stuff up and down the stairs while listening to music." I did just one thing like walking. And just focused on that one thing. It was a major shift. I know people say mindfulness is a tool to help recovering addicts. I don't know how I will ever let go of this baby when I return to work.

Postpartum Part 11: symptoms

My sister says I kept an annoyingly scientific record of my pregnancy symptoms and I said, "it's for you!" I kept wondering if all those things were normal and how long they would last. So I am continuing to track symptoms postpartum as I recover however quickly or slowly.

rhinitis - gone

bleeding gums - gone

flatulence - worse

carpel tunnel - worse

linea nigra - same

stretch marks - not an issue

nipple soreness - not an issue... but breastfeeding is a challenge! It's not 100% painless.

hair falling out - not an issue (yet)

mastitis - constant struggle

discharge - much less

feet hurting - same as 3rd trimester

symphysis pubis dysfunction (SPD) - never had it. But I did have postpartum back pain that was REALLY bad in weeks 3 and 4.

https://www.verywellfamily.com/what-women-needs-to-know-about-post-pregnancy-3520998

According to a chiropractor, the back pain was caused by three reasons (1) diastasis recti (2) a sacrum that may be out of place and (3) the Cesarean section. The whole core is destabilized. Throw in there a high level of relaxin that will persist as long as we are breastfeeding, that is the reason for some of the inflammation.

She let me know that there is scar tissue forming as my body is healing from the surgery. Filaments are forming as the uterus is contracting to its original size, and these filaments can cause pain in the abdomen and even down into the legs. It was hard to get out of my comfy recliner and get in and out of bed. The chiropractor said it will be important to NOT do a sit-up or crunch for at least one year to let the diastasis recti repair.

Now two months postpartum, I have less trouble getting in/out of bed. I can roll from my left to my right side in bed without any pain. I can get in and out of my recliner carrying baby without any pain.

One month after my C-section, I missed: hard laughing, working out, riding a bicycle, leg lifts, squats and lunges. I looked forward to the day when I could lay on my stomach and rest there. 

One month postpartum, laying on my side was nice. Two months postpartum, my breasts are huge and still painful. I could not lay on them, no way. I have bought some new PJs and sleep bras to help alleviate the discomfort of engorgement and the hot flashes I seem to get at night. I sleep really well when my bedroom is like 55 degrees.

One month postpartum, I looked forward to lifting things like laundry baskets, stroller, and carseat with baby in it. I can do most of these now, but the baby is gaining weight so fast I have to keep doing my Fit4Mom workouts to build my upper body to be able to lift baby in carseat. I have done it at least once recently.

My boobs can tell time

Shower thoughts after a night of good sleep seem so profound. I was showering, washing my body, when I thought: wow my boobs can tell time now. 

Want to do more reading about prolactin and circadian clock, MOTN pumping.

https://dornsife.usc.edu/news/stories/3060/breast-milk-helps-babies-tell-circadian-rhythm-from-mom/

https://www.llli.org/breast-milks-circadian-rhythms-2/

The night before Mother's day I had a dream that I went to a roller rink that had two side-by-side indoor wood floor rinks but they were in use. The staff told me I could go outside and enjoy the outdoor rollerpark, which was kind of like the LA County Arboretum. There were popup thrift shops and art participation booths, very much like an open streets (CicLAvia) event. Then Sigourney Weaver showed up to skate and she was heavily pregnant. I thought she was a beautiful symbol of fertility and full of life. And then I woke up to breastfeed my son. I think I'm just dreaming of fun and wonderful things that make me happy, and dreaming of the time before COVID-19, when we didn't think about social distancing and we weren't required to wear masks in public.

It's frustrating to have abdominal cramps and wonder if it's my period coming back, 9 weeks postpartum. Then I read that it's different for every woman whether you are breastfeeding or not. I was rinsing spinach leaves and destemming them for a soup and it occurred to me that every leaf is shaped differently but they are all good and nutritious. So why would all women have the same pregnancy and postpartum symptoms on the same timeframes? 

Pregnancy Part 20

Today we have a friend dropping by. He has experience in the formulation of personal care products. I want to ask him about some specific ingredients and what is their purpose in products such as the ones shown below. I started writing about this topic in a previous post.

LOTION / BODY OIL

 

 

 

 

SHAMPOO / CONDITIONER

 

 

 

 

FACIAL CLEANSER

 

 

SHAVING CREAM

 

So what I ended up doing is writing a big matrix (table) with all the banned ingredients on the rows and all the products I use on the columns. If the product contained a banned ingredient, I put an "X" in the corresponding box. It made the process of sorting out all the information a lot easier.

The common ingredients I found in some of the lotions I like a lot were parabens. Specifically, methyl-, ethyl-, propyl- and butyl- paraben. The parabens are used as preservatives. They are found in 75-90% of all cosmetics. They are the second most used ingredient (after water). After a 2004 study, it was found that parabens can cause breast cancer due to their ability to function as estrogen-mimics. Some "natural" formulations are using oats, pomegranate, pineapple and ginger instead that achieve the same purpose.

