12 weeks

Today I am officially 12 weeks pregnant, and I could not be happier to be exactly one week away from exiting the first trimester. We are still not out of the woods yet, and I realize I won't technically be out of the woods until I have a healthy baby with ten fingers and ten toes and healthy lungs in my arms hopefully around early January. But still, approaching the end of the first trimester is an increasingly welcome relief, if nothing else than the fact that I can finish my progesterone suppositories this week (yes, you heard that right, more on that later!).

Today I marked a milestone: I made my first pregnancy purchase. At Target I bought a BeBand, which is a $17 version of a much more expensive BellyBand. If you're unfamiliar with this product, it's a tight piece of stretchy fabric you wear around your waist that's designed to extend the life of your pants (and I guess it claims to work on skirts as well, though that seems more complicated). When you're more pregnant you can wear the band unfolded, and you can also wear it postpartum when you're in that weird not-pregnant-but-still-have-a-big-uterus stage, but for now I would need it folded in half over my unbuttoned jeans. Right now I can get away with wearing my favorite pair of jeans without a BeBand, but I have to say even those low-rise jeans are more comfortable with the BeBand, so I might be sporting that pretty soon after all.

My belly is definitely starting to make an appearance. Here's a quick timeline since I had my husband start taking pictures of me at week 9 (notice that week 9 is more or less what I look like normally, minus the smallest of small extra bits of flab right at my waistline):

Week 9 -- Baby is the size of an olive!

Week 10 -- a weird little pocket of flesh emerges right below my waist. Baby is the size of a prune!

Week 11 -- My belly is more rounded. Baby is the size of a lime!

Week 12 -- My stomach is most assuredly sticking out. Baby is the size of a plumb, or about 3 inches crown to rump.

I am still hiding my pregnancy at work, so these bump-worthy looks are reserved for home, dog walks and the like right now, so I am thrilled to start having something to show for this pregnancy because the first trimester otherwise feels unreal.

We will plan to start telling people outside the immediate inner circle (my closest girlfriends and our parents and siblings already know) by early July. At that point I will be at least 14 weeks pregnant, and we will hopefully by that point have back positive results from the NT scan we'll be having to test for Down Syndrome. It's a non-invasive sonogram and blood test that I'm having done this upcoming Wednesday, and I'm excited for another chance to see the baby. Then I'll deal with telling people at work, who may have to shift around a few things to accommodate my maternity leave, but oh well.

My friend who gave birth recently sent me a sweet gift of a pregnancy planner the other day. Not only was it a thoughtful gesture, but she included a wonderful card that says the following on the front: "She had never considered herself exactly perfect until right now." "She glowed pleasantly with strength and happiness." Exactly.

Preggers!

Somehow I have kept myself from posting this for almost six weeks, but I am obviously beyond elated to report that I am nine and a half weeks pregnant!

I have resisted the urge to celebrate too hard at this point, but some of my nerves were eased nearly two weeks ago when we got to see the heartbeat. The scary thought of miscarriage is still something I think about every day (though thankfully I am thinking about it less and less and generally keeping myself calm and occupied). But, the good news is that once you hear a heartbeat, the chance of miscarriage drops from 20-30 percent down to approximately 5 percent. It goes even further down after the 10th or 11th week, so I am just crossing my fingers that little Matt Jr. stays in place for the time being and emerges from the womb around his January 2, 2012 due date!

I want to share all kinds of details related to discovering I was pregnant to how I'm feeling to changing doctors and everything else, but for now I thought I would compile my list of what worked for me into one spot. Of course, I can never be sure that any single thing or even combination of things led to my BFP (big fat positive, for those uninitiated in the world of POAS [peeing on a stick = pregnancy test]). Still, I know that my cycles decreased in length every month, and I went from the extremely long cycle to the cycle where I ovulated on CD35 in about four months, and that was the cycle that did the trick.

