Wednesday, October 31, 2007

The Weird Thing About Telling So Late

When I was going through IVF, I told people even before there was a chance I'd be pregnant. I didn't particularly enjoy my family & friends going through the 2ww with me, but the whole process was so intense that everyone ended up knowing. Clearly, as soon as the results were in, everyone knew that too...

This time, Ohad & I really enjoyed having a secret (we didn't even really feel any need to tell when we did)... we knew I was pregnant when Yedda offered to send me to BlogHer & we knew when I ordered the tickets to take Lilach to Croatia. I was careful when I tore through the airport in Atlanta trying to catch my flight (I did) and I avoided riding a gondola in Venice because I get seasick easily even when I'm not pregnant... I was also careful not to volunteer for anything at the school...

When we announced this pregnancy at the end of the 16th week, it was still not obvious. I could still wear my normal clothes for a few weeks, but now (it seems way too suddenly) I'm wearing maternity clothes and it's clear I'm pregnant.
I guess a pregnancy becomes 'real' for me at a many different points:
- a positive home pregnancy test
- a positive beta test (blood)
- the first ultrasound when I see a heartbeat
- the first ultrasound when the fetus begins to look like a baby
- when my ordinary clothes stop fitting
- the first time I *definitely* feel the baby kick
- when people can tell by looking at me and...
- when we tell people.
But maybe this one (telling people, especially family) has more weight, because when other people know, it's no longer just a fantasy (that for some odd reason the ultrasound machine seems to believe), it's not only part of my life, but part of theirs too...
In any case, it's fun that it's gone by so quickly, just strange.

On Saturday, we finish 24 weeks.

Sunday, October 28, 2007

First UK IVM Babies Born

On October 18th, the first babies created using the IVM procedure (which I blogged about in February 2006) in the UK were born - a set of boy/girl twins!

See some articles here and here.

I find this so exciting, as it's a real opportunity for women whose risk of OHSS is too high for them to go through standard IVF cycles.

Congratulations to the new parents & babies!

Wednesday, October 24, 2007

Postpartum Depression - MOTHERS Act

As my contribution to this day I decided to write a post that's hopefully somewhat enlightening & that might help lift the taboo from postpartum depression (also known as postnatal depression), particularly in women who suffered from infertility prior to the birth of their child/ren. (Interested in articles about PPD after Assisted Reproduction? See the bottom of this blog post.)

Infertility usually means at least a year of unsuccessful attemts to conceive before turning to a medical professional for help. After this, it's a process of many months or even years before a baby becomes a reality. During this time, having a baby often becomes a woman's goal in life (I'm deliberately leaving out the father here, because I want to refer to my thoughts on what might contribute to the incidence of PPD specifically in women), often taking a toll on her education, career, marriage, friendships, etc. Having a baby is the goal & the baby can become idealized, frequently as a warm, cuddly creature dressed in pastel colors, who coos on cue and smiles lovingly at her mommy...

I think it's rare for a woman to be prepared for the reality of motherhood (not exactly the description above, at least not all the time). Although I have a sister who is 9 years younger than I (and therefore I should have known something about having a baby), when I first brought Hadas home from the hospital, all I could think was, "OK, so what do I do with her now?" When she cried and I didn't know how to calm her, I was practically in tears. She was a fairly good sleeper - at night - but during the day, she demanded pretty much constant attention - 16 hours a day. She was alert, interested in everything, a good eater and mostly happy, but it was tiring - day after day, every day. I didn't have many people to interact with or places to take her, so aside from walks, we were mostly at home. My whole life changed when she was born but, of course, having her had been my choice, something I'd waited for for over 3 years (3 years of TTC + 9 months until she was born). How could I possibly complain about having a beautiful, healthy baby?

Fortunately, I have no personal experience with PPD, but I'm guessing that's how it is - there are the perfectly normal hardships and then the depression that sets in. On top of that, is the guilt for feeling the way you do - or for completely losing control of your emotions.