The common ingredients I found in shampoos are quaterniums -7, -10, -15, and -18. The purpose of this ingredient is as a germicide. They have antimicrobial (specifically antibacterial) properties. The reason they are not recommended for pregnancy is that they have been shown to be teratogenic in animal studies. Pregnant mammals gave birth to babies with birth defects if exposed to quaterniums.

An ingredient that is not recommended for pregnant women is diethylamine (DEA). I didn't see that listed in any of the products I looked at, but I did see some analogous chemicals: dimethylamine and triethanolamine. The function of these amines is to act as surfactants. When we spoke to our friend in the business, he mentioned that DEA is no longer widely used. In a 1998 study, products containing DEA were found to be carcinogenic, but the FDA does not consider it harmful.

A second ingredient I found in some of the lotions I like a lot was diazolidinylurea. It is added to cosmetics to function as an antiseptic (preventing the growth of disease-causing microorganisms). The problem with this ingredient is that it releases formaldehyde. The reason formaldehyde is undesirable is that it can lead to abortion, birth defects and premature birth. Formaldehyde is a known carcinogen.

One way I have tried to protect myself against formaldehyde is to put some plants in my bedroom where I sleep that are known to clean the air. One is called "Mother-In-Law's Tongue" and the other is called "Pothos." The botanical names are Sansevieria trifasciata and Epipremnum aureum, respectively. You can see that I put these plants (and several others) in my room just prior to the embryo transfer. Not every plant survived, but the two I just mentioned are still going strong, along with an Aloe vera that is also noted in a NASA study to remove formaldehyde from the air.

There were several compounds that I kept seeing over and over as I read through the ingredients of all the products I use (or wish I could still use). One ingredient is dimethicone, which is a skin protectant that smooths crevices in the skin. It is found in many creams that claim to tighten the skin. A second compound that I saw over and over was phenoxyethanol. It is an oily bactericide.

One interesting story that came up in this research was how in 2008, a French health association criticized the freebies given away in maternity wards at hospitals, characterizing the products distributed as a "toxic cocktail" of baby cosmetics. This led to the health minister requesting a label marking certain products as unsafe for pregnant women and young children, which I believe was unsuccessful due to lobbying by the European trade association. I have a similar story. One of the freebies that I was given either from "Motherhood Maternity" or the "Babylist" registry contained a shampoo and conditioner from the Herbal Essences product line. The shampoo contains quaternium-18, which I found is something that causes birth defects. So even though it's free, it's not right to give it to pregnant women in their first trimester!

In short: 

SAFE TO USE

CT Organics Face Wash, Lotion and Deodorant

Clinique Face Washes and Lotions (with SPF)

Burt's Bees Belly Butter and Body Oil

Palmer's Cocoa Butter Stretch Mark Cream

Paul Mitchell Awapuhi Shampoo

Nature's Gate Shampoo and Conditioner

UNSAFE TO USE

C.O.Bigelow Mentha Vitamin Lotion (parabens and diazolidinylurea)

Bath & Body Works Tahiti Sweetie Lotion (parabens and diazolidinylurea)

Gardener's Lotion containing Jojoba Oil (parabens)

Secret Deodorant (aluminum)

Paul Mitchell Tea Tree Shampoo (quaternium)

Herbal Essences Conditioner (dimethylamine, quaternium)

Head & Shoulders 2-in-1 Shampoo and Conditioner (quaternium)

Skintimate Shaving Cream (triethanolamine)

References
Winter, Ruth. A Consumer's Dictionary of Cosmetic Ingredients, 7th Edition: Complete Information About the Harmful and Desirable Ingredients Found in Cosmetics and Cosmeceuticals. Potter/Ten Speed/Harmony/Rodale, 2009.

Pregnancy Part 13

Symptoms you don't hear much about:

1) rhinitis

2) itchy legs

3) rib pain

I think I started getting rhinitis very early on in the first trimester. It was one of my earliest pregnancy symptoms. It's not on the app that I use for tracking symptoms. It feels like allergies or just a small cold. I have a constant stuffy nose, which results in shortness of breath because my nose isn't working properly. I end up doing a lot of mouth-breathing and chewing with my mouth open (which isn't attractive) and I'm surrounded by piles of used Kleenex.

The itchy legs were definitely a second trimester thing. I posted about it on reddit on Oct 7th (pregnancy week 18) but I must have been experiencing it prior to that. It mainly happens at night, after dinner, or while I'm in bed. I got so bad sometimes that it would wake me up in the middle of the night. Dear husband suggested that it was probably due to the dry air we have here in Southern California, but this was way worse than anything I can imagine. It would have me up out of my armchair (where I normally relax each evening) and on the floor stretching and slathering my body with 3 different kinds of lotion.