Here's what I did in a nutshell:

• Fertility Friend daily charting -- I charted not only my basal body temperature before I got out of bed each morning, but I also tracked my cervical fluid (TMI, I know, but necessary if you're serious about TTC) and cervical position as I assumed I was getting closer to ovulating. I would even wake up at virtually the same time on the weekends as during the weekdays. I think my body was so stressed about conceiving that I had an internal clock that would jolt me awake at the same ridiculously early time of 5:15 Monday through Sunday. (Now that I am pregnant I am not temping nor am I waking up early on the weekends, thank God.)
• Daily exercise -- at least 30 minutes of aerobics, sometimes more, plus strength training 2-3 times per week
• Gluten-free diet with an emphasis on no processed foods, lots of protein, plenty of fresh veggies and fruit and minimal sugar
• Green tea a few times a week
• Pomegranate juice a few times a week
• No caffeine
• Extremely limited alcohol (I will admit that this past cycle when I got pregnant was the cycle when I drank the most alcohol -- granted, "most" means I had approximately 5 drinks in the 35 days, but still....)
• Herbal supplements: vitex, red raspberry leaf (capsules, not tea)
• Vitamins: prenantal vitamin, B6, B12, D, E, cod liver oil, evening primrose oil (before ovulation)/flaxseed oil (after ovulation)
• Ate raw pineapple core from 1DPO (day past ovulation) to 5DPO to assist implantation (Who knows if this is a crazy witch-doctor thing or not, but I had a pineapple on hand after I ovulated with a pineapple core divided into five even sections because I didn't want to risk being wrong on this one.)

If this sounds like a lot....well, you're right, it is a lot. I felt really healthy, though, so even if it hadn't worked for TTC purposes I think it was the right choice for a healthy lifestyle that happened to give Matt Jr. a good start at life. Now that I am battling some serious food aversions (more on that later) I wish I could eat the kinds of foods I was eating when I was TTC, but right now my strategy is to eat whatever will stay in my stomach.

The emotional investment of TTC was severe for me. Even though now I have pregnancy hormones for sure and get more easily emotional than I would before (nothing severe....my husband will tell you I am a level-headed pregnant woman), right now I am nothing compared to how emotional I was during TTC. I have never felt so out of control and so alone in my entire life. I would cry myself to sleep on many occasions (when I wasn't having sex....we had A LOT of sex to get to where we are today) and I would cry many times on the way to work (one time causing me to almost get my first traffic ticket of my life) and I would cry when I found out other people were having children. I was not myself. If it had lasted much longer I think therapy would have been the next step because for the first time in my life I couldn't fix what was wrong with me and I didn't know what to do.

Thankfully, because the emotional investment was so severe at least the financial investment was extremely minimal. Because we chose to hold off on the medical intervention route at least for a little while, virtually everything I did to achieve pregnancy was inexpensive. Yes, I bought a bunch of OPKs and HPTs and more expensive food overall and some extra vitamins, but that's all a drop in the bucket compared to what I would have paid for fertility treatment. I'm not saying I wouldn't pay for fertility treatment. Instead, I simply feel exceptionally lucky that this happened the way it did.

I share this information in the spirit of this blog, to share with close friends and hopefully future friends who struggle with fertility problems the hope that you too can take back some of that control that you resigned, advocate for yourself even when your doctor (as mine did) tells you it will be extremely difficult to down right impossible for you to get pregnant on your own. The vast majority of women who want babies eventually have them. We all come about it a different way, and what works for me won't necessarily work for you, but I have faith that something will.

Most importantly, know that you are not alone.

Making Babies review

Many months (Ok, let's be real here, years!) before we started TTC I read several pregnancy books. While I'm happy that I'm already so well informed regarding, well, What to Expect, I did not do any fertility reading before TTC. My philosophy: if approximately 20 percent of couples face fertility issues, the odds were good that we would not and I would get pregnant the first month of trying, just like my mom did with all her pregnancies.

In retrospect, I obviously wished I had read several fertility-related books in the early stages of TTC, or even before we started TTC. I've read a couple PCOS TTC books, but whenever I would go to the bookstore to peruse the shelves I was always disappointed by the regular books about TTC. They are seemed rather simple. I needed something more in between books about IVF and books about the basics of getting pregnant. That's why I was thrilled to find Making Babies. It's written by a reproductive endocrinologist and a licensed acupuncturist, so it takes a balanced approach between Eastern and Western medicine. It leans more toward the side of avoiding expensive and invasive fertility treatments for as long as possible, which appeals to me.

It's almost time for me to return this book to the library (after I renewed it!) so I thought it was about time I shared these insights from the book before I lose them forever.

The book captured my experience from the beginning of the introduction, on page ix, where the authors write:
You want to do everything you can, but you want to be smart about it. You don't want to rush into expensive treatments with their inherent risks and side effects. You don't want to waste your time any more than you want to waste your money. You don't want to be guided by unproven old wives' tales, but you don't want to dismiss something that might work either. Truth be told, you'd try just about anything if it meant having a baby.

OK, that's me, this book is made for me.

As I kept reading, I used pink and yellow Post It flags. Yellow is for general fertility; pink is for PCOS fertility. Here's what I came up with.

