Miscarriage: to know or not to know why

Screen Shot 2015-12-07 at 2.38.50 pmWhen I was a kid, I was full of questions. My favourite thing to do was to ask, “Why?” When I was about five, I remember being in a shopping centre with my parents and sisters, the eldest of whom was pushing my niece in a pram. We had been riding the escalators all day and I kept seeing these big read buttons at the top of every escalator. I asked what they did but, given we were in a hurry, I was told not to worry about what they did because it was not important.

It was important to me though so at the top of the next escalator, when my sister was halfway down with the pram, I pushed the button.

The escalator immediately stopped, almost throwing its occupants off in the process. Dad then had to help my sister carry the pram down the remainder of the now-frozen escalator. Everyone was pretty mad at me.

I didn’t get it. Why were they angry when all I wanted to know was the answer to a simple question?

Of course, the button was an emergency stop button but I didn’t realise that at the time and I wasn’t satisfied with being told that I didn’t need to know the answer to my question. I needed to know.

I know my questioning nature drove my parents insane at times but, unfortunately for them, it is something that has stuck with me. For the most part, this has served me well but sometimes it causes me to create more pain for myself than is necessary.

In the case of wanting to know why I miscarried earlier this year, I nearly drove myself insane trying to figure out what caused it and how I could have avoided it or, at the very least, how I could ensure it wouldn’t happen again.

The doctors, nurses and midwives all said the same thing: sometimes we just don’t have an answer. I couldn’t accept that I would never know what caused our baby to die so suddenly just days after seeing their heart beating strongly, but it looked like that was exactly what was going to happen.

That was until last week when I went to my GP to get an iron test done. Those who know me well will be familiar with my struggles to keep my iron at a healthy level. Anyway, he was going through my history and saw that I never received the results of a test I requested when I was pregnant to find out if I had a mutation or defect of the Methylenetetrahydrofolate Reductase gene. The MTHFR gene for those who prefer to not overcomplicate things. Or the Mother F*cker gene, for those in the natural medicine field who know the havoc that mutations to this gene can cause.

What does the MTHFR gene do, exactly?

The body can’t do too much with folate in its original form, so it needs to convert (or methylate) it into a substance that it can actually use, and that substance is called L-5-methyltetrahydrofolate. The MTHFR gene is responsible for this conversion.

The MTHFR gene can be defective in a couple of different ways, with one mutation being known to increase the risk of blood clots, especially during pregnancy.

For people with this type of mutation (the heterozygous version, for those who are interested), miscarriages are common. It is thought that a blood clot forms in the placental blood vessel, causing the baby to be cut off from nutrients and subsequently causing you to miscarry.

This is the mutation that I have.

I think this is why our baby died.

Of course, I know all too well that there are no guarantees in this life, and there is every chance that something else caused the miscarriage. But there is something strangely comforting in thinking that I might have found an answer, even though I’ll never know if it is the answer. It gives me the opportunity I’ve been searching for to see what I can do to try to stop this from happening again. It gives me a direction to start with rather than flailing around in the dark, hoping I’m taking the right supplements and getting the best treatment. As anyone who is dealing with fertility issues – or any health issue for that matter – will tell you, having some information is better than having none.

The science is pretty new around all of this, which means there aren’t many prenatal supplements that include L-5-methyltetrahydrofolate, or even its precursor – folinic acid. My doctor isn’t even sure about what the best approach is!

After trawling my university’s scientific research database to read about the few studies that have been conducted in this area, it looks like the best thing I can do is take a supplement that includes L-5-methylfolate. I’ve found one that looks pretty good, so I’m going to give it a shot when we do decide it’s the right time to start trying again.

So instead of doing nothing and just hoping for the best, I’m trawling my uni’s scientific research database to find answers and I’m determined to get to the bottom of this.

I’ll never stop asking why.

Laura xx

Note: As always, I’m writing about my own experience. I’m not a doctor and while this post might give you the information you need to start your own investigations with a health practitioner, it should not be construed as medical advice.

Life and death and resurrection

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A quick note before we get to today’s piece:

This is the hardest, but most important, thing I’ve ever written.

It has been sitting in my drafts section for some time, with no reason not to be posted except that I couldn’t find the courage to do so.

Two initiatives have taken place over the last two weeks that have helped me to feel like it was finally the right time share my story. Last week was Mental Health Week and I was reminded that everyone is dealing with something hard in their life, and keeping my struggle a secret helps no one, especially not me. Then, yesterday was Pregnancy and Infancy Loss Remembrance Day, and as I read article after article about women struggling through a mountain of grief in private, I realised that the more people who share their experiences about infant and pregnancy loss, the less this topic will be seen as taboo. It is my hope that by sharing my story it will help another woman who has gone through this loss feel less alone. You are not alone. The level of grief you feel is valid, even if society tells you that it’s out of proportion with what they expect from the death of a life they never even knew existed.

