Overdue Update, and a New Job with a Purpose

Whew. It's been crazy around here. We celebrated our first wedding anniversary, I started my job at Hopkins, we went to Aaron & Maureen's wedding in Philadelphia, I went out with Sarah for her bachelorette party (hubby is the best man in Sarah and Mike's wedding)... all good stuff. I will definitely have a more detailed post and some pics for you soon...ish.

This weekend is Kevin & Shannon's wedding in College Park. Both of their parents were married at Memorial Chapel on the College Park campus, so they're having their wedding there as well (wow - have you ever seen all three versions of "there" in one sentence?!). Hubby is a groomsman in this one, so we'll be attending the rehearsal and dinner Thursday night (at Ruth's Chris! Swanky!) and then the wedding on Saturday, where some of his family will also be in attendance. For those of you who don't know, Kevin and his sister Sam are the matchmakers that brought the hubs and I together oh-so-many years ago :] Sam is my friend, Kevin is his friend, we all lived in the same neighborhood... you get the picture. So of course Kevin and Sam were both attendants in our wedding, I was in Sam's and now he is in Kevin's. One big happy family, right? Love those Knapsteins!

Then NEXT weekend is Mike & Sarah's wedding in York, PA. Mike is (clearly) Ben's best friend - he was Ben's best man and now Ben is returning the favor. They also asked me to write something original to read during their ceremony (how sweet was that?!), so I'll also be participating :] That's gonna be an overnighter for two days (Thursday for the rehearsal and dinner, Friday for the wedding, and we'll be home Saturday). Should be a GREAT time!

In the meantime, I've been getting settled at my new job and getting my first project rolling. More to come on that. Suffice it to say, it's going well and I think I'm going to really enjoy my summer, despite having to get up with the alarm every day and actually work for 8 hours. GASP. It's a change for me, but having my evenings and weekends TO MYSELF is a pretty sweet consolation prize ;] I just LOVE being able to enjoy my evenings and weekends completely guilt-free, with nothing hanging over my head! And the more obvious icing on top of this cake is that my work has a real, tangible, personal purpose.

This is my bright, beautiful niece Lacy.

She's a little math whiz who loves to play teacher and make up quizzes to stump her family. She helps her mom out with her three younger siblings and is a little mommy-in-the-making with her 6-month-old little sister Caraline. She's 10 (almost 11) going on about 25, and seems to have always been a little extra mature for her age. She's always sporting a cute new outfit, and she always greets you with a funny story about something random that happened since the last time you saw her. Unless you heard her cough, you wouldn't know that she has a chronic illness. She has cystic fibrosis, the most common genetic disorder among caucasians, which primarily affects her lungs and digestive tract. She is susceptible to damaging and persistent upper respiratory infections, and has to take pancreatic enzyme supplements at every meal to properly digest her food. She does several different therapies on a daily basis to break up the mucous in her lungs and keep them clear of harmful bacteria, and when she gets a common cold sometimes her body needs some extra help to clear the infection (which lands her in the hospital on occasion). She takes it all in stride, and has become a pro at taking care of many of her own therapies. She's quite a trooper, this girl.

This summer, I am working in the Guggino Lab at the Johns Hopkins Cystic Fibrosis Research Development Center (if you follow this link, you may recognize the little munchkin hugging her doctor at the top of the page!), one of ten basic research centers in the country funded by the CF Foundation. One of the major focuses of CF research today is gene therapy, which is what I'm working on this summer. The CFTR protein is mutated in CF patients, and normally functions as a channel to allow salts to pass through cell membranes. The most common mutation (which Lacy also has) is called deltaF508, and it causes the protein to assemble itself into an incorrect shape. The cell recognizes this incorrect shape and "tags" the mutated protein so that the degradation machinery of the cell can dispose of it. The deltaF508-mutated CFTR protein, however, is still close enough to the correct shape that it could function as a relatively normal channel if it was allowed to survive and go to the cell surface where it belongs. The lab that I'm working in this summer focuses on finding ways to trick the cell into allowing the mutated CFTR protein to escape degradation and reach the cell surface so that it can carry out its normal function, which could vastly improve symptoms in CF patients.

