Monday, December 28, 2009
I wasn't sure what to expect from Christmas this year, but decided go along with whatever came up. Christmas Eve, Steve and I had our own holiday celebration with an elegant dinner at Starkers, watching big snowflakes fall on the Plaza. We spent the rest of the night with my family. I knew this would be a hard year since my 27-year-old nephew, Jack, passed away in August. Christmas wasn't the same without him; we could all feel it, especially his mom and dad.
Even though I didn't decorate or put up a tree this year, I found my motivation in acquiring a good eggnog recipe. I made a total of six batches of Alton Brown's fabulous eggnog. It was perfect! Of course, a holiday cannot go by without making my sugar cookies. I made a few dozen for my brother, but he was snowed in on Christmas Eve, so we've been snacking on them.
Steve and I spent all of Christmas day lounging. We ate pistachios and sugar cookies, drank eggnog, and looked at the 12 inches of snow outside, feeling grateful to stay in. We made our Christmas dinner at 9pm: broiled lobster tails. On December 26, with the city still covered in snow, we finally left the house to meet up with others at La Bodega and ended the night with wine at Cafe Trio.
Someday I'd like to host Christmas brunch, so I practiced on Sunday with Ina Garten's French Toast Casserole. It's a recipe that's definitely company-worthy. We finished our holiday weekend at my sister's house for a Mexican-themed dinner. Our handmade margaritas were a hit, and I also made one of my favorite dishes, Chilaquiles Casserole.
This holiday was all about food, drink, and lounging. My astrological sign is Cancer and my Chinese zodiac is Pig. Cancer-Pigs love everything luxurious: good food and relaxing in comfortable surroundings. Yep, sounds like me. No wonder I enjoyed my Christmas this year! I hope yours was good, too.
Sunday, November 8, 2009
What got me through all the years of spending holidays with "other" families was the hope that someday I would have my own family to share the holidays with. I dreamed about shopping for my children's gifts and imagined their delight as they unwrapped presents from under the tree. I thought about the meaningful family traditions we would create that would be all ours. Dropping by other people's homes on Christmas wouldn't be such a chore because I would have already had my "special" family time.
I've tried different strategies to help the holidays be more joyful. I've decked out our home with creative holiday decorations, threw a festive holiday party, adopted a needy family... But the disappointment was still there. So, I've decided this year I'm only going to participate at the level I am comfortable with. It's doubtful that I will be going to other people's homes to witness their nuclear families being together - a reminder of what I lost almost 20 years ago and what I have not been able to recreate in my own life.
I haven't decided what good replacement activities would be on Thanksgiving and Christmas. Serve dinner at a homeless shelter? Sounds depressing. Take a trip? Just stay home and make an awesome dinner? Pretend like it's just another day, except my husband happens to be off work?
Creative suggestions are welcome.
Monday, November 2, 2009
- No sugar
- No dairy
- No caffeine
- No alcohol
- No wheat
One of the hardest parts is anticipating how our social life will change. So much of what we did with friends and family was centered around good food and drink. I have a feeling we will be seeing lots of movies this winter...
Fortunately, we both love rice noodle soups.
Wednesday, October 21, 2009
Last winter, I started making this chili recipe from Cook's Illustrated and it's great. It's also super easy and fast, so I made some tonight.
Quick Beef and Bean Chili
2 (16-ounce) cans kidney beans, drained and rinsed
2 (14.5-ounce) cans diced tomatoes
1 1/2 pounds 85 percent lean ground beef
1 onion, chopped fine
4 garlic cloves, minced
3 tablespoons chili powder
2 teaspoons ground cumin
2 teaspoons sugar
1/4 cup chopped fresh cilantro (optional)
Process half of beans and half of tomatoes in food processor to coarse paste; set aside. Cook beef and onion in dutch oven over medium heat until meat is no longer pink. Stir in garlic, chili powder, cumin, and sugar and cook until fragrant, about 1 minute. Stir in pureed bean-tomato mixture and remaining beans and tomatoes.
Bring chili to boil, then reduce heat to low and simmer, covered and stirring occasionally, until thickened, about 15 minutes. Off heat, stir in cilantro (if desired) and season with salt and pepper.
Thursday, October 15, 2009
- Drink a lot of wine. And tequila.
- Figure out how we’re going to pay off the $50K in medical bills that we’ve amassed so far in 2009.
- Forget about #2 and take a tropical vacation that involves lots of alcohol and a temporary escape from reality.
- Do hard-core cardio, lift weights, and do hot yoga.
