October, I Love You!

They found the perfect pumpkin!

To follow up my last post, I flew back to Illinois last weekend and stayed with my mom for four days. I was able to be with her at the hospital for two days and afterward at home. It gave my sister a break to spend the weekend having quality time with her family and gave both my mom and I boost to see each other. :) (As for an update medically, we have no diagnosis yet. They have ruled out any problems with her heart, kidneys, and reproductive organs-including cancers-so we are back to the liver. There will be another biopsy in a week and then if the liver still looks fine she will go to the Mayo Clinic in Minnesota for a comprehensive exam.)

I can hardly believe October is halfway over because it is my favorite month of the year and I feel like I have barely had a second to enjoy it! Because I spent last weekend in Illinois, I was looking forward to having this weekend to go to a farm and get Raine a pumpkin. (You know, these are the things that are so fun with children...) I was disappointed to find out when I came back to Oregon that they were already predicting rain for the whole weekend...and the following week. I was afraid that I had missed the last beautiful ~dry~ weekend for the season! (Dan spent it Saturday taking Raine into Portland for a special trip for an ice cream treat at Salt and Straw. So cute! And they totally remembered me and brought home a little pint of Snickerdoodle. Yum!)

However the skies cleared up yesterday afternoon and we abandoned grocery shopping for a trip to Baggenstos Farm. Raine had been a cranky mess all day while we ran errands but he cheered up right away when we got to the farm and showed him all the fun stuff! :)

So much to do! Where do we start??

C'mon, daddy! I don't have time for this. Let's catch up with those kids!

Peek a boo!

Hello goat!

Look out peeps! Here I come!!!!

It was a super fun 20 minutes. Ha! (That's actually about how long Raine lasted.) Even so, I couldn't have asked for a better fall/pumpkin purchase experience. :) He is still too young to really get into these types of things, so just to get his picture snapped a few times and see him so happy ~especially when he was having such a rotten day~ was all I could ask for and more! (You can find all of our photos from the farm here.)

Raine's favorite things at Baggenstos Farm included (in order of 1.) Most Extreme Pleasure to 5.) This is Rotten and I Hate It!) were:

1. The fence around the chickens and goats. (Literally the fence itself. But he also enjoyed the animals. LOL.)
2. The tractor, especially sitting in the driver seat. High five Grampy Jim!
3. Poking his head through the painted photo boards.
4. Picking out a pumpkin.
5. Straw bale maze. (He hated it!)

Hope you are enjoying this time of year. We have a lot to look forward to in the next couple of weeks. I have my birthday to celebrate with my boys, time with friends, and then we will be traveling to Illinois for a very fun visit including Dan attending a Bears game and celebrating Halloween week with Raine's cousins! :)

Even though I feel so busy with work, taking care of Raine (and Dan who sprained his back!) and managing this household, I am trying to slow down and stop to smell the fresh rain, admire those colorful fall leaves, and savor the seasonal brews. Why Autumn has to be the quickest season (at least in Oregon!) I don't know. But it is my favorite! And October is like, the pinnacle! Cheers!

On tap tonight! God Bless Deschutes.

The Thing That I Wanted To Talk About But Didn't.

At the Crystal Springs Rhododendron Garden with my mom and Raine last May.

No posts for a while, huh.

In the middle of August, my mom told me that during her regular check up with her physician, she had complained about some bloating and pain so he had her see a specialist. The specialist did a CT scan and found portal hypertension. Because ascites (the fluid retention) and portal hypertension are often indicative of liver cirrhosis, he ordered a doppler ultrasound to check her liver. While my mother has never been a drinker, nor had any liver disease in her family, she is prone to autoimmune disorders and he suspected autoimmune hepatitis-induced-cirrhosis. I was on pins and needles as I googled the crap out of it, and I was convinced, like her doctor, that she was dealing with late stage cirrhosis. 

However her biopsy showed a healthy liver. 

So we don't know what is happening. She has two more tests to check her heart and kidneys, and if those are OK, she will have to go to the Mayo Clinic in Minnesota.

In the meantime, it has been a little bit of a roller coaster. The diagnosis of cirrhosis was given twice and revoked twice. She is suffering discomfort and pain related to the ascites but she is unable to have the fluid drained often because of the risk of infection. They literally have to make her wait until it is unbearable. Her first drain (a procedure called "paracentesis") removed several liters of fluid (20 lbs!) and it fills up again so quickly. She had another paracentesis two weeks after the first one and we think she is due for another one soon. The fluid accumulation is so uncomfortable that she always experiences pain and pressure and therefore ended up hospitalized because of a bladder infection that she didn't know she had.

Today she went into the hospital again. They are going to do tests and monitor her. Probably just a day or two.

All the while. Here I am in Oregon. 2,000 miles away.

And that's that.

Suddenly It Is Day Eleven!

Rosemary red lentil soup with pumpkin seeds ~ Yum!

Ice cream alternative: Strawberry Italian ice!

Adzuki bean and seaweed soup

Of course I had all the intentions in the world to keep a sort of diary going every day or other day while on this Elimination Diet, but YEAH RIGHT. It was all I could do to quickly scribble what I ate at the end of the day before crashing. It has been one of those weeks. Just NUTS. I struggle to figure out how I can possibly keep up a hobby like blogging while working full time and being the best wife, friend, and mama possible. Sigh.

Anyway, here we are on day eleven and I kept you all in great suspense! Ha! A few of you commented (off-line) that it sounded similar to your low-carb or no-carb diets. My hat is off to you, no-carb ladies, because this has been HARD and your diets are actually MORE difficult! I was able to at least sit around and shove root vegetable chips into my mouth with absolutely no regard for carbs. ;) Truly, I am going to turn into a sweet potato. I have consumed many bags of chips the last eleven days! (Food Should Taste Good and Terra are the best!) I also didn't have the motivation of weight loss to consider, so a few things crept into my diet that were actually No No's, and this was mostly because I was overwhelmed and gave in for convenience's sake. For instance, apples. I didn't make my morning smoothie so I picked up a Naked smoothie which actually contained apple juice. I also absentmindedly had strawberries when I ordered a cup of Italian ice at the car show last weekend. I was so excited about finding an ice cold sweet treat that wasn't dairy, I ordered strawberry because I was so focused on avoiding chocolate. These didn't seem like tremendous slip ups however, because I wasn't truly expecting fruits to be part of my potential problem.

