Saturday, March 29, 2008

Things that make you go hmmm.

I had a consult with my RE on Friday. I came prepared. Why did it fail? Was it egg quality? How would they change the protocol next time? Are there additional tests they would recommend? Dr. Google and I didn't get an opportunity to impress. Immediately, the RE recommended that we undergo immunological and chromosomal testing. He said that most clinics don't recommend either unless there have been recurrent pregnancy losses, but that he felt it would beneficial to rule out these issues for me. I love the way he said "rule out." Turns out if there are immunological issues, they can be dealt with; heparin for example. If there are chromosomal issues, well, cue the chubby opera singer. I snickered when he said we'll know the results of the immune tests early next week but it will take around 4 weeks to know about the chromosomal testing. Of course it will take 4 weeks. Hell, take 6 weeks.

As for the rest, it wouldn't be a trip to the RE's office if they didn't bring up my age. My eggs, you see, have been around 38 years, not to mention the 9 months I hung out in utero. (I knew all those vodka shots back in '69 would come back to haunt me. Bad Fetus.) The good news is that I responded "perfectly" to the stims and have good ovarian reserve. My lining could be fluffier, but it just could have been a bad batch of eggs. Assuming no chromosomal issues, the RE feels we should try again. No need to discuss donor eggs or sperm at this point. (I didn't share that we wouldn't go that route.)

All of us who go through this grapple with the issue of when is enough enough. For some people, I'm sure the answer is when they're successful, when the baby is born. For others, the uncertainty and invasiveness and emotional toll of IVF proves to be too much. Some choose adoption. Donor eggs/sperm or living without a child of your own for others. But at some point, you make a decision. A heartfelt, thoughtful, determined, resigned possibly, decision. I've never been so close to that point.

I know this because my first thought when the RE mentioned that nothing really could be done about chromosomal issues, well then we know we're done. The truth is that the physical process of in vitro has been no problem for me. The shots have been fine. I know, I know, I've complained bitterly, but really, they haven't been bad. Grab fleshy stomach flab, insert needle, depress plunger, go watch Gray's Anatomy. Sure, the butt shots got annoying but I've had worse mosquito bites. I've had two bruises total during this whole process. And the dildo cam, well, it's always been gentle.

The emotional toll of IVF is another story. The uncertainty, the soaring joy following by the bring you to your knees heartbreak, the careful optimism, the preparing for the worst yet hoping for the best, the exhaustive frustration, the please, please, please let me not lose who I am and who the hell am I anyway. No, there is a shelf life on this. When we started this process, I thought, I'll do this as long as it takes. I could not have known how much the process would take. And take.

So, I can definitely see an end to this. Not quite yet, not unless, of course, the chubby woman belts out her final notes in 4 weeks. And if that's the case, then we'll both go on a diet.

Thursday, March 27, 2008

Things better left unsaid

My first thought was to turn this post into a "Top Ten Moronic Dumb Insensitive Things Ever Said To An Infertile Person Or About Infertility." Two Words: Jennifer Lopez*. But that's too easy. And it makes me mean and shrill. Instead, I'm moved to talk about how infertility has made me a less-mean person

  • I try very hard to self-censure before I blab out some moronic, dumb, insensitive utterance that will very likely hurt someone's feelings or make me look like an asshole. For example, I was in a class at work yesterday and a woman walked by wearing, I kid you not, a white, furry, long-haired vest. She looked like half a lama. I caught myself turning to my neighbor to snort derisively at this woman's fashion choice and then stopped. And said nothing. The woman did indeed look like an alpaca, but I had no business verbalizing it to a stranger or near stranger. (Caveat: If my husband had been sitting next to me, I would not have been able to stop myself.) In a way, I'm looking at this as karma-reversal. How many times have I heard things like "when are you having children and how old are you anyway?" and "I've heard relaxation and avoidance of stress helps". I'm sure these are paybacks for the times I did make the lama remarks.

LESSON: One should not dress as a domesticated South American hoofed mammal. No, no, no, I mean: THINK BEFORE YOU SPEAK.

