Eco living

Before I launch into a very cool update on our green living this summer, I wanted to post a quick update about the fertility cycle we were gearing up for: it got canceled two weeks into it. I'm scheduled for a surgery to correct the damage the last pregnancy did (Oct 2008) this August, and for now we're chewing on a slew of options, most importantly a reconsideration of adoption after a brief, albeit exciting, failed private adoption lead.

Anyways, so on to the exciting stuff:

This has been an unusually mild summer. Here it is mid-July and our normally balmy (read: moist) afternoons have been replaced with dry breezes and moderate temperatures. Temps are topping out in the mid-80s, and sunshine is abundant. Our garden, woefully underfertilized, is putting out a bumper crop of tomatoes, jalepenos, swiss chard, peppers (bell & poblano) and eggplants. It feels good to know that not only are there only minutes from "farm to table," but I'm also reducing my eco-footprint by reducing trips to the store and cutting my monthly grocery bill...well, maybe not too much. I haven't given up my addiction to niche ingredients like imported English Stilton, Italian cerignola olives and this heavenly chèvre from the Loire Valley of France. I tell myself it all balances out because I walked from my friend's house to this fromagerie and supported a local mom & pop business...nevermind the two bottles of Parallèl 45 Cotes du Rhone.

But back to the weather! I remember on my visit to Japan this April I came across a t-shirt with the English message: Sunshine's out; Winds are blowing; Great Day for hanging laundry! It was so cute, and more than ever accurate, as everyone in Japan hangs up their laundry to dry. My brother tells me that not only are the dryers in Japan expensive to operate, but they do a lousy job (taking hours to get clothes damp-dry) and cost a fortune to run. Now, this coming from the country that makes some of the best electronics in the world (Sony, Panasonic, Toshiba), I figured it must be a ploy by the government to just discourage use at all to keep energy needs to a minimum. Either way, at home in America, where energy is affordable and easily gobbled up from the terrorist-backed countries who sell it to us, I decided to see if line-drying my clothing would save us that much money. At a JUSCO department store with niece in tow, hubby and I bought two drip-dry hangers common throughout Japan, one well-built at $11 and another just because at $3. So far, they are both wearing the same. In nicer homes in Japan, elaborate covered verandas are dedicated to triple metal poles, hangers w/ anti-slide clips, and pinch-clip, fold-down structures for various sundries.

PJ and I tried to recreate this by hanging a bamboo rod on cord from a tree and putting free coat hangers and our two drip hangers underneath. It's a sacrifice, but I'm surprised at how much time it actually saves, since many of the items I used to leave to cool in the dyer or just had to iron anyways dry wrinkle-free on the line or hanger. Plus, many of the clothes I dry on hangers go straight from the pole to my closet, no folding required.

The system has its drawbacks. We're a pesticide free home (save for home remedies), so ants love to cross the line we strung up (we've gotten in the habit of flicking them off). Spiders and other flying insects tend to drop down periodically and visit the laundry. Praise the Lord I've never had one of those surprise incidents where a bug crawled out of clothing I was wearing, but the more I frequent the laundry line, the less they show their faces. Towels...oh, I don't know how they do it. I keep meaning to save towels for one big load and dry them in the dryer because I can't stand crispy towels. I don't know how they do it as nothing works like friction to fluff up a towel.

With all of that said, our electric bill has been cut by almost $20/month! We haven't had an energy bill over $78 with the A/C keeping our home at a constant 77° (76° if we're really hot). It's the motivating factor (other than reducing our carbon footprint) when all I want to do is transfer a pile of wet laundry 12 inches away and press start.

Soldiering On

I'm nursing a killer headache right now which they tell me can't be treated with Motrin. I love Motrin. It is my friend, and I'm about to cave against my better judgment and take a whopping 800mg dose. If only Tylenol could provide some relief! I've taken two 1,000mg doses since 6am, and it didn't help that the Today Show ran a segment on the FDA issuing warnings about liver damage and lowering the maximum recommended daily dose. Damned if you do, damned if you don't. Motrin, however, is supposed to either cause early ovulation, thin lining or even miscarriage problems. Great!

I've got a wet washcloth crisping up in the freezer, hoping that it abates the pressure building up behind my eyes and temples. I feel like death: tired, pained, weak.

I have a doctor's appointment coming up that's a couple of hours' drive. I need to be packing for the trip up and back, including marinating some chicken to grill for a chicken salad dinner I'm taking on the road. I also need to think about packing all of my medications that I'll be needing, even though it's just for the day. I'm on so many different vitamins, supplements and medications that it gets confusing if not overwhelming. My pee has been fluorescent yellow for weeks, and I had to stop taking coenzyme Q10 b/c of the bleeding it was causing. My pharmacist said it acts like aspirin and thins the blood.