Yellow general fertility flags:

• Self massage: The acupuncturist recommends self massage techniques in four stages to encourage the repositioning of the uterus to increase blood flow: menstruation, pre-ovulation, ovulation, and potential implantation. I have not tested these out, but the techniques sound simple and appealing (92-97).
• Beta-carotene: "The corpus luteum, which helps produce progesterone necessary to sustain a pregnancy, has very high levels of beta-carotene. Research shows that cows deprived of beta-carotene develop ovarian cysts and are slow to ovulate, and their fellow mammals -- humans -- work much the same way. You get beta-carotene in your diet from yellow and orange foods (including carrots, cantaloupe, and sweet potatoes), as well as from broccoli and leafy greens such as spinach" (102-103).
• Omega-3s: "Omega-3 fatty acids have a broad range of benefits, including increasing blood flow to the uterus, thereby increasing the chances of implantation and pregnancy. They also fight inflammation and can soothe menstrual pain and help with other problems that can interfere with conception. Increased blood flow also benefits the placenta, supporting optimum growth of a fetus and ultimately reducing the risks of premature birth and low birth weight" (105).
• Tea: "Women who drank tea every day [in a Kaiser Permanente study of 210 women] -- even just half a cup -- were twice as likely to conceive as women who never drank tea....Scientists suggest that tea might promote fertility in two ways. First, the hypoxanthine in tea might be necessary for the follicular fluid that helps eggs mature and get ready for fertilization. Second, powerful antioxidant polyphenols in tea might help prevent chromosomal abnormalities that can cause an embryo to miscarry or fail to implant...The study did not get into what kind of tea the women drank, but we recommend green tea to our patients. Green tea has up to ten time more polyphenols than black tea and only about half the caffeine. Three cups of green tea a day will keep you within our caffeine guidelines" (109).
• Eating through your cycle: Menstruation = foods rich in iron, vitamin C, protein. Pre-ovulation = protein, foods rich in vitamin E. Ovulation = B vitamins, zinc, vitamin C. Potential implantation = pineapple (or pineapple core, which has the most bromelain and helps with implantation), eat warming foods and avoid cold foods (111-112).
• Essential Fatty Acids (EFAs): "This is the most important supplement after the prenatal multivitamin. Ideally, women should take EFAs for at least three months before they conceive to allow time for them to be fully incorporated into all the tissues. EFAs help ensure that follicles have all the resources they need. They are key to cell membranes and growth in the ovaries. They help form body tissue, including tissue in eggs and in a developing fetus, and are essential for brain development in the fetus. Fish oils, a prime source of EFAs, are natural clot busters and so may be particularly useful to anyone who has had recurrent miscarriages" (125).
• Prenatal vitamin content recommendations and other fertility supplements recommendations for women handy-dandy chart on pages 132-133.
• What's your fertility type??? The authors believe women facing fertility issues fall into one of five types: tired, dry, stuck, pale, waterlogged. If you want to find out your type, you can answer questions in the book, or, in my opinion it's much easier to take the online quiz at www.makingbabies.com. If you take the online quiz, the authors recommend you still read through the five descriptions in the book to see what makes the most sense for you.
• Finding an acupuncturist: The National Certification Commission for Acupuncture and Oriental Medicine "tests practitioners to ensure they are knowledgeable about Chinese medicine and appropriate sterile technique" (287).

Pink PCOS fertility flags:

• Trans fats: Even though I think most of us have eliminated trans fats from our diets, here's further reason to do so: "Eliminate trans fats altogether, because, among other things, they can cause of exacerbate insulin resistance and ovulatory dysfunction and interfere with hormone production and balance. There is no safe level of trans fats in your diet. Eliminating trans fats is crucial for women with PCOS" (104).
• Unsaturated fats: "Unsaturated fats are the way to go: olive oil, nuts and seeds (and their oils), and avocados are the most nutritious sources. These are important for everyone, especially women with PCOS" (105).
• Vitamin-D deficiency: "Vitamin D is an antioxidant, so it helps protect sperm and eggs against genetic damage. Vitamin D also supports the production of estrogen. In some cases, bumping up vitamin D intake to adequate level can restore ovulation in women with PCOS" (119).
• NAC: "Take N-acetyl cysteine (NAC) supplements to help reduce circulating testosterone, cholesterol, plasma triglycerides, low-density lipoproteins, and insulin. NAC included in a multivitamin is fine. Nutrient 950 with NAC by Pure Encapsulations is also good" (207).
• Three-month plan: The authors recommend treatment (diet, 30 minutes of exercise daily, stress management, supplements) for three months before trying to conceive. "Follicles exposed to excess androgens will be of poor quality and lead to a higher risk of miscarriage" (207).
• Give up yams?!: OK, I eat yams at least once a week (not even sweet potatoes, even though I always call them sweet potatoes, we're actually big yam eaters). "Although yams are often touted as fertility boosters, they have too many carbs for PCOS bodies" (315).
• Clomid: "For patients with PCOS who have high or high normal levels of male hormones, I prescribe dexamethasone, too, to enhance the effectiveness of the clomiphene by suppressing the production of male hormones" (321).