  • A close corollary to bullet #1, I'm learning that even if I believe in my heart of hearts that someone is doing or about to do something that is completely moronic or stupid, I don't need to share the full extent of that belief (unless it involves bodily harm or excessive weight gain, particularly mine). Even if pressed for my "honest opinion." Even if someone flatters me excessively, tells me I'm funny, that my reproductive organs are those of a 16 year old, that they will die, just die, if they don't have my brutal, honest opinion. Nope, not getting it. You know why? Nine times out of ten, people just need to be heard. And you just need to listen. And gently, ask questions and reassure that person that you support them. Even if they're making what you perceive to be a huge mistake. I know this because I remember every single conversation I've had about this journey where I was allowed to cry and talk and cry and be heard. For me, I'm saving my brutal, honest opinions for that 1/10 husband.

LESSON: Listening is a gift greater than words.

I realize that I've only written about two lessons I've learned from infertility that have made me less shrill, but I think they're biggies. (Notice how I didn't get defensive or say something mean like, "well you tell me what the hell you've learned in the last five months of any significance other than how not to wear goat.") Next month I will be posting from a yurt in Tibet on inner peace and the oneness of all human beings.


*According to People Magazine, J-Lo said about her pregnancy: "It was natural. We didn't do in vitro, which I know was reported. Everybody assumed that because we had twins. I wanted to have a baby, but I've always said exactly what I said all those years they (reporters) asked us since we've been married: 'Well, when are you guys gonna have some kids?' 'When it happens naturally, I guess!' And that's when it happened. It was a surprise to us."

Sunday, March 23, 2008

The Winter of my Discontent

As the winter of 2007 concludes, I say good riddance you heartless bitch. I can't recall a winter in near history that has leveled me quite like this one. Days upon days of cold, gray, sad, sunless blah. Our week in St. John in January is the one event that saved me from mainlining prozac. (She proudly notes that her advanced needle skills would ensure said mainlining would be a snap.) Couple the sunless blah with my first failed IVF in November and my fleeting pregnancy in March, I flip winter the bird and say bring on the sun. (The attached is Anguilla from 2004...look at that water...look at that girl...She looks so fertile.)

And Friday we had sun. A beautiful, warm, Springish day. I could feel the layers of gloom and melaniecholy slipping away. Yesterday, Easter, we had snow the size of packing peanuts. But today, sun. Shining in through the window, warming my face; it melts away the grime. Like many of us, I have never been so ready for a new season, a fresh perspective, the certainty of warm weather ahead. Because certainty is, well, certainly illusive.

If I have learned anything during this process (other than developing a certain proclivity for the dildo cam) it's that infertility is very much a solitary road. Sure, I've received wonderful support both IRL and through the computer, but ultimately you're trudging through the hills by yourself without a reliable compass and with less than definitive trail markings. And at some point, you're going to be faced with a decision: keep trudging or veer off. Most of us can't pinpoint with any certainty when that decision will be made or where you might veer off. (At the Four Seasons exit, please.)

An illustration: On Saturday I was sitting under the hair dryer, waiting for my natural blond highlights to reappear and a wave of sadness washed through me. The tears flopped over my nose and onto the People magazine and I held my breath. Just to try to center. Blinked a few times. Closed my eyes. Felt the sadness fill me up and felt it slowly leave. Waited for the bitter twinge to also leave; the "why me" to fade away. It did. And then I wondered when I would be certain.

I don't have the answer now. Now I just deal with the uncertainty as best I can. And wait for Spring to settle in and get nicely situated. And for the Winter of 2007 to be a distant memory.

Monday, March 17, 2008

How to get from pregnant to 0 in 12 days

My hcg level is down to "0." Zero. Zip. Nada. Phlgbbt. In a sad sort of way, I appreciate my body for taking care of things. I don't have to linger through weeks of slowly decreasing hcg levels, which easily could have allowed a blip of hope to arise. My return to zero means I don't have an ectopic. In fact, zero means I can start again anytime I want. A new beginning. A clean slate. Cue blue birds with spun gold in their happy little beaks.