The rib pain has been going on about a week. It is all the way around my ribcage. I was freaking out because the 3 pregnancy apps and reddit group I belong to didn't mention it as a common symptom at this point in the pregnancy, but then thankfully the Zita West book mentioned it. Apparently, this is something people experience in late second trimester and third trimester.

30% through "Your Pregnancy Companion" by Zita West...As your uterus continues to rise and expand within your abdominal cavity your ribcage will move upwards and your lower ribs will spread outwards. You may experience some discomfort and breathlessness as a result. @johnkaiser13 pic.twitter.com/rcfIkiZBHq

— Dr. Kayla A. Kaiser (@hamerk02) November 10, 2019

So I wanted to just recap what I learned at birth class last night:

1) pitocin is a synthetic form of oxytocin. Contractions induced by pitocin are not different than contractions induced by oxytocin (both are painful).
2) epidural is not harmful for the baby. There are side-effects for the mom and potential complications. There is epidural and spinal delivery modes, depending on whether you are having vaginal or Cesarean birth. A component of the drug is fentanyl.
3) narcotics (demerol, morphine) are harmful for the baby because they lead to a lowered heart rate which can lead to Cesarean birth because when fetal heart rate drops, urgency to deliver the baby increases. Also, some laboring moms lose the ability to push naturally while medicated. It may be desirable to ask for an intramuscular injection of the narcotic to reduce transmission to the fetus and to slow the absorption rate of the drug into the body.

Fertility Part 20

A few significant things happened this week. First, my acupuncturist will no longer see me because I am pregnant. Second, I got the results of my blood-work back and I am still pregnant.

July 3rd - 11dp5dt - hCG: 260 IU/L - E2: 1,014 pg/mL - P4: 31.4 ng/mL
July 5th - 13dp5dt - hCG: 664 IU/L - E2: 912 pg/mL - P4: 28.6 ng/mL
July 12th - 20dp5dt - hCG: 7,986 IU/L - E2: 1,110 pg/mL - P4: 29.4 ng/mL

What is considered normal E2 levels? 188 - 2497 pg/mL in the first trimester. What is considered normal P4 levels? 100-200 ng/ml by the end of pregnancy. There are also some values presented in this paper. hCG: 4620 IU/L - E2: 1,627 pg/mL - P4: 24.8 ng/mL in 42 women, average age 29, at 8 weeks pregnant.

There are so many acronyms in the fertility community. Human chorionic gonadotropin (hCG) is a hormone produced by the placenta after implantation. This is the substance that is detected in home pregnancy tests, such as First Response Early Response (FRER). E2 is estradiol and P4 is progesterone, these are the hormones that I am taking every day.

The way women tell other women online how far along they are is in weeks+days. For example today I am 5+1. For IVF cycles with a frozen embryo transfer (IVF), the abbreviation is days past (dp) and age of the embryo transferred (dt). So for me, I did a 5dt because the embryo we transferred was a 5 day blastocyst when it was frozen and thawed.

Today I am attending my first RESOLVE meeting. It is a support group for infertility. I do not know how the group will respond to a newcomer that is actually already pregnant, but I know that I do need support and connections in case I do end up with a miscarriage. I am not expecting that outcome, but until 8-10 weeks, there is still a chance.

My symptoms include feeling hot, very tender breasts, sore backside (where I take the shots), alternating between hungry/full/nauseous. I felt a little emotional the past few days, crying easily. I am not in the phase yet of taking pictures of my invisible baby bump. We got our first gift from a friend last weekend in Riverside. So cute booties, hats and onesies. I am starting to create space in our 2nd bedroom to accumulate "baby stuff."

Fertility Part 14

It seems I can write about nothing else until we have an answer: Will our one AA embryo attach? We had an appointment yesterday. Here are our clinical lab results so far:

6/14/2019
Progesterone 0.170 ng/mL
Estradiol 247 pg/mL
Lining 10.3 mm

6/17/2019
Progesterone 0.084 ng/mL
Estradiol 426.5 pg/mL
Lining 11.1 mm

Our team says that these numbers are great! The uterine lining looks pretty much like the image from this paper.

I have been taking Estrace (Estradiol) 2mg tablets for 11 days. I have had two injections of Delestrogen (Estradiol Valerate) 20mg/mL x 0.1 mL and two injections of Delestrogen (Estradiol Valerate) 20mg/mL x 0.2 mL. The first few days it seemed like I was having mild headaches, but nothing near migraine. The last few days I have been feeling very moist. Like, I would take a nap and then wake up with my underwear feeling wet. After a bit of research, I have learned that estrogen regulates cervical mucus and the bump in hormones has resulted in an increase in mucus. After I deduced what must be happening, I felt much more relaxed about it.

Last night, I did my first Endometrin 100mg vaginal capsule. It was not bad at all. Pretty much like inserting a tampon. This morning, I added Medrol (Methylprednisolone) 4mg tablets. The dose schedule for the Medrol is a bit complicated, but I think visually the way the tablets are packaged helps. You load up on the first day and then taper after that. Medrol is a steroid that reduces inflammation. It also suppresses the immune system to prevent Natural Killer (NK) cells from attacking the embryo.