This work, and the vital work of other labs across the country, is funded in large part by the Cystic Fibrosis Foundation. To make a donation to CFF through our Great Strides team and to read more about Lacy, click on the Great Strides button on the left-hand side of the screen (you may notice that the Great Strides walk already happened, but it's never too late to donate!). And for my Baltimorians, there's also a raffle for Club Level Ravens tickets going on right now to benefit CFF!

So that's what I'm up to this summer :] A new job with a purpose. I probably won't make any tremendous new discoveries in my 10 weeks here, but I take heart in knowing that I'm making a small contribution to the HUGE push for a cure, and adding something tangible to the hope that one day, Lacy and kids like her won't have to fight this battle any longer.

One Year

Marriage is a roller coaster. When you're engaged and people assure you that the first year of marriage is always the hardest, you quietly chuckle to yourself and think "How could this be true? We're so excited, we'll be newlyweds, everything will be perfect!" But once you've lived it, you may begin to see a little pearl of truth in that statement.

Everyone's first-year-of-marriage challenges will be different, but regardless of life circumstances, marriage is an adjustment. For one thing, your money suddenly isn't YOUR money anymore, and your spending suddenly affects someone else. There's this expectation of equity and fairness in how "extra" money is spent. It needn't be a huge bone of contention, but no matter how you slice it the first year of marriage inevitably brings up countless situations that force you to forge a new strategy, bit by bit, for handling finances between the two of you.

Then there is the melding of two families, and the priorities of each spouse when it comes to family time. When the holidays come around, there are double the people to make time to visit, and holiday traditions to be respected. Throughout the rest of the year, your weekends become a four-way struggle between "us" time, "friends" time, "his family" time and "her family" time. If you come from tight families and you live relatively close to them, and you're trying hard not to neglect your friends (no one wants to be "the boring married couple"), it becomes easy to let "us" time take a back seat. Not only is that unhealthy over the long run, but it can be downright exhausting at times! It's a tough balance, and it will take some time to figure out what sort of pattern you'll settle in to.

Marriage will teach you just how much you need God in your life, too. Your capacity for forgiveness, tolerance of another's values, and patience will all be tested beyond what you once believed were their limits. There are things that your spouse will want to buy or do that don't seem "worth" the expenditure to you (whether it be of time, money or both). There are hobbies that your spouse will pick up that seem trivial to you. There are days when your spouse will be caught up in his or her own troubles and stresses and you will feel ignored or unappreciated. Your spouse will even say and do things that just outright hurt you on occasion, because the more time you spend together, the more opportunities there will be for that sort of thing to happen. These same things will inevitably also apply to you from your spouse's perspective, whether you see it or not. The bottom line is that you will both choose to act out your promise and commitment of love every day. You will always forgive, you will always forget, you will always be patient, and you will always value the things that make your spouse happy whether you understand them or not. Because that's what you promised, and because the other 98% of the time gives you every reason in the world to feel the same way you felt back when you made that promise.

We often put on our happy faces for the world even when our home life isn't ideal - when we're going through "rough patches". I know I have. It's just what you have to do. But the first year of marriage really DOES have the potential to be the hardest, and it WILL surprise you and throw you for a loop now and again. It won't always be a bed of newlywed roses, despite what we "newlyweds" will tell you ;] Marriage is a challenge because it is meant to be - God uses marriage to propel each spouse ever closer to the image of Christ, as we learn the virtues of Christ in our daily interactions. There is no more effective way to learn and internalize these virtues than to commit your life to serving another human being in marriage, day in and day out. It's important for newlyweds to realize this fact when it does get hard... it doesn't mean that you married the wrong person, it just means that it's working. Change doesn't always feel good in the moment, but you are being molded into the man or woman that God wants you to be.

