I am not not pregnant. I am a little bit pregnant. Which is a lot more pregnant than I have ever been before.
My HCG beta came back at 25. Over 100 is ideal. 25 is really low, possibly/probably a chemical pregnancy. So I am maybe pregnant. On Monday I will go back in for another blood test to see if my beta has doubled. I pray that it does.
Here is the good news: my body can possibly get pregnant. It can happen. I wasn't sure that it could. No matter how this turns out, I can take that piece of very good news with me. The other good news that I should not forget between now and Monday is that there is a small chance that this might work. It's not terribly likely but the chance is there. As I said in a previous post, "maybe" is a very happy place for me.
Saturday, March 30, 2013
Thursday, March 28, 2013
The last real day - 8dp3dt
I am considering this the last real day before my blood test. (I honestly can't bear using the words "pregnancy test." Perhaps I'll pretend I'm being blood typed or something as I sit in the chair with my favorite salsa dancing lab technician. I don't know his name, he probably knows mine or my patient ID. All day he listens and sings out loud to old school salsa. I love it. It's much easier to distract myself while he croons.) I say the last real day because A) I am a child and have a warped sense of time and B) tomorrow is Good Friday and I have the day off of work. Tomorrow will be a fun day to simply fritter away. I might get my bangs trimmed and visit my grandma. It might be that wild and crazy. That is, after I complete the Stations of the Cross. Um, not really. I don't actually even know what that means in a practical sense. I figure it would require prayer and walking on my
knees on stone flooring.
My single goal for today is to be productive at work (good start, eh?). This is a formidable task since I spend much of my day sitting in front of the sickly glow of Dr. Google. Don't google today. There is nothing to be found. There is no magical combination of search terms to tell you if you're pregnant or not, or what medications you should be on next time if there is a next time.
Is it horrible to admit that I think there will be a next time? And that I'm not all that upset about it? Not really. I just expect it. When you've been on such a long road, it's very hard to imagine that you'll ever get to pull over and take a nap. Long distance trucking is an absolutely apt description for infertility.
On this last real day and last real blog post before my blood donation, I wanted to do a little product placement. Here's to you, Tylenol! The only drug I can take during IVF and pregnancy. Cures about 7% of what ails ya. Seriously though, this fertility haul has made me look a lot at my diet. I never ate particularly unhealthily but I have made a few real changes to my diet. First, I scrapped my dependence on caffeine. It hurt. Terribly. But just for a little while. I went from 2-3 cups of strong coffee a day to zero with an occasional cup of decaf to get me through the shakes. I weaned myself slowly going from full blast to half-caf to decaf and then nada. I drank green tea for a while, mostly decaf, but got really tired of it. It is an uninspiring hot beverage and, according to my acupuncturist (yep, I've gone all crunchy granola these days), too cooling to the body. These days I'm allowing myself black tea or homemade chai with almond milk in the morning. It's caffeinated but pales in comparison to a grande dark roast. Product placement #1 - Lipton Yellow Label and Twinings English Breakfast.
Another change has been my full acceptance of the fact that I'm lactose intolerant. No more grilled cheese sandwiches with creamy soup. Worst of all, no more ice cream (well, a very occasional treat). It's remarkable how grateful my digestive system is. Product placement #2 - Almond milk. Any brand. Thank you.
The most difficult change has been avoiding gluten. I don't eat completely gluten free. I don't have the patience nor the ill-effects of a true gluten intolerance to inspire me. While I'm certainly not any shade of Celiac, I have learned that gluten is an inflammatory and is thought to affect fertility. And since my fertility is certainly affected, I thought I'd give going gluten-free (or gluten-limited) a whirl. I don't know if it's affected much of anything. If anything, it's kept me from being so carb dependent. I know that this is not a change I'll incorporate into the rest of my life but it gives me a sense of control for now. One of the hardest things about infertility is the feeling that you can't control your treatments and the outcome. Diet is one productive thing to grab hold of. And with that, product placement #3 - a shout out to Ancient Harvest quinoa spaghetti, Udi's Gluten-Free breads, Pamela's cookies, herb bread from Marie Catrib's of Grand Rapids, MI and rice crackers. Ok, looks like I'm just as carb dependent as before.