I know I said in my first post that I didn't really expect any foods to affect my chronic pain, but I guess I was lying. On day three, I had a huge flare. My legs were horrible and I could hardly walk. By the time I went to bed, my arms were just as painful and I just wanted to curl up into a ball and cry. Oh my goodness, was I surprised the next day at how disappointed I felt. I just wasn't expecting a flare up while off all of these foods. I really thought my pain was going to be very mild or non-existent, and that things would get more interesting as I reintroduced foods. Here I was three days in and in tremendous pain! And that has continued. :( I have had some rough days with awful pain that has made working, taking care of Raine, and just daily life tough to manage. As far as the stomach pain goes, that has remained as well. SO. I feel like this has been a giant FLOP.

However, I'm doing it and learning things from it. What have I learned so far?

1.) I have to eat, like, all the time. And not because of my blood sugar, like I thought. I'm a compulsive eater. I think this is because I still have a restless energy and I used to placate with smoking. Especially when I am stressed. And while I am sitting at my desk at work all day, stressed to the max, I just have to be eating. Like I said before, I ate a lot of chips. I also snacked on grapes and seeds. That's better than donuts!
2.) I don't have blood sugar trouble on this diet. I suppose the foods I have been eating are lower on the glycemic index, so the question will be can I (or do I want to) stick with some of these changes to keep my blood sugar problems in check?
3.) I won't die if I don't have Starbucks every morning. I replaced my addiction to lattes with green smoothies and they filled me up and gave me more energy and stamina for the afternoon than sugar, chai, or espresso ever could.
4.) You adapt. You really do. I adapted to the loss of chocolate, bread, alcohol, etc. Whatever you think you can't give up: You can. I should have known that by the fact that I was previously able to give up smoking and also meat for a vegetarian diet, but you know, I was kind of feeling a little addicted to certain foods. And when you feel addicted it is scary to take a leap and let go.
5.) I don't know where to go from here in terms of my pain. I feel like I've lost a little hope that there is a solution. I don't think there is one anymore. I think I will continue to live with the same pain I have always lived with my entire life and nothing can be done about it. But this is for another post another day.

I'm still going to finish out my 14 day plan. So I have a few days to go over the weekend and I'll report back! I definitely have some recipes to share. ;)

 

The Elimination Diet

Morning smoothie

Fish, wild rice, shallots

Parsnip fries with thyme, rosemary, salt, & pepper

Effective Monday morning, 8:00 pst, I began an elimination diet. My typical breakfast (a soy chai latte and a bowl of plain instant oatmeal) was replaced with a hearty green smoothie (made with avocado, kale, chard, cherries, blueberries, and ginger).

I have been thinking about doing this diet for a while but couldn't seem to muster up the motivation, and probably, the belief in myself that I could do it. It is NOT for amateurs! LOL. In a recent post, I mentioned that I had removed dairy, soy, and peanuts from my diet to see if these foods have anything to do with my Fibromyalgia pain. I kind of got the idea from Sarah. It turns out little Anna has food sensitivities/allergies that created chronic pain in her body, just like the pain I had at her age--and still do. I also saw a new doctor and he suggested eliminating gluten because of stomach pain that I have been having for the past two months. My blood work came back mostly OK and the Celiac test was negative, so he diagnosed with me IBS (he literally told me it was just because he didn't know what was wrong and that is a nice umbrella diagnosis for these types of things--much like Fibro. Ugh.) Often testing negative for Celiac happens even if there is an intolerance or sensitivity, so he said a gluten-free diet was worth a shot.

I figured if I was going to stay off peanuts, dairy, and soy, and also eliminate gluten, I might as well buckle down and do a complete elimination diet. I had read about them online and when I researched them further, I kind of felt overwhelmed. I called up Sarah for advice and Ally for a pep talk. Sunday I chose a particular diet, outlined by The Whole Life Nutrition Kitchen, tweaked it a little because I am breastfeeding,* and made my grocery list and meal plans. I promised Dan that I would make my snacks and smoothies and avoid depending on him too much AND try my best not to be a crazy moody crabby lady.

I am allowed ONLY the following foods:

-brown rice/wild rice
-quinoa
-amaranth
-teff
-pears
-peaches, nectarines
-plums, apricots
-berries (except strawberries)
-cherries
-grapes
-figs (dried and fresh)
-mango
-kale, collard greens
-lettuce, spinach
-dandelion greens
-bok choy, cabbage
-parsley, cilantro
-sprouts (all types)
-brussels sprouts
-broccoli, cauliflower
-beets, carrots, parsnips
-winter squash (all types)
-yams and sweet potatoes
-avocados
-onions, garlic, and ginger
-sunflower and pumpkin seeds
-sunflower and pumpkin seed butters
-pine nuts
-mung beans, adzuki beans, lentils
-wakame seaweed, kombu seaweed
-nori seaweed, dulse flakes
-fresh herbs
-coconut milk
-coconut oil and olive oil
-kudzu, arrowroot (be sure its GF)
-guar gum (in small amounts)
-agave nectar and maple syrup
*-non-processed meats

I am NOT allowed:


-gluten grains and their flours
-gluten-free grains and flours
-potatoes, tomatoes, peppers
-oats
-yeast
-dairy
-eggs
-chocolate
-soy products
-corn
-mushrooms
-pineapple, papaya
-citrus fruits
-kiwi fruit, bananas, apples
-strawberries
-all tree nuts and peanuts
-all beans (except for mung, lentil, adzuki)
-sesame seeds
-refined sugar
-alcohol
-caffeine

After 14 days I will access how practical it would be to keep going an additional 7-14 days (WLNK recommends 28 days). After that, I will do phases of reintroducing foods such as soy, night shade vegetables, grains, and dairy. Dan is placing his bets on wheat. I have to admit that I kind of don't expect any foods to affect my chronic pain (even with Anna's success!) but I will be able to know definitively and not always wonder....

Anyway, it is the end of day three and I am really curious how this is going to turn out. I hope to have updates maybe every other day to keep track of what I eat, how I feel, and what this experience is like. I can tell you one thing: My savior so far has been Food Should Taste Good's sweet potato chips! ;)

Currently

LOVING

Escape to Yoga, a new yoga studio in Sherwood. The space is beautiful and relaxing and the instructors are friendly and helpful. I especially love that they have a full schedule throughout the week of a variety of classes. I have been taking gentle Hatha classes, aiming for the noon hour sessions that are shortened for people who are practicing on their lunch break. ;) I love it so much, I wrote a review for the first time in my life. I guess I'm on Yelp now. ALSO, clover fields. They are raging this time of year.