All that said... after a year of marriage, I find myself a SUPREMELY happy newlywed :] We really have been through a lot this year - more than most people know - and it has been anything but a walk in the park. But through the challenges, our bond has been solidified on such a deep level. We grew more this year as individuals and as a couple than any other year in the (nearly) 10 that we've been together. We are more in love now than we have ever been, because God used those challenges to yield an incredibly fruitful first year of marriage. When I look at my husband, I don't see the hard times. I see the hard-working provider who, despite his supreme distaste for mornings, gets up at 4am to work overtime when it's available. I see the selfless giver who scrubs the bathroom, mops the kitchen floor, does the dishes (every night) and vacuums because I'm studying for an exam and it needs to be done. I see a tired, stressed out guy after work who gets down on his hands and knees and cleans the litter box every day as soon as he gets in the door, because he doesn't want me to do it. I see the guy who won't let me get out of bed to get something I forgot once I'm there - he'll get it. I see the guy who won't let me carry one bag out of Target - he's got it. I see the comedian who leaves everyone in the room in stitches wherever he goes - the "life of the party" who, when he calls to say he can't make it, inspires other people to think twice about whether they even want to go anymore (that always makes me laugh, and I'm not kidding either!). I see the warm, funny, outgoing, confident, giving, loving, caring guy who inspires so much respect and love in me that my measly body can barely contain it all. The guy who brought me these, the day BEFORE our anniversary :]

Marriage to a guy like that will give you a short memory for the "rough patches", because the other 98% of the time, he's all you ever dreamed of. Happy Anniversary babe <3

A Tough Pill to Swallow: COCs and Infertility

One of my greatest fears in life has always been infertility. I feel so strongly called to motherhood, and I am so excited to experience the gifts of pregnancy and child bearing – the mere thought of being unable to bear my own children is nearly (no pun intended) unbearable. I suspect that I am not alone in this fear, though I also suspect that many young women have forced the subject to the proverbial “back burner” for the time being, just as I did. Of course I have always wondered whether I would have difficulty conceiving, and lamented the fact that I supposed I’d just have to wait until the time came to find out.  Little did I know, that’s not entirely true. Little did I know, there are lots of potential obstacles to fertility that can be revealed and addressed well in advance through fertility awareness. More importantly, little did I know that the Pill itself could be masking fertility issues or even creating them.

There are a variety of ways in which combined oral contraceptive (COC) use can affect fertility, some more dramatically than others, but all worth discussing. Some are difficult to quantify by their nature, so this post won’t be full of shocking statistics – it is meant to provide some “food for thought” and to bring to light some of the barriers to future fertility that COCs often present.

Amenorrhea – the absence of menstruation – represents one such barrier and affects many women upon discontinuation of COCs. Amenorrhea implies anovulation (the absence of ovulation), which obviously presents an insurmountable obstacle to conception for as long as it persists. No ovulation, no egg, no conception. While it may only continue for a few cycles, in rare cases post-pill amenorrhea can plague women for years, and younger women are no exception. Anovulation can also go undiagnosed for a time, as anovulatory bleeding is not uncommon when transitioning off of COCs.

Allow me to explain. Normal menstrual bleeding is triggered by a decline in progesterone when pregnancy does not occur in a given cycle. Progesterone, the hormone responsible for maintaining the uterine lining in preparation for the implantation of a fertilized egg, is secreted by the corpus luteum (CL; the remnants of the ruptured ovarian follicle from which the egg was ovulated that cycle). The CL can only survive for a short time without support from the hormone hCG, which is only secreted by a successfully implanted embryo. Consequently, in the absence of pregnancy, the CL eventually dies away and progesterone levels decline with it. Without the support of progesterone the uterine lining begins to shed and recede, giving rise to progesterone withdrawal bleeding or menses.

