Monday, October 10, 2016

Miscarriage, Migraine, and Muslim Jesus

October is Pregnancy and Infant Loss Awareness month. We have all experienced grief and loss in our lives. I am not the first person to go through this, nor am I the first to talk about it. This is my story.

Maybe my story is your story.

It was 2008 and my husband and I were living and working in Amman, Jordan. We had been trying to get pregnant and had exasperated multiple fertility methods to no avail. Our final try was IVF and this also failed.  A failed IVF can invoke the same feelings of loss and hopelessness as a miscarriage. This loss needs to be grieved. I was sad and feeling as though children were not in our future. I was also exhausted from the hormonal roller coaster and just wanted a break.

To our surprise within 3 months of the failed IVF, we found out we were pregnant. It seemed like a miracle, our miracle. The Arab Christian doctor I was seeing at the time brought me in every week for an ultrasound.  Every time he would smile and tell me things looked “good.” We were filled with hope and excitement; we were thankful and for the first time in years, I didn’t have a headache or migraine. This would become a common occurance for me in pregnancy, and years later would prove to be useful information as we worked to make sense of my complicated health and migraines.


Sometime around week 10 of this pregnancy I started spotting. My husband called the doctor immediately and the doctor was very quick to say the pregnancy was probably lost. We were shocked. How did he know this without looking? We went for a second opinion with a lovely Muslim doctor, and after a quick ultrasound, she told us there was no longer a pregnancy.  I had what is called a blighted ovum. Something, if seen on ultrasound can be diagnosed as early as 6 weeks. So we grieved our loss and felt betrayed. 

When my hormones crashed I got a horrible migraine that lasted over 2 weeks and I wanted to die.

Only a few months later, my period was late and I didn’t have a headache again. When it still hadn’t come a week later, I was sure I was pregnant. Over the course of another week, I took three pregnancy tests, but they were all negative.  And still my period never came. It was finally my Chinese acupuncturist, who during a session, told me I was absolutely pregnant. It didn’t matter if the tests were negative, he said. I had the body of a pregnant woman and should get a scan immediately. (This Chinese doctor would later tell me I was pregnant with a girl and he was right.) 

I was too afraid to dream. Too afraid to hope.  And then an ultrasound by my new doctor, Dr. Amal, showed in fact there was a pregnancy and a blood test later confirmed it. At the first ultrasound, we quickly knew how different this pregnancy was. There was a heartbeat.

Even so, I had an unsettling feeling the entire pregnancy. I had no reason, no evidence, but something just didn't feel right. And even through the first trimester as I vomited nearly every day, I couldn’t shake the feeling there was something wrong. So when I started bleeding, I was absolutely sure this was another loss. Instead an ultrasound showed everything to be just fine. A strong heartbeat and our daughter was moving around just fine. I decided I was just paranoid from the last experience and started buying maternity clothes.

Then on a Thursday morning at the end of October, I woke up and and I knew my baby was dead. My husband thought I was over reacting because I had no basis for these feelings. I demanded to go in for another ultrasound.  

It was dusk on that Thursday and the weekend in Jordan had already begun. The muezzin was calling for the evening prayer as we pulled into Farah Hospital. Dr. Zaid Kilani, the founder of Farah and an amazing man who is known all over the Middle East as a pioneer in the science of IVF, met us in the waiting room for the ultrasound. This was the first time I had met him, but I had heard stories of women miraculously getting pregnant under his care. He was a fertility miracle worker.

Dr. Kilani's white hair gave away his age and his eyes were kind and compassionate. His voice was soft and he spoke gently as he searched for a heartbeat on the computer screen.  We all stared desperately at the screen as moments passed and I knew the heartbeat was not there. When Dr. Kilani realized it also, he sighed deeply and began apologizing profusely. Dr. Kilani took us out in his private elevator and explained he wanted me to check in and go through labor and delivery that night. He explained he would do testing to find out what happened. I went along, but the weight of heartache oppressed me. I couldn’t do this, didn’t want to do it. I didn’t want to be there, I didn’t want to be in this hospital, this country. I hated the mother/child symbol on the wall in the Farah hospital. I pleadingly looked at my husband and wanted him to make it all stop. I cursed at God and cried. I felt abandoned.

I was checked into a room on the maternity floor, close to the nursery. An IV was started and medicine to induce labor. Dr. Kilani in his kind and apologetic words told me the goal was to deliver by the following day. He assured me he would not leave the hospital. I don’t remember much about that night or the following morning. I just remember faces. Faces of dear friends that came and sat with me, sometimes apologetically, sometimes saying nothing. There were friends that stayed the entire time I was in labor and pain. Friends that just sat in the mud puddle with me.