THINKING ABOUT
Ways to get my body in better shape. Like, lose the 15 lbs still hanging around after the pregnancy, but also just improve my flexibility and strength. This is a big reason for starting yoga. And, as always, ways to get my body in a better place overall. The seemingly greatest unending challenge of my life, right? I will be seeing yet another new doctor tomorrow, and I am half hopeful / half dreading talking to him about Fibromyalgia and PCOS. Not to mention this weird thing going on with my stomach lately. There is major growling and cramping no matter what I do.

ANTICIPATING
Seeing my mother. In approximately two hours. The only flights I could get her out of Bloomington were evening ones, so this is a very late flight, arriving after delays, too. Dan is going to go pick her up and I don't think they will be back here to the house until 1:30 a.m. I will go to bed but I won't be able to sleep. I can't wait!

LISTENING TO
Ho Hey by The Lumineers. So. Lovely. Anyone in Illinois going to Summer Camp this weekend? I will live vicariously through you. ;)

EATING
Oh goodness. Lately? Nothing with dairy, soy, or peanuts. I am trying to use an elimination diet to see if foods have anything to do with my Fibromyalgia. Daily staples have been: Green smoothies (so way more greens and fruits than I was getting before!) almond milk and cereal, oatmeal, salads, tea, apples with almond butter, yummy dinners by Dan, and a bit of coconut milk ice cream or a little piece of dark chocolate at the end of the day.

WISHING
There was more time in a day. I have all of these items on multiple lists running in my head that I am always trying to check off, and it just never seems to happen. I manage the big things: Pay the bills, wash clothes, take care of Raine, eat something, show up to work, Oh yeah! Kiss the hubby! ;) Other things just aren't getting done...An entire week will go by and I won't even get the mail or touch a dust pan. So never mind reading for fun, talking on the phone with my girlfriends (who I am so out of touch with, UGH!) or working on projects. (So somebody who has an older child inform me that this gets better, right?? Haha.) I mean, really and truly it is worth it to lose a little time to devote what I have to this little dude...

"CURRENTLY" is copied from a blog I read, Sometimes Sweet. ;) FYI! Previously on Herzing Luv: March 28 2012.

Raine's Birth Story (Part 2)

I am writing our story in two parts. The first part is about labor and delivery and the second part is about our experience with Raine in the NICU until he came home three days later.

***

The first 24 hours after Raine's birth were such a joy. We ooohed and aaahhhed A LOT. :) Giddy with happiness, we sent text messages and made Facebook updates about Raine. Dan and my mom called family members. I was fiercely hungry. In fact, the first thing I did after he was born was order a hamburger! LOL. Believe me, I took full advantage of the fact that I could order any food to my room at anytime. We also had a cooler full of fresh fruit and snacks (the hospital didn't provide meals for my family members) as well as a dozen giant oatmeal chocolate chip cookies from Grand Central Bakery!

Raine had his first visitor, Gayle, who was also helping with transporting my mom back and forth between the hospital and our apartment. The following day he had two more visitors, Melissa and Lorri. All the hot ladies wanted to meet him...!!! :)


Friday afternoon, we got a visit from the pediatrician. An ultrasound of Raine's kidneys revealed his ureters and kidneys were still swollen. They did not know the cause and therefore wanted to admit him to the NICU for safety and observation. He needed a catheter and would have a dye test to check for obstructions. He was put on antibiotics immediately in case he got a urinary tract infection that could further harm the kidneys.

I can't even begin to tell you how sad it was to have them take him out of our room. Nothing prepares you for that separation, and especially for the time ahead when you have to leave the hospital without your baby. I cried a little after he left the room and then decided I wasn't going to get more upset than that. Dan also felt sad and powerless to help his little boy. I think he called his father and talked to him while I took a nap. There was nothing we could do but hope that the matter would be resolved quickly and Raine wouldn't have to stay long.

Getting to him seemed to take forever. When he was awake and ready to eat, the NICU nurse would call our nurse and she would notify us. I'd fly out of the bed, throw on a robe, and anxiously wait as she wheeled me through the halls. I would literally tremble with anticipation and anxiety. He was several floors down and we had to take two different sets of elevators. Once we reached the NICU, it was policy to wash our hands at big sinks at the entrance. The smell of antiseptic soap became comforting to me because it was associated with Raine. I think he even acquired the smell from our hands. I don't remember why, but Raine didn't have his own room. He was at the very end of the hall in an empty great room. There was a set of twins sleeping in an area to the left of the entrance and then back in the far corner, all alone, was Raine's bed. I nearly cried at how lonely it seemed the first time we saw him!




We could pick him up and hold him, but we had to be careful of his cords. They brought me a rocking chair and I was able to nurse him. He was also supplemented formula, so Dan had feeding time with him, too. Giving him formula was not something we had planned on (we wanted me to breastfeed him exclusively) but by the second night it was crucial to get him more fluids. The specialist reviewing his case agreed that if his creatinine levels (found in blood tests and used to indicate kidney function) were good, he would be able to go home as long as he stayed on the antibiotic. They also wanted to see a good amount of urine passing, and our nurse advised us to agree to formula in the night to get that result. Coordinating my breastfeeding visits was difficult and our time together was not always productive because Raine might choose to sleep instead. ;-)

I was discharged Saturday and Dan and I packed up and drove home. We were exhausted and overwhelmed so we planned to nap, eat, and return at night to visit and feed him. I think that plan enabled me to not be too emotional about leaving Raine behind in the NICU. It just felt like we were returning to our room on the 6th floor. I will never forget the drive back to the hospital later that night. I kept seeing his little face in my mind's eye and it was accompanied by such an incredible feeling of love and longing. It was utterly distracting. I suppose I could compare it to falling in love with someone and you can't stop thinking about them, and each thought of them brings a rush of excitement. This little creature was such a tiny new part of my life but already could move mountains in my innermost being.

We returned Sunday with a change of clothes for Raine in case he was able to go home. Because his dye test showed no obstructions and his creatinine level was good, his specialist discharged him Sunday afternoon. What a celebration! Our nurses were as hopeful as us and had everything ready for us ahead of time. We were able to put him in his little "going home" outfit and buckle his tiny little body into the car seat for the first time. :-) As we left, we passed so many little babies with their parents and I began to cry because I was so happy to be taking him home and yet so sad that there were so many families who remained (for who knows how long). I felt so. very. lucky.