- Paint the living room without worrying about inhaling paint fumes. Maybe paint the whole interior, even the furniture.
- Find a job since I can’t re-enter my graduate program until fall 2010.
- Work on a creative project I’ve been contemplating for years.
- Plan an elaborate Halloween costume because it looks like I’ll be partying this year.
- Drink more wine.
- Pick another clinic and start this physically, emotionally, and financially exhausting process all over again.
Wednesday, October 14, 2009
Being raised in a pretty conservative Christian environment, I often rubbed elbows with evangelical Christians. My mother regularly watched the 700 Club and listened to irrational preachers when they made claims: If you give your daughter dancing lessons, she will grow up to be a stripper. Consequently, I never got to take ballet or tap. My mom was determined to spare me God's wrath by avoiding the evils that could so easily result from a 5-year-old girl taking ballet.
I know my mom meant well, she loved me dearly, but I think it came down to her desire for someone else to think for her. She didn't want to make decisions in her own life, so she deferred that task to others. Perhaps that is what attracts followers to the religious right? There is no gray area, no perceived uncertainty. When things are black and white, and right and wrong, your ability to reason proves to be unnecessary.
I wonder if these little girls will grow up to be strippers.
Saturday, October 10, 2009
Thursday, October 1, 2009
Unless you’ve been through IVF (in-vitro fertilization) or known someone who has, you may not realize how involved it is. Everyone’s protocol is different, some more complicated than others. I do 3 to 5 injections a day to prepare my body. I spent 5 hours today receiving intravenous immunoglobulin therapy from a nurse who came to my house. I will remain on two injections and the immunoglobulin therapy if pregnancy occurs.
I now live by a calendar that micromanages my life with medications, blood draws, doctor appointments, and ultrasounds. I’m not complaining; I wouldn’t have it any other way. I love knowing I'll be able to look back in 5 years and believe we did everything possible.
It’s hard for me to understand not understanding fertility issues. It's my nature to become well informed and my tenacity put us in the hands of some exceptional physicians. For those who want to offer support to a friend or loved one going through something similar, my advice is to realize how important and consuming it is. Validate that, even if you can’t relate. A huge amount of resources is devoted to an IVF cycle (emotions, health, finances, time), all indicators of its importance. Perhaps it's uncomfortable talking about something so “personal” but remember it’s a medical issue. Treat the person as you would someone going through any type of surgery or treatment.
Next week is our egg retrieval in St Louis! I plan to take care of myself with activities that foster relaxation, and join with those who are sending prayers and good thoughts our way. Other than that, I have done all I can. The rest is out of our hands….
The view from my bed for 5 hours today.
This is an evil Lovenox needle. I think the marketing team deliberately made the syringe clunky to reinforce that these injections hurt like hell.
Follistim did a much better job at packaging their dial-a-dose injection pen. The needles are tiny and sharp and slide right in.
Morning injection is also a tiny little needle.
Wednesday, September 9, 2009
I also think I might be brewing up another topic for future research: Sexism in fertility diagnostics and treatment. For instance, some physicians fall short in addressing or acknowledging the male's contribution to a couple's fertility issues. More to come on this exciting subject!
PS: I'm humbled at the timeliness of how things unfold! Within hours of posting this entry, I discovered my own physician in St. Louis started a blog and is devoting equal time to discussing both female and male issues related to fertility. Awesome! Thanks, Dr. Ahlering.
Saturday, August 29, 2009
Shortly before Tony died, I read a book that changed my life, a book that could be dubbed as The Idiot's Guide to A Course In Miracles. I believe when we are seeking, it's not coincidences that are brought forth as lessons, rather, a heightened sense of awareness grows in response to our seeking. In other words, things are there all along, we just haven't developed the context to see them.
When Tony was sick, I consulted with a talented woman who provided a "reading" that bridged the gap between two loved ones - one who was too wrapped up in the physical world and grieving too hard (me) to directly receive the words of a more enlightened being (Tony). His words that she passed on have been carried with me in a small red envelope for 3 years. While dealing with the grief of my nephew's transition, I am reminded that this physical experience we become so tied to is just one part of who we really are.
We have a little secret. We are all one. So I'm not really going anywhere. It's an illusion, an adventure, a play. You will wake up shortly and I will be there.
Saturday, August 15, 2009
The International House of Prayer offers 24-hour prayer and worship services. That's right, church around the clock, 24-7. This idea is modeled after some Biblical story with King David, tabernacles, and day and night worship.