 

“Resurrection means that the worst things are never the last things.” – Frederick Buechner 

When I first counted the dates, and counted them again, I didn’t admit to myself what a difference one week could make. But I drove to the shops anyway, to pick up the test anyway, because what were the chances anyway.

Then, as I stared at those two little lines I held my breath for all of eternity, blinking and hoping and not admitting that the impossible could be possible. Pregnant, the lines announced, whispered, shouted.

With shaking hands and hearts in mouths, we hugged and hugged and kept checking that those lines were still there as we basked in the bliss of our new names: Mama and Papa To Be. A mum and a dad. A baby would make three.

I said I don’t know how to do this and he said we’ll figure it out together, this perfect new reality of ours.

And so head-first we fell into what we thought was a given. They provided us with urine tests, blood tests, leaflets, a due date. And I did not admit to the fear that had crept into the corners of my heart that while our due date would come and go, just like all of time does, it would not look the way we wanted it to.

As we gazed in awe at your tiny flickering black and white heart beat, our hearts started beating in time with yours. That’s your baby, she said. Everything looks perfect, she said.

Except it wasn’t perfect. Not even close. Or maybe it was and this is just a different, more painful kind of perfect than the version we had imagined.

When my world turned red and it just wouldn’t stop, I squeezed shut my eyes, started building a wall around my heart, and whispered no no no to a god that wasn’t listening.

For a whole day and night and day I didn’t admit what I knew to be true. I couldn’t admit that I was losing you.

I tore apart my body in search of the strength I knew I had to find to utter those terrible, awful words that never should have to be said. I didn’t admit that I was too scared to call the midwife, too scared to hear what she would say but I knew not admitting would not be enough to stop this train that was determined to derail itself.

This happens all the time, she said. Lots of women experience this and they go on to have healthy babies, she promised.

But promises are just words and, oh baby, words can’t save a life. Can’t save a mother or a father. Can’t save a future imagined either.

And so we drove or walked or swam through an ocean of grief to the hospital, and all the while I hoped I could find the courage I needed to lose sight of the shore and swim into this new world that I didn’t want to belong to.

The pain spread from heart to my soul to my body to you. It blurred the white walls and white bed and white everything, and I couldn’t admit that even as I begged for the morphine that entered my blood I wanted to scream at them to stop because if I didn’t feel pain how would I know you were ever even real.

I shut my eyes or maybe they shut themselves to block out the feeling of cool gel on my skin and listened instead to the screaming silence that filled all of the spaces that were once filled by you.

I think I should get the doctor, she said. What we are seeing is consistent with a miscarriage, he said. We can’t see a foetus, they said.

My baby is gone my baby is gone my baby is gone.

You have options, she said.

Options?

How could I have options when the only option I wanted is no longer an option? Surgery, a pill, just wait it out. These are your options when you have no options.

I opened my eyes to another white ceiling, to murky voices and a second of normality before the memories crashed their way back into my heart, jamming themselves into every corner of this body I used to trust.

Into this world I trusted.

This new reality is not the one we wanted but maybe, just maybe, one day we will be able to see that it’s exactly the one we needed.

Some lives are very long, and some are very, very short but they all leave their mark. And you, our beautifully imperfectly perfect baby, have left your mark all over our hearts.

“The best and most beautiful things in the world cannot be seen or even touched. They must be felt with the heart.” – Helen Adams Keller

 

If you know someone who you think needs to hear this message, I would be so honoured if you shared this with them.

Laura xo

Fertility Fridays: the one where I recommend the withdrawal method

Leave hormonal contraception behind.

Leave hormonal contraception behind.

Today I am going to talk about sex. (Sorry Mum and Dad, if you’re reading this!) Specifically, I want to talk about some options for contraception that don’t include synthetic hormones because we all know what I think about those!

About three months ago, I attended Dr Nat Kringoudis’s very first Debunking Ovulation seminar and I got so much out of it. Nat runs The Pagoda Tree in South Melbourne, which is a natural fertility clinic. She is a doctor of Chinese Medicine and an acupuncturist, and is an expert in all things fertility. Basically, when Nat gives you advice, it would be wise to listen.

The Debunking Ovulation seminar did exactly what the name implies: it helped us to understand exactly how our ovaries really work and why you don’t actually need a hormonal contraception method to make sure you don’t accidentally make a baby. I highly recommend going if you  are unsure about exactly how that all works, you are experiencing irregular periods or, really just if you have ovaries.

