A Fabulous Year of Love!

Near the end of 2012, I bought this ornament for our Christmas tree:

Anthony & Alison
2013 - The Best Year Yet!

We were about to become parents. Something we had wanted so badly for such a long time. I didn't want to celebrate until that baby was in my arms but I couldn't resist this ornament and I wanted to celebrate every second of my new year and best year of my life to come with my new family.

This is me on Christmas Day 2012:

And about a week and three days later in 2013 we got the best gift we could ever ask for:

Little Eva Violet 'Peanut Butter, Booba, Cakes' Ciaccio arrived. She spent 3 loooooong days coming down the pike but she came out with her eyes wide open, looking around at this new world and checking out her parents. To say this was life changing doesn't even encompass how we felt holding this little miracle. How do you explain the best thing to ever happen in your life? She was here, healthy and all ours. We didn't have to give her back!

2013 was a year of firsts, a year of total bliss and some tears along the way, ours and hers. We are responsible for this brand, new life. That's overwhelming at times. When she was a couple weeks old I pretty much thought I had already ruined her life. I can't even remember what it was about but I remember crying to my husband about it. Let's just say those first three months were a hormonal roller coaster of emotion and breastfeeding and no sleep and crazy joy and just crazy, crazy! But I loved every second. Even the seconds of pain, I was happy to be enduring and I am not just saying that with rose colored glasses. I was in those moments and was happy with every second of them! Gratitude abounds!

The year in review...in case you haven't seen enough pictures of my daughter :)








We made it through this first year and that's definitely something to celebrate. We kept her alive and she grew and did all of her cute (and smelly) baby things! Cheers to 2013 and here is to another new year ahead of more firsts and lots more joy and love. xxoo

Eva's first Christmas 2013

Reposting - The Second (and Third) Opinion...Sher Institute (SIRM)

This is worth repeating...so I shall repost! This post gets the most visits on my blog.

When I read it over again I feel like I did back in March 2010. I had hope and drive but I was also reeling from the crushing pain of getting a negative pregnancy test every month. I didn't know at that point that I would have to wait another two years until I saw two lines on a pee stick, which at that point had been going on for about three years. But that's the thing - I got to see the lines and I am forever grateful for that.

It all started because I didn't want to accept the diagnosis of unexplained infertility. I am stubborn and persistent and I wanted an answer. I thought about it all of the time, read my test results, then decided to Google "unexplained infertility and immune system." I came across Dr. Sher and SIRM. It was meant to be because at that time I was living in the Lehigh Valley, PA and it just so happened that Dr. Sher was going to be in my area within the week doing a seminar about SIRM. What are the freakin' chances??? Well, chances were good since SIRM had a NJ office that was near my place in PA :)

The post was my best attempt at explaining what I found out at the seminar, which in later years (fast forward to Dr. T in NYC) was how I became pregnant.

Enjoy!

               The Second (and Third) Opinion...Sher Institute

                                   Monday, March 29, 2010

I am going to be completely honest here. I do not trust most doctors. Yes, they have more schooling than me and know more than I do. But they are not god and they do not know everything. It doesn't mean I don't like them or respect some of them but I go into their offices knowing that they do not know it all.

I've been through two Reproductive Endocrinologist offices in the past two years and also two OBGYNs and I have pretty much gotten the same answers from all of them, which is that they don't know why I am not getting pregnant.

All the tests (for the most part) have been done on me and I have come out with no issues or abnormalities. The same goes for my husband. So what gives? 

With the diagnosis of "unexplained infertility" the doctors I have seen take a "one-size fits all" approach to infertility and just move me onto the next level of treatment. It becomes a shot in the dark for them but that isn't Ok with me because this is their "specialty" and they should know more and I am not a guinea pig.

I haven't had any treatments in 6 months and have been on a break from all of it. It's been a nice break because I've had time to calm my anxiety and just be in the moment instead of always looking one month ahead.