I grew up in a church where black and white was taught: right vs. wrong, sinful vs. holy, you get the idea. I was confused about the other "christian" churches that had different beliefs and rules. To help me reconcile the conflicting messages, my mother told me she'd pondered the same question and received a revelation that: They are all right.
Holy crap. That's the wisest thing I ever walked away with in the context of my religious upbringing. It's true; they are all right - Buddhism, Islam, Christianity. But here's where they are wrong: When they tell other people, "there is only one way." When they tell people, "my way is the right way." When they tell people, "you must think and believe like me."
Thursday, August 13, 2009
Reproductive Endocrinologist: We found a knowledgeable and caring physician in St. Louis for our IVF cycle.
Reproductive Immunologist: I've been working with Dr. Kwak-Kim in Chicago for a year. She is the past president of the American Society for Reproductive Immunology and has dedicated her career to research of the immune system's role in human reproduction.
Acupuncturist: Mary Zhang specializes in fertility and has helped many people. Mary and her assistant, also Mary, are extremely knowledgeable and have pointed me to some of the best medical providers in the country. Acupuncture becomes even more important around the time of embryo transfer.
Midwife: This was an accident since I was really looking for a new ob-gyn, but I recruited the most wonderful midwife at my primary care physician's office. Jeanie is a breath of fresh air and doesn't criticize what she doesn't understand. She is excited to learn about our protocol and help out however she can, which includes drawing my blood and handing the tubes back to me so I can ship them to Dr. Kwak-Kim. How refreshing.
Therapist: Kris Probasco is a counselor specializing in fertility issues, has extensive understanding of ART procedures, and is familiar with reproductive endocrinologists and their practices throughout the US. She also runs an adoption agency, including embryo adoption.
Maya Abdominal Massage Therapist: Joan Schmeltz performs this ancient massage technique that can assist with things like getting a tilted uterus in its ideal position.
Hypnotherapy: I already wrote about working with a hypnotherapist in Denver. Since relaxation and a calm mind are important components to conception, I'll be utilizing the meditation techniques that Jim Schwartz taught me, along with some guided meditation CDs.
Tuesday, August 11, 2009
Monday, August 10, 2009
1 oz fresh-squeezed, strained lemon juice
1 oz fresh-squeezed, strained lime juice
2 oz simple syrup
2 oz premium tequila
1 oz Grand Marnier or Cointreau
Fill a cocktail shaker three-quarters full with ice and add listed ingredients. Shake and strain into a pre-chilled margarita or martini glass.
Gomers has Milagro Silver Tequila on sale for about $25.
Costco has the best price on Grand Marnier for $35.
OXO has a good, inexpensive juicer.
You can store lemon juice, lime juice, and simple syrup in the fridge in glass bottles.
Recently I was faced with the dilemma of eating breakfast at a cafe while inhaling second-hand smoke or eating breakfast at Sonic. Even though I chose Sonic, I'm still second-guessing that decision. Sonic doesn't use cheese on their breakfast burritos; they use a glossy, yellow substance that is supposed to look like cheese, but is probably received by the body as a foreign substance. After two bites, I gave my burrito to Steve. I managed to eat 3 deep fried french toast sticks while trying hard to ignore the ingredient list on the package of maple "syrup" and wondered if anyone consumes these things on a regular basis, and if so, how long do they live?
I have colon cancer on both sides of my family, which was my original motivation for adopting a healthier lifestyle and quitting fast food 20 years ago. When you go that long without eating it, fast food becomes terribly unappealing. It's so easy to eat fresh and healthy, and I'm happy more people are doing this, along with supporting local farmers, and demanding more organic products. Look into joining a CSA if you haven't already. Hen House's CSA program is a good one. I find many fabulous recipes using good ingredients - with reader reviews and suggestions - at epicurious.com.
Yikes! What is this?
Friday, August 7, 2009
All things ART-related fascinate me, so here’s some good stuff.
The American Society for Reproductive Medicine (ASRM) claims that:
- 1/3 of infertility cases are attributed to male factors
- 1/3 are attributed to female factors
- 1/3 are a combination of male/female factors, with about 20% of this population attributed to "unexplained" factors
The treatment of male-factor infertility can be treated with ICSI, where a single sperm is injected directly into an egg. The sperm can even be extracted by testicular tissue removal in a process called Testicular Sperm Extraction (TESE). ICSI with TESE is an alternative to vasectomy reversal, as well as sperm donation in the case of heterosexual couples. Patients should plan on spending an extra $2-5K for one or both of these IVF services.