This morning we did our first progesterone injection. I warmed up the ampule about 30 minutes prior to using it. I had a heating compress ready. We have these fun pineapple bandaids. Honestly, giving or receiving a shot with a 22-gauge needle is not that fun. But I am definitely trying to make the best of it and just get on with the program. I climbed the stairs in our house ten times to help the 1 mL of Progesterone in Oil get distributed into the muscle.

There are few times in life when having a BIG ASS is a good thing. Maybe if you are trying to win a twerking contest. Also if, like myself, you are a Los Angeles Lane Blocker (city cyclist). Or also, apparently, if you need to get intramuscular injections in the dorsogluteal site. Our coordinator said luckily, we have a lot of real estate to work with. So this is good because from today forward, we will be doing DAILY progesterone injections.

I made a point this morning of programming in all the medications for the next week into my Google Calendar: when we need them my phone will send a notification. Today, I am going for acupuncture and then heading to Westfield Topanga & The Village (a mall) for an optometry appointment. Tomorrow, we have the Neighborhood council meeting. Thursday, I am meeting with my boss and the man who has been observing me in the classroom. Friday, we have an appointment for ultrasound and bloodwork. Saturday is transfer day!

I installed two new apps on my phone: FertiCalm and Headspace. FertiCalm is an app that has information and humor specifically for those undergoing fertility treatment. It also has some guided meditations that I have used. Headspace I do not fully understand yet, but what I think is that it has some other games to keep you calm. I have been using my Sacred Woman altar at home, so I am very grateful that I have a safe, quiet space to exist and convene with my ancestors, mother, sisters and higher power. This morning I burned a little white sage because I felt like I might want to purify myself before starting the progesterone injection.

Of course, still taking prenatal vitamins. I do not know why some people say to take them in the morning, at lunch or before bedtime. Does it really matter? Well, it is time to be heading to the shower and then to acupuncture and then to the mall to see the eye doctor and do some walking. Life is good.

Fertility Part 13

I wish I could skip #13, because it is considered unlucky. But let me just post an update and not get too hung up on superstitions. I have been weighing in around 193 pounds, my last menstrual cycle was 34 days. I finally got a normal period on June 7th.

I have started taking estrogen. Today is day 6 of taking Estrace (Estradiol) 2mg tablets twice per day by mouth. They are just a teeny tiny aqua blue pill, very small in comparison to the pink prenatal horse pill. I have been taking "One A Day" prenatal vitamins for over a year now. In addition to the "vitamin" there is a liquid gel containing omega 3 fatty acids: docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA). After getting blood-work done, I started taking vitamin D supplements, due to a test that showed insufficient levels.

I have also had two injections of Delestrogen (Estradiol Valerate) 20mg/mL - Inject 0.1 mL intramuscular, every 3rd day. The first injection was in my right hip, 5 days ago. The second injection was in my left, 2 days ago. We have an appointment tomorrow to see how the endometrial lining is thickening. I feel torn between wanting to be informed and not wanting to read too much and getting freaked out.

This is what I did on Monday (6/10)

The injections themselves are not really painful. I have been making a definite attempt to do more walking and gentle exercise like swimming. I got some great pool floats and noodles that are adaptive so that I can work my arms without hurting the injection site. I went to my HIIT workout last night, it felt good to be among people, sweating and suffering together!

Since restarting hormone supplements, I feel sleepy and mentally foggy. Although I am not sure if that is because I am overwhelmed with what this process means or because I have been going to acupuncture or because I am not drinking coffee or because I am on the greatest stay-cation of my life. I keep dropping my car keys and not realizing it. Then I have to dig through the car (without panicking) to find them again.

During my first acupuncture session, it felt like some little gnome was sitting on my forehead, or like there was some unseen hand pressing down on my forehead. Afterwards, about 2 hours later, I had explosive diarrhea. During my second acupuncture session, I did not feel much. About 6 hours later, I had explosive diarrhea. I wrote about those first two sessions towards the end of this post.

During my third acupuncture session, I felt my entire face go numb. Also, my left arm went numb and then had a tingling sensation. I read up on acupuncture a little bit and this may be what people describe as de qi. Or maybe not. Anyhow, when I got home about 10 hours later, I had explosive diarrhea. It's not something alarming or making me feel sick, it actually gives me fair warning and I can sit on the toilet and let it go.

Some of the articles I read say that acupuncture helps support pregnancy through detoxification and improving circulation. Others say that the body's "fight or flight" response is down-regulated and the "rest and digest" mechanisms are stimulated. My practitioner has been placing needles in my feet, shin, hands, elbow and back of the knee. He does a tiny bit of massage just after removing the needles. While the needles are inserted, a heat lamp is placed over my belly for 20 minutes. I focus on breathing and reciting mantras.