Finally, phyto-estrogens. This is sort of a minefield and one I choose not to drive myself crazy with. I've got plenty of crazy. Soy is a phyto-estrogen and can negatively impact your hormonal balance when consumed in large amounts. So I simply limit my tofu and soy milk intake. That's it.
Is any of this making a difference? Who knows. All of the changes I have made simply feel like healthy ones. I haven't lost any weight and have only seen digestive benefits. I'll spare you the details. Much of this won't all stay with me when infertility is behind me. I miss coffee and bagels too much. Together and separately. Coffee and bagels, I will come back. Just not yet.
What diet and lifestyle changes have you made to reach a goal, fertility related or otherwise?
knees on stone flooring.
My single goal for today is to be productive at work (good start, eh?). This is a formidable task since I spend much of my day sitting in front of the sickly glow of Dr. Google. Don't google today. There is nothing to be found. There is no magical combination of search terms to tell you if you're pregnant or not, or what medications you should be on next time if there is a next time.
Is it horrible to admit that I think there will be a next time? And that I'm not all that upset about it? Not really. I just expect it. When you've been on such a long road, it's very hard to imagine that you'll ever get to pull over and take a nap. Long distance trucking is an absolutely apt description for infertility.
On this last real day and last real blog post before my blood donation, I wanted to do a little product placement. Here's to you, Tylenol! The only drug I can take during IVF and pregnancy. Cures about 7% of what ails ya. Seriously though, this fertility haul has made me look a lot at my diet. I never ate particularly unhealthily but I have made a few real changes to my diet. First, I scrapped my dependence on caffeine. It hurt. Terribly. But just for a little while. I went from 2-3 cups of strong coffee a day to zero with an occasional cup of decaf to get me through the shakes. I weaned myself slowly going from full blast to half-caf to decaf and then nada. I drank green tea for a while, mostly decaf, but got really tired of it. It is an uninspiring hot beverage and, according to my acupuncturist (yep, I've gone all crunchy granola these days), too cooling to the body. These days I'm allowing myself black tea or homemade chai with almond milk in the morning. It's caffeinated but pales in comparison to a grande dark roast. Product placement #1 - Lipton Yellow Label and Twinings English Breakfast.
Another change has been my full acceptance of the fact that I'm lactose intolerant. No more grilled cheese sandwiches with creamy soup. Worst of all, no more ice cream (well, a very occasional treat). It's remarkable how grateful my digestive system is. Product placement #2 - Almond milk. Any brand. Thank you.
The most difficult change has been avoiding gluten. I don't eat completely gluten free. I don't have the patience nor the ill-effects of a true gluten intolerance to inspire me. While I'm certainly not any shade of Celiac, I have learned that gluten is an inflammatory and is thought to affect fertility. And since my fertility is certainly affected, I thought I'd give going gluten-free (or gluten-limited) a whirl. I don't know if it's affected much of anything. If anything, it's kept me from being so carb dependent. I know that this is not a change I'll incorporate into the rest of my life but it gives me a sense of control for now. One of the hardest things about infertility is the feeling that you can't control your treatments and the outcome. Diet is one productive thing to grab hold of. And with that, product placement #3 - a shout out to Ancient Harvest quinoa spaghetti, Udi's Gluten-Free breads, Pamela's cookies, herb bread from Marie Catrib's of Grand Rapids, MI and rice crackers. Ok, looks like I'm just as carb dependent as before.
Finally, phyto-estrogens. This is sort of a minefield and one I choose not to drive myself crazy with. I've got plenty of crazy. Soy is a phyto-estrogen and can negatively impact your hormonal balance when consumed in large amounts. So I simply limit my tofu and soy milk intake. That's it.
Is any of this making a difference? Who knows. All of the changes I have made simply feel like healthy ones. I haven't lost any weight and have only seen digestive benefits. I'll spare you the details. Much of this won't all stay with me when infertility is behind me. I miss coffee and bagels too much. Together and separately. Coffee and bagels, I will come back. Just not yet.
What diet and lifestyle changes have you made to reach a goal, fertility related or otherwise?
Tuesday, March 26, 2013
In between, almost there - 6dp3dt
This is such an odd, in between kind of time. I'm so close to the official end of this cycle and so far from where I started, popping birth control pills in February. And yet Saturday, the big blood draw, seems quite distant. I am alternately sure that I'm not pregnant, 10 minutes later thinking that maybe there's a chance, and later that day feeling very positive. I can't stay negative, I'm not letting myself. Notice I don't say that I feel sure I AM pregnant. I don't know how to feel that after 15 months of negative pregnancy tests. Uncertainty is positivity to me. "Maybe" is a very happy place.