Pre-implantation genetic testing (PGS/PGD) is an option that will cost you about $3-4K extra. Two physicians I’ve consulted with disagree on this issue. One is a big advocate, the other claims only a small percentage of abnormal embryos will implant anyway, so the body usually takes care of this on its own. Only 9 chromosomes out of 23 can be analyzed. A false-positive or false-negative occurs in about 10% of embryos. There's also a low risk of accidental embryo damage.
The Moral Police?
Physicians have been criticized for discriminating against single women, unmarried couples, and lesbian couples by refusing to treat them. This may not be the result of a physician’s personal beliefs; it could represent the religious/moral views of the affiliated hospital. In order to bypass any hospital obstacle, a physician would need to set up an independent practice like this one did.
ART can bring up some dilemmas few people think about (and why would you?). Most of them won’t apply to us, but they’re still interesting to ponder:
If you freeze your leftover embryos and decide you don’t want another pregnancy, what would you do with them?
- Destroy them?
- Donate them for research?
- Adopt them out?
If you’re on the receiving end of embryo adoption: How much genetic/background information would you want from the donors of the embryo?
Questions like these are why lawyers and embryo adoption agencies get involved.
Consider the use of donor eggs. Some conservative physicians won’t perform IVF on women with poor quality eggs. But the only true assessment of egg quality requires removing them from the body in the context of IVF. Blood tests and ultrasounds provide some information; however, major life decisions – having a child that is genetically related to you – are sometimes made based on these tests. Would you use donor eggs to increase your chance of pregnancy? As a woman, are you okay with carrying and having a child that is not genetically related to you? If so, when would you tell your child that he/she was conceived with donor eggs? Similar questions arise when donor sperm is used.
And Finally, the Multiples Issue
The ASRM provides guidelines on the appropriate number of embryos to be transferred. This is a decision that should be agreed upon by the physician and patient(s). The option of selective reduction should be discussed before a decision is made on the number of embryos transferred.
Blastocyst culture and transfer is a good way to prevent multiples. Blastocysts are embryos that are approximately 5 days old. The advantage is one of selection; fewer embryos (generally only two) are transferred, reducing the risk of multiple gestation. Blastocyst culture provides the embryologist with more information from which to choose the embryo(s) that are most likely to implant and become a baby. However, the ideal candidates are patients under 35 with a low FSH and large number of good quality embryos, or women using donor eggs.
Wednesday, August 5, 2009
Talk therapy can be beneficial in many circumstances, but can also be too linear since it works with the conscious or critical mind – the part of the brain that is analytical and logical. It’s not necessary to re-live anything during hypnosis, but I see the efficacy of working on issues while the mind is in a deeply relaxed theta state as a time-efficient method of therapy. We made huge strides in just 6 sessions last week.
Hypnotherapy isn’t for everyone. I work extremely well with images and visualizations, so it’s a natural fit. Jim has done extensive research and knows what underlying issues to target. He did a great job tailoring his treatment to my circumstances and I could tell he wasn’t utilizing a one-size-fits-all approach. I’ve worked with two hypnotherapists in my hometown but neither was a good fit – partly because they didn’t customize the sessions to my circumstances.
Jim claimed that some people go on to conceive naturally after hypnotherapy, sometimes while waiting for an IVF cycle. I’m not counting on that, especially since I start birth control pills next week (so my body can be completely manipulated with hormones over the next few months). I believe the emotional issues represent just one piece of the puzzle; but if performing meditation exercises on my own can help me achieve a more relaxed state, then that can only help during the IVF process.
One study suggests that hypnosis prior to embryo transfer doubled the success rate in IVF patients: 28 percent of women who underwent hypnosis became pregnant versus 14 percent who did not receive hypnosis. The study was criticized for numerous flaws; it doesn’t indicate the rate of live births and doesn't control for age or diagnosis, for instance, but I think it suggests enough of a correlation for future research.
Tuesday, August 4, 2009
I bought this cool stainless steel reusable water bottle from Starbucks using a gift card a good friend gave me for my birthday.
I was out of town for 8 days and decided to keep my bottle full of filtered water and not buy one plastic water bottle. Besides morning coffee and evening wine, water is what I drink.
Before I officially decided on my challenge, I purchased a gallon of filtered water at the grocery store. Rest assured, people, this jug was refilled about 4 times and was used to fill up my cool stainless steel water bottle.
I took advantage of the filtered water at Wahoo's Fish Tacos when I ate there five times.
The Sheraton had a gym with a water filtration system, so I was able to fill up anytime between 6am and 10:30pm. Before I discovered this, the bartender filled up my water bottle.