If I had written this post last Saturday, it would have had a very different feel. The bitterness of "zero" would have been too good to pass up and the bluebirds would have been plucked, grilled and eaten with a tangy remoulade. Whether it's a good thing or not, my family and some friends read this blog and they have a tendency to get worried if I sound particularly morose. More so, if I shoot bluebirds. My phantom Saturday post would have had a Jack Nicholson in the Shining feel:


And I do feel much, much better. Really. But I didn't post on Saturday because I was sad and pissed. I didn't post because I didn't want to have to explain later in phone calls that I was sad and pissed, but ok. So I need to add a disclaimer to my family and friends who read this, my struggle with infertility blog. Here goes:

I'm still me. I have not morphed into someone whose sole interest in life is having a child. I continue to be stronger than the average bear. I continue to work. Hard. I continue to have dreams beyond simply having a child. I would love to write fiction. I would really love to go to culinary school. I continue to be the only one in the room who laughs at my jokes. It is simply not my fault that others have no sense of humor. E and I continue to have a wonderful, "how in the world did we get so lucky" relationship, even though he doesn't know where we keep the vacuum. (Dammit, it's in the kitchen closet.) Please don't feel sorry for me and please don't suggest that I'm focusing too much on this having a child thing because of what I write here. This blog is about one subject, which happens to be a fairly emotional one. And a personal one. I get a great amount of support from the act of writing here and from the comments. By reading this blog, you subject yourself to the jurisdiction of me, the Supreme Queen Goddess, which could mean anything I want, depending on the day and my mood. So conduct yourself accordingly. Don't coddle or pity me, unless I ask for it or unless you too have struggled with infertility, then coddle away.

There, that feels better. Thank you for listening. Please sign the attached waiver in triplicate before a notary and we'll be ready to roll. Again.

Friday, March 14, 2008

So I lied...

Oh, no, not about my hcg levels taking a swan dive, but about kicking back for a while and not giving thought to next steps. I like the idea of wallowing, but it's not working for me. I need a plan. I'm not demanding a "Colonel Mustard in the library with a candlestick", just a plan. So, my plan is thus:

1. Continue drinking wine.
2. Get my blood drawn on Monday.
3. Meet with my RE to get an idea about what the flip happened.
4. Go to Cornell April 18th for a consult.
5. Drink more wine.

I would love not to leave my clinic. I love the personal attention and care. I love the convenience. But I think I've only got one more cycle in me and if I'm going to do it, I want the greatest likelihood of success. I would love to know if anyone has any experience with Cornell and what your thoughts are. E is convinced that I'm considering New York because of the shoe shopping. Please. That's only half the reason.

But the real reason for this post is to say thank you. I'm okay. Really, I'm okay and I attribute so much of it to you. For lifting me up, crying with me, checking on me, yelling at the world with me and reminding me that I'm not alone. I've been kicked in the ass by circumstance, but so have many of you. I'm pleased to say that it's hard to wallow in the cesspool of self-pity for too long when you realize that we've all had to shovel shit at one time or another. (And that little piece of literary eloquence should get me the Pulitzer.) You've been wonderful. And I've never had to worry that one of you would say something like "my third cousin twice removed got pregnant after 12 in vitro attempts and a hysterectomy, so you just need to relax."

So my plan is to try this again, either here or there, at some point in the next couple or three months. That's good enough for now.

Wednesday, March 12, 2008

3rd BETA

Unable to stand the uncertainty, I asked to move my blood test to today. Results are a heartbreaking 140. Miscarriage is on its way.

Tonight I will drink wine.

Tomorrow I will book plane tickets and hotel in Anguilla.

Saturday I will have a massage.

I will think about other plans...later.

2nd Beta

My second BETA on Monday was a disappointing 336. The doctor's office left a message Monday afternoon that said "Good news, your beta went up, it's 336. Your progesterone is good also at 30.1." I recognize that my math skills are lacking, but I don't think that's close to doubling or double doubling. So I called back and spoke to the nurse practitioner:

"I thought it was supposed to double?"
"We like to see that, but your first number was so high I wasn't expecting it to."
"Yes, but Dr. Google says that if it doesn't double in 48 hours I will likely miscarry."
"Stay off the internet. It's a good number, we have no reason to be concerned at this point."
"But it didn't double, or double double."
"People are different, bodies are different. There's no reason to worry."
"When can I have another blood test?"
"Ok, let's draw your blood again on Thursday."