But of course, in an anovulatory cycle there is no CL and therefore no progesterone rise or withdrawal. This is where estrogen comes into play – it is responsible for preparing and maintaining the uterine lining prior to ovulation, and for triggering ovulation itself. Without sufficient estrogen not only will ovulation be unlikely, but the uterine lining will also remain unstable and may shed at unpredictable times throughout the cycle. For a woman who is discontinuing COC use this bleeding can look like irregular menses, which seems plausibly normal for a transitional time, and so many women waste months waiting for their cycles to regulate – or worse – go on believing that they are ovulating (since they are bleeding) and spend months trying unsuccessfully to conceive. Not only can amenorrhea and anovulation present a serious obstacle to conception, they can also be deceptive and cause much undue stress and anxiety as a couple struggles to conceive. They are treatable conditions in most cases, but treatment can be expensive and may take weeks or months to be effective.

What saddens me the most about these potential complications is that many women are unaware of the possibilities. For example, my plan was always to “come off the Pill” about 3 months before we were ready to try to conceive (on the advice of my GYN provider). Given my educational timeline as a medical student, future intern/resident and future physician, my husband and I will be trying very hard to time any conceptions carefully. Of course there are many variables and it is often impossible to plan “down to the minute”, but the possibility that ovulation could be delayed by 3, 6, 9 months, even a year…? That would have been a HUGE unexpected obstacle that could have cost us a window of opportunity. Of course I always fall back on the knowledge that God will provide, and that His timing is truly all that matters at the end of the day, but what a heartbreaking turn of events that could have been.

The idea that the Pill has the potential to cause infertility issues is scary enough, but what is even more common is the masking of existing problems. One common setback, for example, is a short luteal phase – the time between ovulation and the onset of menstrual bleeding. As we discussed, progesterone secreted by the CL maintains the uterine lining in preparation for the implantation of a fertilized embryo. It is easy to imagine that, if the CL dies off prematurely and progesterone levels decline too quickly, a fertilized egg would not have time to successfully implant prior to the onset of menstrual bleeding and the conception would be lost without the woman’s knowledge that it had ever occurred. On the other hand, some women may have infertile cervical fluid, which significantly reduces the lifespan of sperm in the female reproductive tract and may hinder its passage into the cervix altogether, presenting another obstacle to conception. Another common “fertility problem” (which isn’t really a problem at all) in women who do not use ovulation predictor kits is late ovulation. There is a very common misconception out there that ovulation always occurs at mid-cycle, around day 14, which for many women simply isn’t the case. If you don’t ovulate until day 20 (which is completely normal for some women), having sex 14 times on day 14 does nothing to improve your chances of conceiving, and so many couples spend months of heartache trying unsuccessfully to conceive simply because they are unacquainted with the woman’s cycle.

The punch line here is that all of these conditions are masked while a woman is taking COCs. There is no luteal phase without ovulation, there is clearly no late ovulation without ovulation, and the quality of cervical fluid is dramatically altered by the progesterone component of COCs. These are all issues that a couple may encounter in their attempts to conceive, and they are all issues that can be uncovered and addressed through natural means (or medicinal means if necessary) far in advance, greatly reducing the time, effort, and stress associated with trying to conceive.

Another potentially serious medical condition often masked by COC use is primary ovarian ineffectiveness or POI, which is often the culprit behind the prescription of COCs for menstrual regulation. Women with particularly heavy or irregular flows or more severe menstrual symptoms (painful cramping, for example) are often prescribed COCs to correct the imbalance of hormones that causes these symptoms. POI can cause particularly heavy, light and/or irregular flows, and while COCs often do restore the proper hormone balance necessary to alleviate symptoms, the underlying ovarian insufficiency remains. When these women discontinue COCs, their ovarian hormones (estrogen and progesterone) will most likely still be insufficient to properly regulate their cycles (with the caveat that POI can come and go in some cases). Though not all women who experience heavy or irregular periods have POI, the disorder affects an estimated 1 in 100 women by the age of 40 – not terribly uncommon. The most disturbing fact is that POI, when left undiagnosed and improperly treated, can result in long-term infertility according to Dr. Lawrence Nelson of the National Institutes of Health. Dr. Nelson also notes that POI can trigger premature menopause in women as young as 30. Women on COCs with underlying POI can go through menopause without realizing it due to the masking effects of the Pill, and upon discontinuation discover that they are no longer able to bear children.