I have been reading and practicing Sacred Woman. For the life of me, I remember reading that the bedroom should be like a jungle (with many plants) but maybe that just came to me in a meditation. Prior to finding this book, I had a thought "I need an altar." But I did not have a framework for "how to make an altar." The Sacred Woman book gave me that. I have been collecting little things around myself that are altar-appropriate, without really understanding why I was collecting those things.

I revisited this post from last summer, which was about the little things I was doing to reduce clutter and stress in my life. I have also been admiring Monty Don's French Gardens and Tidying Up with Marie Kondo. Together, those two programs have encouraged me to clean up and beautify my space and let go of things that I do not need.

I am finding that I am craving a more spiritual connection. I know I am about to go through a big change, whether our IVF cycle is successful or not. But I am definitely putting down some roots that will be beneficial for the long-term, whatever happens.

This is what I did this week

Fertility Part 8

We have been on The IVF Diet for 10 days now, today is day 11. It has been a physical and emotional challenge to keep up with the rigor of meal preparation. I am literally exhausted. I work, rest, cook, eat and repeat.

coconut porridge with raspberry compote and bee pollen sprinkle

Some meals appear twice or three times in the two week cleanse program, others do not. The porridge above is scheduled for Week 1: Day 2 as well as Week 1: Day 6. The first time, I didn't serve it with the raspberries or bee pollen. The compote takes time to make, and for Day 2 we ate in our office at work, so it was too labor intensive to do. The bee pollen I consider an "exotic" ingredient that I didn't find until the end of week 1. We rounded out the ingredients by visiting The Vitamin Shoppe, where we found: bee pollen, spirulina powder, omega 3 oil, and inositol powder.

lentil salad with lemon tahini dressing

roasted root vegetables: sweet potato, parsnip, carrot, beetroot

It was good to make the roasted root vegetables on the weekend (Week 1: Day 6), since they took some time to prepare. Then, those vegetables were used in a frittata the following morning (Week 1: Day 7). If I remember correctly, we finished them for lunch a few days later (Week 2: Day 2). We had some superb heirloom cherry tomatoes, which were used in a variety of dishes.

salmon niçoise salad

I didn't realize it was easy to steam salmon fillets until we made this niçoise salad (Week 1: Day 7). We've gone through so many lemons, making the dressing for all the salads. We had one package of green beans that were in a "steam-in-the-bag" packaging, which made it possible to prepare this salad at work (Week 2: Day 2) where we only have a microwave. On that day we substituted tuna for salmon, which tasted OK but I realized later that salmon is preferred because tuna tends to bioaccumulate mercury.

supergreen flapjack seed bars (8)

After finding the spirulina powder, I made a tray of these date-based bars. They taste actually quite sweet. They have lots of nuts (pumpkin seeds, walnuts, peanut butter) as well as oatmeal and dried cranberries. Added protein powder gives them 3g protein per serving and 20g carbs. I plan to do some calculations based on our grocery bills to determine whether all this effort is saving us money or not. I also made some chocolate protein bars which have 7.5g protein and 19g carbs.

brown rice with red onion and spinach

baked "sea bass" with salsa verde

On some dishes, we are still making compromises. Above was supposed to be a "red rice" with pomegranate (Week 1: Day 7). Unfortunately, pomegranates are a fall/winter crop and are not available in this time of year. It was supposed to have feta cheese, but I forgot to buy it at the store. The toasted pistachios were good though. I saw sea bass at the farmer's market for $34 / lb, and I didn't buy it. The dish above (Week 2: Day 3) used cod instead. Also, I substituted celery leaves for the parsley in the salsa verde.

roast chicken with steamed asparagus 

miso glazed cod with sesame seeds and steamed broccoli

I think you can see that most of these dishes are very colorful. I guess I was too tired to take a photo of one dish that we really enjoyed: fish tagine. The roast chicken (Week 1: Day 6) was pretty easy and tasted really good. We ended up eating the leftover chicken (Week 2: Day 1) for lunch the following week. We couldn't find miso paste, so I bought miso broth and reduced it to make the glazed cod (Week 2: Day 1). We weren't able to make the baked eggs in avocado (Week 2: Day 3) again because of the constraints of being at work.

Today we're having jerk veggie burgers with celeriac slaw and salad for lunch (Week 2: Day 4). As I said, I'm exhausted. Last night I did the meal prep for today's lunch as well as last night's dinner and tomorrow's snack (dreamy salt and vinegar kale crisps). I started writing this post, partly to keep up with what we've been doing, and partly to vent about my feelings. I feel like this diet is something important to do to get my body ready for pregnancy.

During this past month, I've weighed myself nearly every day. This greater than 25% protein, less than 40% carb diet seems to be working to help me shed some pounds. I read that for extremely obese people like myself, it can be beneficial to lose even just 15 pounds before embryo transfer, so that's what I'm aiming for. Dear husband is concerned that this diet isn't sustainable. I kind of agree. It depends on what's motivating a person, and how dedicated they are to that motivating factor. 