So, I've spent probably 47 hours researching HCG levels since Monday afternoon and I'm now exhausted and done. Obsessing, that is. My sobbing spell yesterday left me drained and out of sorts and it's time to center, as much as possible. I have absolutely no control over the outcome at this point. So, I'm going to try to relax and be confident. Otherwise, there's no way, if given the chance, I'm competent to handle this for 8+ more months.

This double, doubling sucks.

Tuesday, March 11, 2008

A few comments on comments

When I started blogging, I made the decision not to review and approve comments. Let 'em post has been my attitude. I've received some snarky posts in the five months I've been blogging, but the majority has been funny, supportive, thought-provoking, indeed lifelines in many instances. I've got a fairly thick skin (particularly as a result of countless outer quadrant of the buttocks injections) so no snarkism has particularly offended me and I've never felt the need to address any of them. (Plus, I'm sure that I'm so charming in real life that I would eventually win over the naysayers given the chance.)

I received a comment to a recent post asking me to remove a comment another person left because she felt it was addressing something she wrote on her blog. My feelings about that request aside, I still adhere to my original decision. Let 'em post. I welcome your thoughts, your disagreements, and, oh so very much, your support.

Thanks for listening. As always.

Saturday, March 8, 2008

With a cherry on top.

I have been tagged by the incomparable Rebeccah at (Rebeccah studied for the bar exam while undergoing her second IVF and took the bar while sick. My hero.) Here are the rules:

Step 1. Reference back to the blog that sent you.

Step 2. Make a list of 5 things that you have to get done this week, no matter how small.

Step 3. Get 2 other people off their asses to get their shit in order.

1. I was supposed to go get blood drawn yesterday for my second Beta. Unfortunately, THE TWELVE INCHES OF SNOW ON THE GROUND prevented it. My team of huskies and I were prepared to go, but the lab was closed. (I can hear the collective muttering of "weanies" from the Northwesterners and Northeasterners ) This is Louisville, Kentucky, though. As much as we salt and shovel and plow, we tend to be, well, weanies in the snow. If the forecast even mentions precipitation, there's a run on milk and bread at the Kroger. (The liquor store is always my first stop.) I hate being denied the information I need. (And I very much hated being denied my massage yesterday too.)

2. So, I will get my blood drawn on Monday.

3. I must refocus on work. I've been preoccupied. Please don't tell my boss.

4. I need to accomplish some very boring domestic activities, like laundry and grocery shopping. I would rather nap and read.

5. I need to work on that syringe art I was talking about. And I need to stop dropping by the Homemade Pie Kitchen after work and picking up two pieces of dutch apple pie with melted caramel on the top. Let me mop up the drool from the keyboard.

My apologies, it's not an exciting list.

I've been thinking a lot about why, how this worked (so far) this time. I was just as diligent with the shots and pills and lifestyle changes in November, but it didn't work. I prayed and wished and hoped just as much for this frozen cycle as I did in November. I don't believe that my prayers were so much more heartfelt this time or my want so much more profound that a Supreme Being felt I exceeded the threshold of piety and found me deserving of this, my prayer. "Melanie was particularly profound in Wednesday night's prayer and has become extremely efficient in administering shots, so I will grant this prayer. Next!"

I have been joyful when good things happened for my fellow infertiles in blogland (admittedly, envious too. And many times, "why the hell not me?") And, if I'm being very honest (sounding eerily like a certain American Idol judge) I've been put off too. It has somehow felt insulting to me when good news is explained by "God heard my prayers and granted my wish" and "God knew that I was meant to be a mother." The clear implication is that those of us who can't get an embryo to stick are less worthy in God's eyes. Or our relationship with a Supreme Being or the Universe is lacking in some material respect. My eggs are shit because God, in her infinite wisdom, knows that I would force my child to eat brussel sprouts?

I would be a big fat liar if I didn't admit that I have had many prayers of entreaty, not just on the infertility front. "Please, please, let this be. Let this happen." I believe, though, that the presence of a higher power in my life has been less in the granting of wishes (much less) and more in dealing with the aftermath of great joy and heartbreaking sadness. Strengthening my backbone, really. My entreaty through infertility has been, help me be strong enough to deal with the outcome. If that means living without a child, help me live a full, meaningful life. If I get to be a parent, help me live a full, meaningful life. Help me be a good parent.

