What’s this odd hope-like feeling?

There’s a smile on my face, a lightness in my heart, and a pep in my step.  This feels weird.  I don’t like it.  I think, dare I say it, it’s hope!

Ultrasound this morning revealed two plump and juicy follicles just waiting to rupture and release my busted beautiful eggs.  (Getting used to this hope thing may take some time…)  Tonight I trigger ovulation with an HCG injection and then it’s non-stop rubbing naughty bits for the rest of the weekend.  Mr. But IF should get a good night’s sleep tonight; I mean, I know I will thanks to the sudden introduction of 10,000 units of straight synthetic pregnancy hormone into my system.

Tonight will be my last shot for three. whole. days.  I’m not gonna know what to do with myself.  I guess I’ll resort to doing things with Mr. But IF… 😉

My regimen for the rest of the cycle will include:

  • Continue: Synthroid (112mcg), Metformin (2,000mg), L-MTHF (2mg), Vitamin D (5,000IU), Vitamin B12 (500mcg), Baby Aspirin (81mg), and Prenatal Vitamin daily.
  • Starting Tuesday 6/11: Progesterone in oil (50mg/1ml) and Lovenox (40mg).
  • Add on Wendnesday 6/12: Crinone 8% and HCG boosters (2,500 units every 3 days).
  • On Friday 6/14: Return to RE for intralipid infusion.
  • On Monday 6/24: Go for first beta (pregnancy) test.

I’m trying not to think too long or hard about that last one for a few reasons.  First, it just so happens my beta falls on my 7th wedding anniversary.  Usually I’m not a big believer in chance or fate or luck or what have you because, let’s face it, if I were and I’d lived the life I’ve lived I’d be pretty fatalistic about my chances, my fate, and my luck.  However, this timing definitely made me stop in my tracks when the NP pulled out my calendar.  “Oh, we’re testing on that day are we?  Fantaaastic…”  (All the while dripping with sarcasm.)

Second, I know full well that that first beta is going to be anything but conclusive.  In three pregnancies I’ve had three abnormal beta rises.  The first was diagnosed as “ectopic” due to those low and slow betas, the second didn’t survive into the fourth week because of them, and, for the most recent, I remained pregnant with clear and strong fetal heartbeat to 9 weeks and still was sporting the beta levels of a very newly pregnant woman.  My body refuses to produce pregnancy hormone.  So, this time around we’re giving it some help from the start with injections of HCG every three days from 3dpo on.  We tried doing this when my last pregnancy was already failing but it was a step too small coming at a date too late.  Who knows whether the HCG boosters will do a damn thing medically, but mentally I’m happy to be on them from the start this time around.  After all this time, regret management is a good enough reason to do just about anything.  Sure, the downside is that it will likely take us quite a while (and several repeat beta draws) to determine if my hormone levels are elevated from a pregnancy or just from the injections, but I can live with that.  It’s almost calming to know that, unlike my prior cycles where beta day was – duh duh dummm – the day, that beta day this time around will just be one of many days that will inform a final verdict a few more days and blood draws in the making.  Beta hell isn’t my favorite thing in the world, but walking into it eyes wide open seems like it will be a lot easier than enduring the unexpected uncertainty of my prior pregnancies.

Finally, and perhaps positively, I’ll be away at a work retreat all day on the 24th.  I bemoaned that fact when the date for the retreat was announced (seriously, my anniversary?), but now it feels like good timing.  I have a feeling the distraction and time away from Dr. Google, my online patient portal, and my browser’s refresh button will be a good thing.  I just hope I’ll be able to swing a phone call at some point that day.  With non-stop meetings held at a remote camp site I’m a little anxious, but I’ve gotten through worse.

So, there you have it folks, I’m actually feeling hopeful.  From a teary day in my blanket nest on Tuesday to today’s constant cheery mental refrain of “Oh my what beautiful follies I have!” – gotta love the thrilling emotional roller-coasters of BarrenLand.

Crossing one finish line and preparing to pull the trigger

Enough mixed metaphors for you?  It’s late-ish, I’m tired, that’s the best you’re getting.

Ok, yea, it’s not that late but I’ve got another 5am drive to Dr. Soulpatch staring me in the face tomorrow, so it might as well be 3am.  The glamorous life of an infertile – nothing else like it!  But before we address that drive, let’s take a moment to celebrate something (for once).

