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Kristy

IVF and Running

June 29, 2013 by Kristy 38 Comments

I guess my next logical post is to explain how I got myself into this situation, especially since it was not the norm. As you can tell from the title of this post, we conceived via IVF and were fortunate (very fortunate) to be successful on the first cycle. To put it in perspective, women age 35 to 37 have a 30% chance of a live birth per cycle. For women under 35, it’s 40%. Like my sister-in-law told me, someone has to be that 30%. We are lucky to be included in that percentage.

I don’t want the focus of this post to be infertility. Yes, we had fertility issues but I was able to get pregnant in less than a year. I don’t consider it a struggle, compared to others. This will be the only time I mention it on the blog because, in my mind, how I got pregnant is irrelevant at this point. What is important is that I am pregnant.

So why am I writing this post? Running, of course. When I knew we had to go through IVF and I was told I couldn’t run, the stubbornness in me Googled “IVF and running”. I didn’t find much information, considering exercise is contraindicated while going through IVF. But the thought of not running for a month plus, during an incredibly stressful time, was unfathomable. I am writing this post to document what I did during each stage, in hopes that it will provide information to others – with one caveat. This is what I did and sometimes it was against the advice of my doctor. If you are going through IVF, please consult your doctor, listen to your body, and use common sense before you consider lacing up your shoes for a run.

A brief background first. After trying for 6 months unsuccessfully, we were referred to a fertility clinic. Numerous tests later, we found out that our only way to conceive was IVF. Skip Clomid, IUI, and proceed directly to the end of the line. It was devastating news but luckily I have a husband who sees the glass as half full.

Knowing that I was about to go through something completely out of my control, I felt the need to control something. Enter my self-proclaimed quasi-training during the months of January to March. I was coming off the Rehoboth Beach Marathon and pretty much kept going, running 40-50 miles per week. Many of you asked me which marathon I was training for – or secretly training for – but the truth is I was training for IVF. I figured quasi-training would serve me well. Either I would enter pregnancy in the best shape of my life or, if the first cycle failed, I could easily start back up again and train for a Fall marathon (which would have been Steamtown – I’m actually registered for it!).

Finally – to the point of this post! I’ll break down each stage of IVF (as I see it), describe it briefly, and describe how my running was affected.

3 weeks of BCPs
Looking back this was the “honeymoon” phase of IVF. 3 weeks of birth control pills – piece of cake. I could run as much as I wanted so I kept my mileage between 40-50 and squeezed in a few solid long runs of 18 and 20 miles. I do know that some IVF protocols start Lupron injections towards the end of BCPs but my protocol did not.

Stimulation phase
Let the injections begin! I began injections with Follistim and Menopur on March 28th. The point of this stage is to stimulate your ovaries to produce multiple eggs. I was on stimulation meds for 12 days (adding Ganirelix to the mix towards the end to prevent ovulation). The ballpark range for stimulation is 7 to 14 days but that all depends on how you progress. My progression was very gradual – meaning my ovaries didn’t grow to the size of grapefruits overnight! When your follicles are roughly 16-20mm in size (measured via numerous vaginal ultrasounds), ovulation is triggered with a big dose of hCG.

Running (or any exercise other than walking) is contraindicated during this phase for good reason. Ovarian torsion is a very real threat once your ovaries start to swell with follicles. The size and weight of your swollen ovaries can cause them to flip and cut off their own blood supply. You can imagine how any high impact exercise or any exercise with excessive bending and twisting (yoga) could increase your chances of ovarian torsion.

So instead of running, I walked…30 miles a week! The fertility clinic’s version of walking was a “nice post-dinner stroll with your husband”. My version of walking was a balls-to-the-wall sub-15:00 pace…multiplied by 30 miles. One day a nurse told me I was doing too much – I knew I wasn’t – I politely said “OK”. I never felt any cramping (a sign that you are doing too much) and, even though it sucked to not be running, it was better than nothing. I even did long weekend walks – 4 miles in the AM and 5 miles in the PM. Like I said, I’m stubborn as hell. I could not sit around and wait…or curl up with a book or movie (which was suggested to me numerous times).