Overpriced $3.25 bottles of water weren’t my motivation, but I've heard enough about BPAs in plastics that I find myself guarding my reproductive system. And yes, I did refill that plastic gallon jug... but I didn't heat it up!
I wasn't shy about asking Starbucks to fill my bottle up with water.
The Warwick Hotel had an awesome workout room on the 15th floor overlooking downtown Denver. And, yes, we did actually workout and didn't just fill up on water.
The Warwick's workout room also had lemon water, which is my favorite.
I also managed to avoid the $5 Fiji water bottles at the Warwick.
I DID IT!
I made it 8 days without buying a plastic water bottle (other than the initial gallon jug). Some other places that filled up my water bottle: Whole Foods, The Randolph Room, 24-Hour Fitness, and Red Rocks Grill.
Tuesday, July 28, 2009
Inspired by a recent visit to Extra Virgin, I attempted to duplicate their tomato, watermelon, watercress, and goat cheese salad. I didn't have Michael Smith's ancho chili vinaigrette recipe, so I had to wing it with Tyler Florence's citrus-chile vinaigrette. I used arugula in place of the watercress.
Steve made jumbo prawns which we marinated in lime juice and a spontaneous combination of spices, a little similar to Tyler Florence's shrimp preparation in the vinaigrette recipe.
Tomato, Watermelon, Arugula & Goat Cheese Salad:
Slice one tomato and place on platter
Scatter arugula over the tomato
Scatter watermelon pieces and goat cheese over the arugula
Dress with citrus-chili vinaigrette (add dressing between the layers)
1 vine-ripe tomato, seeded and chopped
2 canned chipotle peppers in adobo, chopped
1 teaspoon sugar
1 orange, zested and juiced
1 lime, zested and juiced
1 lemon, zested and juiced
Extra-virgin olive oil
Kosher salt and freshly ground black pepper
Sunday, July 19, 2009
For awhile, I was bitter about having to allocate our resources to out-of-pocket medical expenses. It's prevented us from buying a bigger house, going on vacations, doing much-needed remodeling, and buying newer model cars. I could become a heroin addict by choice and my rehabilitation would be covered by insurance; however, anything to do with getting pregnant is not covered.
We've narrowed our search to two doctors. One is Dr. Zouves in San Francisco. I read his book a year ago. I was inspired by it, but had no idea that I would someday consider becoming his patient.
Hopefully our very first IVF cycle can happen as soon as September. My reproductive immunologist needs at least one month lead time to treat me before she gives the green light to our reproductive endocronologist.
This will be an exercise in giving up control. Making travel plans isn't possible since I'm at the mercy of my own body and Dr. Zouves' schedule. We're hiring one of the best physicians in the country so we can be assured that our protocol is tailored to the needs of our individual case. In giving up control, the last thing I need is the responsibility of micro-managing a physician. I finally feel a little bit hopeful...
This book is an amazing read. I could hardly put it down. Presented are many interesting family planning choices and dilemmas that most of us will never be confronted with.
8 oz lowfat sour cream
1 tsp chili powder, divided
1 tsp ground cumin, divided
¾ tsp ground red pepper
¾ tsp salt, divided
¼ tsp ground cinnamon
1 lb unpeeled medium shrimp
3 Tbs orange juice
2 tsp olive oil
2 garlic cloves
For the sauce:
Whisk together the sour cream, ½ tsp chili powder, ½ tsp cumin, ½ tsp red pepper, ¼ tsp salt, and cinnamon. Stir until smooth. Cover and chill until ready to serve.
For the shrimp:
Peel and devein the shrimp (you can also chop it). Combine the remaining ½ tsp chili powder, ½ tsp cumin, ¼ tsp red pepper and ½ tsp salt in a ziploc bag or shallow dish; add orange juice and shrimp, turning to coat. Chill for 15+ minutes.
Remove the shrimp from marinade, discarding the marinade. Saute the garlic in olive oil in a large skillet over medium heat. Add shrimp and cook just until pink. Serve on tortillas with spicy cream sauce, shredded cheese, avocado, shredded lettuce, and whatever else you like!
Saturday, July 18, 2009
Friday, July 17, 2009
I have some exciting things coming up, including a possible IVF cycle this fall. I love to cook and will post the good recipes that have been tested in the Michnick kitchen. Once in awhile one of my creative projects turns out well. Who knows what other interesting things will end up here.
Ouch! Tell it like it is: No one cares about your blog. No one reads your blog. Enough about your blog already. Your blog is not special or interesting. Your blog is boring.