Today I reached my individual fundraising goal for the Walk of Hope.  A goal I set five times higher than I did last year.  An increase I initiated because last year I raised nearly eight times more than my 2012 goal.  I’d like to say I’m proud of myself, I’m thrilled with these achievements, and I’m happy to see hard work pay off, but you know what?  That’s casting the spotlight in the totally wrong direction.  The curtain call is owed to the amazing women and men in my life – from my oldest high school friends to my IF gals in the computer to my husband’s astounding extended family – who demonstrated by putting pen to check (or, more appropriately, typing credit card number into secure site) that we most certainly aren’t on this journey alone.  Taking a 1-mile stroll through a park with some of the bravest and strong women and men you’ll ever meet?  That’s the easy part.  Caring enough to read my story, to click my link, to acknowledge the validity of infertility as a worthwhile cause, and to help break the silence of infertility?  That’s truly amazing.

Meeting the goal has caused a certain thread of thought to start running through my brain.  I find myself reevaluating years of deep-seated feelings of isolation and loneliness.  No, I don’t think those two emotions will ever be removed from the infertile’s playlist, but two consecutive years of fundraising for this event has got me thinking of how the actions of today might help future generations of infertile women and men mitigate those very real feelings.  The loneliness, the “otherness,” of infertility is at its apex in my life whenever I am reminded of the blissful ignorance of the fertile masses.  Nothing makes me feel more alone than when I hear women meticulously plan their pregnancies (“Not to close to Christmas or to baby #1’s birthday!”), when the cashier at the grocery store nonchalantly asks if I have children when she spies chicken nuggets in my cart (“Nope, no kids, I just feel like eating like one while I wait out this 2-week Lupron headache”), or when the you-should-know-better nurse at my endocrinologist’s office tells me she has terrible Hashi’s and it never stopped her from having kids and would I like one of hers (“Well isn’t that amazing… for you”).  I’m sure if you polled a hundred infertile women and asked them about their hardest moments the vast majority of them would stem from interactions they’ve had with others.

And these others aren’t all hypercompetitive bitches either.  They’re often well-meaning grandmothers, small-talking strangers, and otherwise supportive fixtures in your life.  What they all have in common is what we as a society largely have in common – they aren’t conditioned to anticipate infertility and they aren’t equipped to address it when it’s present.  The result is a total blindspot toward the 1 in 8 (and growing) couples in this country for whom our preconceived notions are most certainly not the norm.  Today, it is rare to find someone who truly appreciates the potential heartache of a question like, “When will you have children?” unless they have lived/are living infertility.  I still cringe thinking of all the times I asked that totally normal, socially acceptable question of the women in my life before my diagnosis.  After 3.5 years of infertility and repeat loss I view this question as as acceptable as asking one’s weight, or, better yet, a man’s dick size.  Bonus points for doing it in front of grandma.  Truth is, that’s a highly personal question that can be so very loaded.  I’ve certainly never been at the front of the line in support of political correctness, but knowing the statistics I know now and experiencing the traumas I have to date, I can’t believe this is a question we still ask unprompted in the lightest of social settings.  And we don’t even have to get into the whole “infertility thing” here either.  With upwards of 25% of all pregnancies ending in miscarriage according to some studies and with the miscarriage rate higher for first pregnancies, it’s very possible that when you asked recently married cousin Sally at last weekend’s family reunion about her family building plans that she may have just had (or is having) a miscarriage.  Just hold back and wait for Sally to bring it up, K?

It often doesn’t get better when/if these questions are answered with honesty (whether on the first or five hundredth time you’ve asked them).  Whether the answer is a subtle “We’re trying,” or my typically blunt, “Well, in 3 years I’ve ovulated six times, been pregnant 3, and have 0 live births, pass the gin!” publicly acknowledging infertility comes with its own landmines.  So far on this blog I’ve avoided discussions of the typical things the misinformed masses say – the “Just adopts”, the “Go on vacation,” the “Stop stressing,” and the, “I knew a woman who…” stories – because they are so common they’re comical.  And, most other IF blogs and resources have covered them ad nauseam already.  But, these common reactions to IF further demonstrate how out of touch most of this country is with the realities of human reproduction.  As I touched on yesterday, by the time we are grown most of us have some semblance of what to say and how to act when a loved one experiences a loss.  Sure, things may not always go smoothly, but most folks generally learn to, you know, not tell the cancer patient “At least you won’t have trouble losing weight with how much that chemo is making you throw up!”  Trivializing and diminishing the pain of infertility is a lot easier, though, because most of us aren’t equipped with the words we should say to our infertile loved ones are experiencing emotions far outside our comprehension.  (If you want a great resource check out Resolve’s Infertility Etiquette guide!)