It has been great to have dear husband helping out in the kitchen and grocery store to make this two week cleanse come into reality. He has stated that he is giving up on Week 2: Day 6 since we plan to go out to Riverside for Easter weekend to be with family. I'm sad, and I don't know in what capacity we will continue applying the principles of the IVF diet going forward. I'm trying to remain in gratitude for what we've learned thus far. I'm trying to avoid going into fear-mode for what we will face next.

The clue app is predicting maximum PMS for tomorrow, so maybe that's why I'm feeling sensitive today. We'll see how it goes, but it seems for now that my next cycle will start April 26th and the one after that will start May 23rd (which is after I will have grades turned in). The end-of-may cycle is likely when we will start the next phase of our treatment (stimulating the uterine lining with estrogen and progesterone). That's only 5 weeks away, so wish me luck on my goal of losing that 15 lbs.

Fertility Part 7

We've been following "The IVF Diet" by Zita West for the past 4 days. Today is day 5 of the "plan to support IFV treatment and help couples conceive." I heard about the book online. It has all the measurements in grams and the oven temperatures in Celsius because the Zita West clinics are located in the UK, but luckily unit conversions don't bother me. The thing about the diet that is intimidating is the sheer number of ingredients, and to me, exotic ingredients.

We made a master list of all the ingredients from days 1-7. We summed up the quantities of each item that would be needed. We went through the pantry to see what we already had, and then we made a grocery list using a commercially-available template. The original template didn't have many of the items on it, but it was useful for grouping items into the big categories: produce, dairy, baking, meat, etc. There are still a few items I have no idea what they are: inositol, lucuma powder, baobab powder. There were also a few things we couldn't find: juniper berry, spirulina, oatcakes, okra, peaches, arrowroot flour, vegetable starter (for pickling). But we made a good effort.


I hope you don't count all these items to check me on this, but I count 114 separate things, and that's not including the stuff we already had at home. We went over to Whole Foods to buy organic produce and filled up two shopping carts with $350 worth of groceries for 1 week! Dear husband refused to pay $35 for like 4 oz of spirulina granules. If you know an affordable source, please let me know by posting a comment. Mid-week on Wednesday we had to go to Von's to get some other items, which cost another $80.

The meals have been good -- delicious even! I've been checking, and this diet does meet the same requirements of my previous post. The less than 40% carbs and greater than 25% protein is already calculated into the meal plan. I still check it because it's tough to stay within the 1700 calories per day limit and eat all the foods recommended in the diet.

chicken schnitzel (day 1 dinner)

9-bean soup with turmeric bread (lunch day 2)

chermoula-baked salmon (dinner day 2)

kale hemp pesto (day 3 lunch)

turkey san choy bau (day 3 dinner)

sardines with olive tapenade (day 4 dinner)

Of course, I'm not a professional food blogger, so these pictures are just quick and dirty. I don't think I could publish these recipes, or the complete meal plan, due to copyright restrictions. I think you get the idea. What I can say is that it's giving me some peace of mind and freeing me to stop worrying about coming up with recipes. The detail provided in the book is sufficient for a competent cook to follow.

There are a lot of pieces of equipment required to make the recipes. So far we've used:

• blender (every morning there is a protein shake) you could use a NutriBullet 
• juicer (we used this one day, but you could alternately use a NutriBullet)
• food processor (this is used almost every day to pulverize nuts)
• mandolin (I used this to make zoodles, but you could use a spiralizer)
• grater (there is zest in one of the recipes)
• garlic press
• grill (we have a George Foreman)
• oven
• stovetop
• bread machine (you could bake in the oven, but it's easier to do overnight this way)
• baking pans and cooling racks

The recipes come together pretty quickly (for some), and others can be prepared ahead of time so that it takes just a few minutes at the moment when you actually want to eat it. All the recipes are proportioned for two people, with the assumption that both partners will be doing the diet together. This is a big help for us since my husband doesn't really like to eat leftovers and the variety is good.

This weekend we'll spend time planning for week 2, which is ~80% unique from week 1. Dear husband has been helping out with all the cooking. He is a BIG help. I could never do this alone. Having this "food project" is helping me stay busy during the waiting time for the end-of-semester and another "normal" menstrual cycle to pass.

I had a little moment of guilt thinking about how I "should have" been on this diet before egg retrieval. But luckily dear husband corrected that course of thinking. He said that we could go so far with the "what if's" and it's not very useful. Like what if we had been vigilantly saving for retirement, what if we had a large 401k, what if we would have been 100% responsible with our student loan money (or not even taken out loans)... the list could go on ad infinitum. So we're trying to keep a positive mental attitude and be in the present moment.

I've been getting really into classical music lately. It's relaxing, engaging and nostalgic. I've also been carving out more time to be outdoors. My body is craving sunlight and fresh air more than ever. Last week, I went to the Future Currents: Los Angeles River event at the Soraya Performing Arts Center here on CSUN campus. In the background is a sculptural piece made from Arundo donax, giant cane, which is an invasive plant found in the LA river.