Egg retrieval
This was hands down the worst part of IVF. 36 hours after you receive your injection of hCG, your eggs are retrieved by passing a needle through your vaginal wall. If it sounds painful, it was. You are under anesthesia and the procedure is quick. It’s the aftermath that is the worst. I felt like someone took a shovel to my torso and beat me up and down. And the bloating. Oh the bloating. I wish someone would have told me I would have looked 5 months pregnant. After your eggs are retrieved (and they retrieved 25 eggs from me – a huge amount), your follicles fill back up with fluid, causing excessive bloating. The only way to get rid of the bloating is to drink and eat excessive amounts of salt. I was eating table salt and washing it down with Gatorade. It was unreal. The soreness and bloating subsided after a few days.

I did run the 3 days after my egg retrieval (4 to 6 miles). And, if I had to do it all over again, I would not run. My ovaries were still very swollen and I could have risked ovarian torsion. It was completely stupid (and, again, stubborn) on my part. I should have stuck with walking.

Embryo transfer
This was definitely the most exciting day! After retrieval, your eggs are fertilized – love in a petri dish! Depending on how the embryo(s) are progressing, they are transferred back on Day 3 or Day 5. I had a Day 3 transfer. The transfer process is quick, painless, and does not require any anesthesia. With the help of an ultrasound the embryos are guided and placed into your uterus, with the hopes that one embryo (or more) will implant and result in pregnancy. After the transfer procedure was complete, I was on bed rest for 24 hours.

I ran the morning before my embryo transfer, just to ease my nerves and relax. The day after the transfer (after 24 hours bed rest) I walked 7 miles. I know this sounds insane to some people. Why couldn’t I just relax? Was I worried about interfering with the (possible) implantation process? I wasn’t. I know many of you can agree with me that, as runners, we are hyperaware and in tune with our bodies. I know when to push, when to pull back, and when to call it a day. I know immediately if something is off. I felt fantastic and didn’t feel like I was overtaxing myself. I just went with my gut.

The 2-week wait
The most stressful part…waiting to see if you are pregnant. After your transfer, you wait 2 weeks and return to the clinic for a blood draw to see if you are pregnant. The first week went by pretty fast and without much stress but the second week was awful. My blood test was scheduled for a Friday but Matt and I caved on Wednesday and took a home pregnancy test. Technically you’re not supposed to take a home pregnancy test due to the high rate of false positives (the hCG trigger shot you administered before retrieval can trigger a false reading). BUT, I knew the hCG was out of my system and this was the real deal. Three tests (1 good one and 2 cheapies) – all very positive!!! The relief, excitement, and sheer joy that we felt was (and still is) unexplainable.

I was told not to run during the 2-week wait. I followed that rule for about a week (continued my balls-to-the-wall walking) and then I began running again. I actually got the call from the nurse that I was pregnant while I was out running Smile Was I putting myself at harm or putting the baby at harm by running so soon (and against medical advice)? No, not in my mind. Again, I felt incredible and running made me feel even better. Obviously, I would have stopped at the first sign that something was wrong.

And…I’ve been running every since. And I plan to continue to run for as long as I’m able.

If you’re wondering, I’m not having twins! At 6 weeks, they confirmed the presence of 1 baby, not 2!

If you have any questions, I’m more than happy to answer them through email. Again, this is what I did. You may feel differently. Always consult with your doctor and do what makes sense.

Unrelated bump shot – 11 weeks vs. 13 weeks.

11 vs 13

the good and the bad

June 23, 2013 by Kristy 14 Comments

Thank you for all the wonderful comments, tweets, and FB messages!  Now that the beans have been spilled, many of you asked how I am feeling and if I’m still running.  I’ll start off with the good…

GOOD
I was truly expecting the worst during the 1st trimester – morning sickness and fatigue round the clock.  I don’t know how or why but I managed to escape both of them.  Honestly, I feel fantastic.  Compared to what I thought the 1st trimester would be like, I have very few complaints.

