Why hello CD1! My lady-bits they are a shedding and it’s time to get this cycle on the road.
Of course, that “getting the show on the road” thing requires my RE. Or, should I say, my RE’s minions. You might have heard me say this before? I NEVER FUCKING SEE THE RE!!! I guess that might be for the best since Mr. But IF almost decked him the last time we saw him. And, of course, there’s also the fact that I always have the strong urge to pee on him mid-probing just to see how his little east-meets-west, hippie, self-love and positive thinking self would respond. OK, so maybe it’s a good thing we rarely see the man we not-so-lovingly call Dr. Soulpatch. (And, I mean, I sometimes cannot remember his actual name. Heaven forbid someone ever steal my phone and peruse my address book. “Paging Dr. Soulpatch!”)
So, anyway, I called the office bright-eyed, bushy-tailed, and bleeding first thing this morning to schedule my baseline appointment (and, no, that’s not my clinic). Baselines are usually done on CD2 or, most commonly, 3, and include routine blood work and a trans-vaginal ultrasound. Before each treatment cycle the doctor must ensure that blood hormone levels are about where they should be and that no abnormalities exist on ultrasound (cysts, unusually thick endometrial lining, etc.). I’ve baselined more times than I care to count in the past several years so it’s old hat. What’s not old hat is being able to accurately predict CD1, but due to the wonders of better living through chemistry and my past two months of birth control use, I knew it was coming this time. I mean, I planned her arrival to the minute and, as such, planned my busy Saturday in the city an hour from home where my RE is located. Early morning probing, drop off the sewing machine at the Singer repair center, get paint for the bathroom, go antiquing for a medicine cabinet. I’ve been looking forward to this Saturday. My clinic doesn’t do baselines on Sunday, and I knew my period would arrive on Friday, so my baseline would have to be Saturday. How convenient!
Of course, we’ve already seen how much my clinic cares about convenience. These are the same folks that asked “What do you want us to do about it?” when I started miscarrying and needed a D&C on a Saturday. Why I have any reasonable expectations left for them remains to be seen. Ah, the joys of working with doctors who have no competition within 200 miles.
Turns out Saturday is “busy,” Sunday is “impossible,” and Monday? Burly voice on the other line of the phone indignantly said, “You know Monday is a holiday right?” I replied that, yes, I knew it was a holiday, but apparently my uterus didn’t so they would most certainly be seeing me either Saturday (preferably) or Monday and if they wouldn’t they’d have me to deal with. My appointment is on Monday at 8:15am.
I felt so thrilled that I won my little battle that it wasn’t until I got off the phone and did the math that I realized that’s a CD4 baseline. Now, seriously, it’s probably not that big of a deal, but there are miles of difference between “not that big of a deal” when you forget to get the milk at the grocery store and you are commencing an invasive, expensive, emotionally-charged, long-waited for fertility treatment cycle. You can all feel free to talk me off the ledge – tell me it’s not that strange to do a CD4 baseline on an injects cycle – but I totally reserve the right to be well and truly pissed the fuck off. Not the least of which because I will now spend the next 4 days considering all the many things that could happen as a result of my late-ish start of meds. Will my PCOS-self recruit too many follies? Will one start to take off? Will I still be adequately suppressed? Will my hormones be in check? Aaargh….
So, yea, the cycle-related head games and constant question asking have begun in full force. I made it, oh, 1 hour from start of menses to freaking the fuck out. That’s actually pretty good for me.
Well, that isn’t even entirely true. The head games started immediately. Has anyone else every noticed the tendency of nurses at RE offices to think all patients are total idiots? Like, I think they assume that because you are infertile you aren’t able to talk and walk at the same time. I may be barren, lady, but you’re the moron. >:-( Each and every time I’ve called to report a day 1 (and, again, this has happened MANY times) the nurse gets all high and mighty and doubts me. “Is it really a full flow? You know, it only counts if it is full flow, right?” Yea, I learned that 3 years ago, but thanks for giving me another thing to fret about. It never fails. Even though I’m damn well sure this is CD1 (I mean, even more so this time around since, you know, it’s been totally controlled by the artificial hormones of oral birth control), I still hear that question and think, “Oh my fucking God! What if this isn’t CD1? What if I’ve been wildly incorrect all this time? What if that’s why I’m infertile???” So, I stammer, I mutter, I try to politely explain the size, texture, color, and consistency I’m witnessing on my pad. Then I get more flustered. Honestly, someone need to invent a cycle tracking app that hooks in with your eIVF chart that allows the patient to snap a quick pic of a used pad, removed tampon, or wad of toilet paper and send it along. No more calling with day 1, just text-a-tampon. Brilliant I tell you! Alas, I must still call. And mutter. And melt into a puddle of uncharacteristic uncertainty. Joy!
And, this was just the first phone call I had to make. The lead up to call #2 in and of itself was awash with crazy. Do I call the RI? Do I need the RI? Am I willing to send more money to the RI? Why the hell can’t the RI be less cryptic and more capable of writing in plain and decipherable English in his emails? Ultimately, I decided it was worth the $350 to give him a call and get him back on the team for this cycle. So I call the office, listen to the oh-so-familiar phone directory, press 1, and explain the whole confusing thing to the receptionist on the other end of the line. As usual she doesn’t sound remotely surprised that the doctor left me with no clear instructions, as always I must explain I am on the other side of the state and no I can’t just bop in tomorrow for a baseline, and as I expected I got my usual, “I’ll talk to him about this and have him give you a call back.” So I wait. Luckily, waiting is one thing I’m totally used to doing.
