The Medical Monster vs. Vacation

I haven’t been so good with the blogging lately, have I? It’s not that I haven’t had things to write about. Maybe I have too many things to write about and not enough time or mental energy… I’ve been thinking about posting with medical updates (boring?) or updates on my crazy food intolerances (too overwhelming to think about), or how I’m excited we planned a spontaneous awesome trip last minute, and we’re leaving Saturday for Europe despite me not being all better and not being able to eat most things (there, I just blogged it, done. jk). I’ve wanted to blog about how infertility and endometriosis gave me medical PTSD and have made me feel like I’m inherently broken. And I’ve been wanting to blog about how adoption is not (or is, but mostly is not) the same as having biological children, but why I’m thinking about it anyway. Agh, where to start? (feel free to vote for future posts, if that suits you!)

Ok, happy stuff first. We had a dream vacation idea for our 10th wedding anniversary this summer: hike the 100 mile tour du Mont Blanc trail in Switzerland, France, and Italy (over 10-11 days, staying in B&Bs and pensions). If you don’t know what this is, type in ‘tour du Mont Blanc’ into google and click over to the images to cry at how beautiful it is (you can do this even if you do know what it is). We started training for it in January (we’ve never done anything this intense before), and then our plan was totally derailed by me getting sick and staying sick starting in March. We wanted to do in early July so we could see my family afterwards who were getting together for a little reunion nearby in July. But I was sick so we didn’t book the trip, and we postponed it thinking maybe we could still do it in August if I started feeling better. This back-up plan was starting to look suspect too (since I am still nowhere near well enough to do something like that, and maybe I never will be), and I was feeling pretty depressed about health issues and medical crap taking over my life, and daydreaming of booking a last-minute flight to see my family in Europe despite being sick. And then … a bunch of things came together making the trip actually logistically possible, and I decided I wasn’t going to let all the medical crap take over my life and make me miss out on seeing my family all together, which was really important to me. And, not only are we going to see my family, but we are going to spend 3 days in the Mont Blanc region basking in the beauty and/or doing day hikes (depending on what I am able to do), and we are taking a 2 day road trip sightseeing the Black Forest region of Germany. Europe, here we come!

Hmm, maybe I should have saved that for last because everything else will be such a downer after that. I suppose I should just summarize the medical situation. I still have the positional vertigo, but it’s getting better. It’s no longer like being on a boat constantly, only occasionally, and the blurry vision is improving. I now have a referral to see a vestibular rehabilitation physical therapist which is supposed to help. The kidneys seem to be ok, and no more side/back pain. The sciatica seems to be slowly improving: I’ve had a couple of days without shooting pains in my foot, but my hip is still sore a lot of the time and I feel like I have a subtle limp that is driving me crazy, I don’t know how to stop it, and I’m worried it means I will soon injure it again soon as soon as I do anything strenuous. I have a referral to see an allergist (who is not going to help me – yes, I am that optimistic. But, I have good reason since I already went to an allergist two years ago for related food problems and he told me he can’t help me – thanks a lot. I won’t give up so easy this time, but I’m not expecting much, and my primary physician wants me to see them, so I will. But then I will just come back and tell him what I already told him, that they won’t help me, and send me to someone else already) to discuss the possibility of histamine intolerance, which I waited six weeks for, and then they canceled it on me today and rescheduled for fucking August 18th.