Ultimately, this gets me back to what my fundraising success has me pondering.  No, raising money for Resolve will never take away the loneliness or isolation of infertility, but I do truly believe that the act of raising this money and the grassroots advocacy and outreach work that it will allow Resolve to do will help to minimize the external factors that directly contribute to those feelings.  I notice it in many of my friends and family already.  The act of contributing to an organization like Resolve and the experience of having a friend or family member open up about infertility goes a long way toward validating infertility as a cause and a disease akin to so many others of which we are much more familiar.

According to the Lupus Foundation of America, 1.5 million Americans have Lupus, the Leukemia and Lymphoma Society reports that just over 47,000 Americans were diagnosed with leukemia last year, and the CDC lists the current HIV infection rate in the United States at approximately 1.1 million.  Add all three of those figures together, then add another 4.3 million Americans, and you are about at the current estimated number of women and men – 7 million – experiencing infertility in this country.  Given my recent Lupus scare, my aunt’s leukemia, and my college HIV/AIDS awareness group presidency I don’t remotely intend to compare the severity of these conditions to infertility, but the numbers are illustrative.  I’ve walked in AIDS walks, I’ve supported my aunt’s participation in multiple leukemia walks, and 50 Walks to End Lupus are being held from Oregon to Florida this calendar year.  Did you even know there was a walk in support of infertility awareness?  Did you before you or someone you know was diagnosed as infertile?

Now it is officially way past my bedtime but to part deux of my metaphor.  Tomorrow I get my third and, hopefully, last probing of the week.  Ideally I should get the green light to trigger (aka administer a shot of the pregnancy hormone HCG to initiate ovulation) and then it’s off to the races (well, off to the bedroom).  Trigger, ovulate 24-48 hours later, go at it like bunnies, begin different injections (PIO, Lovenox, and HCG boosters), and wait.  Oh, and wait a long time because those pesky boosters are surely gonna screw things up.  That’s the plan at least.

But, as the now-snoring Mr. But IF asked as he drifted off to dreamland, “What could happen tomorrow and on a scale of 1-10 how bad or good would those possibilities be?”  He’s an optimist that one.  Trained by the very best of course.  His ever hopeful (har, har!) wife.  The options are too many to recount, but in 100 words or less.

  • Follicles could have stopped growing or substantially slowed again meaning we’re delayed.  Sadly, the thing I’m probably more worried about is not the delay but the fact that I’d have to break into another 900IU pen of Gonal to keep stimming.
  • Too many follicles may have taken off.  I had 8 measurable (>10mm) with 2 nice lead (aka bigger than the rest at 15mm and 14mm) follicles on Wednesday.  If any of those 6 felt like catching up to thing 1 and thing 2 I’ll freak a little.  I’m not even cool with the idea of going at it with two follicles and risking twins, but more?  Ugh, when do you call it quits and regroup for the next round?
  • My lining (nice and thick at 9mm on Wednesday) could have thinned out.  Unlikely, but with two Clomid miscarriages under my belt and having never had a nice lining before I’m gun-shy.

Now off to prepare for the excitement of tomorrow with my all-too-typical 5 hours of sleep.  TGIF, Mr. Wandy, TGIF!

Needles and numb

Where the hell have I been, right?  A number of you have reached out to me and for that I’m immensely grateful.  Doubtlessly others of you have raised a virtual eyebrow at my sudden absence.  (You have, right?  Ah, how I love narcissism!)  Again, I thank you.  To the rest that haven’t noticed, I thank you as well for caring enough to follow my story in the first place.  And about here is where the positive happy-sounding elements of this post will end.

I’ve kind of been a mess lately and I’m struggling with exactly how to approach this post.  Writing from a raw place – an emotionally and physically overwhelmed place – is no small task.  But, the longer I let the feelings fester, the longer I leave the blog unattended, the more overwhelming it all becomes.  I started this blog as a way to channel my feelings and emotions into something both productive and therapeutic, and it’s been a great fit for the emotional needs I’ve had.  Life got busy, I stopped blogging, and my cycle started.  Having those three events occur simultaneously was not a good thing.  Without the ability to blog about my fractured psyche and my increasingly bruised body, the mental and physical scars had no access to the healing power of getting it all out onto virtual paper.  At the same time, as the screen remained blank, my treatments continued, and the prospect of returning to this blog for just a simple update became overwhelming given the range of emotions and events that have occurred in the past week.  My forum for maintaining sanity had become yet another element on the to-do list that contributed to exhaustion, frustration, and depression.  It’s strange how that happens – how things that help can hurt in equal measure.  How a call or a message from a loving friend can feel like stacking one more weight on a body already overburdened. How the offer of a back rub or a home-cooked dinner from a worried husband can make you feel like the steam engine of your life is running perilously low on water and edging ever closer to disaster.  How a much-needed blog can turn into your own Frankenstein’s monster hellbent on destroying it’s maker.