But over the weekend I had a chance to meet three men, one in particular who really, really impressed me with his knowledge, thoughtfulness and just general empathy for infertile couples. Up to this point, I really have not felt that way about any doctor - ever!

They were the doctors at the Sher Institute for Reproductive Medicine (SIRM). The man who started the group is Dr. Geoffrey Sher and he spoke to a room full of infertile couples on Saturday about his love of reproductive medicine and all that he knows about it.

My husband is the ultimate critic when it comes to the doctors we have met thus far and even he was  impressed.

Dr. Sher's approach is that he doesn't stop at the basic tests and he doesn't take the easy way out. He was the first to open private fertility clinics in the U.S. in the early 1980's and he studied under the men who pioneered IVF. Dr. Sher is a pioneer himself and takes to treating the cause of infertility rather than the symptom.

What I learned at this seminar is that he likely knows more about reproductive medicine than most doctors anywhere. He wasn't obnoxious about his knowledge or a "know it all" but rather he showed great compassion.

He talked about issues that you wouldn't hear your everyday RE doctor talk to you about. It is beyond some of them and sometimes people don't want to expand upon what they already do and how they treat it. But the sense you get from the doctors at SIRM is that they are always thinking ahead and beyond.

They are pushed to think outside the box and they know that not everyone is the same when it comes to infertility.

Here are some of the things I gathered from the seminar:

1. The uterus has to be receptive to the embryo for implantation and pregnancy to occur. If it is not, then continued miscarriages can occur. What this means is that if the uterus and embryo are too close genetically then the body can reject it. This is where the doctors at SIRM have pioneered tests for immune issues causing infertility. The explanation below is from Dr. Sher's fertility blog,IVFAuthority, and explains these immune issues.

There are two (2) forms of immunologic implantation dysfunction. The first and by far the most common is autoimmune implantation dysfunction. This variety is usually easily and successfully remedied through treatment with heparinoids (e.g., Lovenox, Clexane), Intralipid (IL), and corticosteroids. The second variety which is often ignored or overlooked is alloimmune implantation dysfunction.

Autoimmune implantation dysfunction is by far the most common variety. It is believed to be implicated in >90% of cases of immunologic implantation dysfunction and occurs when an immunologic reaction is produced by the individual, to his/her body’s own cellular components. Aloimmune implantation dysfunction on the other hand, arises through the reaction of the uterus to an embryo that shares certain genetic (genotypic) similarities (DQa and other HLA genes)with the recipient’s uterus causing immune cells known as natural killer (NK) cells that populate the uterine lining, to start over-producing “ toxins” known as TH-1 cytokines (TNFa and Interferon gamma). Such activated NK cells (NKa+) attack the cells of the embryo’s “root system” (the trophoblast) damaging it and so compromising implantation. Alloimmune implantation dysfunction, while far less common than the autoimmune variety is considerably more complex, much more poorly understood (even by most RE’s) and far more difficult to treat successfully. It involves a reaction by an otherwise normal uterus to the intrusion of one or more embryos that through the contribution of sperm DNA share certain immunogenetic (genotypic) similarities with the recipient.

2. This issue that arises when the uterus and embryo are too close in generic makeup leads to a "natural killer cell" issue. The good news is that in most cases this issue can be resolved with medication called Intralipid.

3. There are tests that can easily be done to find the natural killers cells and to see if you are and your partner are a DQ match. The excerpt below is from Dr. Sher's blog:

For some reason, there is a tendency to consider all couples with alloimmune implantation dysfunction (who share DQa similarities) to be incapable of achieving a viable full term pregnancy. Nothing could be further from the truth.