Since I felt so good, there were no excuses when it came to running.  Running is going well (albeit slow) and it makes me feel “normal” and more “me” again.  But more on that in another post.

BAD
It’s not all rainbows and unicorns!  Constipation (sorry!) is my top problem right now.  This is such a foreign concept since running always, without fail, kept me regular.  Now no amount of fiber in the world, coupled with running, can do that.  I finally started an OTC med (OB approved) and it works pretty well.

Insomnia is becoming more frequent.  On Saturday morning I was up from 3-5AM, counting down the minutes until I could leave for my run.  But insomnia does have its perks.

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long run sunrise

I’m technically out of the 1st trimester on Wednesday and I’m hoping new symptoms don’t emerge!  I’ve been so lucky so far.

So, about the future of the blog…

This will always, first and foremost, be a running blog.  RTLR will not turn into a baby blog.  But pregnancy affects running, just as having a kid affects running, and my content (as it relates to running) will change accordingly.

I do promise to never use #motherunner or #zombiemom.    Don’t get me started.

My next few posts will focus on 1st trimester running (with a race recap!), heart rate/pregnancy/running (a hot topic that seriously fires me up), and running during IVF (another controversial topic that deserves attention).  I hope you read along!

Spilling The Beans…

June 16, 2013 by Kristy 27 Comments

At last!

This post is a long time coming and it feels good to finally spill the beans…

You know where I’m going with this, right?

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the bump makes an appearance at night

12 weeks pregnant today!  Yup…fo shizz up the spout –> name that movie!

Hawk is just as excited to be a big brother.

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I have a lot more to blog about (and I’m happy to be able to blog again!) but, for now, we’ll leave it at that.

Seattle

May 24, 2013 by Kristy 12 Comments

Last weekend I headed out to Seattle to visit Matt (he was out there for 2 weeks for work).  It’s a great town – I was never there before – and reminds me of San Fran…although it could never replace my beloved San Fran!

I have 3 general observations about Seattle:

1.  It’s cold.  Really cold.  Temps ranged from low 50s to low 60s each day.  Not bad, right?  But Seattle’s 50 degrees is on par with Philly’s 30 degrees.  Guess I really do like humidity?

2.  There really is a Starbucks on every corner.  Seattlers are well caffeinated.  We did visit the first Starbucks – total tourist trap – but it was cool.

3.  7-Elevens are really clean, which is totally not the case in Philly.  If you’re from the east coast, Seattle 7-Elevens are on par with Wawa.  I could practically eat off the floors.  Philly 7-Elevens smell nasty and I purposely walk on my toes so my pants don’t drag on the ground when I walk into one.

I arrived on Friday and had a few hours to kill until Matt was done with work.  Naturally, I went for a run.  Nothing felt better after sitting on a plane all morning.  I love that so many people were out and about running over lunch.

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We did typical tourist stuff – The Space Needle, Pike Place Market, and Chihuly Garden and Glass exhibit.

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chihuly pic
random photobomb

We love Farmers’ Markets so we checked out Fremont Market.  Definitely not our scene – a little too hippy-ish and flea market-ish.  Although they did have a large pig truck in the back where Matt enjoyed some pulled pork.

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mobile pig truck

We loved Discovery Park and walked the Loop Trail – a 2.8 mile trail with incredible views of the Puget Sound.

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We even saw the Fremont Troll.

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It was a great weekend overall.  For only having 2 and a half days we saw a ton of sites.  I just have to remember to pack winter clothes next time.

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I almost jumped in…

Ever been to Seattle?  Or live in Seattle?  What’s your favorite place, park, running route?

Be Your Own Coach

May 5, 2013 by Kristy 8 Comments

Most of my running clients are half marathoners and marathoners.  Some are first timers and some have a few races under their belts and are looking to improve their time.