*Of course, I am writing this two and a half months later (holy moly!), so I can give you an update on his condition...

Raine has had another renal and bladder ultrasound, followed by a renal MAG3 scan at Doernbecker's Childrens Hospital in Portland, and we have met with his specialist and pediatrician. "Hydronephrosis" is what they call his swollen kidneys, and it is usually caused by structural abnormalities of the junctions between the kidney, ureter, and bladder that occurs during fetal development (Raine's specialist said that his would have developed as early as 8 weeks in utero!) Because they have found no obstructions and no reflux, Raine's official diagnosis is Hydronephrosis and Non-Refluxing, Non-Obstructed Bilateral Megaureter. Which basically means, "everything is dilated but we don't know why." LOL.

Of course I don't like the idea that his kidneys and ureters are dilated and I fear that it could eventually cause permanent damage, but there is no reason to suspect that now. His kidneys function completely normally and his specialist said that over the next three years there is a 1 in 5 chance that his condition will get worse. It is strange that this is something he will "grow out of," but that seems to be the case. He will have semi-regular ultrasounds to monitor everything, but other than that, there is nothing to be done and nothing to really worry about at this point!

future-baby making: month thirteen

so, the past seven weeks have been very difficult.

my blood work in october showed an abnormally low level of progesterone indicating i did not ovulate despite a surge on my home test kit. my doctor gave me an rx for the maximum dose of clomed to use the next cycle but then i didn’t start.

my new doctor did a whole lot of “well, gee whiz.” “boy, i don’t know!” “gee, i wonder why you can’t ovulate?” “hmmm.” “huh.” he had me schedule an appointment with the fertility nurse, who i couldn’t get an appointment with for two months. at my suggestion (from past experience) he prescribed progesterone to make me start. it was day 40, after all.

after ten days of provera, i started. and it was a mess. i mean, there was a lot of blood. i was changing a super tampon every half hour for three god awful days (which made traveling especially fun). i was exhausted. and i was really emotional.

i couldn’t even talk about it anymore.

i started reading a blog by another woman who has PCOS and her journey with infertility. and she had links to other blogs, who had links to others….suddenly a whole community of infertile couples revealed itself online. (it started here.)

and i realized: we are an infertile couple. i mean, it is kind of official at this point.

and i felt angry.

i finally said out loud to dan: “it’s not fair.” instead of trying to make me feel better, he simply agreed. it isn’t. we are beautiful people with a loving relationship who want to have our own child. and we can’t make it happen.

i began to have the sort of thoughts and emotions that i swore i absolutely never would. i was jealous and irrational. the thought of hearing someone else got pregnant freaked me out. i started to dread the baby shower i was invited to. i regarded anyone who tried to comfort me with utter contempt.

“it’ll be ok” or “it’ll happen!”

“look at so and so,” or, “look at me, it happened!”

i thought if i heard the story where “the couple who were trying to get pregnant finally stopped trying and got pregnant” …one more time…i was going to scream at the poor individual who shared it.

and good god, did i feel guilty. so guilty. because i let my pain actually diminish, if not eclipse, my joy for another friend’s pregnancy, for other friends’ children, for, actually, everyone alive on the goddamn planet because somebody gave birth to them. how awful. who wants to hang out with the mean and bitter infertile girl?

when we first arrived in arizona, i couldn’t even look directly at baby nexus. when she was brought into a room, everyone turned their gaze to her. i mean, she is a gorgeous baby. and exciting! What is more fun than waiting and watching to see how a miraculous little creature like that will react to you? smile? burp? giggle? it is all delicious. but i couldn’t look.

i quickly covered the fact that yes, we were still trying, and no, the medications weren’t working, so we are on to the next thing. i didn’t create a conversation that left room for anyone to contribute. it felt like an elephant in the room but it was my elephant, only i could see it. and it was annoying! it made me feel isolated and anxious around my dearest friends. while we were there, i also started taking clomed at 200 mg. i had an upset stomach and couldn’t escape a wierd jittery sensation. i felt like i was going to crawl out of my skin.

but by our last night there, i had held nexus. i had smiled at her and meant it. i loved her and pax-simply loved them without bitterness. they made me laugh. i made progress.

our last night, while dan got his tattoo, despite my fear and resistance, i talked about it all with tina. she didn’t say any of the things that i hate to hear. she just listened. and then she started to cry and told me that she is angry, too.

i could have lived in that moment of solidarity forever. it was very healing. i really need more of it, and the only way to get it is to keep sharing. even though it is hard.

and trying. future-baby is not a lost cause, even though sometimes it feels like it. i have been doing the home test-kit the past 10 days to no avail, but there are at least 10 days to go. hell, i might just test-kit my way into the next cycle just to be thorough. :)

i have an appointment with the fertility nurse next week. dan is going to have his sperm checked. i opened up to my coworker and it turns out her husband is an acupuncturist who treats infertility and she gave me the name of a highly recommended naturopath who also specializes in infertility and female hormones. i'll meet with her in february. and life goes on. dan and i are happy and have so much fun together it is probably disgusting. we just ooze love.

and the baby shower? it was good. :) i was truly happy to be there and truly happy for her and her family and i can’t wait to meet the lil’ guy. (xoxo, mel) and of course i enjoyed every moment of putting together her gift, because really, i like giving gifts. a lot.

we found her the elephant that was on her online registry but sold out (thank you, anthropologie) and gave her a nice little stockpile of onesies, four for nb, 0-3, and 3-6 each. thank you, target, for making a sweet and simple alternative to blue for a boy. :)

october thirtieth o'ten (reader participation please):

i turned thirty this month. i like it. i have a love hate relationship with my twenties. this birthday is also the best birthday i have ever had. even better than my six year old celebration at skateland. (oh wait. maybe not best. my sixteenth i got my 74 vw bug. that will probably never be topped).

i also completed my first six months at my new job. i am now eligible for company benefits including health care. i have dreamt of employer coverage ever since i dropped out of college and lost my student insurance. i couldn't get back on my parent's plans (i was twenty years old--a problem that would now be moot because the age has been extended by the new federal health care law to twenty six.)

however there are two ironies to this situation.

