Drug Interactions and Supplement Absorption Crazy

Someone in my Facebook Reproductive Immunology Support group (LINK HERE: this is group of knowledgeable and sassy ladies that have helped me beyond measure.   If you feel that you require RI help or have something to contribute, please make your way over there and join us) pointed out that I was taking my calcium at the completely wrong time.   In fact, she said,  I should not be taking it with iron (i.e. my multi-vitamin), but should be taking it with my vitamin D.

This sent my crazy brain into overdrive.  Shouldn’t I be taking my medications in a way that maximizes each and minimizes the less than ideal interactions?    OF COURSE I SHOULD.  I am still trying to decide if the subsequent hours of googling/reserach are the mark of intelligence or excessivism, but maybe I will just settle on a little bit of both?  Here’s a peek into the sticky note from my desktop:

no vitamin E with fish oil
no vitamin E with aspirin
no vitamin E with prenatal
no vitamin E with metanx
no vitamin E with Lovenox
no doxy with prenatal
no doxy with calcium
no doxy with aspirin
no doxy with any vitamins
no doxy with fish oil
no metanx with aspirin
no metanx with d
no metanx with fish oil
no metanx with vitamin E
etc…

I am a night owl by nature, so that is a bit of a roadblock for me in terms of spacing medications properly/psychotically.   Also, I will be relieved when the Doxycycline is out of the lineup, so I can move things around a bit.     Either way, I now have a medicine schedule that has me injecting or swallowing a pill nonstop.  Fan-tastic.   Behold my crazy:

10AM – Lovenox, Doxycycline
12PM – Prednisone
2PM – Estrace, Vitamin D, Calcium
4PM – Vitamin E
6PM – Metanx
8PM – Calcium
9PM – EV2, Progesterone, Prenatal
10PM – Lovenox
11PM – Doxycycline
12AM – Probiotic, Baby Asprin, Fish Oil

An Anti-Inflammatory Diet for Infertility

10259325_10152432689699602_7098055327429859716_nAs I gear up for a fall FET, I’ve been slowly working towards following an anti-inflammatory diet. I came to this decision after talking to Dr. Braverman, researching on the internet, and discussing the inflammatory properties of food with the woman in my Reproductive Immunology Support group.

The stress of inflammation has been linked to several infertility diagnosis including PCOS, endometriosis, recurrent miscarriage, poor sperm and egg quality.

The following are things I have been limiting or eliminating from my diet:

Caffeine
Alcohol
Gluten
Dairy
Sugar and Artificial Sweeteners (Aspartame is evil)
Soy
Nitrates
GMO’s

Keep in mind a few things:
1- I am not a doctor
2- Prior to this I generally stuck to mostly organic foods and tried to limit the consumption of GMOs

As a NYC girl whose adores espresso, bourbon (generally not together) and restaurant hopping around the city, this has been quite an adjustment for me. I have no problem giving up gluten, I have done it in the past and I am comfortable creating meals and snacks that work for a gluten limited diet. Having said this, I was tested for celiacs and I do not have it, so my goal is to cook and snack as gluten free as possible, but I will not beat myself up for cross contamination or the occasional mistake.

Saying goodbye to coffee and dairy has been an absolute fight. I love coffee with cream. Not for the caffeine, I’ve learned, but I love the flavor and ritual of coffee. I’ve been working towards drinking decaffeinated coffee (Nespresso or Starbucks) with coconut milk. However, the RI group informed me that even decaffeinated coffee is bad for blood flow issues (one of my problems). Tell me I have to give up cheese for a year and I think OK that’s doable, but take away my coffee and I spiral down in panic.

So what am I eating? That will be answered in the second part of this series of posts. Stay tuned.

Have Embryos, Will Travel

FrostiesYesterday we transported our embryos from RMA of NJ to SIRM NY.

It was not a quick process. The transfer paperwork and coordination took a few months to complete, then plans needed to be made to synchronize the 2 labs (and pickup/dropoff times), next we had to schedule the day off work, and last drive through the Lincoln Tunnel 4 times in a 6 hour period.  At the final leg, we handed our 2 hard-earned-over-6-fresh-cycles PGS normal embryos directly to the head of embryology at SIRM. Today, she e-mailed me to let me know they both made it safely.    I am so relieved to have that process behind us.

Yesterday I realized I was not happy (nor comfortable) setting foot on RMA of NJ property. It dawned on me that I am harboring quite a bit of anger towards the clinic in general as well as our former RMA doctor, Dr. Morris.

She dropped the ball and she gave up on us.  In fact, for the last year of our cycle she was on a hardcore, restricted calorie diet and became difficult and rude.     She stopped calling.  She stopped following up.   She passed too many important conversations off to our nurse. In fact, her last voice mail to me said “there is nothing else we can do for you.”  However, she would of allowed us to cycle on the same crappy protocol over and over, just taking our $$ and not making any changes.

I know RMA of NJ is ranked as one of the best clinics in the country.  But be aware, it comes at a price.  It’s such a large facility that you could complete multiple IVF cycles and never see your actual doctor.   I would recommend that if you are planning to cycle at RMA of NJ, that you choose these 2 founding doctors:  Dr. Scott or Dr. Bergh, or Dr. Kim.      Especially if you are a difficult case.   Keep in mind though, in the end, they wanted nothing to do with our difficult case, well nothing but our money.

That’s a bitter pill to swallow after 6 IVFs, a failed FET of a PGS normal that I miscarried 9 weeks, and the donation of our entire savings.

Allergens

I am at the allergist with egg yolks and whites all over my arm. They are trying to determine if I am allergic to eggs.  I react to them sometimes and apparently intralipids are egg based?

The things you learn.

Proposed Immune Protocol for FET

Supplements (daily):
Vitamin E (400-600iu), Vitamin D (2000iu), Calcium (500mg twice a day), Fish Oil (1000mg), and Probiotics

FET Medications
Prenatals
Lupron 10 units
DelEstrogen Injections
Estrace Pills
Progesterone in Ethyl Oleate (100ml / 2m l)
Doxycycline

Immune Medications
Metanx
Baby aspirin
Prednisone 20-30mg
Lovenox (30mg 2x a day until first ANTI-Xa)
Intralipids