Corresponding with a Patient

I think it might be a good idea to show you a correspondence between me and a patient. I am changing the name to keep her privacy. This is her third month taking Chinese herbal formula from me.   Receipt Statement for Angelina Jolie (hahaha... I am just joking about it being Angelina Jolie. I am not really working with her but everyone needs a laugh once in a while) Date: 7/25/12  Chinese Herbal Formula:  30 day supply $120 Includes shipping fee  Total paid via paypal Angelina, I have made big changes in your formula. Your period sounds very good. I took the herbs out of your formula that you can't take when you are pregnant that are used to clear the tubes. The only way to know if your tubes are open and clear is to go for another HSG test.  I have added herbs to help with the headache and pain you felt with the last period. You can try get pregnant now. You need to be following your cycle to know when you are ovulating. Ovulation usually happens midway between periods though women in their 40's sometimes ovulate earlier than this. I have a lot of women who ovulate as early as cycle day 9 (cycle day 1 is always the first day of the period). You can use an ovulation predictor kit (purchased at the drug store) starting on cycle day 9 to see if you can see your ovulation. The best time to use the kit (you will urinate on a strip of paper) is between 3-3:30 pm. You should do this once a day until you see that you are ovulating. You are probably ovulating on cycle day 13 but start checking earlier than this in case you are ovulating earlier. I don't want you to miss it. When you see that you are ovulating you should have intercourse that day (best day) and the next 3 days (4 days total). When you are ovulating you should see that your vaginal discharge has turned clear and slimy. This is the fertile cervical mucus that helps the sperm swim towards the egg. Don't check when you are sexually aroused  as you wont be able to tell the difference between this mucus and normal sexual secretions. If you are ovulating but don't see this mucus you should get a vaginal lubricant called "Pre-Seed" which you will see in the drug store right by the ovulation predictor kits. This is the only vaginal lubricant that acts like the fertile mucus. All the others will kill the sperm or not allow it to swim properly. You only need to use this vaginal lubricant during ovulation. It doesn't really matter the rest of the month.   The herbs should help with the fertile discharge but we don't want to wait around for the herbs to work. If you are ovulating and don't see enough good fertile mucus just use the Pre-Seed. You will be receiving the herbal formula from Kamwo Chinese Herbal Pharmacy located in New York City. The formula will be sent out today. Since you are on Staten Island you will get the package very quickly.  If you have any problems with the delivery please contact me rather than the pharmacy and I will track down the problem.   Your formula contains the following herbs: shu di huang shan zhu yu fu ling mu dan pi ze xie ye jiao teng zhi my chuan xiong yu jin sheng jiang bai shao chi shao   Dissolve 2 scoops in warm/hot water. Take 3 times a day with food. Do not take the above formula during your period.   If you have any adverse reactions (problems) to the herbs, please stop taking them and contact me and I will decide how to proceed.     Do not double up on herbs. If you miss a dose just skip it and wait to take the next regular dose.    Please consult me before you take any medications or herbs along with the herbal formulas. If your doctor prescribes medication for you and you are not able to get a hold of me for any reason, stop taking the herbs and follow your doctor’s orders. Stop taking the herbs 3 days before any planned surgery including a tooth or gum surgery. If you have an emergency surgery you would stop taking them as soon as possible.  Do not take them again without consulting me first.      If you would like to look up the functions of the herbs in your formula you can look at the herb guide on the Chinese herbal pharmacy’s website   http://www.kamwo.com/help/help.html . Keep in mind that this is Traditional Chinese Medicine and the workings of the body are not always the same as Western biomedical sciences. So you may not completely understand what they are talking about. In this particular formula how the herbs work together in more important than the function of each particular herb.   Angelina, it will not hurt and may even help to continue using the castor oil packs but remember you can't do this if there is any chance that you are pregnant. Since you will not know if you are pregnant for 2 weeks after ovulation it would be better to stop when you ovulate.  Castor Oil Packs- Pour castor oil onto a rag. Place this over your fallopian tubes. Put another rag over the top of this one. Then put a heating pad on medium/low over the top of this for 20 minutes a day. Massage the area afterwards for a few minutes. Never do this during your period or if there is a chance you could be pregnant.    I will need to check on your progress before ordering your next formula. So, email me or give me a call in enough time (3-5 business days) before you are finished with this batch of herbs to allow for shipping time. One important thing: I never "auto-ship" products to my patients. Likewise your credit card will never be charged unless you specifically place an order.  Feel free to contact me via phone or emails anytime while under my care. I do not generally answer the phone on the weekends but I check my emails often on the weekend and if you need to talk to me I will call you if you ask me to in an email.   Best Regards, Chinese Fertility Herbalist   Patricia Karnowski M.S.O.M.   910- 420-2194 office hours: Monday to Friday 9am- 7pm EST    www.FertilityFormulas.com