Either way, it's exciting to be moving forward with this process. One day at a time.

To skip a month is good

I realize I haven't posted an entry since April. Have I really been that busy? I look at my "making lemonade from rotten lemons" entry and frown. How is this finding contentment in the everday? Two months later has my diagnosis of an auto immune disorder & hypothyroidism really affected my daily living? I suppose everyone has down days, but what does it do to my witness? If I were to catalog good days vs bad, I would wager that I'd have more cheery than dismal ones. I mean, I'm not a Rwandan refugee, nor am I locked up in a North Korean labor camp like Lisa Ling's sister. Infertility is definitely a "rich man's" problem. Rich indeed...I just paid more for my 3rd IVF cycle than the average Iranian makes in a year ($300-400/month). It was "only" two months living expenses for us, but a disciplined sacrifice all the same. We consider it a blessing from God to not have the desire to buy $1.50, 20-oz bottles of water at the checkout counter or $4 lattes at Starbucks. We spend weekends at the park, reading books we checked out at the library or overnighting at my parents' home on the River instead of at the movies with a $15 popcorn and soda combo. I love the Allstate commercial where Dennis Haysbert says, "In the last year, we’ve learned a lot. We've learned that meatloaf and jenga can actually be more fun than reservations and box seats. That who’s around your TV is more important than how big it is." I love Haysbert, if nothing for his strong, reassuring demeanor that everything is going to be okay, but also for his amazing portrayl of an Army Special Forces operator on CBS's The Unit. This idea of caring more about creating your own memories with family than watching others in TV land live theirs really appeals to me...and it costs nothing. Everyone is being called to count their blessings in life--especially when they're not so little compared to most of the world's population.

Over my shoulder my dog is napping cosily in his bed. His forelegs are crossed over one another (how ladylike!), and his whiskers are twitching to the rhythm of a great dream. Get that bunny, Boston!

It's moments like this that I can't help but smile. All seems well with the world. The sun is shining; my heart is light; God is good. July will bring good things: more opportunities for the Lord to wow me with His amazing gift of provision and more opportunities to please the Lord with my faith and obedience to His will!

How do you make lemonade from rotten lemons?

When I started this infertility journey back in 2004, I never would have imagined the extent and complexity of conditions that led to our four losses and five years of waiting. Now that my eyes are open, I am blinded by my prognosis. Is God working overtime to close doors to biological reproduction, or am I really just that messed up as a coincidence or twist of fate?

I'm struggling deeply to not let this come out as sounding bitter, but somehow, even when I thought I knew what was wrong and that there was no cure, I still had faith that God could provide a miracle. Now that I feel I have a complete diagnosis, I am crestfallen.

So, let's recap the journey. I have polycystic ovarian syndrome. Metformin and a vigorous exercise and diet regimine took off 54lbs of excess weight, restoring menses and sporatic ovulation, as well as a renewed sense of health and well-being. In an effort to jumpstart my still-cystic ovaries, I had a laparoscopic procedure that revealed (SURPRISE!) stage 3 endometriosis, as well as extensive damage from an early ectopic pregnancy. After a few failed ovulation inductions and IUIs, we prayerfully moved on to IVF (twice), where after transferring two "grade-1, textbook flawless" 8-cell, compacting morulas, we ended up with pregnancies that failed to develop past 8 weeks and 11 weeks, respectively. A little over a year after our latest loss, in an effort to trust God for a miracle and provision, the Lord allowed us to conceive spontaneously, and after much fan-fare and praise, we realized the pregnancy was not only not in the right part of uterus, it was in the worst possible part of the uterus, possibly sacrificing any future attempt of a healthy, normal labor and vaginal delivery (see October 2008). Six months later, after seeking signs from the Lord and guidance about a possible third IVF cycle, we finally see God working through an out-of-the-blue call from our clinic asking US if we'd like to cycle in May. And in two short weeks of interpreting test results, I learned that I had a condition called subclinical hypothyroidism, a condition marked by an elevated TSH level (5-10mIU/mL with a normal range of 0.45-3.00mIU/mL) but normal thyroid function (T4) level (0.86-1.1, my level is 0.88). The doctors treated this new "diagnosis" as benign, harmless, nothing that could interfere with proceeding as normal. How wrong were they! And now my suspicions as to the gravity of this condition have been confirmed, and our May IVF cycle has been canceled due to failure of my body to respond to synthetic thyroid hormone (levothyroxine). Actually, after a month of l-thyroxine therapy, my TSH levels actually rose.

