DES Drama

I found this article on the U.S. National Institutes of Health: National Cancer Institute's website. I hope you'll read it in its entirety.

Overview of DES

Diethylstilbestrol (DES), a synthetic estrogen, was prescribed to millions of pregnant women in the United States from 1938 to 1971. Manufactured under many different names, the drug was marketed to prevent miscarriage or premature birth by supplementing a pregnant woman's natural estrogen production. Research noted that a decrease in urinary estrogen and progesterone preceded adverse pregnancy outcomes. Thus it was postulated that administering estrogen would induce placental hormone production; therefore, sustaining a viable pregnancy (Smith, et al. 1948). Despite a landmark study in the early 1950s finding DES ineffective in preventing miscarriage and premature birth (Dieckmann, et al. 1953) and subsequent research showing harm to the developing fetus, it was not until 1971 that the Food and Drug Administration issued a warning about the damaging effects of DES. In the United States, it is estimated that between 5 and 10 million people were exposed to DES during the years it was prescribed. DES was similarly prescribed in several European countries from the 1950s into the 1970s and may still be used in developing countries.

Although DES is no longer prescribed to pregnant women in the United States, DES exposure continues to affect many lives:

DES is associated with a number of adverse health effects; some of those health effects, including third-generation effects, are still unknown. Research to date suggests that health risks for daughters born to DES mothers include:

Increased risk of clear cell adenocarcinoma (CCA), a rare form of vaginal cancer
Structural differences in reproductive anatomy
Increased risk of intraepithelial dysplasia and neoplasia
Increased risk of infertility
Increased risk of pregnancy complications
DES mothers, or women prescribed DES, appear to have a slightly increased risk of breast cancer. DES sons—boys exposed to DES in utero—have an increased risk of being born with genital abnormalities.

Identification of Individuals Exposed to DES

Today, clinicians may still encounter patients who are DES-exposed. It is difficult to identify and confirm DES exposure in an individual. No simple test can be given. There have been limited efforts to contact and subsequently monitor the health of those exposed to DES, but researchers have been unable to identify everyone. Many women and their children do not know whether they were exposed to DES, and DES-related cancers often take many years to develop and appear.

The ideal, but not always practical, way to identify DES exposed individuals is to review complete obstetrical, hospital, or pharmacy records. This method can identify mothers who have forgotten that they received DES or daughters whose gynecologic examinations reveal no changes. However, in many cases, old records have been destroyed or are incomplete; antenatal medications are not always mentioned in hospital obstetrical records; and mothers of exposed children cannot always be contacted.

A 2003 update on the Health Canada website to draw the public's attention to a letter sent out to prescribing physicians, went into slightly more detail:

"•ovulation disorders: as yet unconfirmed data suggest that there may be a risk of early ovarian disgenesis cervical problems:
•cervical mucus abnormalities which inhibit the penetration of spermatozoa
•ectopic pregnancy, risk multiplied by a factor of 6 relative to the general population
•early miscarriage: more frequent than in the general population
•late miscarriage: at 17-22 weeks of amenorrhea, particularly characteristic of these patients
•prematurity"

Things that make you go WHAT?!

Indian woman delivers, abandons baby in plane toilet

By Harmeet Shah Singh, CNNJuly 8, 2010 -- Updated 1000 GMT (1800 HKT)

New Delhi, India (CNN) -- An unmarried Indian woman delivered a baby in the toilet of an international flight and abandoned the infant in the plane's washroom, police and doctors said Thursday.

Cabin crew of the Turkmenistan Airlines rushed the newborn to a hospital as the plane arrived in the northern Indian city of Amritsar on Wednesday, said Varinder Kumar, city police commissioner.

The toilet was taken to the hospital with the baby, and surgeons had to cut it away to get the newborn out, said H.P. Singh, a doctor at Amritsar's Fortis Escorts hospital.

The baby's condition was critical, Singh said, and it might take at least two to three days to recover. The mother admitted to the same hospital was, however, stable, he said.

"She was unmarried. It looks like she wanted to get rid of the baby," Singh said.