Having the "baby blues" is normal, but baby blues are very different from Postpartum Depression. Here are some brief descriptions adapted from
emedicinehealth (in purple):

The "baby blues" are a passing state of heightened emotions that occurs in about half of women who have recently given birth. It peaks 3-5 days after delivery and lasts up to 2 weeks, during which time the woman may cry more easily than usual and may have trouble sleeping or feel irritable, sad, and "on edge" emotionally. Baby blues don't interfere with a woman's ability to care for her baby.

Postpartum depression is depression that occurs soon after having a baby. Some health professionals call it postpartum nonpsychotic depression. It occurs in about 10-20% of women, usually within a few months of delivery. Symptoms include depressed mood, tearfulness, inability to enjoy pleasurable activities, trouble sleeping, fatigue, appetite problems, suicidal thoughts, feelings of inadequacy as a parent, and impaired concentration.

A woman who experiences postpartum depression may worry about the baby's health and well-being. She may have negative thoughts about the baby and fears about harming the infant.
Postpartum depression interferes with a woman's ability to care for her baby. It can also lead to suicidal and homicidal thoughts.

Having PPD, from what I learned is a serious problem, but what is really important is to know that it's treatable. Treating PPD is the best thing a woman can do both for herself and for her baby. Women with PPD may have difficulty taking the first step, or even acknowledging that there is a problem. If you're a woman with PPD - tell someone. Let them help you get help. If you have a friend with PPD, find out more about getting help for your friend. If the first professional doesn't help, persist until you find someone who does.

Getting help means giving yourself an excellent chance of going on to having a healthy, rewarding experience as a mommy.

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Special thanks to Katherine Stone who took the time to speak to me at BlogHer 2007 and who, as a survivor, devotes incredible amounts of time and energy to increasing awareness about postpartum mood disorders.

Recent research performed by Karin Hammarberg (link to doctoral thesis), who also published an article entitled "Assisted conception is a risk factor for postnatal mood disturbance and early parenting difficulties" in Fertility & Sterility (link to abstract) has indeed shown a higher incidence of postpartum mood disorders among women who conceived with the help of ART.

An additional article I read, entitled "Impact of a multiple, IVF birth on post-partum mental health: a composite analysis", published in Human Reproduction (link to abstract, full pdf available from that page), suggests that the higher incidence of multiples in IVF births is a factor that raises the risk of PPD after ART.

Feel free to ask for explanations :-) This post is just getting too long...

Monday, October 22, 2007

Tap Glitch

I thought I heard the phone ring a little before 6:30. This is one of the mornings when my older kids are at their dad's house, so they sometimes call. Having just gotten a cable phone line (yesterday) and not having new phones to hook up to our old line, the only phone is downstairs... So I went downstairs to see if it really was our phone. What I saw was that our entire first floor was flooded...

I also immediately knew it was coming from the tap under the sink (where we have the dishwasher, the fridge and the water purifier connected, in addition to the sink).

Ohad was downstairs in about 1-1/2 seconds and he turned off the water as we both started to squeegee the water out of the house. The phone rang again & it turned out that the overflow of water somehow ran down into the parking lot, so now our neighbor (who speaks Russian very well, but absolutely no Hebrew or English) is trying to help us fix it (he actually came in with a briefcase that gave me the instant reference of "Dr. Sink").

In any case, no one can say my floor's not clean...

Special thanks to Abigail & Nomi who just woke up now (at 7) and let us get the whole floor clean by then and to the weather, for being so warm that we still haven't put the carpet back in the living room. Fortunately, we have no damage.

New Nephew!

Ohad's SIL gave birth to a baby boy late last night, making him exactly 3 years and 2 days younger than his brother.

He may only be Ohad's parents' 4th grandchild, but makes us aunt and uncle to a whopping 21 kids(!)