Here's a summary of what I have learned reading the latest medical journals in regard to both hypothyroidism and subclinical hypothyroidism (the latter is my official diagnosis).

#1) Thyroid disfunction is a huge cause of infertility.

Thyroid dysfunction [...] interferes with human reproductive physiology, reduces the likelihood of pregnancy and adversely affects pregnancy outcome.
Subclinical hypothyroidism may be associated with ovulatory dysfunction and adverse pregnancy outcome. Thyroid autoimmunity increases the miscarriage rate, and thyroxine treatment does not seem to protect.
Curr Opin Obstet Gynecol. 2006 Aug;18(4):446-51
Trokoudes KM, Skordis N, Picolos MK

#2) Hypothyroidism is often caused by Auto-Immune Disorders.

Thyroid auto-immunity (TAI) has been implicated as the most common cause of hypothyroidism in general population, especially in women. Many studies revealed that increased infertility incidences with TAI.
Gynecol Endocrinol. 2008 Nov;24(11):649-55.
Kilic et al.

#3) Hypothyroidism is linked to recurrent miscarriage & birth defects.

Several studies have shown that thyroid autoimmunity (detection of anti peroxydase antibodies) may account for the occurrence of repetitive miscarriages.
Detection of thyroid antibody seems to be worthwhile for the assessment of recurrent miscarriages, due to the potential benefit of thyroid supplementation. In pregnant women, assessment of thyroid function seems specifically crucial to ensure adequate fetal development. Indeed, it has been well established that untreated maternal hypothyroidism may be associated with disturbances of brain development and low intellectual quotient. Additionally, other fetal (growth deficiency, premature birth, low birth weight) as well as maternal (gestational hypertension, pre-eclampsia...) complications have been also reported in pregnant women with untreated hypothyroidism.
Gynecol Obstet Fertil. 2007 Mar; 35(3):240-8. Epub 2007 Feb 23.
Ouzounian et al.

#4) Hypothyroidism presents obstacles to Assisted Reproductive Technology (IVF).

In infertile women, the prevalence of thyroid autoimmunity (TAI) is significantly higher compared to that in parous age-matched women. This is especially the case in women with endometriosis and the polycystic ovarian syndrome (WHICH I HAVE!!). TAI does not interfere with normal fetal implantation and comparable pregnancy rates have been observed after assisted reproductive technology (ART) in women with and without TAI. During the first trimester however, pregnant women with TAI carry a significantly increased risk for a miscarriage compared to women without TAI, even when euthyroidism (normal thyroid function & TSH levels, either naturally or medically stabilized) was present before pregnancy. It has further been demonstrated that controlled ovarian hyperstimulation (COH) in preparation for ART has a significant impact on thyroid function, particularly in women with TAI. It is therefore advised to measure thyroid function and detect TAI in infertile women, before ART, and to follow-up these parameters after COH and during pregnancy when TAI was initially present. Women with thyroid dysfunction before or at early gestation stages should be treated with 1-thyroxine to avoid assisted pregnancy or further pregnancy complications.
Verh K Acad Geneeskd Belg. 2006;68(5-6):357-77.
Poppe et al.

#5) Subclinical Hypothyroidism provides its own challenges.

Subclinical hypothyroidism (SCH) is associated with a higher miscarriage rate. It is unclear how the thyroid function in SCH differs from that in euthyroidism during early pregnancy. We intended to determine the regulation of thyroid function in women with SCH receiving constant l-thyroxine (T4) replacement during early pregnancy as compared to euthyroid controls. Although both SCH and ovarian hyperstimulation were associated with an intermediate rise in TSH, the pattern of thyroid function followed similar changes as in euthyroid controls and is unlikely to cause the higher miscarriage rate observed in SCH.
Thyroid. 2009 Jan;19(1):53-9.
De Geyter et al.

#6) Subclinical Auto-Immune Hypothryoidism carries risks to pregnancy.