Meds as promised. I still can't find the Lovenox...

Meds as promised. I still can’t find the Lovenox…

Last week work was busy.  It was the type of week that would have challenged me whether in treatments or not, but having that week coincide with the onslaught of early morning drives to the RE, the phone tag and unanswered online portal messages, and the daily hormone injections that are the day-to-day of an infertility patient was brutal.  Friday offers a wonderful case study.  The day earlier I had stayed at work late into the evening preparing for the following day and, as a result, delaying my 7pm date with my needles.  I ran home, shot up, shoved some food in my mouth, and went to bed.  I awoke on Friday at 5am to be showered and dressed by 6am to be in the car and on the road for my 7am appointment 50 miles away to be wanded and pricked by 7:30am to drive the hour back to work by 8:30am to begin my day.  Oh, and because of my important day at work I got all gussied up which, in retrospect, was not the best idea.  My pantyhose came off for Mr. Wandy and, having the constant fear that I do that the nurse will bring the next eager patient in on the fertility clinic conveyor belt before I’m zipped up and out of the exam room, I opted not to put them back on until the coffee shop bathroom halfway home from my drive.  (Yes, the coffee shop where my sleep deprived self drooled over the enticing aroma of that amazing black elixir that is now verboten to barren me.)  But, the coffee shop stop was still a necessity because I needed somewhere other than the open country roads to try and get the ultrasound gel off my wrap dress.  Mr. But IF laughs at my demeanor when alone in the exam room, but years of practice have bread utter complacency about the ins and outs of morning probings.  I always hop off the exam table, scoop up the paper sheet that is useless as a sheet but brilliant as a human-sized paper towel, shove that sheet up the hoo to clear out the blue goo, dump the sheet in the waste bin, ruffle around in the exam room drawers for a pantyliner (why are they in different drawers in different exam rooms?), and commence re-dressing.  Maybe it’s this somewhat elaborate bare-assed clean up regimen that makes me worry that the next patient can’t be far behind me?  Anyway, it’s my routine, and in the years since I’ve practiced it I’ve gotten far less goo on my panties, had fewer moist drives home, and worn my fair share of free pantyliners (sure, I have my own in my purse at all times, but something at the RE should be free and if this is all there is you better believe I’m raiding their shelves).  However, on Friday something went awry.  In my hurried zeal to mop up Wandy’s remains with the sheet my dress got sandwiched between gooey hoo and sheet.  This is 1. why I should never wear a dress EVER, 2. why I decided the pantyhose were staying in my purse, and 3. why I was praying for half an hour that the coffee shop bathroom would have paper towels not an air dryer.  So before my busy day at work had even started I’d emptied a public restroom of paper towels and ate a delicious my-life-is-so-fucked bagel.  And that was just Friday.

Work finally died down on Sunday in time for my second follicle check on Monday.  Since I’d worked long hours the previous week and through the weekend I had already decided I wasn’t going in on Monday.  I scheduled my appointment for later in the day and actually got a decent amount of sleep for once.  I also was able to plan to run a few errands in the big city where my clinic is because I usually don’t have that opportunity when running up and back for 7am appointments.  Arrive at clinic, shell out co-pay, make awkward small talk with the overly talkative receptionist, sit in what Mr. But IF has named our “angry rocking chairs of doom” (aka the only chairs in the waiting room that aren’t oversized and overstuffed to the point of hilarity when my 5’4″ frame sits in them), and wait.  Hear my name, run to exam room, blood out, pants down, sheet on, and wait.  Knock on the door, shit its the idiot, tight-lipped NP, double shit she’s got a 20-something resident with her, and triple shit the resident’s doing the scanning.  Verdict?  “Well you’ve got some stubborn ovaries don’t you?”  Judging by the NPs tone I was expecting her to suggest intentional self-drowning in the spa fertility center’s obnoxious “pond of tranquility” as the final solution to both my “stubborn ovaries” and her misfortune at having to put up with me and said ovaries.  “Put your pants on and I’ll be back with instructions.”  On they go and I’m left wondering what was seen on the ultrasound since nothing has yet been discussed with me other than a less-than helpful personification of my lady-bits.  When the NP reappeared she told me to double my dose and return in a few days.  I balked at that news since the visit prior (gooey hooey dress visit) I had been warned I was developing too many follicles by a different NP.  I noted that I would not proceed with the planned intercourse cycle if I developed too many mature follicles (in my mind, more than 2 is too many!) and asked her what she saw that justified the drastic dose increase.  She said I still had 7 or 8 follicles of about equal size but they weren’t growing quick enough and, “We have to do something with you, we can’t just keep treading water.”  She seemed utterly amazed that I would cancel a cycle with too many follicles (this, methinks, is why the clinic’s multiples rate is astoundingly high) and finally, unhappily, agreed to move a little slower and up me one click of the dial on my stim pen, instead of outright doubling.  So, I’ve been on the new dose since Monday.