As I wait, I remain in my total emotional tizzy that began yesterday. In my post yesterday I questioned whether my sense of exhaustion and stabby rage was the result of impending menses. I casually suggested that PMS was at the root of my foul mood. What you didn’t see, however, was that in draft 1 of that post I went on a loooong tangent (have you noticed I’m good with the long tangents?) about how I absolutely hate it when women – especially those of us in the infertility community – exclusively blame hormones for their feelings. I’ve been known to engage in a little bit of a throw down on infertility message boards when I feel like women are taking advantage of the PMS card. Not because I want to be dismissive or make anyone feel uncomfortable expressing what they are feeling or exploring the reasons behind those feelings, but exactly because I feel expressing and examining these feelings is so very important for those of us bogged down in a protracted battle with our reproductive systems. We are doing ourselves a disservice if we always default to, “I’m in a terrible mood and it’s because of these injections.” Yes, the injections most certainly aren’t helping, but you know why else you are in a terrible mood? Because life as an infertile mother-in-waiting is really fucking hard. We all need to collectively cut ourselves some slack and be able to say, “Yes, I’m pissed off and I don’t need to justify that. I’m just pissed off.” But, there I went dismissing my own sentiments on the matter and blaming PMS. Why wasn’t I remotely surprised that, after reading my latest post, Mr. But IF sent me the Slate’s XX Factor’s recent “Is PMS All in Our Heads?” Maybe because, again, I have no idea what a “normal” cycle is like or what “normal” hormonal fluctuations can do to your psyche, but I totally buy it. Though I’ve never been nearly as good at expressing it as this article, I can accept PMS as a, “‘culture-bound syndrome,’ a disease of societal expectations, not biological influences.” And, I think that concept is actually pretty empowering if you get right down to it. Why are we blaming our bodies for our moods? And, even more so, why are we tacitly accepting via that logic that we only get to be moody at certain times of the month? When Mr. But IF has a bad day at work, or a difficult conversation with his mother, or notices our next-door neighbor is pregnant he’s allowed to be emotionally impacted, why do I have to wait until I have a bloody hoo to do the same? I reserve the right to be in a foul mood whenever I damn well please because you know what? Rarely are my hormones the only thing to blame. As screwed up as my body is, as certain as I am that my PCOS created some crazy, and as negatively influenced as I was in the brain by my years of overt hypothyroidism, the number one precursor to my crappy moods are the words, thoughts, and actions of ignorant people.
And, finally, speaking of ignorant people, have you seen this Slate gem? In a rebuttal to Amy Klein’s recent “I Should Have Frozen My Eggs,” Miriam Zoll writes:
When I first signed up for IVF treatments in my forties, I never thought the science would fail, and it never, ever occurred to me that the ‘reputable’ donor egg agency our clinic referred us to would promote egg donors who were infertile.
Yea, read that one again. Wait, what? I think I’m circling back around to stabby rage. So you signed up to go through the emotionally, physically, and financially taxing process that is IVF and never once thought to ask about your chances of success? It infuriates me enough when Mr. Average Joe doesn’t comprehend that IVF is far, far from a guarantee even under the best of circumstances, but you – a patient undergoing IVF – “never thought the science would fail”? To quote SNL, “Really?” And this, ladies and gentlemen, is why, as difficult as it sometimes may be and as nasty as the politics sometimes get and as depressing as the outcomes may sometimes be, I’m so very glad that I work in academia. Even more so, I’m glad that (at least in the sunshine and rainbows idealistic sense) I work at a small liberal arts college where great emphasis is placed on encouraging critical thinking, question asking, and information literacy. I just can’t accept that it’s alright to walk through life acting without first questioning. I can’t accept that you’d do IVF without first learning the very real odds of failure. On the flip side, maybe I am starting to understand why all nurses treat me like an idiot if this is their typical patient base?
And, to that second point. Did anyone else feel like a leper when they read that next little line. How dare she be forced to work with “egg donors who were infertile.” I mean, seriously guys, she might have “caught” infertility by coming in contact with those eggs! In my experience, individuals like this author are often the ones on infertility message boards that start every post with “I’m not infertile, I’m just of advanced maternal age.” Guess what sweet cheeks? You are one of us now, whether you like it or not. (And, believe me, I know I don’t like it.)
Aside from the way that statement rang in my head, the way I envisioned that word “infertile” hanging scornfully from the author’s lips, there’s also the fact that, once again, where is the critical reasoning? Where were your questions in this process? First, if it mattered so much to you that you weren’t getting icky infertile eggs, why didn’t you learn more about these eggs? Why didn’t you demand more information about your donor? About how the eggs were created? Second, why would you assume donor eggs from infertile women automatically pose a problem? Perhaps it’s because you appear to know so little about the process of assisted reproduction in the first place, but did you ever think about the fact that certain causes of infertility may actually enhance a potential donors’ egg-making potential? For example, most of the estimated 5 million women in the United States with PCOS would be rockstar egg donors if only for the fact that we so often over-respond on even extremely small doses of stimulation medications. My old RE called it “a basket full of eggs for the price of one.” Don’t get me wrong, you have every right to decide what conditions you are willing to accept in the woman that will comprise half the genetic makeup of your offspring, but please understand that infertility comes in many shapes and sizes and does not always a bad donor make. Similarly, you have every right to be outraged if your agency promised you these eggs were from women with no history of infertility. But to dismiss these eggs as defective in the same breath you admit your total ignorance of the nitty gritty of infertility treatments leaves you standing in a very hard light.
And lest I be seen as the judgmental infertile casting stones at glass petri dishes, you all have every right to disagree with me. In return, I get to remind you I’m bleeding, I’m waiting, I’m stabby, I’m crazy. And that’s alright… just don’t blame the hormones.