Future Currents: Los Angeles River

Future Currents was a music / dance / art event that had a panel discussion on eco-artists who push conversations about sustainability and ecology using their various art forms. I made a pan flute out of the Arundo donax which I had a great time learning how to play. This week, I went to the Earth Fair with some friends from the chemistry department and saw some of my bicycling friends once we got there. Like I said, it was just great to spend a couple of hours mid-day outdoors, which I don't usually do.

I added pain into the topics for today's blog because my fingers are really hurting from all this cooking. I feel like my hands have been through the meat grinder! But the good news is that I seem to be losing weight. I read that I don't have to get down to "normal" body weight for my body to take the pregnancy better. If I lose even 15 pounds, that would be good. So I guess that's a goal too.

Fertility Part 3

I would like to rewind and press play again on some other aspects of this fertility journey. I want to share with you what I ended up eating, because my appetite changed dramatically. I read some good advice, after my egg retrieval, that it is a good idea to stock up on items you will need BEFORE the procedure. Also get the laundry done and have lots of clean comfy clothes and clean sheets for your bed rest. I did some of this, but now we're out of clean clothes and I'm still not supposed to be lifting anything over 10 pounds for another week or so while my ovaries calm down.

We were told to "eat healthy" and "no exercise" which is why on Wednesday and Thursday (March 6-7) I enjoyed my last CSUN CTBF workout followed by an egg McMuffin and regular cheeseburger for dinner. I have been using MyFitnessPal diet tracking app, which recommends 50% of your diet in the form of carbohydrates, 30% fat and 20% protein. I had been struggling to get enough protein and I was almost always getting too much fat. So let's remember that my DAY 1 = Thursday, March 7th.

Dear husband and I both agreed that this process became primary focus in our daily lives. Thank goodness I have been on Spring Break since DAY 10. I'm at work today, trying to ease back into it. I haven't had any coffee yet and I will try to stay off of it since we don't know when we'll go for implantation. There were so many things to remember to do each day, not listed in my meal plan below are the vitamins. My LabCorp results indicated that I was Vitamin D insufficient so I started taking 2000 IU at two separate meals, in addition to the 400 IU included in my prenatal vitamin. I also take DHA/EPA softgels.

Vitamin D-3

During the first week of March, I decreased my carbs and fat to 46% and 32% respectively, and increased my protein to 22%. During the second week of March, I decreased my carbs and fat to 35% and 39% respectively, and increased my protein to 26%. The third week of March, my carbs and fat were 37% and 38% respectively, and increased my protein to 25%. I am targeting these numbers based on a study finding that when women's daily protein intake was 25% or more (of all food eaten) and whose carbohydrate intake was 40% or less, they achieved four times the pregnancy rates of patients who ate less protein and more carbs daily before and during IVF cycle.

It started off innocently, and unintentionally. I didn't even read about that study until March 17th. It started off with a craving for Think Thin bars (20g protein, 0g sugar). At first I made fun of them but after getting used to it, I really started to enjoy those for breakfast (March 5, 6 and 7). On March 6th I went by myself to Rite Aid and bought Vitamin D 1000 IU pills, four cans of B4Y coconut water, and six GNC Total Lean shakes (25g protein, 2g sugar). I settled on that brand of shake because it had some whey protein, and it said on the label gluten free, lactose free and low-carb friendly. Turns out it was made with lactase enzyme in it so although it did contain milk, it was digestible for me. So then I felt ready.

Other protein sources that I utilized included Pure Protein bar (20g protein, 2g sugar) and Rx bar (12g protein, 0g sugar). I had already had Garden of Life (28g protein). My sister let me know that Whey protein has leucine and Garden of Life does not.

leucine

We went to Von's grocery store on March 12th, Whole Foods grocery store on March 13th, the Matador Mercado on March 14th. We went to the Encino Farmer's Market on March 17th to pick up avocados, apples, salad, broccoli, and Brussels sprouts. We finally got around to Trader Joe's on March 17th to pick up the Whey protein, some coconut water, salt-free raw nuts, frozen fish, almond milk and vegetable juice to help me during my recovery days.

We had some Pedialyte in the fridge leftover from some time when we were sick, so I started drinking that around day 8. The Ovarian Hyperstimulation Syndrome (OHSS) prevention instructions from the doctor recommended low sugar and to include coconut water and vegetable juice specifically. I tried drinking Gatorade one day and it just had too much sugar. The Trader Joe's low sodium Garden Patch juice is actually really good.

Importantly, I was instructed to take in 3 Liters of water per day. I found it handy to have two 500 mL bottles and I knew that if I drank them three times then I was getting my fluids. It is annoying to have to get up and pee every 45 minutes, but I would rather be flushing everything out of my system than sitting in a puddle of toxins. The instructions also noted that I should be weighing myself every day and call the doctor right away if my weight fluctuates 5-10 pounds (gained) over 1-2 days.