Afraid of Not Getting Pregnant

I received this email from a patient today:

“Just an FYI... after my GI bug 2 weeks ago, I had horrible epigastric pain for about 10 days.  My fatigue that had started after ovulation last cycle has continued.  I had an upper respiratory infection which began on the day of my insemination on Monday.  I am starting to feel better (as far as the cold) but now I have dark circles under my eyes which had gone away in the last couple of months.  My skin is still pretty good and I am sleeping better.  I don't really have any irritability and only become depressed when I find out month after month that I am not pregnant.  The depression is not a premenstrual symptom.  I feel like I am going backwards.  Also, in my reading I have come across a few other herbs that I have questions about...would huang qi or shan yao help me?  The GI bug and the cold are unusual, as I rarely get sick”

I am sharing this email correspondence because it illustrates so clearly how the journey can sometimes go as my patients are trying to conceive.  Nobody comes to me at the beginning of the journey though I wish they would. They come to me when everything they have tried has failed and they are ready to give up but they are going to try one last weird thing… Chinese herbs.

Here is my response back to her. I want to address everything that is concerning her:

“When you have a GI bug it can really drain you. Make sure that you eat really well and you should take a probiotic to get the intestines back in order.

I don't think that Huang Qi would be good for you. It can create a lot of bloating and heat. I have added American Ginseng to your formula in hopes of increasing your energy. Shan Yao is good but it is pretty mild.

The dark circles around your eyes are coming from a "Kidney" deficiency not a "Spleen" Qi deficiency. Lots of herbs in your formula address this. You are not slipping backwards. You just had a GI bug.

Make sure that you get a lot of sleep. This is going to help the most.

I know what you mean about feeling depressed about not getting pregnant. I wish there was something that I could say or give you that could take this depression away but you have a real reason for this feeling. If we take away this feeling it wouldn't give the full respect that this feeling deserves. We can't drug away or herb away your longing for another child. You have this feeling that there is a baby wanting your love and you can't seem to get to this little soul. The thought of this makes me want to cry and I haven't even met you in person..

I will tell you something personal about me as it might help you. I was never able to have children myself. I had ovarian cancer. I am fine so don't give a thought to this part of the story. I couldn't believe that I was never going to have children when I was struggling with this. I LOVE kids and I wanted one of my own. I thought my life would be horrible without them in my life every day. All of this happened a long time ago for me(I am much older than you). Anyways, now I have to admit that it is completely okay that this never happened for me. I LOVE my life and there doesn't even feel like there is a big hole in it like I thought I would always feel.

I am telling you this to let you know from personal experience that no matter what happens for you around this, you will be okay. I hope that you can find the place inside of yourself that knows what I am telling you is true. Perhaps you need to go off by yourself, preferably in nature which will remind you that nature is much bigger and wiser than we are, and connect to your inner wise woman who can trust that you will have an amazing life no matter what happens with all this. I think it might give you peace so that you can continue this journey without letting the depression and fear take over.”

And this is how she responded back:

“Thank you for your very kind words and all the effort you have put forth in my behalf. Your words made me cry.  I consider myself very lucky to have your support in this journey.  I appreciate your compassion and most of all your honesty.”      

The truth is that she is right. I do everything I can to help my fertility patients. I have so much compassion for their difficult and lonely journey. 

Fertility Herbalist
Patricia Karnowski M.S.O.M.

910-420-2194
www.fertilityformulas.com

Office Hours: Monday thru Friday 9am to 7pm EST

Natural and Effect Help for Cystic Ovarian Syndrome (PCOS)

Poly cystic ovarian syndrome (PCOS) can be one of the most difficult conditions to have when you are trying to get pregnant. Woman with PCOS have a hormone imbalance  where the testosterone levels are too high. The developing egg is trying to grow in this high testosterone, bad environment. Sometimes the eggs don’t develop at all. The egg won’t ovulate (release from the ovaries) and women will not have a menstrual period. Women with PCOS can go months without a period. 