Treasures

The pictures you see here are of a card created by lovely Amanda. On it she printed a poem she found and presented it to us as a keepsake for Jordan's box. Thank you, Amanda! xo

These are my footprints
so perfect and so small
These tiny footprints
never touched the ground at all
Not one tiny footprint
for now I have wings
These tiny footprints were meant
for other things
You will hear my tiny footprints
in the patter of the rain
Gentle drops like angels' tears
of joy and not from pain
You will see my tiny footprints
in each butterflies' lazy dance
I'll let you know I'm with you
if you just give me the chance
You will see my tiny footprints
in the rustle of the leaves
I will whisper names into the wind
and call each one that grieves
Most of all these tiny footprints
are found on Mommy's and Daddy's heart
'Cause even though I'm gone now
We'll never truly part

All Quiet on the (In)Fertility Front

I've been trying to come up with something to blog, but it just isn't in me. Perhaps it's because - as the title of this entry suggests - not much has been going down on Infertility Island. Or is it possible that my creative juices have been sucked dry with the onset of summer vacay? My once productive days in the classroom have given way to lounging poolside with my book-of-the-moment, playing in the kitchen and experiencing summer events in the Emerald City.

Cyballs and I toyed with the idea of trying again this cycle, but I'm just not "feeling it." I have no desire to chart my temps, analyze my CM and deal with OPKs. And I'm definitely not into thinking about another HSG and beginning Clomid in the fall as per our discussion with Dr.H. Truth is we're scared. After 3 years sans BC, the doc is encouraged to see we were able to get pregnant. But we both have this sinking feeling that if we manage to get knocked-up again, we're headed for another loss. Oh boo.

I hope we're wrong.

Anyway, where was I? Oh yes, my fading inspiration.

Or is it feasible to believe I've made a small break-through at counseling? During my most recent counseling appointment with Jen, she reminded me of the Four Stages of Competency. This model was one of the first things we learned in our class, Group Counseling, at university. The model had been filed away in the back of my brain, but as soon as she wrote it down for me, I could see how it was going to help me get my mind back.

We'd been discussing how much energy it takes to worry about the what-ifs and how it could work against me. I'm tired of "all baby all day" running through my mind. I want to live a normal life again; have normal, everyday thoughts.

The model looks like this:

1. Unconscious Incompetence
The individual neither understands or knows how to do something, nor recognizes the deficit, nor has a desire to address it.

2.Conscious Incompetence
Though the individual does not understand or know how to do something, he or she does recognize the deficit, without yet addressing it.

3.Conscious Competence
The individual understands or knows how to do something. However, demonstrating the skill or knowledge requires a great deal of consciousness or concentration.

4.Unconscious Competence
The individual has had so much practice with a skill that it becomes "second nature" and can be performed easily (often without concentrating too deeply). He or she may or may not be able teach it to others, depending upon how and when it was learned.

Relating my fertility issues to the conscious competence theory works like this:
In the beginning when we stopped using BC, I had no idea I had any reproductive issues, nor did I truly understand charting, CM consistency, temp shifts, follicular phase, corpus luteum or luteal phases etc.

Somewhere over those 3 years, I began to suspect something was up. I didn't seek out advice from my doc and I certainly didn't know the in's and out's of fertility. This can be thought of as stage 2.

When I finally sought out Dr.O. and the testing began, I couldn't read enough on the subject. This is when the temperature taking, CM analyzing and luteal phase dissecting became part of my daily routine. One could say I was consciously competent. However, after our loss, I began to obsess: inspecting toilet paper, agonizing over 1/10 of a degree change in my morning temperatures and praying for sore boobs and edema. It's exhausting and isn't doing me any good.

Jen wanted to see me make it to stage 4 or unconscious competence. Here, I can take what I know and perform it second nature without obsessing. I don't know what happened, but suddenly I'm doing it. Jen knows how my brain works, I need something concrete to make it stick.

Jenifer, hopefully you're still reading...You're amazing. I'm so very thankful to you for all you've done for me!

I hope you'll come back soon to see a picture of the poem/card Amanda made us for Jordan's box.

"The only journey is the journey within."
~Rainer Maria Rilke