DAY 1
breakfast Think Thin Bar, Coffee with Creamer (2 cups)
lunch Flatbread, Turkey, Colby Jack Cheese
dinner Egg McMuffin, classic cheeseburger

DAY 2
breakfast raw almonds, oatmeal, raisins, Coffee with Creamer (2 cups)
lunch reduced fat Triscuit, Turkey, string cheese
dinner grilled chicken salad (IHOP) + 2 scrambled eggs

DAY 3
breakfast yogurt, banana, English muffin, peanut butter, 2 egg whites, Coffee with Creamer (2 cups)
lunch grilled chicken, vegetables, 2 oatmeal cookies, cantaloupe, honeydew, strawberry, grapes
dinner spaghetti with meatballs and fresh steamed broccoli with mizithra cheese

DAY 4
breakfast yogurt, cantaloupe, honeydew, biscuits, gravy, Coffee with Creamer (2 cups)
lunch oat bread, peanut butter, strawberry jam, 2 oatmeal cookies
dinner lentils and sausage

DAY 5
breakfast burrito with potatoes, egg and cheese
lunch Coffee with Creamer (2 cups)
dinner roasted cauliflower, roasted sweet potato cubes, boiled chicken breast

DAY 6
breakfast Pure Protein Bar, Coffee with Creamer (1 cup), Triscuit, Lemon Zest Luna Bar
lunch pupusa with pork and black beans and cheese, cole slaw with salsa
dinner chicken tortilla soup (chicken breast, black beans, corn) with avocado

DAY 7
breakfast Pure Protein Bar, Coffee with Creamer (1 cup)
lunch egg salad, green salad with peas, beef meatloaf
dinner chicken tortilla soup, avocado, roasted carrots, braised red cabbage

DAY 8
breakfast Rx bar, Coffee with Creamer (1 cup)
lunch firm tofu, steamed broccoli, chicken breast, candied pecans, arugula salad, quinoa, cucumber, tangerines, raw almonds
dinner coconut water, Pedialyte, Total Lean shake, braised red cabbage, white fish, 1 egg

DAY 9
breakfast Think Thin Bar, Total Lean shake, Coffee with Creamer (1 cup)
lunch apple with peanut butter, 2 hard boiled eggs
dinner Total Lean shake, kale salad, avocado, coconut water

DAY 10
breakfast Total Lean shake, 2 hard boiled eggs, 1 stuffed grape leaf, quinoa, barley, mixed vegetables steamed, Pedialyte, beef meatloaf. This is the first day I tried drinking herbal tea instead of coffee.
lunch southwest chicken salad (half), soy milk, Garden of Life protein powder
dinner southwest chicken salad (half), edamame, cherry tomatoes

TRIGGER DAY
breakfast 2 hard boiled eggs, walnuts, Total Lean shake
lunch chicken southwest salad, coconut water, blueberries
dinner beef and black beans with turkey sausage

DAY 12
breakfast Total Lean shake, 2 hard boiled eggs
lunch lamb gyro meat, green salad, grilled zucchini, white fish, babaganoush, 4 stuffed grape leaves
dinner Pedialyte, Whey protein, almond milk

RETRIEVAL DAY
breakfast Whey protein, almond milk, 2 hard boiled eggs, 1 small avocado
lunch beef and black beans with turkey sausage
dinner chicken, cole slaw, mixed greens, garden patch juice, apple, coconut water

DAY 14
breakfast coconut water, Whey protein, almond milk, 2 hard boiled eggs, apple, walnuts
lunch chicken, cole slaw, mixed greens, Gatorade, garden patch juice
dinner Whey protein, almond milk, 2 hard boiled eggs, blueberries, 1 small avocado

DAY 15
breakfast Whey protein, almond milk, 2 hard boiled eggs, apple, walnuts
lunch beef and black beans with turkey sausage, garden patch juice, coconut water
dinner Whey protein, almond milk, egg salad, roasted Brussels sprouts

DAY 16
breakfast Whey protein, almond milk, blueberries, oatmeal, yogurt
lunch egg salad, mixed greens, chickpeas, almonds, coconut water
dinner salmon and steamed broccoli

One of the side-effects of the hormones reported was constipation, but I didn't experience that. I tend to include a good amount of fiber in my diet, so maybe that's why it wasn't an issue for me. Some people said "don't eat cold food" or "don't eat raw vegetables" but I think the most important piece of advice is LISTEN TO YOUR BODY and when I did, I ended up eating exactly the right stuff.

That's all I can share with you because Day 16 is actually today! I mentioned in a previous post that I was feeling so good when I was on Follistim and Menopur. It was like walking on a cloud. Also my appetite was like, normal. I wanted to eat only healthy food. It was easy to eat a bit and then stop eating. Now, I'm back to myself. Hungry as a hippo. Short-tempered. Anxious. I wonder how I will be feeling on the pregnancy hormones...