 For me, these were the highlights. Because I'd already done a decent amount of fertility reading by the time I read Making Babies, it wasn't as revelationary as it would have been had I read this three months before starting TTC. In retrospect, I wish I had read this in April 2010, three months before we started TTC, rather than April 2011. Oh well, now I know! At least it's reassuring that all my other research revealed a lot of the information I found in this book. This book is just a good one-stop shop for fertility info, and I wish I had started here!

Amazing Google commercial

It would be weird to post this on my public blog, so I thought I would post it on my private blog. I saw this commercial for the first time a couple nights ago (thanks to the DVR I hardly ever see commercials, but I somehow managed to sneak a peak at this one). I can't watch it without crying. It is just so sweet.

Progress!

Last month I said that if I could get a positive OPK on CD35 that would be amazing. Well folks, it actually happened. I am taking a break from my normal morning routine to report this positive progress. Maybe exercise, vitamins, diet and a (slightly more) positive attitude is helping.

I AM SO EXCITED. THIS IS THE BEST THING THAT HAS HAPPENED TO ME IN A LONG TIME!

In other news, I started taking a bunch of herbal supplements last weekend. And that will be the subject of a future post.

Cheating

This week I thought a miracle was happening. On CD21 and 22, I got OPKs that were so close to positive that I nearly borrowed a plane so I could write a celebratory message in the sky.

But the OPKs never turned positive. I was silently willing them positive with all my being, but I got nothing but a really clearly negative the following days, and my temps did not change to indicate any sort of ovulation that the OPKs may have missed, so I am pretty certain nothing happened and nothing is currently going on.

Even though a CD21 or 22 ovulation would be highly unlikely for me to the point that it's the stuff of out-of-this-world fiction, I was still disappointed. I want so desperately to be normal that I'll believe in miracles.

So, this weekend I went wild. Friday night I had a glass of red wine and about five crackers. Saturday I had half a cookie and a salad with croutons. (Of course I ate more than this; just trying to highlight my decadent sinning.) They were divine. Although I've never been a huge bread/general glutten product eater, these little breaks from my strict diet were an awesome indulgence.

Now, though, I'm back to the straight and narrow, and I'm trying to keep the optimism alive.

Eggs for eggs

Ironically, this past year I have finally gotten really good about having a full breakfast every morning, and at the center of that breakfast has been cereal and milk. I grew up absolutely hating milk, so adding it to my cereal has been a big move. Now that I am finally into a routine of getting up even earlier than I used to and having cereal, milk, fruit, orange juice and usually tea/coffee/hot chocolate, I have to adjust again. Cereal doesn't keep with the gluten-free diet I am trying to keep. So, I am learning to love eggs.

When you cut out bread and cereal, that really reduces the number of breakfast foods you can eat. It basically leaves eggs, meat and fruit. So, I am still eating the blueberries I started adding to my cereal, just sans cereal, and I am still drinking my hot chocolate, just with whole milk rather than skim milk, and now I am trying to give myself a few more minutes each morning to scramble up a couple eggs. If we have any bacon in the house, which we sometimes do, depending on our dinner menu for the week, I might make a couple strips of bacon as well.

To keep up the protein kick, I am also eating almonds and walnuts as part of my daily lunch. These aren't my favorites, but they're good for me and they keep me from snacking on something gluten-filled that I really like, such as Cheez-Itz, which ultimately have limited if any nutritional value.

Finally, although my husband and I have become what I would call flexitarians -- we've been known to eliminate meat from about two or three meals a week -- I've moved us back to having meat with every dinner we make. I am even trying to get him to add a little more red meat to our diet, no more than once a week.

It's hard to go against conventional wisdom, it's hard to give up pasta and pizza and alcohol, but my digestive system is thanking me (it's in GREAT shape these days -- sorry for the TMI, but it's worth noting). So, I hope that the more seriously I stick to my new food habits, the more my body will start to change soon.