They are so unbelievable, I don’t even want to think about this anymore. Except that I have to think about it ALL THE TIME, because I am so screwed up that I have to deal with tons of appointments, and referrals, and specialists, and lab tests, and cancelations, and it actually is taking over my life even though the doctors are not doing anything to help me! I don’t know how people who are really sick deal with all this crap – I can easily see this becoming a full time job, and I’m not even that sick, really. In addition to three scheduled appointments this week (one of which was canceled, but that certainly doesn’t take away time I’ve spent dealing with it), to which I have to travel 3 hours each way since I’m living with M this year , I had a surprise visit to urgent care over the weekend because I had one of my lovely endometriosis periods, which had me moaning in pain, sweating and vomiting. Several hours and a painful intramuscular pain injection (a new one for me!) later, I was ok, asleep in fact. Anyway, if my writing about this seems somewhat less coherent than usual it’s because my experience of it is a totally incoherent, panicked, and overwhelmed blur. I have no clarity about this, just lots of very negative feelings. Since the doctors don’t actually do anything that helps me, I’ve been very tempted to just try to forget about them and try to live my life and take care of myself on my own. But, I still hold out hope that they will finally discover what’s really wrong with me and help me, and they certainly can’t do that if I never see them. The other reason I am putting myself through all this is because I am applying for an extension on my tenure clock for all this medical crap, and I have to see the doctors to get letters from them and to create a record of everything in order to have documentation for my application. This means I’m also actively working on coordinating with my university about obtaining all this documentation for their records. Fun times, I tell you, fun times. Let’s just say that the vacation is more than a vacation, it’s an escape from the medical monster that has been wreaking major havoc on my mental health for the last few months. I will have 10 days where I get to pretend that this is not my reality. Can’t wait.

Why I need to blog again

If anyone is still out there, they may remember that back in December I decided to take a break from infertility and blogging, and give up on infertility treatments. At first this seemed to go really well. I began enjoying life again and stopped feeling imprisoned by never-ending infertility treatments and lifestyle modifications. I gave well-received talks on my research all over the place, went to a bunch of conferences, wrote a few small papers, and I even almost got a new job. I was so productive and happy about it! I focused on all the flexibility that not having kids and not trying to get pregnant allowed me to have. I  appreciated not having to constantly watch and care for another human and actually have the ability to do what I want to do much of the time. I loved living with my husband again. I imagined a (happy) future for us without children. I felt free!

This was roughly December through February. There were some signs that this was not a stable state for me even during this period. I began having increasingly frequent thoughts of adopting. These thoughts were usually about random children, like going to the grocery store and wondering what it would be like to be the parent of some random child, and thinking increasingly often that it would be nice (this has not historically been my reaction to random children at the grocery store, believe me!). I haven’t been able to imagine having my own child or being pregnant for a while now, probably because I believe my body is too broken, but these abstract thoughts of having children in my life kept coming up, and mostly I would think, hmm, maybe I’m opening up to the idea of adoption. I tried to put these thoughts aside since adoption is out of the question given our current living situation, but thought this could be a good progression in my acceptance of my infertility.

Paradoxically, during this whole time, even though I had officially given up on infertility treatment and supposedly given up on having biological children, I could not stop myself from tracking my cycle at least a little, working on my endometriosis (and hence fertility?), and trying naturally, actively, sometimes stressfully (for those of you who have TTCed for long periods of time, you know what I mean, right?). I realized this was contradictory to my acceptance of not having biological children, but at the same time, I thought not trying was illogical, like purposely shooting yourself in the foot. At least I wasn’t ever disappointed when I didn’t get pregnant: I guess that’s an improvement, no expectation. I guess I had really given up on the idea of any actual, active hope, but I didn’t want to rule out the minuscule chance we had completely by not even trying (and yes, it did occur to me that the ‘sane’ thing to do would be to stop tracking and timing, but because I know how bloated, crampy, and moody I often feel during ovulation, I thought this would basically be equivalent to not trying). After all, if I wanted to stop trying completely, I would just go on birth control to help the endometriosis and experience much less pain. But apparently, I’m ready to give up on actual hope but not teeny, tiny, smidgen-of-possibility, hope.