I won’t go into the detail of what Nat talks about because I’m not an expert (and don’t want to be responsible for any unexpected babies!) but one of the take-home messages was that we ovulate exactly once between periods. Only once. That means that there is only a period of about three days where you can actually fall pregnant each cycle. The key is understanding your body well enough to be able to know when you are ovulating.

OK, here are my top three non-hormonal contraception options:

Condoms

I thought it made sense to start with what I’m sure is going to be the least popular option. I know, I know. Condoms kill the mood, they interrupt the fun and can dull sensation. There’s nothing new there. But, they are an effective method of contraception for when you are ovulating and they have come a long way in recent years. There are so many ‘ultra-thin condom varieties that they have almost made their regular counterparts redundant. They also protect against STDs and, hey, no-one wants to have that conversation with their doctor and, subsequently, their new partner.

The Withdrawal Method

Before you all shut your laptops in disgust that I could be so irresponsible, hear me out. The withdrawal method is actually very reliable if you use it correctly. By that I mean that the guy must pull out before he starts ejaculating. ‘What about pre-cum?’ I hear you ask. It’s a misnomer that pre-ejaculation contains live sperm. This fluid is simply there to clean out the pipes before the real action begins. The only footnote to this one is to make sure your guy pees first if you are planning on heading into round two.

The Cervical Cap

The cervical cap is something that I am really keen to find out more about. I first heard about it a while ago and then completely forgot about it. Nat talked about it at the seminar and spoke about how it works. It’s basically a new-and-improved version of the diaphragm. It’s a small silicone cap that you insert prior to sex. It sits flush against your cervix and acts as a barrier to sperm. You can put it in a few hours before sex, which means it won’t interrupt the moment. You just have to leave it in for six hours after sex, so you can just take it out when you get up in the morning (if you’re a nocturnal love-maker). You can pick up a cervical cap from your chemist and find out more from your GP.

One final note: if you are interested in finding out more about ovulation but can’t attend one of Nat’s seminars, you’re in luck! Debunking Ovulation is just about to be made into a podcast.

Laura

Fertility Fridays: best fertility boosters

Leafy greens are great for fertility (and just generally everything).

Leafy greens are great for fertility (and just generally everything).

When it comes to keeping yourself fertile, there are a number of things you can do to ensure everything is in top shape in that area. By making a few tweaks to the things you put in your mouth, you can help support your reproductive system. Of course, there are many other factors that affect fertility but we shouldn’t discount the effect of the things we put in our gob.

Without further ado, here is my list of top fertility boosters:

Avocado

Along with being a fantastic source of protein and fat, this little baby is a nutrient power house and is high antioxidants, rich in fibre and just generally all kinds of amazing. And, get this guys, avocados take exactly nine months to ripen from the date of flowering. Remind you of something else that takes nine months to grow? If you’re still not convinced, cut an avocado in half and check out what it looks like (hint: a woman’s body encasing a womb). Yup. Avocados are amazing.

Leafy Greens

Leafy green plants like spinach, silver beet and kale are non-negotiable. These guys, along with the rest of their vegetable friends, contain an array of vital minerals and nutrients that can help to balance your hormones. As a bonus, the more veggies you jam into your diet, the less room there is for not-so-brilliant food, which may help you to lose weight.

Protein and Fat

Hormones are made of protein and fat, which means it is absolutely vital that you are getting enough of these two things in your diet. In my opinion, the push to switch to low-fat food has been one of the most devastating things to happen to our health. Our bodies need fat. If we aren’t getting enough fat, our body freaks out and shuts up shop on the fertility front because we don’t need to be uber fertile to survive whatever famine our body thinks we are experiencing.

Protein is equally important and we should be loading up half of our plates with the stuff (with the other half being veggies). Either go for high-quality, locally grown organic meat or, if you prefer plant-based protein, try something like chia seeds, hemp seeds or pea powder. I like the Vital Greens brand. You can add all three of these things to your smoothie or sprinkle them on your breakfast.

The two Ms (Maca and Mesquite)

I spoke about maca in last week’s Fertility Fridays but it does such amazing things that I thought it deserved a place in this list too. Maca (also known as Peruvian ginseng) helps to rebalance whatever hormonal issues you may be experiencing, it stabilises your mood and boosts libido. Hello, maca.

Mesquite is one of the most antioxidant-rich foods we know about. Its other claim to fame in the fertility arena is its ability to stabilise your insulin, which is important if, like me, you have a history of polycystic ovaries.

Organic, Organic, Organic

This one is pretty straight forward. If you want your reproductive organs to be running at their best, you should avoid the fungicides and pesticides that go hand-in-hand with non-organic produce. These days, you can access organic produce for comparable prices to conventional produce. Try your local farmers market or, if you prefer someone else to do the hard work of shopping, get it delivered. Companies like CERES Fair Food are great.