My symptoms are nil. No waves of nausea, boobs are no more sore than normal on progesterone, no particularly interesting twinges or cramping. Nothing significant. I want projectile vomit and boobs on fire. I want something dramatic and sure. Like the results of a blood test. Saturday. Breathe, wait.
I think I will feel relief either way the test goes. I will be really sad and frustrated if it's negative. I plan for a Starbucks and a bottle of wine in that case. And I'll be thrilled and mostly shocked if it's positive. Either way I can stop holding my breath for this cycle and move onto the next challenge, whichever it may be.
My symptoms are nil. No waves of nausea, boobs are no more sore than normal on progesterone, no particularly interesting twinges or cramping. Nothing significant. I want projectile vomit and boobs on fire. I want something dramatic and sure. Like the results of a blood test. Saturday. Breathe, wait.
I think I will feel relief either way the test goes. I will be really sad and frustrated if it's negative. I plan for a Starbucks and a bottle of wine in that case. And I'll be thrilled and mostly shocked if it's positive. Either way I can stop holding my breath for this cycle and move onto the next challenge, whichever it may be.
Sunday, March 24, 2013
The Survivor - 4dp3dt
Today I feel like time is finally starting pass normally. Not as painfully slowly as before. The work week is ahead of me and as gruesome as that can be, it typically passes in a blur. Part of the beauty of having an unmanageable workload.
Downton Abbey is playing a large, nay enormous role in my time management. I'm a total junkie. If Maggie Smith and I aren't smirking then it is simply time wasted. Netflix is so crucial to a bearable "two-week-wait." TWW in TTC lingo. There is an hilarious amount of verbiage associated with the IF (infertility) online community. Your husband is your DH - darling husband - and your children are your DS and DD - darling son & darling daughter. There's more, loads more, but the required prefix of "darling" is the one I find the ickiest. A typical post on a TTC form look like this:
DH and I went to the RE yesterday while DS stayed with my MIL. After TTC for 2 years, a diagnosis of PCOS and 2 failed IUIs, we're on to IVF. I'm most nervous about the PIO shots and, gulp, of course the HCG beta!
I'm not translating. It's best that you have no idea what that means. I have never ever called my husband "darling." He is hairy and sometimes farts in bed. While he has many endearing qualities, I could never pin the term "darling" on him.
I did end up getting a call from the embryologist yesterday. Of the 3 embryos we were waiting on, 1 made it to blastocyst stage and was frozen for possible future use. The other two didn't make it past their day 3 development. 3 viable embryos out of 7 mature follicles and 11 total follicles is nothing to write home about. Should this cycle not work out, I have to have a discussion with my doctor about changing medication protocols to encourage better quality embryos. I may never have the best eggs in the hen house but there are medications that tend to work better for those of us with quality issues.
All of this said, I was actually very encouraged by my talk with the embryologist. I had the opportunity to ask about the two 6-cell embryos that were transferred. Both of them had zero fragmentation (parts of cells breaking off) which is excellent. One of them was a Grade 1 (all cells equally sized) and the other was a Grade 1-2 (slight variation in divided cell size) which she assured me was not problematic. If my lone survivor cell was able to keep growing into a blastocyst then why not the healthy (if a little slow - like me) embryos that were actually implanted? No reason. No reason at all. Focus on growing, implanting and hatching. Yup, even human eggs hatch.
Downton Abbey is playing a large, nay enormous role in my time management. I'm a total junkie. If Maggie Smith and I aren't smirking then it is simply time wasted. Netflix is so crucial to a bearable "two-week-wait." TWW in TTC lingo. There is an hilarious amount of verbiage associated with the IF (infertility) online community. Your husband is your DH - darling husband - and your children are your DS and DD - darling son & darling daughter. There's more, loads more, but the required prefix of "darling" is the one I find the ickiest. A typical post on a TTC form look like this:
DH and I went to the RE yesterday while DS stayed with my MIL. After TTC for 2 years, a diagnosis of PCOS and 2 failed IUIs, we're on to IVF. I'm most nervous about the PIO shots and, gulp, of course the HCG beta!