Despite these paradoxes, things were basically going great until March, when I got sick and everything went to hell. It has now been three months that I haven’t felt well, and I am going crazy. I keep vacillating between: “you’re so stressed out about being sick and trying to find what’s wrong that you’re making yourself sicker. Stop researching what’s wrong and trying different diet remedies, worrying about everything you eat, and work on your stress level instead” and “sure, stress is a factor, but you have to believe in yourself and what your body is telling you. You’ve never had symptoms like this from stress – they are real, not imagined, and if you don’t do something about it, you won’t get better.” I need to blog because I am going crazy keeping all of this bottled up. I avoided blogging at first because I wanted to take a break from the infertility world, and then after I starting feeling bad, I didn’t want to blog because I don’t like being negative, and most of what I have to blog about now is negative. But keeping it all inside is not working, and I need to do this to process and deal with this and to try to keep myself in perspective.

The three month long (so far) health saga is really long so I leave it for last in case you want to skip it… I had an electrolyte imbalance in March with orthostatic hypotension. I was dizzy and weak, and after minimal upright activity I would become extremely weak, faint, and confused. Previous to this I had been exercising strenuously and feeling great. All my blood work, including electrolytes, were normal, of course (I am ALWAYS FUCKING NORMAL, the picture of health, when I feel awful, until 10-23 years later when doctors finally find what’s wrong with me). My blood pressure was very low, though, sometimes as low as 95/60 or so, but my doc didn’t think that was a problem – I just needed to hydrate and take more electrolytes after exercise. I had been hydrating like crazy, just not using any salt… Drinking salty water and eating more salt helped a lot at first. But then it didn’t. Next visit to the doctor I was diagnosed with benign paroxymal positional vertigo, because I had spinning vertigo induced in certain positions. He thought my inability to concentrate was from the screwy messages being sent to my brain and would get better on their own in 5-6 weeks. Several sessions of Epley maneuvers seemed to eliminate the spinning sensation, but the inability to concentrate and vertigo continued, although the vertigo was no longer spinning but more like being on a boat. I felt weak and unable to concentrate from the vertigo for most of April. I used a lot more sea salt in food and in water (I used to get virtually no salt in my diet), which often made me feel at least somewhat better and energized, but did not help with the concentration problems. At some point I realized my progressive lenses were making me dizzier so I got a new prescription and new single-vision glasses, and this seemed to make my vertigo better. At the end of April, I started a higher-protein diet (which for me is only about 15% as a pescatarian), eating more eggs in particular since I can only eat so much fish, and I don’t do great with dairy (which was confirmed once again on this diet). I started this diet hoping to give myself more energy and try to limit grains and beans (paleo-like) to see if it helps. I can’t remember if I’ve blogged about the problem I previously thought I had with eggs. Well, it seemed fine at first. But after a couple of weeks I was feeling noticeably worse. Sometime toward the beginning of May I started having blurry vision and even worse concentration difficulties, and sometime in the middle of May I started feeling ill after eating eggs and fish (previously, having some sushi would fill me with boundless energy, which was part of the inspiration for eating more protein), and now it seems I feel ill after almost everything I eat. I basically feel like I have a mild hangover all the time, and no, I am not drinking, at all. I’ve been going crazy trying to figure out which foods are triggering it because it seems to get better/worse depending on what I eat. On top of all this I got an kidney infection last week and am on antibiotics; thankfully the kidney pain only lasted a short time. There’s a lot more to say, but I have to stop this tedious story now or absolutely no one will read it!

Steady Progress (and Some Regression)

As those of you who have been following for a while know, I decided to make some lifestyle changes after our third fresh IVF cycle failed a month and a half ago. It takes a while to develop and adjust the lifestyle choices because they need to be evaluated after a month or more. It takes a month to see how the choices affect my endometriosis pain during my period, and it takes a month (or more) to see if there is any change in my cycle (which I track judiciously). So it is slow going since you need a month or more to evaluate each change. At least that’s how it would be done if I were actually doing this scientifically, but I don’t have the time or control to try one thing at a time ad infinitum. Also, life has a funny way of injecting its own factors that screw up any attempt at a semi-controlled experiment anyway.