Let me explain: Each individual has two (DQa’s), one is derived from their mother and the other from their father. The fact that many individuals carry identical DQa's (i.e. both are the same), of necessity means their parents must of necessity have had “matching” DQa’s and yet they were born healthy and normal. The reason is that it is not the “matching” DQa that matters. It is whether upon arriving in the uterus, a DQa “matching” embryo encounters activated uterine natural killer cells (NKa+). These NKa+ release large amounts of TH-1 cytokines that attack and damage the cells of the embryo’s “root system” (trophoblast).It is the extent of such trophoblastic damage that will determine whether such an embryo will immediately “die on the vine” (implantation failure) or “limp along” for some time only to be aborted a few weeks later.

4. The SIRM doesn't just accept an "unexplained" reason for you not getting pregnant. This was the biggest factor that made me get up at the seminar and make an appt to see Dr. Peters (one of the docs at the Lehigh Valley office) tomorrow (March 30). Read below for Dr. Sher's insight:

Unexplained Infertility: True Diagnosis or Cop Out?

For about 10% of all infertile couples, the cause of the infertility cannot be readily determined using conventional diagnostic methods. Such cases are often referred to as "unexplained infertility." The truth, however, is that in most such cases, this diagnosis is in fact “presumptive” because a more in-depth evaluation would have revealed a cause.

I feel very strongly that most RE doctor's are not really looking at individual patients and their needs and are just trying what they can because it may have worked for someone else. Many patients go to the Sher Institute because they have exhausted all other possibilities. They specialize in IVF but don't be deterred if you are not at the point yet, emotionally or financially.

I am going into my appt tomorrow with an open mind. This may or may not be the answer for me but at least I am following my gut to a place where I might get more answers.

Even if you are happy with your current RE - take a look at Dr. Sher's blog. It is a wealth of knowledge and insight and you can search for any topic. 

Breastfeeding is a mindF#&K!!

I am 19 weeks into motherhood and it's been crazy!!! Crazy good, crazy awesome, crazy-i-think-i-will-lose-my-mind-soon. Just crazy crazy. Just like my sweet little peanut, I too can cry and laugh all in the same breath. That's what raging hormones on a roller coaster mixed with a lack of sleep mixed with breastfeeding will do to you.

We will all have different experiences as mothers and this is just mine but seriously, who would have thought breastfeeding - one of the most natural things a woman can do - would be so damn complicated, thus the title of this blog post.

For the first three months of Eva's life I nursed her every hour. I would be sitting on the chair in my living room when my husband left for work in the morning and still be there when he got home. I barely made it to the bathroom or ate. Thank god my mom was here for a week feeding me and doing my laundry. And if my mother in law also didn't make food for us, I would have just gnawed on my arm.

And the pain was awesome too, well no, not really. I saw stars when Eva would latch, like in cartoons when a character gets hit over the head. I saw them and they sucked. My husband likely thought I was an uncontrollable lunatic during that time. I wonder if he thought he was ever going to get his normal wife back.

But alas, I finally called someone to help me. I waited so long because I thought it was supposed to hurt and you were not supposed to sleep or get a break and that was just how my baby was. WRONG!!

I called a lactation counselor/postpartum doula who saved me (and my nipples)! Little Miss Eva was tongue-tied which means her tongue movement was restricted due to an attached frenulum (that skin under your tongue). In other words, her latch wasn't great and she was working overtime to get milk because her suck was lacking.

When my LC, Kathy Koncelik, came to my house and found Eva's tongue-tie it was as if the darkness had been lifted and I was reborn. There was hope and breastfeeding didn't have to be do damn painful, which it is not supposed to be at that point!

Needless to say, we had the issue fixed with a quick snip of the frenulum by a lovely doctor in NYC and Eva was latching and nursing like a champ! It wasn't all rainbows and unicorns after that...there were still times when I continued to doubt my supply and that constant question of "was she getting enough??" still lurked in the background. But after Eva gained a pound in 10 days I knew things were working out. Also I have no more pain in the nips! Yahoooooo!!!

This isn't me but I love this pic!

Here is what I would do differently. Call a lactation consultant/postpartum doula from DAY 1. After that baby pops out, have an LC at your house when you get home or when your milk comes in. IT IS SO WORTH IT!!!