Subclinical autoimmune hypothyroidism during pregnancy is associated with an increased risk of miscarriage and has a deleterious effect on fetal development. The aim of this study was to evaluate a screening and treatment strategy of subclinical hypothyroidism, and to establish normal ranges of thyroid-stimulating hormone (TSH) and thyroxine (T(4)) during pregnancy. METHODS: A retrospective study was carried out on 784 consecutive files of pregnant women; the files were systematically searched for thyroid function and antithyroid antibodies in order to determine the effect and the prevalence of anti-thyroid peroxidase antibodies (TPO-Ab) during pregnancy, and to evaluate treatment with levothyroxin (LT(4)) in TPO-Ab carriers. RESULTS: Among the 75 TPO-Ab-positive patients, 42 received LT(4) treatment during pregnancy. Although the range of TSH serum levels was wide, the mean TSH level was significantly higher in TPO-Ab-positive women (3 vs. 1 mIU/l, p < 0.01). No significant difference in the obstetrical complications rate was observed between TPO-Ab-positive and TPO-Ab-negative populations. CONCLUSIONS: Our study provides information on normal ranges of serum TSH and free T(4) for Belgian pregnant women receiving iodide supplementation. Based on our results, we suggest supplementation of TPO-Ab-positive pregnant women with 50 microg/day of LT(4), unless their TSH levels are lower than 1 mIU/l, to avoid the risk of hypothyroidism during pregnancy. Copyright 2008 S. Karger AG, Basel.
Gynecol Obstet Invest. 2009;67(3):178-82. Epub 2008 Dec 18.
Debiève et al.

I will save my grand analysis of this information for later. It is quite overwhelming. Frankly, there are so many rules and restrictions for taking levothyroxine that it makes living less of a joy. There are so many foods, medications and vitamins that interfere with the absorption of l-thyroxine, requiring at least 4 hours before or after your pill to eat them. And if it's true that I have the auto-immune antibodies present, I am not sure whether I will continue to persue IVF due to the grim prognosis of success. In the meantime, I have an appointment with an Endocrinologist next week in which I will discuss my options and ask for further assessment. From there, I must wait another 4 weeks to get my TSH level under 2.5, then prove my levels are under control for at least two more weeks before I'll be allowed to cycle again w/ IVF. With God's help I will make lemonade out of these rotten lemons...sweet or not.

Torn

I know...I'm not good at this blog thing at all. Who else skips two whole months?

I've been doing a lot of soul-searching. The other day at my church lifegroup I deigned to ask for prayer for the "IVF cycle" that is approaching. I said that I felt a peace from the Lord about it and that we were moving forward. I lied. I feel nothing, and I'm paralyzed to move anywhere. I think I'm having trouble letting go. Maybe I'm hoarding all the false hope that my body really isn't as flawed as the doctors think it is, or that I could really do something honorable enough to attract the attention and favor of the Lord as to reverse the diagnosis I have been given. When I think about the rigors of a treatment cycle, I think, "Of course I could do it, but do I want to?" Then I think of this down economy and our able savings account and how it won't be so "able" if we drop six grand on trying to have a child...again. So much of me just wants to adopt and get it over with, but I can't part my mind from wanting at least ONE biological child.

I was standing next to my husband as he was washing our car yesterday, taking a break from the incessant Super Bowl coverage. It was cold; the wind was blowing, but there we were, talking about our families and families-past while filling buckets with soap and water. Recently the geneaology bug has bitten me, and I have an insatiable appetite for discovering the seeds of my heritage. My aunt said that on my mother's side I am Dutch and French-German, probably from the Alsace-Lorraine region. My mind quickly wandered to our trip to France last Spring and how we toured Metz and Nancy and headed down to Colmar to experience the Route du Vin. It oddly felt like home, in an etherial sense, and part of me knows why. It is my histoire. The story of where I came from, and I long to tell any future children of their histoire, a piece that will likely be missing from children raised via closed adoption. I don't know how some women are better able to mourn that. A fellow member of a message board to which I belong once said, even after adopting two beautiful children whom she loves and considers her own, that she still has pain regarding her inability to bear biological children. I always assumed that it went away when any parenthood was bestowed, but I imagine that God designed us to want to reproduce, and so it is understandable that closure of that door can take time to heal.

Anyways, in the middle of the conversation with my husband, I started to tear up. I thought of my nana, a woman who died prematurely in her early 60s due to a post-operative infection. I wondered if she were alive would she be proud of me and all that I accomplished. If my papa were alive, what would he think of all that I had done? What kind of relationship would I have with them? What would they share with me as I got older that I otherwise would have been too young to understand, but now that I'm married and desiring children could benefit from hearing? I feel like I lost my grandparents too young (they are all long passed...even on my dad's side). And it just increases the urgency for which I feel the need to HAVE children (be it bio or adopted). I want whomever the Lord has picked out to be our children to arrive...sooner than later...so they can be blessed by my parents and get to their 20s and 30s and ask my parents all sorts of questions...but ahhh...I don't even think that will happen. My mom is 61 this month, my father not far behind. In 30 years they will be long gone, if they live close to as long as my eldest grandfathers did (86-ish). That is a hard pill to swallow.