Sunday, October 21, 2007

Uh Oh - The Opposite Direction

Today, as I was crossing the street with Abigail, I saw E. E has a daughter in the same grade as my twins & a son who's about 3 years younger. When I was pregnant with Nomi, we met at the bus stop & spoke (we first met about 7 years ago). She was in about the same week I was and she was really excited. My impression was that she'd been trying for a long time. She subsequently lost the pregnancy at around 20 weeks, I was never aware of the circumstances. Because she was already showing at the time, she had an email sent out to our community, explaining that she had miscarried. My heart fell when I heard. It seemed so unfair... I hoped that they would be successful again soon.

Today, when I crossed the street, I'm sure she couldn't miss the fact that I am expecting again. I thought about how looking at me with Abigail must remind her of the fact that we would have had children who were the same age (even though hers would have been Nomi's age). I thought about how hard it must be for her because I'm only one of the women she sees all the time who's gone on to have more children while she hasn't been successful (and when you have 2 kids in school, you run into these women often).

I also wonder if, after already having 2 children and then losing a long-awaited pregnancy so late, you wouldn't just give up at some point & think, "I can't do this to myself anymore."

Mostly, I felt guilty for how seeing me might have made her feel.

Wednesday, October 17, 2007

Every other day? Maybe not...

In Israel, I sell discount ovulation kits, along with telephone support - so the question as to whether to have sex every day or every-other-day during the fertile time comes up a lot. Being unable to take any sort of responsibility, I quote a doctor (who gave me permission to quote him) and say that if they don't suspect a problem with the quality of the sperm, then every day is fine too. Now it seems that even if there is a problem with the quality of the sperm, sex every day might be better than sex every-other-day.

A pilot study (see article) led by David Greening, of Sydney IVF tested 42 men whose sperm showed significant DNA damage and found that daily ejaculation reduced this damage by 12%. These results were presented at the American Society for Reproductive Medicine conference in Washington yesterday.

Abstaining from sex increases the number of sperm cells that are ejaculated - leading to the recommendation for couples who are trying to conceive to only have sex every two to three days - but the article says that beyond this time period, although the quantity may rise, its quality declines; a trade-off.

I wonder if such DNA damage is tested in a normal sperm analysis, if so, what parameters show it and how common is such damage? If it makes an important difference (knowing whether there is or isn't DNA damage), it seems like information couples should have - and may even make it sensible to have two sperm analyses day-after-day to check if the sperm quality improves.

Tuesday, October 16, 2007

Scary Story - Swapped Babies

In Trebic, a town in the Czech Republic two babies were switched in the hospital, after the nurses wrote only the mothers' first names (both Jaroslava) on the baby ID bracelets...

Here (in Israel), and I'm sure in most places, they show you the baby and the bracelets on him or her before ever leaving your sight. They also use stickers that include additional identifying information - and the mom, dad & baby stickers are all a part of the same numbered set, so that mix-ups like this can't happen.

The amusing part of the article, in my opinion, was the husband going for DNA testing because he suspected he wasn't the father (he wasn't) and the mother doing the same (she wasn't the mother either...)

Currently (as I read in another article) both moms are refusing to give up the babies they raised.

Results just in...

It's a....

healthy baby :-)

(We decided we'd rather find out the gender at the birth.)

Monday, October 15, 2007

The Goofballs Strike Again...

Since I last posted about the partial results of my amnio, I hadn't checked if there were any new results - simply because I get an email notification when there are. Tonight, I decided to check anyway. Get this line:

Karyotype Preliminary AF - 0 (that's the digit 0) *see edit below

A quick search in Google revealed that this reporting system is used only by my health insurance company in Israel (2 results, both in Hebrew forums) & is completely meaningless to anyone but perhaps a gyn who's already encountered it in the past.

As soon as I finished my search (one answer from a doctor said it's fine, another doctor said he had no idea what the woman was talking about) I checked my email & there was the notification that the new result was in. What is the point of giving me these results directly, especially at 9:30pm? I don't even know who to complain to...

edit: my doctor said that the digit 0 actually has no meaning other than that they don't give the results over the internet. ARGGGHHHH!

and... in Hebrew, for my Israeli searchers - אין כל משמעות לספרה 0 - לא מפרסמים את התוצאה באינטרנט!