As POI is masked (and often improperly “treated”) by COC use, it is not uncommon for the disorder to cause unnecessary and devastating infertility problems in unsuspecting women. If you have been prescribed COCs for the kinds of cycle irregularities discussed here, I would encourage you to ask your doctor for a simple blood test that can screen for POI by evaluating your FSH levels (follicle stimulating hormone, which is secreted by the pituitary and is responsible for follicle maturation prior to ovulation).

Infertility is one of those subjects that really hits home for many women – particularly young women who have yet to begin or complete their families. I do not wish to employ fear tactics to scare women off of the Pill, but these are real concerns worth discussing openly. Most young, healthy women will never be touched by the heartbreak of infertility, thank the good Lord, but the gift of child bearing is one worth protecting through careful consideration of the risks. If you are interested in discontinuing COCs and becoming acquainted with your cycle prior to trying to conceive, I highly recommend charting (see Taking Charge of Your Fertility in Books I Recommend, or click here to learn more about Natural Family Planning online). It's worth taking a few extra months to sort out your cycle, look for any irregularities or potential challenges, and have a thorough understanding of your own cycle - and if all is well, charting is still worth its weight in gold as it will give you all the tools you need to conceive whenever you're ready!

If you're just joining us in this series and would like to read more, see the sidebar for links to previous posts, or start here at the intro. And stay tuned for the next post in the series (yeah, there's more!)...

Resources:

http://www.independent.co.uk/life-style/health-and-families/new-fertility-fear-fueled-by-the-pill-1964647.html

Taking Charge of Your Fertility by Toni Weschler, MPH (see Books I Recommend) 

The Dusty Little Box

When I began using the Pill, my fertility was little more than a nuisance in my life. Like a gnat at a barbeque it always seemed to pop up and ruin the moment, and just wouldn’t be shooed away. The constant worry (particularly as that time of the month approached), month after month after month, was driving us both insane. Well, I just wasn’t going to stand for that kind of oppression at the hands of my own biology – I found a way to stick it to those pesky ovaries. I’d shut them up. The Pill freed me from the chains of fertility, and for me, that made the Pill just about the greatest thing since sliced bread. It allowed me to drop my fertility into a tiny box, seal it up and pack it away. I knew I’d use it again someday, but for now I didn’t care where it ended up. I just pitched it under the bed, left it to collect dust bunnies and went about my business.

Fast forward seven years. I find myself a married, twentysomething woman with a deep, agonizing ache in the pit of my soul. Some call it “the baby itch”, which makes me laugh. Some man must have coined that phrase, because “itch” just doesn’t even begin to cover it. An itch, I could scratch. An itch would go away. An itch is a minor irritation that might distract one for a brief moment. This ache of which I speak is utterly unmanageable, unremitting, and all-consuming. Day and night, regardless of other distractions, it is perched on my shoulder whispering sweet baby sighs and projecting images of tiny wrinkly toes and adoring toothless grins. Yes friends, I’ve got it bad.

But even despite all that, the light bulb still hadn’t flicked on in my mind. I still hadn’t reached the realization that my chemicalized body was completely incapable of giving me what I so desperately desired. Well, I knew it intuitively, but I failed to recognize what it truly meant to me. I had taken it all so lightly for so long. “When we’re ready, I’ll just go off the Pill and we’ll get pregnant” …I hope. “I’m young, so my cycles will bounce right back” …I hope. Those lingering fears, coupled to my concurrent discovery of the myriad health risks associated with oral contraceptive use, set off an entirely novel train of thought, and triggered an unexpected uprising of emotion that I’ll never forget.