Pretty please.

Thursday, March 6, 2008

Just the facts

I am so humbled to say that it's good news. My BETA is 260.

It makes me weep.

Wednesday, March 5, 2008

I'll take your two weeks and raise you two.

Those of us who don't have the reproductive systems of 20 year olds ("hee hee, I get pregnant just thinking about it." Whatever.) need to find creative ways to soldier through the obstacles of assisted reproductive technology, including the dreaded two week wait. As my second in vitro attempt concludes, I feel compelled to share my "learnings" (corporate-speak, sorry) of how to do just that.

1. It's too easy to dispose of needles in a Sharps container. Stop throwing those syringes in the trash. Instead, use them to recreate miniature replicas of early 17th century cargo ships (the Mayflower, anyone?). Use your left over estrogen patches as sails. They'll look fabu hanging above your couch.

2. Forget the millennials and their texting. The language d'infertile has real promise and should be explored as an alternative means of communication:

"So, TTTC?"
"Yep, PCOS."
"Me too. And AMA."
"Not yet, IUI."
"3day or 5day?"
"POAS yet?"
"Nah. BETA tomorrow."

3. One should take care to remember that not all medical personnel you encounter are involved in your reproductive trials and tribulations. For example, you do not need to spread your legs for your dentist (unless you are confident his sperm function is superior and then ask for the written report). Do not question the competence of your eye doctor simply because she does not have a dildo cam in the examining room. Do not call the nurse at your internist's office a "weanie" after a tenuous blood draw. Similarly, it's not kind to tell the mother of an obnoxious three year old that you're sure her child would have been a CC blast.

4. And last, avoid the two week wait if at all possible. For example, my BETA is now tomorrow instead of Monday, which means my two week wait is actually just over a week. I'm now convinced that, by the end of my in vitro journey, whenever that is, I will not only not have a two week wait, I will know the results of my BETA prior to transfer.

I will post tomorrow with the news.

Saturday, March 1, 2008

Come Rain or Shine...

I'm glad this cycle isn't my first. Flash back to November, four days after my transfer, I was convinced I was pregnant. I had all the signs, twinges of nausea, sore breasts, food aversions coupled with ravenous hunger (I've mentioned the iced sugar cookies before I'm sure), headaches. Intellectually, I knew that they were most likely the symptoms of the estrogen and progesterone, but I thought to myself, surely these symptoms were on top of the meds. And I recall clearly the interminable two week wait. Every day, every minute, am I? Am I not? I can admit this now, I even went to Pottery Barn Kids. No, no, I did not browse online. I. Physically. Went. to. Pottery. Barn. Kids. I'm convinced the mini-kitchens and stuffed frogs caused my embryos to revolt and jump ship.

I'm doing much better this time. Sure, I think about it, but not with the frequency and intensity of last time. A heightened sense of self brought about by superhuman strength and evolving maturity? No. Just plain superhuman strength and evolving maturity? Unfortunately, nope. I have a cheesy, self help author to thank.

I was traveling several weeks ago and was required to attend an annual meeting with several thousand of my closest friends. Any participant in corporate America knows that a meeting of this size requires a key note speaker with name recognition. (Here's the part where I admit I can't remember the name, but he's the author of a popular series of "feel good" "self help" books). He was a good speaker, but his message wasn't anything new. Believe in yourself. Persevere. Blah, blah. Then he said something that did resonate, not because it was new or eye opening, but because it was exactly what I needed to hear at this exact time in my life. Don't be afraid to dream big. Act on it. Hmmm.

When did I stop dreaming big? When did I start crossing off dreams because they were too big? More importantly, when did I stop thinking of myself as capable of doing many things, having many passions? What I mean is, having a child is not my only dream. In fact, it never was a dream until much later in life. And for several months now I've been letting this one dream scootch all the other dreams out of the basket. The Pottery Barn Kids basket. If I examine all of those times in my life when I was unhappy or not centered, each involves letting one thing, one event, one obsession to crowd out everything else. I need dreams. Plural.

I want this to work. I want my little Mae West blast to shake her thang and grow into that precocious little Minx. I want my little BB to color in the lines in real life. And I've done everything I can to make that happen. But they're not the only eggs in the basket.