I am stubborn and also I hate quitting or giving up on anything. So breastfeeding became a mindf&*K because I wanted to continue so badly but the pain and constant nursing was weighing on me. I remember at the time saying to my husband that breastfeeding was the hardest thing I had ever gone through in my life. I was really down in the dumps.

My sister in law who gave birth five weeks before I did had other issues with bfeeding. Her supply was too much and my niece was choking and spitting up and it was just a mess. Then when she went back to work and tried to pump she got barely anything. She changed from an electric pump to a hand pump and that has worked out for her but not before she lost her mind in the process.

Thankfully we both have our minds back (well partially anyway) and breastfeeding is moving forward. During some of our dark hours we would talk about calling it quits and going to formula but both of us are determined women so if we had to pump extra for each other for the next 6 months to make sure both of our babies were breastfed, we would do it. That's mommy drive for ya!

Eva Violet has arrived!!

Well between my last post and now, I am sure you assumed that I had the baby and no, I am not a month late :)

Eva Violet at just a few minutes old! 

My little miracle baby decided she wanted to arrive five days before her due date then at the last minute thought that she should take her good old time making her way down that birth canal. So some 72 hours after my contractions started, little missy was born. Not in the way I had (fully) hoped but she was born healthy and happy and that is all that counts!

So here is the birth story: My contractions started on Wednesday, January 2 at midnight and continued throughout the night at 15 minute intervals. We waited until the morning to check-in with my midwife and doula. I was prepared for a home birth and had everything set! My midwife and doula arrived at my house Wednesday evening and I was dialating and my contractions were closer together and much stronger.

I labored all over my house...in the kitchen, in my living room hunched over furniture. On a birthing ball, on the toilet and in a kiddie pool in my living room. We really thought we were getting close and by around 2 am on Thursday we thought she was coming out soon. I got into the pool and I guess it was just too soothing bc the contractions slowed and not much happened. About 90 minutes later I was out of the pool and still in labor but no baby yet. She was making mommy work!

At some point in the early morning hours I got back into the pool but still nothing was moving forward. Things seemed to be stuck. All was fine with both our vitals so we continued to try other things. I laid in bed for a while and got a  little rest. Then I was back up swaying from side to side in my kitchen...saying "down and out" over and over again. I was using my hypnosis that learned from Hypnobabies throughout all of it. I was in the "off" position or "center" and really working on pointing the anesthesia where it needed to go! I was all about the "peace" cue and that got me through a lot of it.

I was also listening to the Hypnobabies recordings...fear-clearing, deepening, birthing affirmations and pushing the baby out. But this particular baby did not want to come out just yet. But I didn't want to give up on my hope for a home birth. So I got a second, third and fourth wind and pushed through. I was determined to make this work.

The rest of the day on Thursday just sucked but I did whatever I had to to get this baby down and out! But she had other plans and it did not involve a home birth. So by Thursday night, after my water had been broken for more than 12 hours and I was actually regressing (went from 8 centimeters back to 5-6) we had to make the decision to transfer to the hospital. I was dehydrated and hadn't slept in two days and after two days of labor without pain meds, you could say I was beat.

I was still having strong contractions about every 2-5 minutes so off to the hospital we went!! I was lucky to be going to the hospital with the lowest C-section rate on Long Island. I met another midwife there and she was awesome! They got me into a room right away and then an epidural and then I was in La-La land. I needed to sleep and rest and that is what I did for the next 24 hours. Yes, that's right. I still had to wait another 24 hours for this little petunia to be born!

So while resting all day Friday I dilated and was all ready to push by Friday night. Two hours of pushing and little miss cone-head was born at 9:47 p.m. She is just perfect and still is!!

There is a part of me that is disappointed that my home birth didn't happen and that i ended up at the hospital doing the things I didn't want to do. But it's a small part that gets smaller everyday and is trumped by the fact that I am lucky enough to have this beautiful, precious baby girl in my life.