1.) is that i am now covered (effective november first) by kaiser permanente, one of the largest (if not the most?) medical groups on the west coast. when dan and i moved to portland in 2004 and discovered his employer's insurance did not cover spouses or other dependants, i independently applied to kaiser for coverage. i was denied because i had chronic depression and fibromyalgia, which they errantly defined as related to multiple sclerosis. now here i am in 2010, one of 8.6 million kaiser permanente members, just because i work full time for an employer with a company plan. so this is quite bittersweet.

2.) kaiser requires members to remain in their system for all services including hospitals, pharmacies, and practitioners. i had to leave my general practitioner, psychiatrist, physical therapist, and gynecologist to see kaiser doctors. i gained coverage at the expense of losing the doctors with whom i have built trusting relationships with over the past four years. needless to say, i totally cried when i said goodbye to my gyno who diagnosed me with pcos and has been helping us try to conceive, and the psychiatrist who saw me through several medication adjustments and a very rough patch of depression in 08-09, as well as referred me to portland dialectal therapy which played an integral role in my recovery. again, bittersweet.

of course, i have every right to not accept coverage and keep my membership with omip. but my co-pays and deductible are small and my employer generously pays 100% of my montly premium. it would be ludicrous to keep paying $350 a month + higher co-pays just to keep my doctors.

i am crossing my fingers that i will find good doctors and the adjustment into a new system will be as stress-free as possible.

i saw my general care doctor at the last possible second, on thursday, for a sore throat. the past two days i have been on the couch with cough drops watching a generous amount of tv. we figured out a great compromise until our tv system is better: an hdmi cable to plug our laptop directly into the tv to use hulu. i was so happy i watched anything i could. anything. general hospital, grey's anatomy, fringe, better with you, modern family, house, saturday night live, cougar town, community, parenthood. and i swear i believed that i would never watch this show, but i did: i got gleeed.

because i am sick i missed the sufjan stevens concert last night. i couldn't find a replacement so dan ended up selling our tickets to a very grateful couple outside the venue. sufjan is the kind of musician that i have on my list of "must see live." so i'm totally bummed. he was also part of our 2010 AMAZING concert line-up, which included band of horses, arcade fire (one of the best shows i have ever been to) and two shows in november: black keys/sleigh bells and over the rhine (my eleventh otr show! woot!)

in summary: please answer one or all of the following questions:

what was your favorite birthday? do you like your health insurance company? do you watch glee? did your respect for me diminish slightly when you discovered that i watch general hospital? who is on your "must see live" musician list?

future-baby making: month eleven (wow. almost one year)

the last time i wrote about this, things were slowly moving along and i was pretty optimistic (but also afraid to get my hopes up). i was waiting for my body to find a natural cycle, and after five months i actually had "spontaneous menses" (as my doctor refers to it, as if it is the most super exciting thing, like i need a party hat and a noisemaker.) then it didn't happen again so i went back to taking the progesterone medication.

with a return to the progesterone medication, we went back to the usual routine. after working my way up to the maximum dose to induce ovulation (hello, triplets!) i still wasn't able to get a positive with the ovulation home test kits. so we scheduled an ultra-sound to see if the drug was actually contributing to the cause. :)

remember the first post i wrote about this? i compared the first two months to a roller coaster ride. it was up, it was down. and then it was up again. and down again. by my second post, i was just trying to avoid the extremes. i was taking a road trip, steady going, right? well, the day of the ultra sound and the weeks to follow were like riding the batman roller coaster; up and down while suspended by the seat of my pants (or paper gown, if you will).

dr. 1 visit #1 there are my ovaries on the screen while dan asks nerdy scientific questions. for no apparent reason, i feel optimistic. ...up!

sorry, folks, it's note what we hoped for. your ovaries are covered in dark round circles which are the cysts (in PCOS talk these are referred to as 'black pearls' but to me they look like craters on the moon). there should be some elevation (doplar radar looking specks of green and yellow or red) indicating whether follicles are about to produce eggs. ...down!

actually, there is a hint of elevation over here on the left ovary. it's small (a beautiful radiant yellow if i ever saw one) so we could be a little early for the testing window. this could be growing. it could be a recruit. yes, dr. g actually called it a recruit. :) ...up!

and, wow, actually, there is another tiny one there on the right ovary. that could be two recruits! let's see what happens when you do your test kit this week. ...up!

BUT. if we don't see a positive for a hormonal surge on the test kit (so far this week we haven't) and your blood work confirms you didn't ovulate, the next step could be one of three things:

• try a new medication. it is a diabetic medication, metformin, which is also commonly prescribed for PCOS as a substitute for birth control to create a regular menstrual cycle.
• try a new medication that could work but it is being used off label.
• i can refer you to a fertility specialist where you can begin trying more aggressive medications, like monthly injections, or other procedures...

hubby + wifey convo #1: so we might have two recruits. cool. love you, love you too. ...up!

hubby + wifey convo #2: i tried metformin two years ago, to no avail. i was nauseous every day and the bleeding didn't stop for over a month. but i'm willing to try it again if there needs to be a next step. and neither one of us is comfortable using a drug off label. love you, love you too. ...down!

the NEXT day after our ultra sound, i have a positive surge on the test kit. hubby is notified and the proper arrangements are made for us to get busy making future-baby over the next few days. ...up! ...inversion!

wifey fantasy #1: this is one of those stories that you'd never believe: not only are we going to conceive, we will have seen the follicles that led to that conception. and there were two, one on each ovary. twins! ...up!

doctor 1 visit #2: your bloodwork is the best way of knowing if you ovulated. at this point in your cycle, you should have a level of progesterone around 14.

yours is 0.5. ...inversion! ...down! ...down!

hubby + wifey convo #3: neither one of us wants to see a specialist. that leads to an entirely more intense experience physically, emotionally, and financially. controlled multiovulation, like the GnRH infusion pump, immature oocytes harvesting, etc. our hearts just aren't in it. of course we want to conceive, but we are also fulfilled by our marriage and if it just going to be us, we are okay with that. besides, we know plenty of people who randomly, miraculously became pregnant eventually without even trying! love you, love you too.

pregnancy test (just in case): negative. ...down!

doctor 2 visit #1: how are things going? no luck? are you taking the rx for folic acid? essentially, you do not have the luxury of leaving it up to the random and miraculous. if you are not using preventative measures, you HAVE to take the folic acid. if you do not, the damages from lamictal to the fetus are earliest, before you will even know you are pregnant. ...down!