This is all a prelude to say that a) something I did helped my endometriosis pain! (YAY!), and b) I’m not completely sure what it is (sigh). But, I can make some educated guesses and construct my new lifestyle plan based on them and see how it goes. You may recall that last month I had 3+ days of debilitating pain, which reached a pain level 8, and I had to take 3 oxycodones to get by. Last month is how things have been for most of this year, getting worse more recently. In contrast, this month, I only had two really crappy days, my pain only ever reached a level 6, and I got by on alleve alone without ever being totally debilitated!  Also, last month, I had mild/moderate cramps for days before my period actually came, while this month I had zero pain before my period actually came. I can’t emphasize enough how unusual this is for me. It felt surreal for my first period day – I had lots of bloating and vague feelings of period-ness, but no pain. Kind of like I feel when I’m jacked up high on super pain killers, except I didn’t need any painkillers!

So what were the changes in my lifestyle (intensional or otherwise) that could have had an effect?

1. I started exercising moderately/strenuously again. (Ok, it was quite strenuous on our trip since we hiked over 50 miles of moderate/strenuous trails in two weeks.)
2. I started taking pycnogenol.
3. I increased my magnesium supplementation to 400mg (100%).
4. I decreased (but did not eliminate) soy. (I eliminated soy milk but had tofu and miso occasionally)
5. I started eating fish again.
6. I took a baby aspirin everyday.
7. I eliminated all dairy just before my period
8. This was the month after a failed IVF cycle
9. No acupuncture (due to traveling)

And what changes did I observe in my cycle?

1. Less horrendous period!
2. Spotting mid-cycle and before period for a week
3. Ovulation happened really late (around day 23). I ran out of sticks on the trip so I inferred it from rising temps and ovarian pain (the fact that my period came exactly two weeks later confirms this also since I am extremely regular once ovulation happens).

Here’s my thinking. I blame effects 2 and 3 on potential causes 8 and 9. I have gotten ovarian cysts after previous IVF cycles, and I bet that’s what the spotting was. I suppose it could also be the lack of acupuncture, causing my cycle to become deregulated again. Or a combination of the two. A nagging little voice in my head says, ‘or maybe it’s the lack of the estrogen from the soy that you were eating’, but I don’t want soy to be the explanation for anything because it’s so hard to regulate soy intake as a pescatarian! Because I think they are probably the aftermath of all the IVF hormones, I won’t worry too much about effects 2 and 3 unless they continue for subsequent cycles.

So effect 1 is my main concern, or rather reason for celebration! What helped my period? Well, I did 1, 2, 3, 4, and 5 specifically to help with my endometriosis pain and fertility since all of these have been associated with decreased dysmenorrhea. So maybe all of them helped. What do I really think? I really think the main reason is the exercise. Hopefully, I don’t have to hike 25 miles a week to see the effect like I did this month. And I hope, hope, hope that 2 and 5 really helped too because maybe it’ll just keep getting better the longer I continue this anti-inflammatory regimen. I hope it’s not magnesium because (TMI alert!), I am really sick of loose stools/diarrhea (which I’ve had for years), and I’ve stopped taking it to see if it helps (so far, no change on that front). I would like it not to be 4 because it would make my life so much easier if I could eat soy without worrying about it. I suppose the dairy avoidance could be helping too, but this is very hard to maintain.

So, obviously, I want to keep doing everything feasible that helps, but I would also love to simplify things if they don’t matter (like eating soy and dairy). My plan for this month is largely to continue:

1. Exercise moderately 5 hours a week
2. Keep taking pycnogenol
3. Keep eliminating gluten
4. Avoid soy
5. Keep eating fish
6. Keep taking baby aspirin
7. Start acupuncture back up again
8. Take extra magnesium at least 3 days before period
9. (maybe) avoid dairy especially before/during period
10. I am cutting out several supplements that I’ve been taking for months without apparent improvements (DIM, evening primrose oil, l-arginine, b-complex)

If the next cycle goes well, then I will know that the supplements I cut were not essential, and maybe I will try to add back more soy and see if it helps or hurts. Agh! So much to think about! I am overwhelming myself! And I haven’t even talked about the new diet I am trying right now for my blood sugar, which I will write more about later.