I'm not translating. It's best that you have no idea what that means. I have never ever called my husband "darling." He is hairy and sometimes farts in bed. While he has many endearing qualities, I could never pin the term "darling" on him.
I did end up getting a call from the embryologist yesterday. Of the 3 embryos we were waiting on, 1 made it to blastocyst stage and was frozen for possible future use. The other two didn't make it past their day 3 development. 3 viable embryos out of 7 mature follicles and 11 total follicles is nothing to write home about. Should this cycle not work out, I have to have a discussion with my doctor about changing medication protocols to encourage better quality embryos. I may never have the best eggs in the hen house but there are medications that tend to work better for those of us with quality issues.
All of this said, I was actually very encouraged by my talk with the embryologist. I had the opportunity to ask about the two 6-cell embryos that were transferred. Both of them had zero fragmentation (parts of cells breaking off) which is excellent. One of them was a Grade 1 (all cells equally sized) and the other was a Grade 1-2 (slight variation in divided cell size) which she assured me was not problematic. If my lone survivor cell was able to keep growing into a blastocyst then why not the healthy (if a little slow - like me) embryos that were actually implanted? No reason. No reason at all. Focus on growing, implanting and hatching. Yup, even human eggs hatch.
Saturday, March 23, 2013
Waiting - 3dp3dt
3dp3dt - fertility lingo for "3 days past 3-day transfer." Good lord time is passing slowly. They should send you on a mandatory vacation during this wait. I am trying to visualize my embryos growing, cells continuing to divide and latching on to my uterine wall. Hard things to imagine.
I have come along way in 3 days from my sorry state on Wednesday, transfer day. When the doctor told me that my so-so embryos could be the reason for my not getting pregnant, it made me feel like a complete failure. All along, trying so hard, restricting everything in my diet and my eggs could have been bum the whole time. I'm sure my body is glad to not have guzzled Starbucks and labored over digesting dairy for the past year to several months (depending on which phase of my diet shenanigans we focus on) but it's hard not to think that perhaps I could have had a coffee now and then and not made a bit of difference. That said, I haven't reintroduced any of my vices. Old sad eggs made me feel awful. Proving annoyingly that there is a Sex and the City episode for all of life's situations, I felt very much like Miranda when she is diagnosed with a lazy ovary. "Those ovaries went to Harvard!"
I started mourning much too early. At least that's what my loving and supportive friends, family and, shockingly, Google, taught me. My B - B+ eggs, the ones that were transfered were 6-cell embryos. Ideally, they would have been 8-cell. So they're a little on the slow side. So's their mama, as I was reminded. My dear friend S immediately recalled that my first grade teacher told my mom and dad at the first parent teacher conference that I would never learn to read. Ever. Didn't have the capacity. Not only that but I "just wasn't going to make it." In life? After knowing a first grader for 6 weeks, can you really sentence them to an illiterate adulthood spent jobless living in their parents' basement? Mrs. Farmer felt that was exactly the case. Surprisingly, I am not dictating this to my transcriber. I am typing this myself. Because I can read. Quite well, actually. By second grade I was a voracious reader. I just started out a little slow. My mother pointed out that I didn't learn to walk until I was 17 months old. And then became a pretty decent ballet dancer. I have a tendency in life to take my time and get things right instead of rushing in and falling down. This is the hope for my embryos. They are like their mama, starting out slow, taking their time and then getting it right.
Dr. Google is typically a very evil thing. I should know since I received my medical degree in part from Google University and in part through osmosis by hanging out near my doctor dad, nurse sister and psychologist mom. It is a wonder no hospital will hire me with my credentials. Google tends to get me all anxious as I sift through every perfect search term with various combinations of infertility, unexplained, embryo, endometriosis, psychosis. In this case, when I searched the term "6-cell embryo" I found encouragement both dependable sites written by fertility centers as well as crazy baby forums willed with posts by unstable, mentally-frail women. Fertility centers look for embryos to be between 6 and 10 cells on day 3 with 8-cell being ideal. I don't need ideal. I just need a fighting chance. And it looks like I have one. I have to stay positive and know that they embryos that were implanted were in the range that fertility doctors hope for.
As for the others, 2 5-cell embryos and a 4-cell, they were to be cultured in the lab until Friday or Saturday (today) and then either frozen or discarded. I was supposed to get a call by today with the news but never got one. I'll stalk the embryology lab down on Monday.