So, in light of all of this reflection, I don't know where I stand. I keep beseeching the Lord in prayer for His blessings and mercy. He knows we want children--and we want them in a most prudent way--the kind that costs as little as possible. Whenever I think about "earning" God's favor, I remind myself that I can only please God through my faith, and so in having "faith," I'm glossing over the realities and necessities of an impending ART cycle. I cling to the chance that if we only just keep in the Word every day, increase our tithe just a little bit more, never miss a Sunday of church, or do great things for the Kingdom, that the Lord will "bless" me for my steadfastness. I guess that is unrealistic, though, and it's hard to let go of the "earned mercy" philosophy. I think I need some time with the Lord to make sure this is really what we want to do. Am I hesitant because it's hard to the let the money go, or is the Lord asking me to step aside so His glory can prevail? Am I dragging my feet because I'm a procrastinator or because God wants me to chose an entirely different path? May the Lord make His will known to me.

I'm Baaaaaaaack!

And you thought I went AWOL!

Really, I didn't know how to handle being out of town and posting. I thought of a million and one things I have wanted to say on a hundred different occassions, but I thought better of it for fear that I hadn't dotted my i's and crossed my t's well enough to prevent some crazy cyber stalker from noticing by my entries that I was nowhere near my home, thereby being signaled to invade my home. Yep...I've got issues.

Anyways, to summarize, I spent the end of October and most of November in Arizona visiting in-laws & family with my husband. It was a surprising culinary adventure as we endeavored to find the most authentic Mexican food. I figured with as close as we were to the border, it would as easy as pie (which, if anyone knows anything about pie can attest to there being nothing easy about it, and so technically it lived up to our expectation). We first went to El Molinitos...surprisingly a BIG disappointment. They only had one kind of salsa, and it was just okay. The menu was limited, which is fine, but when I ordered the shredded beef & chile verde burrito, the meat came out dry and clumpy, with a faint whiff of chile verde sauce. The rice was also mushy and watery, the beans too larded. It made me think of that awful episode with Gordon Ramsay (not the BBC one) where he invades the Mexican restaurant of some lazy, swindler who blew through his step-daughter's life savings by putting his restaurant into the ground. Gordon raided his walk-in-fridge to find days and weeks-old beans, salsa, enchilada filling, etc. It was so sickening that Ramsay brought out the vats of nasty, pre-cooked food and set it on the table, telling all the diners to leave! Yeah...this place felt like that. And they didn't even have tomatillo salsa! Plus, when my husband's fish tacos arrived, they smelled so much like spoiled, weeks-old seafood that I nearly threw up. Not only did it smell way too fishy, but it was so dried out it looked like it had been FRIED weeks ago as well! You can see the episode here.

After that experience we were a bit burned by Mexican food, so we went to Buffalo Wild Wings. Yes, I know, how commercial. But their wings were actually very good, and 5 out of 10 of their sauces don't contain HFCS. I had the unique privilege of casting my ballot absentee, but I don't know what difference it made since the rest of the voters went for Obama anyways. On election night we crowded into BWW where the excitement was tangible and every teen & college kid over the age of 18 sat in huddled groups plotting electoral votes for their desired candidate. It was quite the special evening, and being on the west coast meant I heard the definitive call on Fox News 2 hours before my eastern compadres.

Days later we wound up at a different Mexican restaurant, which was ¡muy auténtico! It was so "auténtico" that I think we wound up in el barrio. Hubby (who is part hispanic himself) said the only thing that would complete the "scene" would be a small street-side motel room with 8 or 10 Mexicans crammed inside sitting around an illegal cooking pot...and then we saw that, too. I didn't even know it was a restraurant, actually. When they say hole in the wall, they mean it. We were walking along some concrete-faced buildings in an unsavory part of town when all of the sudden it got very dark. Our hosts told us to push, and a door seemed to appear out of nowhere. Inside was a bustling restaurant with Elk Lodge-style tables and chairs, frozen in the 1960s, but swimming with modern-day patrons. The salsa was delicious, spicy and scant. Hubby's relatives ordered a tostada-type thin pizza wafer with copious amounts of cheddar cheese and diced green chiles. Afterwards came our burritos and chimichangas, tastey and plentiful with moist meat. Hubby tried the carne seca, which was flavorful and delicious. The only postre on the menu was some whipped almond-flavored, tri-colored meringue/mousse with sweetened condensed milk poured over top. Unfortunately our hostess ordered two. It was edible but not my favorite thing in the world. Unique but impossible to describe or find a picture of online.

Our final night in town we went to another Mexican restaurant, less authentic, but with the best prickly pear cactus margaritas. Man...that was so good. If I wasn't driving I could have easily had a second and a third. The food was fine, but I think what we came in search of the entire trip was not found there. We had a great experience, but I think the best Mexican is made at home, con amor!