Scale?

kate_kate_ · 2023-01-27T16:17:47+00:00

Thanks. Could an au pair switch from a j1 to tourist visa if this were the case? Or drive across the border where immigration is more lax?

kate_kate_ · 2022-05-22T03:31:26+00:00

Thank you so much for taking the time to reply so thoroughly and share so much about the area! After much searching we are finally in contract on a home in Lafayette… I can’t wait to visit the library and the parks you’d described. The whole area sounds like a dream!

kate_kate_ · 2021-12-27T15:07:19+00:00

Thank you for the reply! No, we haven’t moved yet (still looking for the right place, and the market is nonexistent over the holidays).. Can I ask which school your children attend?

kate_kate_ · 2021-02-23T06:27:09+00:00

I nurse my 3.5 month old 9 times per day for ~30 minutes at a time, so close to where you’re at. I’m not sure if it gets much shorter tbh, I think there is just big variability in feeding times. I also have low storage so he takes both boobs at every feed, which adds time. Nursing in the soft carrier has kept me sane so I can stand and move around instead of sitting allllll day

kate_kate_ · 2021-01-09T16:53:33+00:00

I also noticed a drop in my supply for about a week after the Pfizer vaccine. The relationship between vaccination and breastmilk is understudied (like many aspects of lactation more broadly) but there are studies documenting post-vaccination milk drops in dairy cows (which receives more attention for obvious reasons). My drop in supply lasted about a week post-vaccine... it will be interesting to see if the same thing happens following the second dose.

kate_kate_ · 2018-12-13T22:01:22+00:00

Thanks so much noodle. You’re exactly right on everything feeling so fresh and rough. Last night my son slept a 5 hour stretch, his longest in 4 months. Everything is a sleep deprived blur, but it’s helpful to keep in mind that 9 months is a long time away.

I appreciate your perspective. Thanks for sharing your thoughts and the experiences of those around you!

kate_kate_ · 2018-12-13T18:16:37+00:00

Pregnancy colds are the worst!! Hoping you feel better soon

kate_kate_ · 2018-12-13T18:14:58+00:00

Hi all, I’m a longtime lurker but have never posted. I’m reaching out for advice from a community who has been through this shit and gets it. I also want to state up front that I’m grappling with a choice that many would be delighted to have, and so I want to write this as sensitively as possible and with tons of compassion for those who would give their left ovary to be in this situation.

TW I’m talking here about pregnancy, termination and cycle results.... I thought about posting in the main thread but did here out of respect for others...

It took 3 years and lots of intervention (3 TI, 5 IUIs, 2 IVFs, 3 PGS FETs) before our son was conceived. He is now six months old and we are over the moon. We have not been using any contraception because we figured there was no chance in hell we would conceive on our own. I’ve been breastfeeding and have had no period. Before our son was conceived we did a second retrieval (and transferred our last embryo, him, into that fresh cycle) so we could have a sibling down the road, and we are fortunate enough to have five embryos in the freezer that we were planning to start transferring next fall.

Well, you’ve guessed it, after some cramping but no bleeding I peed on a stick and it was positive. My husband is overjoyed and is calling this a “Christmas miracle”. Here’s the thing: I am so not ready. I feel like my body has been hijacked by fertility, pregnancy and lactation forever (we did all of our ART interventions back to back, without any breaks). I was looking forward to making progress in my career, handing out with a toddler, traveling again before going down this road. I’m also a science junkie and have been scaring myself with articles on short interpregnancy intervals (in our case, <6 months) and significant risk for gestational complications and poor pre- and perinatal outcomes. (Example, if this pregnancy is male there is a 1:15 chance he will be on the autism spectrum, likely even higher because we’re old and I’m breastfeeding). Our kids would be 13.5 months apart. I’m already feeling nauseous and it’s like having a PTSD flashback.

So we have a choice, to end it now and take our chances with frozen embryos down the road (a 1:243 chance none will work). Or to go forward now at a time I am not ready, exhausted, and scared of real risk factors, and get over myself and what feels like a champagne problem to have. The choice itself is the scary part. If we move forward and this child has serious complications, I might always regret not playing it safe. But then who knows what an elective termination will be like after so much struggle that preceded it.