No one at that hospital would give me any form of pain medicine and I couldn’t figure out why, although I suspect they were scared of my complicated medical history. Eventually when it was over, I cried. I cried in relief. I remember someone asking if I wanted pictures and I definitely did not at the time. It wasn't something they did in Jordanian culture and I didn't want it.

Dr. Kilani with his kind voice and eyes showed her to me and pointed out what he could see wrong. The intestines were outside of her belly.  He still needed to do testing and without saying the words exactly, he very kindly inferred it was better this happen rather than to carry all the way to full term. And then he reassuringly told me in his entire career, he could count on two hands how many times he had seen a situation like this. It was one in a million and unlikely to happen again. His words were prophetic and he reminded me of Jesus. Dr. Kilani was my Muslim Jesus. And because he knew we had already been through so much, he allowed my husband to stay with me and hold my hand while they put me to sleep and did a D&C.

I was alone in my room as my husband walked with friends who were leaving. I was crying and hopeless, wondering how we would ever recover. And very quietly Jesus visited me and said, Not this time N, but next time. I sighed. And then Muslim Jesus entered my room and boldly told me this wasn’t the end of my story. I would get pregnant again. I would have a baby, and he wanted to be the doctor to deliver it. He patted my leg and told me I was free to go home and rest.

In the weeks that followed, I spent as much time as possible in our apartment, sometimes with all of the shades down and curtains closed. I didn’t want to be alone and I didn’t want to be around anyone. I hated God and I hated everyone else.  After two weeks, Dr. Amal called to let us know the baby had Trisomy 18 and would not have lived much after birth. I was in hormone hell and got a horrible migraine that lasted for what felt like a month. It was a daily reminder to me of death and I couldn't find God in any of this.

Sometimes I would awaken in the dark hours of night and scream out, remember and start sobbing again in the darkness. My husband would hug me, speechless and hurting himself. Grief is always the darkest in the night and it was in those moments I contemplated taking my own life and pleaded for God to just take me. But morning always came. Numb, we muddled through our lives the following months. My doctor suggested we start trying again after 2 cycles, but I just couldn’t. I felt choked by fear and I didn’t want another baby, I just wanted the one I had lost.

People said a lot of dumb things to me during this time, and a lot of ridiculous religious clich├ęs. I have always been fairly real, real with people and real with God. I think God appreciates realness, so I told him daily exactly what I thought of my situation.

It is in our deepest pain, both physically and emotionally we come to see the face of God.

By other people I often felt judged by how I was responding to my situation, or choosing not to respond. I was judged by the things I said out loud; by what books I was reading or not reading. I was judged by everything I did or didn’t do. If I had been a Muslim, I would have been expected to say, “It was God’s will,” and not cried or questioned, lest God bring something even darker upon my life. Seemingly the same, as a Christian, I learned I was expected (by other Christians) to respond nearly the same. Could God not handle my words or thoughts? He could. When something horrific happens, often well-meaning people show up and start talking. They speak as God’s advocate, thinking they need to defend Him, as if He can't defend Himself. Knowing when to just sit silently next to a person in the mud puddle, in the mud puddles of life, is a skill few people have. The friends who did, who sat quietly in the mud puddle with me, are a treasure and I will never forget them. 

My husband planned a nearly three week trip to Turkey in January of 2009 and I felt like I could breathe again. It didn’t fix anything, it didn't heal me, but it helped me process. And when we returned to Jordan, I decided I would try again with fertility treatments. Only a few short months later we were pregnant with twins and they were born the following October, almost exactly one year later. Two beautiful miraculous gifts that were not given to replace the ones we had lost, but were just simply given and entrusted to us. And then a few years later a third little miracle, a baby girl, joined our family and we finally felt complete.

My story has a happy ending and I realize it doesn’t always happen this way for everyone. But I do know there is always hope. In every horrific situation we will eventually find hope, because the worst is never truly the end. 

Saturday, October 1, 2016

MSG and Headaches


 In the small town in Ohio where I grew up, we can boast of many things when it comes to food. The best ice cream, the best chocolate, the best hamburgers, and in my opinion THE BEST Chinese Food. I grew up eating at Ming's Great Wall, weekly. Ming the owner, is from China and he makes the best Almond Chicken, Sweet and Sour Chicken and Chicken Fried Rice. My husband and I have made a point to eat Chinese food all over the world and we still believe Ming's is the best. Now when I look back and think of how much MSG (Monosodium Glutamate) I consumed over the years, well it almost gives me a headache.

Fourteen years ago when my migraines turned chronic, someone mentioned I should give up MSG, but I was given very little direction on how to do it. And it's no wonder, MSG is nearly everywhere and seemingly in almost everything, often hidden under other names. And giving up food, especially your favorite food, is really hard. What pushed me to finally start a diet elimination was multiple chronic health issues and modern medicine offering me very little to improve my situation.  I am a firm believer, there is almost always a diet component in chronic migraine.