[HAULT] for me, taking the folic acid, putting those little white pills in my palm everyday, feels like i am hoping and i am making a conscious choice to try to conceive. and i don't like doing it. i'd rather not hope so that i'm not disappointed. so i don't take the pills. but. we aren't "not" trying and i am taking lamichtal. i am the most horrid casual, mindless, cursory, disregardful, slipshod, sloppy, heedless, improvident, offhand, perfunctory, imprudent, inadvertent, lackadaisical, loose, incautious, negligent, nonchalant, inconsiderate, indifferent, irresponsible, reckless and regardless future mother ever. you pick the adjective. [RESUME]

doctor visit 1 #3: let's start metformin. three pills a day every day. eat something when you take them.

a month passes and at day 61 of my cycle, i start. spontaneously. dr. g tells me to see if i have a regular cycle over the next month and then we'll resume clomed, but at a low dose. no need to amp things up just yet (goodbye triplets!) ...up!

23 days and i start again. spontaneously. i am nauseous and crabby and will continue to bleed heavily for two weeks. i don't take folic acid. i forget to even take clomed. ...down!

hubby and wifey convo #4: i just don't know what i want or feel anymore. well, i do: future-baby. i want you to keep taking everything and hang in there. ok. i love you, i love you too. ...up!

TODAY.

today i am having my blood drawn again. i had a typical two month cycle and ten days ago i had a positive surge for ovulation. we will hopefully know on monday. :)

future-baby making: month five

after the initial roller coaster, things have settled into a slow and steady drive. kind of like our road trip.

for me, future-baby making is riding in the car with dan and he's driving while i keep dozing off and then waking up to find drool at the corner of my mouth. i am literally trying to sleep until we get there.

it's the only way to keep my wits about me. i take my emotions to the extreme and this is my way of keeping still. so i don't watch the road. i don't make him stop the car. i don't think about anything good or anything bad. i don't ask if we are there yet.

literally the day after my last post, i started, thanks to a healthy dose of progesterone. since then, we are slowly working with my body to coax it into creating a cycle. i take a medication to help my body ovulate, then use a test kit to determine when i do and have my blood checked at the end of each cycle to see if i did at all. no luck yet, but we've seen other progress. april was the first month that i didn't have to take the progesterone to stimulate menstruation, which means my body was able to work naturally at something for the first time. yea!

so we do have a route of sorts. and i gave dan a map. i'm surprised with the scientist in him dan hasn't constructed a graph or chart by now...he is in charge of tracking my basal body temperature. (april told me she did this when trying to conceive. the body averages a single degree spike at ovulation) so every morning when his alarm goes off at 5:30, he wakes me up to stick a thermometer in my mouth. i'll drift in and out of sleep until it chirps, then practically throw it back at him as i roll over into deep sleep again. he notes the temp on a piece of paper we keep on the floor and then hobbes lays down on it as if he's keeping guard.

and so it goes. nothing exciting. days pass, notes are taken, and we keep moving. someday we'll get there. ;)

future-baby making: month one + two*

roller coaster up!

dr. #1 visit #1 go ahead with the future-baby making! first, take this pill so you can ovulate. then, take an ovulation test every day for a week. next, come in for blood work so we can check to see if you ovulated. don't forget your prenatal vitamin and talk to your psychiatrist about your medications because three are class c. (class c drugs have animal studies that had adverse effect on the fetus and/or there are no adequate and well-controlled studies in humans.)

roller coaster down!

dr.#2 - visit #1: you haven't had a period in five weeks? take a pregnancy test. in the meantime, here's an rx for folic acid. now let's talk about your medications. here are your options:

• stop all three medications. this is the safest for future-baby. this is not safe for you because you can have withdrawal and/or a relapse
• stay on all three medications. this is risky during pregnancy for the baby and he/she will experience withdrawal after birth.
• stop trazodone, my sleeping medication. it should be the easiest to come off of.
• stop an additional drug but stay on at least one
• • stop lamictal and stay on cymbalta. (the most recent study with lamictal had cases of birth defects like cleft palate or lip.)
  • stop cymbalta and stay on lamictal. (cymbalta is a very new drug and there are no studies.)

roller coaster down down down!

hubby + wifey convo #1: wean me off lamictal and stay on cymbalta. monitor my condition. post-pone future baby-making until i am off the drug. i love you, i love you too.

roller coaster up!

dr. #3 - visit #1: you haven't had a period in six weeks? take a pregnancy test. your bloodwork is good. you are only deficient in vitamin d. here are drops to take every day. yes, you should see a specialist about your hand and head tremors.

roller coaster up!

dr. #4 - visit #1: you haven't had a pregnancy test in seven weeks? take a pregnancy test. i am diagnosing you with essential tremor. this will more likely get better rather than worse while you are pregnant. after your pregnancy, there are medications you can take if you continue to have trouble with this. i have prescribed lamictal for epilepsy and my patients have had very successful pregnancies. i strongly urge you to stay on lamictal and try going off cymbalta. i have seen too many cases where unknown drugs have caused problems. also, do you have a doctor who will monitor your blood sugar during pregnancy? you are a high risk for gestational diabetes. [at which point i express, given everything from depression to fibromyalgia to diabetes, "i feel like the worst person to get pregnant..." at which point she tells me, "don't even think that. not for one second. you are healthy and young and you are perfect for being pregnant." at which point (as i am recounting the conversation to dan) dan tears up.]

roller coaster up! roller coaster down!

hubby + wifey convo #2: wean me off cymbalta and stay on lamictal. monitor my condition. post-pone future baby-making until i am off the drug. i love you, i love you too.

dr. #2 - phone call #1: i am glad you got a second opinion with the neurologist regarding lamictal. i want to see you in a week. you still haven't had a period? take a pregnancy test.

roller coaster up! roller coaster down!

dr. #1 - phone call #1: you haven't had a period? take a pregnancy test. if it is negative, take this pill to induce a period. then take this pill to ovulate. repeat ovulation kit and appointment for bloodwork.

roller coaster down!

dr. #2 - visit #2: glad to hear you have no withdrawal symptoms! monitor your mood and as soon as you feel like you might be slipping back into a depressive state, we'll talk. if that happens, we can try a class A medication. it is safe to stay on trazodone at a low dose since you are activated at night without it. here's an rx for more, and for the new dissoluble lamictal tablets. let's meet again in six weeks.

roller coaster up!

hubby + wifey convo #3: one more week and we're good to go!!! except the getting the period thing! so now we wait for that in exciting anticipation. ironic. i love you, i love you too.

roller coaster up! roller coaster down! roller coaster up!