I also shall continue to remember that Miranda and her lazy ovary made a baby. In additon, I'll try not to feel like too much of a typical white, 30-something urbanite quoting Sex and the City. Ewwww.
I have come along way in 3 days from my sorry state on Wednesday, transfer day. When the doctor told me that my so-so embryos could be the reason for my not getting pregnant, it made me feel like a complete failure. All along, trying so hard, restricting everything in my diet and my eggs could have been bum the whole time. I'm sure my body is glad to not have guzzled Starbucks and labored over digesting dairy for the past year to several months (depending on which phase of my diet shenanigans we focus on) but it's hard not to think that perhaps I could have had a coffee now and then and not made a bit of difference. That said, I haven't reintroduced any of my vices. Old sad eggs made me feel awful. Proving annoyingly that there is a Sex and the City episode for all of life's situations, I felt very much like Miranda when she is diagnosed with a lazy ovary. "Those ovaries went to Harvard!"
I started mourning much too early. At least that's what my loving and supportive friends, family and, shockingly, Google, taught me. My B - B+ eggs, the ones that were transfered were 6-cell embryos. Ideally, they would have been 8-cell. So they're a little on the slow side. So's their mama, as I was reminded. My dear friend S immediately recalled that my first grade teacher told my mom and dad at the first parent teacher conference that I would never learn to read. Ever. Didn't have the capacity. Not only that but I "just wasn't going to make it." In life? After knowing a first grader for 6 weeks, can you really sentence them to an illiterate adulthood spent jobless living in their parents' basement? Mrs. Farmer felt that was exactly the case. Surprisingly, I am not dictating this to my transcriber. I am typing this myself. Because I can read. Quite well, actually. By second grade I was a voracious reader. I just started out a little slow. My mother pointed out that I didn't learn to walk until I was 17 months old. And then became a pretty decent ballet dancer. I have a tendency in life to take my time and get things right instead of rushing in and falling down. This is the hope for my embryos. They are like their mama, starting out slow, taking their time and then getting it right.
Dr. Google is typically a very evil thing. I should know since I received my medical degree in part from Google University and in part through osmosis by hanging out near my doctor dad, nurse sister and psychologist mom. It is a wonder no hospital will hire me with my credentials. Google tends to get me all anxious as I sift through every perfect search term with various combinations of infertility, unexplained, embryo, endometriosis, psychosis. In this case, when I searched the term "6-cell embryo" I found encouragement both dependable sites written by fertility centers as well as crazy baby forums willed with posts by unstable, mentally-frail women. Fertility centers look for embryos to be between 6 and 10 cells on day 3 with 8-cell being ideal. I don't need ideal. I just need a fighting chance. And it looks like I have one. I have to stay positive and know that they embryos that were implanted were in the range that fertility doctors hope for.
As for the others, 2 5-cell embryos and a 4-cell, they were to be cultured in the lab until Friday or Saturday (today) and then either frozen or discarded. I was supposed to get a call by today with the news but never got one. I'll stalk the embryology lab down on Monday.
I also shall continue to remember that Miranda and her lazy ovary made a baby. In additon, I'll try not to feel like too much of a typical white, 30-something urbanite quoting Sex and the City. Ewwww.
Wednesday, March 20, 2013
Transfer Day
It is 11:37 am, I was supposed to arrive at 10:45 with a partially full bladder. Now, nearly an hour later, my bladder is preposterously full. They're running late. At this point my day 3 transfer may turn into a day 5 transfer merely due to the office backlog.
Breathing. Not peeing on myself. The upside is that rather than getting myself all anxious about the health of the embryos and the actual transfer, I'm instead focusing on my bladder. I have a handy-dandy diazepam (sweet, sweet muscle relaxant) ready for the actual transfer. Lets hope that it doesn't have the effect of relaxing my bladder during the procedure. Although it would serve them right.
Fast forwarding...
That didn't go as I had hoped. I know I am not the only woman to cry on the exam table during the required 20 minutes on my back. My eggs are, in technical terms, "meh." By today, they were supposed to have divided into 8 cells. Only 2 of the 5 made it to 6 cells. The doctor, not my usual, said that he would expect to see better quality embryos at my age. Me too. He also said this may explain why I haven't gotten pregnant. Regardless, he said these embryos gave me a "reasonable" shot at pregnancy. That's the bright side because until today my chances have been unreasonable.