Over the years, I believe I just always had a constant headache. Some days more intense than others and some days tolerable. When you live in this state it is nearly impossible to know if food is triggering headaches. I was completely unaware and honestly didn't give it all that much thought. I unknowingly consumed MSG everyday, and it wasn't until about a year ago after I had completely eliminated, I was able to decipher MSG as a major trigger for me.

WHAT IS MSG?

MSG, which stands for Monosodium Glutamate is a food additive and a flavor enhancer that has been added to our food for over a century. It is the salt form of glutamic acid, which is a naturally occurring amino acid. The food industry injects MSG into our food because it intensifies taste, giving food a more salty and savory flavor. This excites your taste buds and stimulates the release of brain chemicals called neurotransmitters. Ever started eating Doritos and before you know it, have consumed half the bag? It's likely the added MSG, which will almost always leave you craving more. MSG can be found in everything from Chinese food to canned vegetables, soups, and processed meats, broth, stock, bouillon, seasonings, chips, and salad dressing. Sometimes it is hidden in the most unexpected places. We would not have processed foods without MSG.

MSG comes in different forms and names, so an ingredient label will not always specify monosodium glutamate. You can find other forms of MSG on labels under these names:
  • Hydrolyzed Protein (including vegetable/soy/plant/rice protein)
  • Yeast extract and autolyzed yeast
  • Natural flavors/flavorings
  • Soy Protein
  • Textured Protein
  • Whey Protein
  • Protein-fortified items
  • Malt extract
  • Malted barley
  • Maltodextrin
  • Carrageenan
  • Kombu (Seaweed Extract)
  • Sodium or Calcium Caseinate
  • Glutamic Acid
  • Gelatin
  • Fermented or cultured Items
  • Ultra-pasteurized items
  • Enzyme-modified items
  • Glutamate
  • Monopotassium Glutamate
  • Calcium Glutamate
  • Monoammonium Glutamate
  • Magnesium Glutamate
  • Natrium Glutamate

MSG can also be found in Skim milk and often added to diet food. But ironically it has also been linked to weight gain and overeating, mainly because glutamate stimulates senses in the brain. This ends up making you want to eat more (3).

MSG AS IT RELATES TO HEADACHES AND MIGRAINES

Over the years, people have reported to the FDA unusual symptoms after consuming large quantities of MSG. These symptoms include:
  • Chest pressure
  • Tightening and pressure in the face
  • Burning sensation
  • Facial flushing
  • Dizziness
  • Headache pain across the front and on the sides
  • Abdominal discomfort (2).

The FDA has classified MSG as a food ingredient that is “generally recognized as safe.” (4).  My faith in the FDA and what they choose to approve or not, has waned over the years. Because of the endless reports the FDA has received over the years about these adverse reactions, food companies are required to include the forms of MSG in their nutrition labels. But the use of MSG still remains highly controversial among experts. While a few studies have attempted to prove the correlation between MSG and headaches/migraines, there has been no definitive evidence to support claims.  It is extremely difficult to have success on these types of studies with migraine patients, mainly because there are so many other variables, triggers, and factors at play when it comes to headaches. A known headache trigger might not necessarily trigger a migraine every time (1). Like other headache triggers, MSG attacks by dilating blood vessels and exciting nerves in the brain. This can trigger electrical dysfunction in the brain which begins the migraine process (3). All of the major headache specialists and clinics in the US including Mayo, Cleveland Clinic and Diamond Headache Clinic, mark MSG as a major migraine and headache trigger and suggest avoiding it.

I never believed MSG was a problem for me, until I eliminated it for several months. With MSG, I will get a bad headache within a few hours of consumption. Although for other people a headache from MSG may not always develop the same day.  Sometimes they can develop 24-48 hours later (1). When I do get a migraine from MSG, it is usually because there are other factors at play. Migraineurs tend to have a certain threshold with several layers of triggers. Often if there are several factoring triggers at play, the chances of a full blown migraine are high. For example, I struggle with hormonal migraines, so if I eat MSG during a time my hormones are fluctuating, you can bet I will get a full blown migraine. If I add lack of sleep on top of these two triggers, well then, it's going to be a doozy! This is often the case for anyone with migraines, several triggers at the same time, will likely produce a migraine. If you have never eliminated MSG, it is another good place to start.


 




1. Buchholz, David. (2002) Heal Your Headache. New York: Workman Publishing Company.
2. Foods That Cause Headaches and Migraines. (n.d.) Retrieved September 2016 from Cleveland Clinic Online: www.clevelandclinic.org
3. Xiong, J. (2009, November 15). Deciphering the MSG Controversy. Retrieved September 2016, from National Institutes of Health: www.nih.gov
4. Zeratsky, K. (n.d.) What Is MSG? Is It Bad For You? Retrieved September 2016, from Mayo Clinic Online: www.mayoclinic.org