When they first contact me, they complete a questionnaire where I ask them all sorts of questions.  I call this “getting to know them more as a runner”.  It’s so important that I gather as much information as possible so that I can properly develop a plan for their goal race.

When I begin to lay out a training plan and begin to work with my clients I always keep the following in mind…

Plan, plan, plan
I always tentatively plan the long runs first.  I say tentatively since my training plans are highly adaptive and, in general, I only plan 3 weeks of training at a time.  I would be weary of a coach that hands you a 16-week training plan at once (unless you asked for it).

Long runs are the bread and butter of any endurance training plan.  I take into account tune-up races, drop back weeks, vacations, and any other things I may need to work around.  It’s easier to manipulate the long runs later on if you pencil them in for the entire training plan.

Keep your eye on the prize
Speaking of tune-up races, I ask my marathon clients to keep racing to a minimum during marathon training.  I generally allow 1 HM and they either race it or use it as a marathon-paced training run.  Either way, it’s a great confidence booster for race day.

For chronic racers, marathon training can get a bit boring.  Long runs are the priority and racing has to take a backseat temporarily.

The more you run, the better you get at it
I have my clients run as much as they can.  What constitutes high mileage is unique to each runner.  Thirty miles can be enough for some while 70 is enough for others.  I like to have enough time during marathon training to do adequate base building…slow and gradual increases in overall mileage and long run distance.  This increase in aerobic capacity will not only make you faster but will lay a solid foundation for marathon or HM-specific speed work.

There’s a time and place for speed work
Many clients want to jump right into speed work thinking it is the only thing that will make them faster.  Speed work will make you faster…to an extent.  Over time, without proper increases in aerobic capacity, your speed will plateau.  As I said above, the right time for speed work is after we have a solid foundation of base mileage.  Your body is stronger and can handle the increased stress of speed work.

When clients begin training for a HM or marathon after a period of low mileage, I begin with so-called “pre-training” to base build.  After an adequate base is established, then we can layer on the speed work.  I sometimes use strides and hill repeats during the base building phase just to break up the monotony of all those slow miles and to help with leg turnover.

That’s just a few of my basic principles I follow when coaching.  To find out more, hire me as your coach! Winking smile

let’s talk about gait

April 28, 2013 by Kristy 7 Comments

The most common question I receive as a coach is regarding gait.  Are you going to fix my gait?  What is the best “way” to run? 

My answer to the first question is generally no, unless there is an injury that cannot be explained by too much, too fast, too soon, improper running shoes (thus an unsupported foot/ankle), weak hips/glutes, or some other imbalance.

My answer to the second question is there is no best “way” to run.  Sure there are things you can do to make yourself a more economical runner but the best “way” to run is what your body already figured out on its own.  I love this article written by my RRCA Coaching instructor – I could not agree more.

Thirdly, if you are running injury-free why do you want to mess with your gait?  Seems counterintuitive.  If it ain’t broke, don’t fix it!

Looking at my own gait, it’s not ideal.  I heel strike – always have and probably always will.  Look at my back foot.  See how it turns inward?  I’m sure when my foot makes initial contact with the ground, I’m underutilizing my big toe for support and stability.

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I assume I’ve always run this way.  I’ve never been injured so it works for me.  This is the “way” I run.

The only issue I have, as I mentioned before, is overstriding when my pace dips to HM pace or faster.  Overstriding is not good.  Landing too far in front of your center of mass is not economical.

To illustrate my point, stand with your toes touching the bottom of a set of stairs.  Keep one foot on the ground and place the other foot on the step in front of you.  Without leaning forward, step up.  Now try this again but stand about one foot away from the bottom step and try stepping up without leaning forward.  Impossible, right? (Taken from Dicharry’s Anatomy for Runners.)

For general tips on running form, check out the March 2013 issue of Runner’s World, page 66.

For an in depth look at gait read Chapter 8 of Anatomy for Runners (did I mention I love this book?!).

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