Sometimes rather than an egg forming and releasing, a cyst will form. Not all women with PCOS will have cysts on their ovaries but most do. Some will have a row of cysts developed over the months. In the worse cases her ovaries will look like a bunch or grapes with many cysts covering the ovaries. A waxy coating will form over the top of the cysts making it even more difficult for an egg to get through.

So what do we do? How can we get the testosterone levels to normalize so that a good quality egg will form? How do we help clear the cysts? How do we clear this waxy coating? 

Traditional Chinese Medicine sees this condition as a problem with a poor transformation and transportation of food function within the body. Maybe we in the west would call it a “slow metabolism”. This is causing stagnation to develop. Phlegm can easily develop with this type of stagnation. Chinese Medicine would call this a “phlegm accumulation” that is strangling the ovaries.  

There are Chinese herbs to clear this “phlegm” and also herbs to improve the food transformation function (improve metabolism) of the body so that the PCOS patient does form more “phlegm” (cysts). 

Okay so we can clear the cysts and we can treat the underlying cause of the cyst forming but what do we do about the high testosterone levels? This is the part any woman with PCOS is going to absolutely hate. She must change her diet. It is hard for anybody to change their diet but it is worse for women with PCOS because this imbalance will make her crave sugar. She has to fight the intense craving for about 7 days until the cravings stop when she stops eating all sugar. 

When a woman with PCOS eats foods that are high in sugars her blood sugar will go up very quickly and then drop just as quickly which makes her crave more sugar. When the blood sugar is doing this it will not allow the body to metabolize testosterone.  Doctors have started giving women with PCOS a drug called metformin to try to regulate the blood sugar levels. 

In China where the culture is very pragmatic the Chinese medicine practitioners don’t talk about “blood sugar levels” but instead they say, “Eat this and don’t eat that”.   When you examine what they have been saying you will see that they have known for thousands of years that the blood sugar must be regulated for these women to get pregnant. 

I am going to give you a perfects day’s meal plan to do this. Keep in mind that I am not a dietitian. I am a practitioner of Traditional Chinese Medicine living in a Western world so I will give you my recommendations based on Chinese Medicine but tweek enough that you can go to the grocery store in the west and get the ingredients.

Here are the rules:

• You have to eat all the amounts and types of food I suggest

• You have to eat 3 meals (300 calories per meal) a day

• You have to have 2 snacks a day (150 calories per meal)

• You have to eat breakfast within one hour of waking up in the morning

• You have to have 30% proteins, 30% fats, 40% carbs (Use thedailyplate.com to log your food and keep track of these percentages.

• No more than 50% animal protein (chicken, fish, red meat including pork, veal, turkey, goat. You can only have one egg a day but you can have as many whites as you like)

•  All grains are WHOLE GRAINS

•          Vegetables are your first choice for carbs followed by fruit then whole grains.

•          Fats are best eaten in the form of nuts, seeds followed by olive oil

•          Aim for 1200 calories a day but you can go as high as 1500 once in a while.

•         Before bed take 1 tbsp of apple cider vinegar in ½ cup of water.

 Here is an example of what would a day of meals look like?

Breakfast

·        1 egg plus 3 servings (9 tablespoons) egg white

·        1 multi whole grains toast (“Healthy Life Whole Wheat Bread” is low calorie, high protein)

·        1 fruit (med size apple, pair, ½ banana, 6oz berries or melon)

·        1 cup light soy milk

Morning snack

·        ½ cup nonfat cottage cheese

·        ½ cup cucumber, red bell pepper, onion

Lunch

·        ½ cup lentils (other beans are good too but if you get them out of a can rinse them to remove the salt.)

·        2 servings egg white (6 tbsp egg beaters) (high in protein but low in calories and carbs)

·        1 cup cooked vegetables

·        1 whole grain tortilla

·        1 tsp olive oil

Afternoon snack

·        1 oz dry roasted peanuts

Dinner

·        6 oz wild salmon (best choice), other cold water fish, chicken or turkey breast  

·        8 oz vegatables

·        1 fruit

There are so many egg whites in this plan because they are high in protein but low in fats which is always the biggest challenge to create in a meal.

Your “blood sugar” will be well regulated with this meal plan.  The “food transformational function” of the body will be nourished.   

An added benefit of this diet is that a woman with PCOS will lose weight which is almost impossible for with this imbalance. I have seen many young women up to age 26 who find that their cycles regulate and get they pregnant even without herbs.

Okay okay… I know it is hard to make such a big change in your diet but isn’t worth trying before you take drugs with all the side effects. The women who call me have tried the drugs with no results when this diet has helped.