Fertility Scorecard & The New Plan: Part 2

Overwhelmed. Totally overwhelmed. That’s how I feel after reading tons of stuff and trying to figure out my new supplement regimen. I thought I had made a decision this morning, and now I am second guessing it. But let’s start at the beginning. First things first: the fertility scorecard.

Fertility & Health Progress (recent changes underlined)

1. Hypothyroidism diagnosed and now under control with synthroid (current dose set 1 year ago)
2. I do not have severe fatigue that made me too tired to even sit up right for dinner, let alone do anything productive
3. My BMI is now 23 after losing ~30 pounds over the past few years (current weight reached 1 year ago)
4. Endometriosis diagnosed and (supposedly) destroyed, supposedly temporarily increasing my chances at natural conception (but no pain relief)
5. My polyp that was causing me to bleed nonstop was removed
6. Asthma and allergies have been under control all year even during IVF (with claritin and singulair only)
7. My SI joint does not constantly hurt and barely hurts after strenuous exercise
8. I do not have an ulcer anymore
9. I do not have bloating and gas every evening no matter what I eat
10. I do not have mid-cycle bleeding anymore (or 45 day cycles)
11. My follicular phase BBTs are now around 97.6 whereas they used to be 97.2 or lower
12. I have positive OPKs each month now and O now sometimes comes before day 18
13. My luteal phase is longer, the temps are higher, and the spotting starts later than it used to
14. My periods have been regular (aside from the polyp issue in Feb-March)
15. I rarely have headaches anymore
16. My muscles are not constantly in pain from stress and tension
17. I no longer have insomnia
18. Anxiety does not dominate my life
19. My skin has been clearer
20. I usually feel energized instead of sluggish after eating

Fertility Impediments & Failures (recent changes underlined)

1. I am not pregnant
2. We have had 3 IVF failures, 1 FET failure, 3 clomid failures, 1 IUI failure, and 3.5 years of TTC failure
3. Our last IVF cycle didn’t go so well (fewer eggs and embryos, no blastocysts)
4. I am getting older. I will be the dreaded 35 in May.
5. I have endometriosis
6. I have asthma
7. I have severe environmental allergies
8. I have had polyps and cysts, and I have a fibroid
9. Our embryos don’t develop properly into blastocysts (hypothesis: poor egg quality caused by endo)
10. My endometriosis pain is getting worse
11. Despite my major diet changes that are supposed to help with this, I still get seriously screwed up if I don’t eat every 4 hours (dizzy, weakness & fatigue, confusion. One time I had trouble forming sentences. That was scary). My glucose and insulin are supposedly fine.

Several things are clear from glancing at this scorecard:

• The score is 20 to 11 (I’m winning! Ha, take that Infertility! )
• I have made amazing progress in the past year in my overall health (I have to say I’m pretty impressed with myself right now)
• There is nothing I can do about 2-8 on the second list so there’s no point dwelling on them
• So I need to focus on fixing 1 and 9-11 without screwing up the first list

I have no idea what to do about 11. Any suggestions would be greatly appreciated. This is a daily challenge. I eat a very low glycemic load diet. This ‘crashing’ as I call it usually happens daily at around 5 or 6pm if I don’t have a ‘second lunch’ (a healthy, balanced snack is not enough to prevent it). I assume this is low blood sugar, but I have not been able to document this even after buying a blood glucose monitor after refusing to believe the ‘normal’ test results from the doctor. I usually feel better shortly after eating, especially if the meal has whole grains. My blood pressure is really low, and this might be contributing so I try to drink a lot of water and increase my sodium intake, but this seems to have no effect. I refuse to think that the ‘solution’ is that I have to eat every 4 hours to feel alright. Normal people don’t have to do this, right?