Tears welled up in my eyes as I figuratively reached under the bed and fumbled around for that dusty little box. It was different than I remembered it – it was nearly bursting with its contents and the seal was barely holding it closed. What I had stuffed into that box so many years ago had been growing and multiplying, but had gone unnoticed for all this time – it was out of sight and out of mind. That tiny little box could barely contain the significance that my fertility had taken on, though it fit so nicely when I packed it away. I held that little box in my quivering hands as I contemplated our future, my longing for children, the past transgressions that the Pill had allowed me to perpetrate without a second thought. The tears were flowing down my cheeks by now. How could this weighty box ever have felt so light? How could the matter of my own fertility ever have meant so little to me?

And then, it really hit me. There I sat, in the prime of my biological child-bearing years, a virtual desert of infertility. I felt like a stripped down version of myself. On the outside I was all woman, complete with eclectic accessories, expensive handbags and a closet full of shoes. I wore feminine clothes and feminine scents, embraced my role as a wife, loved to cook… all the pieces were there. There was just that one minor detail that was missing – an internal detail that sustained my biological role as “woman” – and I had given it away. That precious gift that so many women would almost kill for… I had it, and had run from it like a house on fire, thanking my lucky stars that I had escaped unharmed.

Of all the things that I fear in this world, the inability to have children just might be #1 – yet I had willingly rendered myself infertile. It suddenly seemed so unnatural that my body had not been allowed to cycle in years, and that I knew nothing of my reproductive health. I suppose I was planning on waiting until we were ready to conceive to find out where we stood as far as my fertility was concerned. Great plan. This giant question mark was far more worrisome than the prospect of leaving the Pill behind, particularly in light of the highly effective natural methods of birth control that I was learning so much about. I wanted to know myself. I wanted to reclaim control over this pivotal aspect of my world – a subject that meant so much to me yet had been so casually and carelessly ignored.

Knowledge is power, and the female body is a wealth of it – harvesting that information just requires a little extra attention and a thermometer. That vital information can be used to postpone pregnancy, to achieve pregnancy, to troubleshoot fertility difficulties… all without ever stepping foot in a pharmacy or a doctor’s office, and most importantly, without harming a woman’s health or future reproductive capacity. No chemicals, no regret. Just your body doing what it was made to do, naturally and effortlessly. That, my friends, sounds like a great plan for me.

A few months ago, I was more empty inside than I realized. The growing weight of my fertility was blindingly apparent in some ways, yet I had failed to notice that the dusty little box that contained it was ready to burst. I understood all too well the significance of the gift of child-bearing, and how exceedingly important that was to me, yet I had stripped myself of it and taken my body for granted. I can forgive myself for the decision that I made all those years ago – young girls simply cannot understand the profound magnitude of their fertility – but I’m having a hard time wrapping my head around what took me so long to put two and two together.

But today, I stand before you a new woman. It is as though a sizable chunk of my soul has found its way home. I suppose it was in that dusty little box all along, alongside a little slice of my heart. These missing pieces were so small in the beginning, I thought I’d barely notice them. Oh how they grew, but it was such a long, gradual process that it fooled me for a very long time. Now that they’re back where they belong, I feel full again in a way that I never anticipated. I never knew what it all meant to me until I had it back. One thing is for sure – I’ll never let it go again. I know that there is little I could say to convince most young women that they’d feel the same way if they allowed themselves to unpack that dusty little box, but I hope that my story will at the very least give you a moment of pause to contemplate what your fertility means to you.

For the full story of my journey from the Pill to Natural Family Planning, catch my Guest Post on Planted & Blooming. 

You KNOW You Want One...

I simply couldn't resist taking a moment to promote Lisa's blossoming bow business! You KNOW you're just dying to snap that bad boy into your little cherub's wispy ponytail! The cuteness is darn-near unbearable!
Check out Pretty Ditty Hair Bows 

to snatch up a few unique hair bows for your special little one.
Viva La Dainty-little-girl!