* gosh darnit. blogging is such a good way to vent. i guess there will be future-baby making posts.

At My Desk: Health Insurance

Listening to: NCAA coverage

Stack of books: Carnet de Voyage by Craig Thompson, From Dawn to Decadence by Jacques Barzun, The Quiet American by Graham Greene.

Pile: Daily planner, magazines, Prescott College Master of Arts catalog.

Miscellaneous: Triscuits, NOMC chronic pain support group pamphlet, scissors, beer.

The boys: Rocco sleeping on the chair, Hobbes making the rounds, Dan watching the game.

Thinking about: Two weeks ago my doctor put me on a new anti-depressant, Cymbalta. It's a young drug...Only three years old and therefore has no generic form yet. I took the introductory pack she gave me and then went to get my prescription filled before I left for Illinois. My insurance denied the medication coverage until I tried 4 alternative drugs that have generic forms. (Had I actually taken that route, it would have taken at least six months to try those and see if they were working effectively--no matter my doctor's opinion that this is the best drug for me to try at this point.) It took a week for the pharmacist, my doctor, and the insurance company to work it out. (My doctor submitted information claiming I had already tried those drugs and need to be on Cymbalta.) This was very frustrating. Isn't it my doctor's job to determine what I take? Who is the insurance company to prescribe my meds? I am not a real person to them, just another policy holder. They are pinching their pennies (rightfully so, given the economic climate in Oregon and the threats to subsidized state health care)...Yet, the snafu left this policy holder dangerously dropping off a medication and helpless for over a week. I don't know how I got through my trip feeling so unstable...I did a lot of crying and sleeping in between seeing friends and helping with the wedding. Dan picked up the medication today, and even with the final approved copay, we're going to shell out $75 every month until we can see how the drug is working....and then go from there. Of course I want the drug to work. I want to feel better. At the same time, I don't. I don't want such an expensive drug. This experience has made me very angry, yet I don't know who to blame. Myself? I fail to find a secure job with a company that can offer me health care. The insurance company? They are doing their best to offer coverage for everyone else like me in this state who is denied coverage by regular insurance companies. We already have pre-existing health conditions and I'm sure they are all very costly to treat. Those insurance companies denying me? Politicians? Investors? What can I even do to make this better for myself or other people like me? I feel very helpless.

Tell me who to write, who to call, what house to egg.

Week of Ups and Downs

Well, mostly downs. The job hunt has been stressful and unfruitful. I'm grasping at anything at this point...About ready to apply at the gas station as long as they have benefits. I've also had a tough time with my depression...Which hasn't been easy but has lead me to believe that the medication I have been on a long time may not be doing the job anymore. I had two doctor visits, which always stress me out the night before, but in the end they were good. Dr. G. is supportive of baby-making in good time and gave me a time-table to work with, and he also recommended a fabulous psychiatry clinic in Beaverton where I can start to work with someone specifically on my anti-depressant medication instead of with a general practice doctor. It has also been a year since I was seeing someone in therapy, and I've learned in this time that I need to have that. Today I had blood drawn and even though that stresses me out, my day was brightened by the adorable man-nurse with dreads and a great sense of humor. He took really good care of me and I can't wait to see him next time. ;-) I've also been struggling with a major bout of insomnia this week, which hasn't helped my Fibromyalgia or Depression. What it has done is fired brain cells. I have gained knowledge regarding the major flea markets in the country and a special chateau in North Carolina, learned more from Pastor Scott (anyone who is awake at 2 in the morning is familiar with this Biblical scholar) and thanks to the Discovery Channel's Shark Week, I have come to understand the nuances of all American shark breeds and their locations, as well as South African Great Whites and Tiger sharks, the crazy experts that dive and swim along with them, and the not-so-wonderful stories of six people who have survived being eaten alive. I LOVE SHARK WEEK!

Anyway, tonight I was particularly frustrated after an entire day of rejections and employment trails that lead nowhere, but I had a wonderful massage and now I'm watching the results show of So You Think You Can Dance (or as we like to call it "So You Think You Have Pants"), with a whiskey and coke my hubby mixed, awaiting the fabulous bean and egg burritos he is preparing, and the lovely booger also pulled up six new job listings for me to look at while I was away earlier. I love my hubby. He takes such good care of me!

P.S. If you are in the greater Portland area and reading this and have the knowledge of a fabulous job for me, please let me know. ;-)

Economic Stimulus Check

We got it--finally. I wish we could use it to get Dan a new fishing pole, myself a new bike, or maybe just for fun to go out to dinner and see a movie. Instead, the whole whopping thing will go to medical bills. And I have insurance. And we MET the $1000 deductible practically right off the bat! Medical bills are such a pain. Did I mention I'm looking for a new job with benefits? We also have a special assessment on our condo to get new roofing completed on all of our buildings. Luckily Dan has been doing side jobs every weekend over the past year, so his savings will cover that, enabling us to use our "economic stimulus check" to pay for past due medical bills. What is necessary. For blood tests. Doctor visits. Invasive pelvic probe procedures. Thyroid testing. A shot of a powerful painkiller straight to the hip. How stimulating.

Please share the wonderful things that the rest of you have done with your checks!!! I want to live vicariously through you........!

FMS Nest

See today's post here.

Tuesday: Long Overdue Baby Update

Usually Dan posts on Tuesday nights, but tonight he is at a class at Clackamas Community College for work. I am supposed to be in class but again I have stayed home. I am trying to placate Hobbes.

Let me fill you in on a little bit of what we've been dealing with lately...

Remember when Dan wrote this adorably honest and sweet post about us trying to start a family? Well, we've never really followed up with that because we didn't have that exciting we-did-it!-there's-a-little-human-on-the-way! post.

So what happened? I gave it a-go with the medication for four months, only to give up. I was experiencing lots of nausea as a side effect and toward the end, I had a hard time faithfully taking that gag-inducing horse pill three times a day. My doctor offered an extended-release tablet that I only had to take twice a day, but with no change, I finally threw my hands up in the air and asked for the GODDAMN BIRTH CONTROL PILL, ALREADY!

We realized it just wasn't the best time for aggressive-baby-making, given my daily struggle with health problems combined with school, work, etc. At this time, we also received the exciting news that we would soon become an Aunt and Uncle, and we've also been able to get our baby fix with Pax, the cutest little peanut on the planet.