As for 1, well duh, obviously, that’s what I’m trying to solve! And I’m trying to solve it by solving 9 to the extent that I can do anything about it. For 10, I have a hypothesis (or two), and I am implementing a solution (or three) as I write this.

So why has my endometriosis pain gotten worse despite the surgery that is supposed to help it? Well, I think a likely answer to this is some of the changes I’ve made in my lifestyle:

• exercise: I have not been exercising hardly at all. Only occasional hikes/walks and some gentle yoga. In retrospect, this seems like an obvious culprit since regular exercise has been shown to improve endometriosis symptoms.
• diet: I used to eat a TON of dairy, mostly skim milk. I have dramatically reduced the amount of dairy I eat, which is supposed to help with fertility and endometriosis. But after my magnesium discovery last week, I started thinking about magnesium and calcium and realized that I may not be getting enough of either anymore. A deficiency in magnesium can cause cramping and so can an imbalance of calcium.

So I am making some changes to address this:

• exercise: I will do moderate exercise 3-5 hours a week. No jogging. The exercise should be spread across the week not done all at the same time. I will limit strenuous exercise as much as possible. No more than 1 hour a week. This is hard for me due to my extreme tendencies I talked about before.
• nutrition: I am increasing my magnesium and calcium supplementation. I switched them both to more absorbable but much bulkier ‘citrate’ forms, and I will go from 500 Ca, 250 Mg to 750 Ca (75%), 400 Mg (100%) a day.
• diet: Here’s the shocker. I have decided to start eating fish again.  The healthy oils in fish are anti-inflammatory and may help endometriosis. The added protein and healthy fats may also improve egg quality. Starting to eat fish again is part of my overall effort at being more moderate and less extreme.

These decisions were reached after a lot of research. Please see my page about exercise. I had been planning to start jogging again, but my research thoroughly convinced me that strenuous exercise is not a good idea while trying to get pregnant. I also did a lot of research on fish before deciding I would start eating them again. My main concerns were dioxins and mercury. Dioxins are one of the leading theories about what causes endometriosis (and makes it worse). Dioxins are toxic byproducts of many industrial processes. The primary human source of dioxins (which is considered by many experts, e.g. the EPA, to exceed healthy levels) is animal fat so I was hesitant to add animal fat back into my diet. The half-life of dioxins is seven years so trying to lower exposure to them is a long term commitment. Anyway, I did the research about dietary sources of dioxins and learned that by far the worst dioxin offenders were butter, freshwater fish, and breast milk. I’m not planning on eating butter or breast milk, and since the dioxin levels in ocean fish are much, much lower, I felt that the potential benefits outweighed the risks. So wild salmon (as a low dioxin and low mercury fish) is back on the menu!

Wish me luck with my plan to be extremely moderate! More on supplements and diet later!

Fertility Scorecard & The New Plan: Part 1

I haven’t posted in a bit because I’ve been quite busy getting ready for a last minute vacation M and I will be leaving for on Friday! I started vaguely planning this trip as one of my 2ww coping strategies, but since we officially got the negative result a week ago, I’ve been busily making it happen. We are going to one of the most beautiful parts of the country, northern California, and we’re going to go on an adventurous, hippie road trip in a camper van (;-) that will hopefully take our minds off our recent disappointment and recharge us for the continuing fertility battles ahead.

I’ve also been a little slow to write because I wanted to write about my new fertility lifestyle plan, but it’s been taking me a long time to figure out exactly what that is. I finally decided that I should start compiling all the research I’ve done somewhere where I can reference it in the future and where it might actually be of some use to someone else. So I’ve set up a new menu on the blog for ‘Fertility Lifestyle Research’, including studies on exercise, nutrition, and supplements. I’ve started to fill this out already, but it’s going to take me some more time to compile all the information I’ve gathered.