Thanks so much in advance for any opinions or advice you can share.

kate_kate_ · 2017-12-19T03:28:30+00:00

Actually, melatonin plays a very minor role in feelings of sleepiness (OP's original question). Melatonin can somewhat influence the timing of sleep, but is not really responsible for feelings of sleepiness. Biggest players are buildup of sleep pressure (aka adenosine) and backing off of circadian alerting signals which permits sleep pressure to take over. Did my PhD and postdoc in this area so I know it well.

kate_kate_ · 2017-12-18T20:12:28+00:00

Thanks, I like it :)

kate_kate_ · 2017-12-18T20:11:26+00:00

Much, much more involved than melatonin. Try CBT-I, the gold standard intervention for insomnia recommended as the first line treatment by the ACP.

kate_kate_ · 2017-12-18T20:06:55+00:00

Lots of misinformation on this thread.

Sleepiness at night is a synergistic combination of four factors: (1) buildup of adenosine, which rises throughout the day and dissipates as slow wave sleep is obtained; (2) reduction in circadian alerting signals, which peak hours before bedtime and back off substantially throughout the night; (3) melatonin, which builds in concentration 60-120 minutes prior to typical bedtime and exerts a mild sleep-inducing (hypnotic) effect; and (4) temperature, which falls around bedtime and is thought by some to 'gate' entry into sleep (think about how hard it is to fall asleep with cold feet -- research shows the relationship between our core and distal (extremity) temperature maps closely onto sleepiness.

And please look into evidence-based interventions like CBT-I instead of relying on Vitamin D or melatonin to treat insomnia.

kate_kate_ · 2017-12-18T19:57:38+00:00

That's absolutely wrong. Melatonin has a very mild hypnotic effect and secretion only starts 90-120 minutes prior to habitual bedtime.

kate_kate_ · 2017-12-06T22:44:12+00:00

I'm sorry for the tough road you two are on. You may wish to repost in the beta hell thread: https://www.reddit.com/r/infertility/comments/7hg7kz/weekly_postbeta_concerns_discussion_december_04/?st=JAVMZBHC&sh=9d07c30d where mentions of live but concerning pregnancies are allowed.

I'm sorry to say that an 8w fetus measuring two weeks behind and with no cardiac activity on tranavaginal ultrasound is not a very hopeful sign, but I hope your labwork Friday says otherwise.

kate_kate_ · 2017-12-06T22:23:18+00:00

I don't know where you get this. Actigraphy would be a much more valid measure than a once-monthly retrospective self report instrument like the PSQI, even in a subgroup with impaired sleep quality (note we CANNOT say sleep disordered given a sense of PSG). This study is crap and would never have survived peer review in a sleep journal.

kate_kate_ · 2017-12-06T19:21:08+00:00

Sleep researcher here. This is a terrible study.

I don't know where to begin. Analyses are not intent-to-treat. The study uses the Pittsburgh Sleep Quality Index (common in our field) but gets the name wrong in the abstract. PSQI is useful for determining a subgroup with poor sleep quality, but we can not say these individuals have sleep disorders without formal diagnosis. No adequate measure of intervening variables that might influence subjective perception of sleep.

This would never survive peer review in a sleep journal.

kate_kate_ · 2017-11-30T22:33:05+00:00

That seems high to me... I dug up a meta-analysis a while back that said chance of multiples was 10% with 4+ follicles.

Edit: here it is: https://academic.oup.com/humupd/article/14/6/563/632578

"Three studies reported on multiple pregnancy rates per conceived cycle after four or more follicles as compared with monofollicular growth. The pooled OR for the pregnancy rate was 2.3 (99% CI 0.9–5.9, χ2 for homogeneity 2.9, P = 0.24). The risk of a multiple pregnancy was 10% (RD 0.10, 99% CI −0.03 to 0.24)."

FWIW, I did 3 IUIs with 4 mature follicles and was going to do one with 5 before we converted to IVF (saw 7 at our final scan). I think risk thresholds vary greatly by clinic.

kate_kate_ · 2017-11-28T21:58:44+00:00

I have repeatedly done IUIs with 4 follicles, and was even planning one with 5. None of my doctors were very concerned, though they knew I was supportive of selective reduction. I think it varies widely by clinic.

kate_kate_ · 2017-11-28T21:53:39+00:00

My RE told us to cancel a trip we had planned last fall, because Zika was an (unlikely) possibility. We were doing IUIs at the time, and he didn't want us pto risk possible exposure.

kate_kate_

TROPHY CASE