All in all, it wasn’t that bad of an appointment, but I still found myself ten minutes later crying uncontrollably in the parking lot.  I cried from the parking lot to the Singer repair store where I got my shit together and dropped off my busted sewing machine.  I cried more from the sewing shop to the Staples parking lot where I plastered on a smile and tried to drop off my FedEx package only to find they didn’t accept packages that big.  I cried even more about my follicles and my FedEx failure until I reached a FedEx drop off site where I parked next to a dad tucking his little one into a car seat.  I dropped the package quicker than if it had been made of molten lava and Googled the nearest Starbucks in this unfamiliar town.  I’m not even a Starbucks fan, but there isn’t one within 45 minutes of my home and after weeks of being good and 15 minutes spent listening to criticisms of my ovaries I was in the mood for a little self-sabotage.  If I couldn’t down a fifth of Scotch before the hour drive home, at least I could wallow in a Frap.  Through tears I followed Google to said Starbucks only to find… no Starbucks.  I laughed through the tears at the prospect of being the only woman on planet Earth who couldn’t find a Starbucks, and started the long drive home.

Yesterday, I again stayed home from work and watched a season’s worth of The West Wing while drinking tea and being warmed by my aging cat.  Today I’m working, but my mind is still traveling at the speed of molasses and each visitor to my office makes tears line up just behind my eyes despite the decent news I received from my scan this morning.  8 follicles, 2 strong leads at 15 and 14, with an anticipated trigger date of Friday.  Good thing Mr. But IF is used to performing through my sadness.

I’m not sure what is causing the funk, but the options are plenty.  The stimulation meds could be impacting my thyroid which could be causing these not unfamiliar feelings of worthlessness and overwhelming lethargy.  The stimulations meds themselves, and the estrogen level they’ve caused that is now more than double my normal estrogen level, certainly aren’t helping any.  Or, quite frankly, I could just be reacting in a totally predictable way to my totally unpredictable situation.  The grief of infertility is unlike any other that our socialization prepares us to face.  When my mother died in 2002 I wailed, I mourned, I burned with rage, and I went numb with sadness.  As the days, weeks, and months wore on, however, a new life developed in the place of the old.  It was a life that would not, could not by the very fact of nature include my mother, and despite my deep and utter sadness at the realizations that she would not see me graduate from college, she would not be at my wedding, she would not hold my child, as time passed on I silently revised my visions of my future to include her absence.  Even a decade later I’m still often angry and sad in equal measure at the phone calls I don’t get, the visits I don’t make, and the birthdays I can’t celebrate.  These emotions ebb and flow with the days and the moments, and last weekend was a hard one as I grocery shopped and paid bills on what should have been her 59th birthday.  But, despite it all, she will never be a part of my life on this Earth again, and a decade goes a long way toward granting me acceptance of that fact.  Infertility is an entirely different ballgame.  I constantly feel the need to live two different presents as I speculate on two very different futures.  There is the one where I have children somehow and someway, and the other where I don’t.  Nearly 4 years in I can’t begin the process of acceptance because I don’t know what it is that I’m accepting.  Will the 5am drives result in a child or more heartache?  Will I ever be the mother tucking her child into a car seat in some strip mall parking lot or will I always be left crying in the next spot over?  Will children play in our backyard or will we forever mow the lawn of a yard that could be much more, that represents so much more, that is a living emblem of the backyard birthdays we can’t have?  It’s easy to blame the meds, but if I’m being truthful with myself I know why I’m numb.  This is the same numbness I felt in the early days after losing my mom, the same shutting down of synapses and socialization that accompanied my grief at the irrevocable alteration of my future.  And I’m experiencing it because I think I’m starting to accept that I need a definite future to focus on and there’s only one future option that is within my reach.  Quitting treatments and accepting a child free life is the only future I can control myself.  The alternative is to keep living two lives, two futures, forever hoping for one but preparing for the other.  And if there is anything sci-fi has taught me it’s that we can’t live two realities without ultimately being torn apart by the paradox.