Of course, if you feel you need a bit of extra help to sort out a specific issue you may be having, I suggest you go to a natural fertility expert. It might also be worth asking your doctor to test your hormone levels so that you know what area you need to focus on. Despite what some doctors will have you believe, there are natural ways to balance your hormones. The power is yours.

Laura

Fertility Fridays

Welcome to Fertility Fridays!

I was contemplating doing one mega post on fertility and then quickly realised that there is so much to cover on this topic that it deserves its own series. So, here it is. Post one of Fertility Fridays: my story.

This pic was taken shortly before I was diagnosed.

This pic was taken just before I was finally diagnosed with polycystic ovaries after a year of tests, when I was still very much experiencing a case of not seeing the forest for the trees.

It took 14 months, nine doctors, three blood tests, one trip to the emergency department, one ultrasound and countless misdiagnoses for me to discover that the excruciating pain I had been experiencing was caused by polycystic ovaries.

After that lengthy and stressful process, I was exhausted and at my wit’s end. My symptoms had gotten worse: my hair was falling out, I was moody and my period was MIA. I was almost constantly in pain and I had well and truly had enough. I had also spent enough time at various doctors’ clinics to realise that they didn’t have the answer I desperately needed.

They couldn’t tell me how to correct the imbalance. I should make it clear that I don’t think the doctors deliberately mislead me. Far from it. They just didn’t have the framework that I needed to find a solution, as opposed to a bandaid. Don’t get me wrong, I’m all for bandaids. I think they’re a fabulous invention. Sliced your finger open? Whack on a bandaid. Popped a blister? A bandaid is your best mate. Fix your ovaries? Maybe not.

I’m all for bandaids. I think they’re a fabulous invention. Sliced your finger open? Whack on a bandaid. Popped a blister? A bandaid is your best mate. Fix your ovaries? Maybe not.

I turned down the doctor’s suggestion of putting on a bandaid (aka, going on the Pill) and, in doing so, closed the book of options that the conventional medical field could offer me.

Not being one to easily accept defeat, I decided to give naturopathy a go. I was lucky enough to quickly get a booking with, who I consider to be, one of Melbourne’s best naturopaths. He immediately suggested that I strip my diet back to basics and cut out all processed, refined, acid-forming foods for a month. I needed to give my abused body a break so that it could start to repair itself.

I needed to give my abused body a break so that it could start to repair itself.

At the same time as overhauling my diet, he put me a strong probiotic to help eliminate any candida and sort out the gut issues I was experiencing.

The ultimate goal of all of this was to reduce the estrogen build-up in my body (a common problem in our plastic-obsessed Western world). It turns out that my issues were stemming from my bowels. My body was so overloaded with toxins that my bowels simply weren’t able to keep up with getting rid of them all.

OK, let me back up a couple of steps and explain what I’m talking about. During every woman’s cycle, the body builds up a store of estrogen. This additional estrogen should then be expelled via bowel movements. If your bowels aren’t working properly, they can’t get rid of all of that estrogen, which means it gets absorbed back into your body. The cycle will continue to repeat itself every month unless the issue is corrected.

This overload of estrogen wreaks havoc on your endocrine system (your whole body, really) and can contribute to issues like polycystic ovaries and endometriosis. I’m not saying it’s the only cause of these issues but in my case it certainly played a big role.

When the month was up and I was free to return to my old diet, I found that a lot of the food I used to eat held no appeal. While I eased up on some of the really strict guidelines (like no high-sugar fruits, such as mangos), I largely stuck within the parameters and my body repaid me in spades. My period came back, my hair stopped falling out and my PMS almost completely disappeared. These results were far better than anything I imagined possible. One of the symptoms of polycystic ovaries is inconsistent ovulation (and hence periods) so I was beyond thrilled when my cycle fell into a 28-day pattern. Yep, you read that right: thrilled. Anyone who has suffered from irregular, or completely absent, periods will know what I mean.

Over the course of the following six months, I worked with my naturopath to bring my body back into balance and I learned so much about how to protect my fertility – not because I wanted to have a baby (fertility is about so much more than that) but because protecting my fertility meant I was protecting my health. And in my eyes, that was (and still is) my number one priority. There are so many things I want to achieve in my life and to do that, I need a healthy body. Fertility is just one, albeit very important, part of that.

There are so many things I want to achieve in my life and to do that, I need a healthy body. Fertility is just one, albeit very important, part of that.

I look back now and I’m glad that I developed polycystic ovaries because it was the catalyst for so much change in my life. I benefit every day from what I learned during that intense period of healing. It completely changed my perspective on a lot of things and it helped put me on the path I’m following today, and for that I’m incredibly grateful.

Laura