Good Luck,

Chinese Fertility herbalist,

Patricia Karnowski M.S.O.M.

www.fertilityformulas.com

Listening Closely

Today, I got an email that said,” This is Miranda's Mom sending you pictures of her and her beautiful baby girl.  The baby was born on October 26th at 9:26 a.m. by c-section.  The baby turned breech about 3 weeks before the due date.  She was 6 lbs. 9 oz. and 19" long. They are both doing wonderful.  Miranda and I both believe that it was due to your herbs that she was able to get pregnant”.

Mariana really is beautiful. She has a full head of dark hair and in one photo she seems to be pointing her finger.  I want to post the picture so you can see her but I don’t think that would be the right thing to do. Her mother will decide who should see her baby and keep her privacy from prying eyes. 

I am just so excited that I might have had a part in the birth of this beautiful baby that I want to share my joy with someone who would understand what a big deal this. Miranda was having such a hard time trying to get pregnant before she found my website. 

When she told me her story and I asked her a million questions to try to understand what her body was doing, I was pretty sure that the Chinese herbs would help her even though nothing did before. I have to say that sometimes it seems so obvious what the problem is after talking to these women,  even though medical tests don’t reveal it. 

In the west we are so convinced that the medical tests will tell the objective truth. Over and over I have seen that the body reveals the truth and when I talk to the women long enough and compare what her body is doing against the backdrop of what her body should be doing it becomes so darn clear.  

Luckily, there are thousands of herbs to combine in just the right way to fit each and every woman and if we combine these with destiny a beautiful baby has a chance to come into the world. Perhaps, the real key to helping these women get pregnant is just to listen… really closely.

Young Women Trying to Get Pregnant

I just received 3 emails today from women in their early 20’s who are trying to get pregnant. This should be the most fertile time of their life. Why would they be looking for help from a fertility herbalist? In my experience there seems to be are two main reasons they are searching for help.

The biggest reason is that they really aren’t sure how to get pregnant. Of course they know that they are supposed to have sex but that is all they know for sure. For most women in their 20’s this might be all they really need to know. They are having sexual intercourse regularly enough that just by accident they will get pregnant.

But what if their husband is in the military and they aren’t able to see them regularly? I get calls every day now from women who tell me that they want to get pregnant when their husband is on leave or they want to get pregnant before he is deployed. They aren’t able to have sex every day or every other day.

I am not going to go into all the intricate details in this blog there are plenty of places to find this information. The best book on this subject if you ask me is Taking Charge of Your Fertility by Toni Wheschler.

Here are the very basics of what it takes for a young woman to get pregnant:

1- Know your cycle. You don’t care what an “average” menstrual cycle is. You care about YOUR cycle. Your “cycle day 1” is always the first day that your period starts. Don’t count the days that you might spot before your real period starts. Your cycle will end when your next period begins.

2- Know when YOU ovulate (when the egg releases and you can get pregnant). The “ovulation calendars” only tell you when the “average” woman would ovulate. Who cares about “average”. You care about YOU. The only way to know for sure when YOU ovulate is to use an “Ovulation Predictor Kit”. You can buy these at most drug stores. Read the instructions on the package. Basically, it will say to pee (urinate) on a stick and look at it. Ovulation usually happens half way between periods but everyone is not exactly the same so use the kit to see when YOU are able to get pregnant.

3- Look for fertile vaginal discharge. When you see that you are ovulating by using the kit you should also see some other changes in your body. The biggest indication that you are ovulating and can get pregnant is that your vaginal discharge will become clear and slippery and it will look like uncooked egg white. Don’t look for this when you are sexually aroused because it combines with your normal “wetness” and it will always look "fertile" if you check at this time. You need to see this discharge when you are not aroused.

Some women will have so much of this discharge that they need to wear panty liners and other women will only see this slippery slimy vaginal discharge when they wipe after urinating. You need this discharge to get pregnant. The sperm will be able to swim in this discharge but when it is sticky or watery.

When you see this “fertile discharge” you should also check to see if the “Ovulation Predictor Kit” is also indicating that you are ovulating so that you can get pregnant.

Once you have seen that the kit is telling you that you are ovulating and you see that it is happening at the same time you see this “fertile mucus” you will not have to keep using the kit. You can just look for the right discharge.

4- Have sexual intercourse for 4 days in a row as soon as you see the fertile discharge and/or you see from the kit that you are ovulating. We never know exactly when the egg releases. We only know that it is about too so cover your bases and have sex for 4 days and this should do it. If you can’t do it for 4 days in a row you can do it every other day as the egg will wait for a few days before it is reabsorbed into the body and also the sperm will also live for a couple days before the body absorbs it too.