So I’m ready to unveil some of my new lifestyle choices and the reasoning behind them. My general approach to lifestyle factors is one of trying to improve my health in general and optimize fertility in particular. This means I do a lot of research on any supplements I take to understand potential risks and effects on other aspects of my health (for example, I don’t want to take something that supposedly improves egg quality but is going to mess up my thyroid or significantly increase my risk for ulcers, which I am already at risk for). This also means that I view any health issue I have as potentially fertility related – I think my best chance for becoming fertile is by being as healthy as I can be in general.

So as I’ve been going through this infertility journey I’ve been taking stock of my health in general, making adjustments to my treatments, diet, exercise, and reassessing constantly, in a perpetual loop. I’m happy that this loop has been on an upward trajectory overall, although there has also been a decline in some aspects of my health. My instincts are always for the extremes. If I hear X is good for fertility, my instinct is to do/eat X as much as possible. If Y is bad for fertility, I best cut it out entirely. And when something doesn’t go well, my instinct is to react by going to the opposite extreme of whatever I’ve been doing. So as I reassess and try to decide what modifications to make (if any), I have to remind myself that a lot of what I’m doing already is working so I shouldn’t reverse everything I’ve been doing. I need to carefully consider my lifestyle choices and make small adjustments that are specifically aimed at improving whatever is still wrong or has become wrong without undoing all the good things I’m doing.

So first off, what have I been doing? Like I said, I am prone to extremes so be forewarned. For the past 8 or 9 months, I’ve been on a diet that, based on my readings, is supposed to improve my fertility and my endometriosis. I’ve been a vegetarian for ethical reasons for several years so these changes are on top of this self-imposed restriction. I stopped drinking coffee several years ago and switched to tea. In the past year I’ve gradually reduced the amount of tea I’m drinking also – right now I’m down to one green tea a day. I stopped drinking alcohol years ago. I’ve almost entirely cut out gluten. I do not have celiac disease (I had a biopsy done), but gluten is rumored to have inflammatory properties that aggravate endometriosis, and my personal experience is that cutting out gluten had a noticeable effect on my digestive and respiratory issues. Since my diet is about avoiding processed foods in general, cutting out gluten is not that much extra effort on top of that. I’ve also been trying to limit dairy and soy (also implicated in endometriosis), but I have not cut these out altogether. This is quite hard to do being a vegetarian. This has been a very restrictive diet, not restrictive in an unhealthy sense, but in a social/convenience sense because it’s the opposite of how most Americans eat. Can you imagine going out to eat and saying that not only do you need a vegetarian meal, but it can’t have gluten, dairy or soy in it? Good luck. Not possible. Needless to say, I’ve barely eaten out at all in the past 12 months, which means I’ve been making food at home more than ever before, which in itself is a very healthy change.

For supplements, I’ve been taking a moderate amount that are aimed at general health, not specifically at fertility (prenatal, probiotic, calcium, magnesium, b-complex, epa+dha, vitamin d, l-arginine). The last couple of months (before the IVF) I started taking DIM and natural progesterone cream (after ovulation) which are supposed to help with endometriosis (but no such luck so far). Finally, for exercise, I did the ‘extreme’ thing I was referring to earlier. For the first 2.5 years of infertility (and like 1-2 years before that), I was exercising strenuously as much as I could (I was jogging, biking, hiking, and doing power yoga), assuming that more exercise would make me healthier and therefore more fertile. 14 months ago I stopped exercising, at first because I couldn’t, and later because after reading a bunch of fertility books, I decided that what they said about needing to leave some energy reserves for my reproductive system made sense. So I went from regular strenuous exercise to nearly no exercise, except for some gentle fertility yoga and occasional walks/hikes. The last 8-9 months has been about rest and recovery. Which reminds me that 12 months ago I also started seeing a therapist and about 8 months ago I started going to weekly acupuncture sessions.

Given this massive ongoing effort I’m devoting to my (constantly evolving) fertility lifestyle, I thought it would be wise to compile a ‘fertility scorecard’ of my current situation, as a reference for later and as a way to organize my thinking about what changes to make. But this post is already way too long, so I will write more about the effects this lifestyle has had on me and my future plans next time.