A Tough Pill to Swallow: Contraindications to COC Use

The following is a reference list of underlying medical conditions that, if present, may increase a woman's risk of experiencing medical complications as a result of combined oral contraceptive (COC) use. This list was gleaned from the Merck Manual, a common reference that can be found in any doctor's office or hospital unit in the country.

Contraindications to Combination Oral Contraceptive Use
Degree	Condition
Absolute	·      Abnormal uterine bleeding with an undiagnosed cause ·      Diabetes mellitus (or other disorders) with vascular complications ·      History of estrogen-dependent cancer, coronary artery disease, hepatic adenoma, idiopathic recurrent jaundice of pregnancy, stroke, thromboembolism, deep venous thrombosis, MI, or active SLE (because risk of cardiovascular sequelae is increased) ·      Hypertension if uncontrolled ·      Immobilization of a lower extremity if prolonged ·      Liver disorders if active ·      Major surgery for 1 month after (and 1 month before if elective) ·      Pregnancy ·      Renal insufficiency ·      Smoking after age 35 ·      Triglyceride levels > 250 mg/dL
Relative	·      Amenorrhea with an undiagnosed cause ·      Cigarette smoking if heavy in women < 35 ·      Depression ·      Diabetes (treated) ·      Family history of blood clots ·      Fibroids ·      History of liver disorders with recovery ·      Hypertension (treated) ·      Migraines with neurologic symptoms ·      Obesity ·      Precancerous cervical lesions (treated) ·      Premenstrual syndrome ·      Seizure disorder (drug-treated) ·      Varicose veins

Allow me to take a moment to define some terms and abbreviations. First of all, the categories absolute and relative essentially refer to the level of caution a provider ought to observe when prescribing COCs to a patient. Any of the medical conditions in the absolute list are absolute contraindications - patients with these conditions should not take the Pill. Medical conditions in the relative list are relative contraindications, meaning that patients with these conditions may have an increased risk for complications relative to the general population and should consider other alternatives, though use of the Pill is ultimately permissible. As for some of the terms and abbreviations within the list...

• Diabetes mellitus is type II diabetes (usually adult on-set)
• Hepatic adenomas are benign liver tumors
• MI is myocardial infarction (a fancy clinical term for heart attack)
• Thromboembolism and Deep venous thrombosis are blood clots
• SLE is systemic lupus erythematosus (commonly known as Lupus)
• Hypertension is chronic high blood pressure
• Renal insufficiency is chronic kidney failure
• Amenhorrea is the chronic absence of menstrual bleeding

Please feel free to leave a comment should you have any other questions or concerns about this list. I'd be happy to clarify any other terms or abbreviations, though medical questions concerning your relative risks and decisions about your medications should be directed to your physician, since I am not (yet), in fact, a doctor ;] 

It is absolutely critical, when evaluating the relative risk you assume in taking COCs, that you be made aware of the underlying medical conditions that may augment that risk. The statistics that I've offered in other posts in this series refer to the baseline, general population risk - having any of the contraindicated conditions (relative or absolute) immediately puts a patient at a higher risk for complications. 

Stay tuned for the next topic in this series on the health risks associated with oral contraceptive use, and if you're just joining us, catch up on previous posts:

• Introduction
• Vascular Complications
• The Pill as an Abortifacient (not part of this series, but a relevant read)

***UPDATE: Catch the next post in this series on Infertility

Books I Recommend

So, apparently I couldn't stay away. Or I'm a professional procrastinator. Or both. You be the judge.

Just wanted to call attention to a new page I created, aptly named "Books I Recommend". You can also find it (for future reference) in the pages bar just below my blog header. It contains a few suggestions for great reads on Love & Marriage (and sex, too... can't forget sex!), Science & Faith, and Family Planning & Fertility... for now. Check back every so often for additions... after my exam. Because this really is the last you'll hear from me until Thursday afternoon. I hope.