Just when I thought everything had settled down and I would be popping the pill until further notice, I continued to have bleeding as I always have. Last Tuesday, I went in to talk to my doctor and check on my uterus and all those special lady parts in light of my diagnosis with PCOS, only to find that the lining of my uterus was much like "an overgrown lawn" that needed some weeding, pruning, and mowing, if you will. Concerned at the sight of my uterine jungle that had grown 5 times the normal size, my doctor performed an emergency procedure to procure tissue from the untamed garden, leaving me doped up on painkillers and bewildered as I told Dan that the doctor feared I might have endometrial hyperplasia or cancer.

We waited--HOW do you even articulate this sort of waiting?--for four days for his CHEERFUL phone call that let us know the cells of the tissue were benign. In the meantime, I had to put schooling on hold as I rested and medicated, as well as leaving EVERYTHING up in the air until I knew whether or not I would need surgery to remove the overgrown lining.

At this point, the plan is for me to weather this "period from hell" (direct quote from Dr. Girolomi) with some Vicodin, heating pads, and copious amounts of super tampons and chocolate milkshakes. I will continue to take THE PILL in order to get enough progesterone, and in six weeks I will get tested again, just to make sure everything is back to normal, and that sufficient pruning has occurred.

I really have to laugh as I write this because if I don't find the humor in it all, I just can't keep going. I am not one to talk openly or aggressively about my health problems, but I have to say that it is a daily reality that really beats me down. At this point, I am at least learning how to talk about having Fibromylagia, using FMS Nest to help me articulate the convoluted existence I have with that illness, but what do I do with the rest? Do I have to start a blog for every diagnosis I get? It's all just so overwhelming.

I hope y'all don't mind if I occasionally use this format to vent or analyze my medical existence. Thank God I found a partner that is sensitive and caring, not to mention the best goddamn cheerleader on the planet. If he didn't make me giggle everyday of my life, I don't know what I'd do.

So, hopefully, I'll get to write another post someday that says BABY!

And the best part is...

Starting a family with...

So How Do You Make a Baby Again?????

You put the guy's thingy in the girl's thingy, and presto: Instant little human!!! Movies and TV make it seem that easy, but I don't think it is. On this blog there are baby clothes, a crib, and baby toys, so one might ask, "Is Leah pregnant?!!?!" Well...the answer is NO for those inquiring minds.

However, we HAVE been doing some research.

One of the only truly heated discussions Leah and I have had during our almost 3 years of marriage, was the issue of adoption. I am not against adoption at all, but my basic stance was: if we couldn't have children the old fashioned way, I would consider adoption because at the root of it all....I want to be a father. Those of you that have known Leah, or read about her on her various blogs, you know by now that she has some pretty big health issues--fibromyalgia being a tough one. She does not (or did not) think that her body could handle the rigors of being pregnant. (Of all the research I have done, I have found that for 99% of the female population, being preggers ain't a Sunday afternoon stroll.) I have to give my wife so much credit because she has decided with me to give it a try the "old fashioned way."

Now comes the hard part.....

(By the way, this is going to be long, so please feel free to excuse yourself and grab your favorite snack item.)

Enter more research and health class information.

So here is the deal. The best time to conceive a child is when the woman is ovulating: Leah's got an egg and it is waiting to hook up with one of my little fellows. Most women ovulate 10 or so days after their period has ended. Hence first issue. Leah is on her period anywhere from 24-35 days. RED FLAG. THAT AIN'T NORMAL! She went to visit the "lady doctor" to be like, "ummm got some problems goin on down there," and it turns out she has Polysystic Ovarian Syndrome. So she produces an egg, but then it multiplies into cysts (preventing her from being fertilized by one of my playa's) and then she bleeds forever! Now there are 2 options for this syndrome: 1) Take birth control to regulate hormones (baby makin not an option) or 2) Take another type of pill to regulate the period and start ovulation. Which door did they choose Alex??? We went with #2. Again, mad props to my wifey, because one of the side effects is nausea and for the first month she was not feeling in the best of sorts. Her bleeding has stopped, but she has not had a period yet. Who knew there was so much going on down there that could go wrong!? I mean, with guys it is easy. Hmmmm, its purple....see doctor.....hurts when I pee.....see doctor....can't find it......probably see doctor. Anyway, the point is that Leah is undergoing "under the hood maintenance" so we can try for futurebaby.

(Why don't I use the correct scientific terms for this process? People, this is entertainment. Plus, I know my Mom reads this.)

Speaking of my mom. Leah was wondering why I have not told my mother all of these things? She has told friends and family that we are in fact T.R.Y.I.N.G. I don't have a good answer for that. I guess that I am a big fan of surprises, so I wanted to be on the phone one Sunday and say, "Hey mom, by the way, Leah and I are pregnant!" I love surprises! I also think part of it is that I have always been a reserved person who does not talk to people about feelings, and things, in my life, you know......Typical male traits (I also drink beer and obsess about football.) I have always wanted to know about other people, listen to other people, and make other people happy, and I think part of me doesn't want to talk about this because I don't want to let people in, and also I think making other people happier means more (perhaps I should see a psychologist about this stuff?) I also think part of me doesn't think it will be easy, something will go wrong--maybe drastically wrong. It may be a deep-seeded pessimism I have with many things, but I don't want to imagine some of the hardships that my parents went through. Did my parents survive? Yes, they have two healthy, tall, and incredibly good looking sons (heh heh). I guess I would rather tell my parents once I knew everything was going OK, healthy, and running smooth. Now the cat is out of the bag, and we are "trying" officially (because I have typed this). To my mother who I know is reading this, "You know I have always been better with writing words than saying them, so I hope you understand. I love you, and ELBOWS to dad."

So, the best part.....getting to try to make a baby!! As everyone knows, being the male in conceiving is pretty easy and awesome. I am all for practicing as much as we can and as often as we can. When you think about your parents it always comes down to the same equation...."Honeymoon + Child #1 + Child #2 + repeat for the # of children = # of times parents have had sex." I know that isn't true, but I think most kids like to think so. I have told Leah we can practice as much as she would like, because I am committed to do my part. Which I alluded to above was easy and fun :)

So I am sure now that the secret is out that Leah will be filling everyone else in on the specifics and the everyday life of a married couple trying to start a family.

But the best part is......

Starting a family with....