5- Don’t do anything that you wouldn’t do if you are pregnant because you won’t know if you got pregnant for about 2 weeks. You can use an early pregnancy test but a lot of the time it isn’t accurate until you have missed your period. The babies’ brain and spinal cord are the first things that start developing and if you drink alcohol or smoke or take drugs it can affect the brain, heart and spinal cord.

6- Once you have missed your period use an early pregnancy test (purchased at a drug store) to see if you are pregnant. YOU HAVE TO USE THE FIRST MORNING URINE at the very beginning of a pregnancy for the test to be accurate.

The second big reason that a young woman might contact a fertility herbalist to help her get pregnant is that her body isn’t doing any of the things that everyone says should be happening. Her period doesn’t come regularly or she doesn’t have fertile discharge or the ovulation predictor kit never picks up an ovulation. When she goes to the doctor they usually want to put her on birth control pills but somehow this doesn’t seem right when she knows that she took them to prevent a pregnancy. Why is it that they are giving the same medications to her when she is trying to get pregnant? It just doesn’t make sense to her.

This is a good reason to contact a fertility herbalist. I can figure out what the problem is and give you herbs to help. If the problem is something that I don’t think Chinese herbs will help with I will try to convince you to go back to the doctor but you would be surprised at how effective they can be. I know I was shocked about this.

FSH… The Good, The Bad & The Ugly

Every day I get calls and emails from women from around the world asking the same question, “Can you bring down my FSH with herbs”? The story goes on. “I want to get pregnant but the doctor said my FSH is too high.” 

I will explain what I have learned about FSH as a practitioner of Traditional Chinese Medicine (TCM) working exclusively with women trying to get pregnant for the past 11 years. I am not an expert on FSH but I have helped many women with “high FSH” get pregnant. 

I have found that there is a very big range of what FSH (follicle stimulating hormone) can be. The highest I heard from the women calling me was 189.  A normal FSH is 8 and below but doctors are okay with 10, but usually the cut off is 12. There are some rather rogue doctors who will be okay about a 15 if the woman is in her 20’s or early 30’s.  

But what do these numbers mean? 

Doctors seem to enjoy or at least that is my impression, telling a woman with “high FSH” that she has “old eggs” or “not many eggs left”. Oh my gosh, a healthy vibrant 40 year old woman being told she has “old eggs” is not something that can be comprehended easily. 

The bottom line is that if your FSH is too high you will not respond well to the drugs and medical procedures that are available from your doctor. MD’s do not have anything in their bag of tricks to help a woman with high FSH get pregnant other than to use a donor’s eggs.  

Let me start by giving you a “few statements of fact” as I have observed and researched.  First, no one knows what the FSH is of women who get pregnant without any challenges. Secondly, we are born with all the eggs we are ever going to have and we will die with some too.  

(By the way, I like this image because it means that we developed as eggs in the womb of our grandmothers) 

The problem seems to be that the eggs aren’t developing properly for some reason. The body is working extra hard trying to get the follicle (where the egg is) to develop and so it is producing more follicle stimulating hormone (FSH). 

In Traditional Chinese Medicine we look at what the body is actually doing to see if there is anything that might be affecting this process. A woman’s reproductive system is governed a lot by blood flow and how the Qi moves (energy or life force) and how well temperatures are regulated in the body. If we can create the normal balances in these things the body doesn’t have to work so hard and the FSH goes down naturally. 

There are great difference in how women present with these imbalances and there are thousands of Chinese herbs to bring together to address them but practically speaking there seems to be a limit. I am pretty confident that the herbs will help women with FSH of around 40 as long as she is still having her period. The higher it goes up or the more irregular her period gets the less confident I am that the herbs will help enough. 

Even if your FSH is higher than this I would advise you to try to herbs for 6 months. We should see improvement in this time. If you are not pregnant in this time I would think we should really evaluate if we would go any further. 

Remember, I said that there is a cut off with how high your FSH can be for doctors to help you? You should be aware that even if we get the FSH to go down to a perfect “magical” level, many doctors will still say that they will not have anything to offer.  Some say that “once it is high they will always use the highest number even of it goes down”.   

Not all doctors say this though. If your doctor decides to give you something, make sure to tell your herbalist because there are many Chinese herbs that you can’t take along with drugs… but there are some that you can!