I have not given up on this cycle but I am really, really sad. Sad for my future, the certain decline in quality of my eggs as I continue to (prematurely?) age.
Switching tunes, I need to try to be positive and encouraging to myself and my average embryos. I should probably sing.
Breathing. Not peeing on myself. The upside is that rather than getting myself all anxious about the health of the embryos and the actual transfer, I'm instead focusing on my bladder. I have a handy-dandy diazepam (sweet, sweet muscle relaxant) ready for the actual transfer. Lets hope that it doesn't have the effect of relaxing my bladder during the procedure. Although it would serve them right.
Fast forwarding...
That didn't go as I had hoped. I know I am not the only woman to cry on the exam table during the required 20 minutes on my back. My eggs are, in technical terms, "meh." By today, they were supposed to have divided into 8 cells. Only 2 of the 5 made it to 6 cells. The doctor, not my usual, said that he would expect to see better quality embryos at my age. Me too. He also said this may explain why I haven't gotten pregnant. Regardless, he said these embryos gave me a "reasonable" shot at pregnancy. That's the bright side because until today my chances have been unreasonable.
I have not given up on this cycle but I am really, really sad. Sad for my future, the certain decline in quality of my eggs as I continue to (prematurely?) age.
Switching tunes, I need to try to be positive and encouraging to myself and my average embryos. I should probably sing.
Tuesday, March 19, 2013
Signs Everywhere. Simply Everywhere.
I am really into signs. Good and bad omens. Frankly, almost anything can be a harbinger of what's to come. My mother and grandmother share this unshakable belief in signs. I think its the benevolent Puerto Rican witch in each of us. And perhaps a failure to excel in science and statistics.
This morning, I was driving to a job site just across the border in Wisconsin. The day was going well enough, sunny and clear, and I was very close to being on time. In the right lane, there was a truck with a four-leaf clover logo - a shamrock, if you will - and the name "Luckey Transfer." Now, the name alone seems like good luck, right? Literally. But there's more.
A) The shamrock refers to our St. Patrick's Day retrieval.
B) "Lucky" is the name that J and I keep using to refer to our someday baby. J says, quite morbidly, that he will be lucky to be alive. I prefer not to think like that. Also note that J refers to our hopeful future child as "he." I've been coming back to Lucky because of how lucky we'll be to have a child. That's much sweeter.
That has insanely-good-omen written all over it. Luckey Transfer and our lucky transfer is tentatively tomorrow (assuming we go for the 3-day embryo transfer, standard at my doctor's office). Minutes later a truck passed that said "Mills Transfer" on it. That is not an omen at all. Simply a truck.
On my way back from Wisconsin, I listened to a podcast of "Here's the Thing" with Alec Baldwin. His Guest? Quarterback Andrew Luck. I understand that's not quite the dancing leprechaun that the truck was but it can't be overlooked either.
This post alone could have me committed. Or at least my meds increased.
This morning, I was driving to a job site just across the border in Wisconsin. The day was going well enough, sunny and clear, and I was very close to being on time. In the right lane, there was a truck with a four-leaf clover logo - a shamrock, if you will - and the name "Luckey Transfer." Now, the name alone seems like good luck, right? Literally. But there's more.
A) The shamrock refers to our St. Patrick's Day retrieval.
B) "Lucky" is the name that J and I keep using to refer to our someday baby. J says, quite morbidly, that he will be lucky to be alive. I prefer not to think like that. Also note that J refers to our hopeful future child as "he." I've been coming back to Lucky because of how lucky we'll be to have a child. That's much sweeter.
That has insanely-good-omen written all over it. Luckey Transfer and our lucky transfer is tentatively tomorrow (assuming we go for the 3-day embryo transfer, standard at my doctor's office). Minutes later a truck passed that said "Mills Transfer" on it. That is not an omen at all. Simply a truck.
On my way back from Wisconsin, I listened to a podcast of "Here's the Thing" with Alec Baldwin. His Guest? Quarterback Andrew Luck. I understand that's not quite the dancing leprechaun that the truck was but it can't be overlooked either.
This post alone could have me committed. Or at least my meds increased.
Subscribe to:
Posts (Atom)