Sunday, October 14, 2007

21 Week Scan

Today was our 21-week ultrasound (meaning we're currently in week 22). Normally, they kind of zip through it, saying, "this is the heart, here are the chambers, everything's normal..." but we got special treatment today - this was the first time the doctor did this particular scan for my insurance company (each company has different requirements for the scan - he wasn't sure of all the details). First, he went over everything twice, then he was busy showing the ultrasound technician and the secretary (who typed the data in during the scan) everything else that he knew how to do with the machinery (take a 3D pic of the face, measure the cerebellum, etc.) It was very amusing. The only thing we didn't get to do was count the toes, because of their position. I can't believe how much it already looks like a baby :-)

The doctor claimed that if anything were wrong with our amnio we would have been called within 2 weeks. I finally got through to the clinic today and it seemed as if the nurse had the results in front of her but wasn't yet allowed to tell me (she said something like, "I should be getting them any minute," which sounded strange). She said that we'd have the answer by Wednesday.

Since the last time I was weighed, just a few weeks ago, I gained 5 pounds(!). I don't even have much of an appetite (unlike Bea).

Congratulations to Karen on being able to bring her babies home!!! And thank you to Suz for sharing her terrible scare with Savannah. I hope everyone will take her advice and go for an infant CPR class. I did & I hope I never have to use what I learned...

Saturday, October 13, 2007

Support for the MOTHERS Act

October 24th is blog day for the MOTHERS act.

Katherine Stone from Postpartum Progress (who I was fortunate enough to hear speak & actually got a chance to chat with at BlogHer 2007) posted all the relevant information. - Here's a tiny excerpt from Postpartum Progress just to clarify:

"What is the MOTHERS Act? The Moms Opportunity to Access Help, Education, Research and Support for Postpartum Depression Act, or MOTHERS Act (S. 3529), will ensure that new mothers and their families are educated about postpartum depression, screened for symptoms and provided with essential services. In addition, it will increase research into the causes, diagnoses and treatments for postpartum depression. The bill is sponsored by Senators Menendez and Durbin."

I will be blogging about postpartum depression on this day, with an emphasis on PPD in women who conceived using ART. If you have any information or insight on this topic, please feel free to share it.

I have also added a button to my sidebar, where you can click for more information.

Wednesday, October 10, 2007

An advantage to having an ex who's lost his mind

It doesn't just pass people by anymore. Sure, they still believe some of his phony reality, but you can't miss that something is seriously wrong with him. He has the scariest look in his eyes that I've ever seen.

Anyway, today went OK. It wasn't what I thought it was going to be. She is trying to mediate so that we can settle the issues out of court. I was kind of at a loss, since I didn't know what the issues are... but I proposed 3 different issues to discuss. And then it was his turn. He went on and on about 'the children's best interest' and about 'doing what's best for the children' and blah blah blah, until finally she shut him up and told him to actually say something and not just keep throwing slogans around. The bottom line is that this whole thing is about money. And not even a lot of money. And not even money that he claims to have paid. It's about the fact that he thinks that I am evil for going to the court to claim the money that he owes. For some odd reason, the social worker almost bought this at first, saying that claiming the money that he owes caused conflict & I should have avoided conflict at all costs. If this is true, then why do you need agreements in the first place - are they meant only for people who would follow them even if they didn't exist? How can it be that she doesn't see it as HIS obligation to pay the child support and that if I had to go to the court in order to get it that something is wrong on HIS side? Anyway, he sat there smugly saying that he didn't pay, with no explanation as to why he thinks that's OK... Finally, she did catch on, but she still thought that we should settle it in her office.

I've been trying to settle these issues for over 5 years now. He's refused anything but my completely letting him off the hook. Why should I compromise on the amount now, so far into the process? Wouldn't that just show him that in the future he can do whatever he pleases? I think the pressure she's putting on me is unfair...

Overall, it really was OK & now, since the GPS was programmed better, I actually even know where I was :-) I was even able to stop on the way home and get some special paper that Hadas can use for paper folding (I got her a fancy paper folding book for her birthday which is next Monday - she's going to be 14!!!)

Still waiting for the results of the amnio. 15 days and counting. They said it's usually around 2-1/2 weeks. That's soon.

Tuesday, October 09, 2007

Ugh

Warning... you may detect a bit of anger in this post...

Tomorrow I get to meet with a social worker (a new one, from another city) and my ex, to try to find a way to communicate. Now, in theory, that might be a nice plan. In practice, the #$(!@#* I was once married to (for 13-way-too-long-years) is an extremely irrational, terrifying creature who lacks self-control & doesn't hold himself accountable for things that he says or does. Most of our phone conversations end with me deciding I'm not going to listen to any more of his maniacal shouting and hanging up. The truth is, not communicating with him ever again about anything sounds pretty good to me.

Why is it automatically assumed that every divorced couple CAN achieve civil communication? I got divorced because I was way past the point of even trying to communicate with him... I mean, for the last 6 years of my marriage I wasn't allowed to ask questions like, "How was your day?" because it infuriated him. (Yes, I'm totally serious.)
The bottom line, though, is that I have to give it some sort of shot, because it will be completely obvious if I don't & that will knock points off my scorecard (the judge gets a report about these meetings).

At least the settings on my GPSGPSare better than last time, so it should take me on faster roads. Hey, that's something to look forward to, right?

In other news, I posted a new page about early pregnancy. It still needs to be expanded (a lot), but I think it's a good direction, especially seeing that so many of the blogs I follow have gotten two pink lines in the past few months (and I hope many more will in the coming months!). Comments, as always, are welcome :-)

Sunday, October 07, 2007

Thank you, goofballs...

Ohad & I just got home from our late night stroll to the supermarket. Imagine there's no bread in the whole place. I mean, not a single loaf. No pita, no rolls... Ohad managed to find some things that pass for bread & didn't look to healthy to be eaten. So, after putting the bag with the bread in the microwave (to keep it safe from our cat) and the ice cream in the freezer (to keep it safe from me?), I came in to check my email.

I don't check my email that often, only about 47 frazillion times a day, and in my inbox I discovered that I have a new lab result. But, um, I don't recall having had any tests... It turns out that it's a result from my amnio (not THE result). Apparently they test the AFP in the amniotic fluid & the result is 7.9. Yeah, that helps a lot. The MoM is 0.9, which, from previous experience (with AFP) I understand to mean normal. In any case, I don't find that result to be particularly informative or helpful in any way. So, I just thought I'd thank the goofballs for giving me partial, non-informative results in a place I never expected to see them. Does this mean we'll get the amnio results soon?

Tuesday, October 02, 2007

A week into the wait

Not that wait. The wait for the results of the amnio (expected to be 2-1/2 to 3 weeks). Since the amnio, I've been somewhat sluggish, suddenly feeling more tired than before. I can still wear most of my regular clothes, but they are beginning to get tight (total weight gain so far ~6lbs). I am feeling UI (ubar Inbar) move much more recently - many times a day.

Abigail (now 2-1/2) knows to say that the baby grows in the uterus. Today at dinner she told us that she has a little uterus and so when she has a little baby she will be able to put it there. I wanted to tell her that I hope she won't have to go through that :-)

I am pretty much back to doing everything I did before, though I've yet to wash the floor. You really don't want to see my floor when it hasn't been washed for 2 weeks. Maybe tomorrow. My doctor told me to keep things low key for a whole week.
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For anyone who's interested, I fixed up the download page for the free IVF guide. I think it actually makes it possible to understand where you're supposed to click.