I hate what infertility’s made me

I’ve debated long and hard about writing this post.  That logical side of my brain tells me that I’ll regret it later, that emotional side of my brain tells me I’ll feel better once I write it.  Sensibility says there’s no way this post can come out right, that it can never hope to convey the range of emotions, thoughts, and questions flowing through my mind and body.  Practicality says this blog was created to document it all, and there’s no point in maintaining that mission statement if I’m going to hide in the corner and cry when things get really, truly difficult.  I don’t know whether this is just another narcissistic call for attention, or a positive step I need to take toward healing.  All I know is I’m writing.  And, at least the act of writing slows the endless flow of tears.

I’m hiding in my bedroom right now.  I cried through the night and knew working today would be unbearable.  Now, as I sit here, I’m finding being stuck in my house unbearable.  Seems I can’t win.  There are contractors working in our basement; Mr. But IF told them I’m home from work “sick.”  Truth is I’m home from work heartbroken and crying into a pillow to soften the sounds of the whimpering.  I hate what infertility has made me.

When deciding to call out this morning, I also accepted I’d be unable to make our usual Wednesday night trivia game.  It’s a small town.  Half my co-workers would be there watching me contentedly answering quiz questions, after being conspicuously absent from my incredibly demanding job.  I’m frustrated to lose that one social outlet of the week where I get to just be me, but am reminded how even that relaxing night has plagued me lately.  How recent competing trivia team names like, “Better late than pregnant” and “My sperm count is” stung.  How last week’s theme of the royal birth was nearly unbearable.  How one well-intentioned friend – single, alone, and still hoping for a family “some day” at age 35 – always grills me for advice on her own fertility, incessantly discusses that Atlantic article, and naively celebrates how easy adoption will be for her as a well-off African American woman.  I hate that infertility has infested every moment of my life, removing the fun from a game of trivia and the relaxation from a post-game beer (or, as the case may be, seltzer).

Another home pregnancy test this morning showed a much lighter second line than the one I saw yesterday.  Looks like my clinic may have finally gotten something right for once.  That beta of 38 was almost surely just residual HCG from Sunday night’s booster.  As I type this my right arm is throbbing.  I’m afraid the blood draw site from yesterday may be mildly infected.  It’s swollen, it stings, it’s not the first time.  The sore draw site, my Lovenox bruises, the heating pad I’m sitting on on the last day of July to ease the pain of the PIO lumps – they are all physical reminders of the science experiment my body’s become.  I hate how infertility has left so many physical scars, so many indelible reminders of my inability to do what comes naturally and effortlessly to so many others.

With my husband at work, trivia night cancelled, and sobs so hard I couldn’t even begin to call my “never lose hope/why are you injecting yourself with all that poison?” aunt if I wanted to, I’ve turned to my rocks, my dearest friends in the computer, my LFPers (don’t try to puzzle it out, you won’t get it).  I’ve been making an endless barrage of teary, “woe is me” Facebook updates today.  Well, this week, really.  As one welcomes home her lovely baby girl, one learned the gender of her second, one sits in a hospital waiting for the delivery of her high-risk twins.  All these moments to celebrate and to rejoice, and here I sit crying and alone.  Wailing out (if only in type) for help and hope to these strangers that are so dear to me, and receiving support in spades in return.  But, I hate that infertility has stolen much of my joy for them, and replaced it with this whining, desperate person that bears no resemblance to who I once was.  I hate that I don’t recognize myself through the words that I type, and that change has resulted from infertility.

As I hide in my bedroom I stare at the paintings, the photographs, and the furniture that surround me.  The two landscapes painted by my mother when she was slightly younger than me.  The collage picture frame that contains a photo of the fledgling But IF’s on one of their first dates and my mom and dad experiencing the same in their finest 70s attire.  The cherry wood furniture my mother bought me one happy Christmas long ago.  It reminds me of the mother I lost, and makes me realize how much harder it’s become to live this life without her.  I hate that infertility has made her absence more raw, brought that pain all crashing back, well over a decade since I initially lost her.

After returning to bed this morning to commence my teary day of solitude, I heard from Barb Collura about the final results from the Hope Award voting.  My blog was not selected.  And, I hate that that hurt as much as it did.  That I couldn’t just be supremely proud to have even been nominated.  That the knee jerk reaction was, “Well, here’s another thing I’ve failed at.”  None of those responses are like me.  Anger at my situation, at doctors, at insurance providers, at inane comments, yes, but anger at failing to win a popular vote when I damn well know everyone else in the running deserved some good news just as much as I did?  That’s not me.  I loathe the pain olympics that so frequently comes with this infertility business, and I despise myself for indulging in even a tiny bit of, “Why not me?”  I hate that infertility has made me ashamed and afraid of the jealous monster always lurking under the surface.  I hate how I’ve become accustomed to living all aspects of my life as if they were a competition.

The Mr. just texted to ask me how I was “holding up.”  I’m frustrated that the answer always seems to be, “not so hot.”  I know he’s in pain too, but I somehow am lacking the capacity to acknowledge or respect that.  If not altogether, than at least to the degree to which I think I should.  This man has brought years and years of joy to my life, and now I feel as if all I give him in return is pain and suffering.  No one should have to have the “in sickness and in health” part of their marriage come to full bloom before their spouse even turns 30.  I am angered by the fact that he’s a pro at giving PIO shots, that he knows what the products of a miscarriage look like, that he holds our friends’ 5 month old with a mixture of joy and deep sorrow, that he constantly has to text, “How are you holding up?”  Infertility has forever changed this man who did nothing wrong except make the mistake of loving me.

I didn’t start this post intending for it to have a happy ending.  But, getting it down, I realize in a small way it has to have one.  I’m hiding in my room, but I’m doing so because infertility has taught me my limits.  And, that is good.  Stepping back from social outings when your heart is aching is something the old me wouldn’t have done.  I’d have put on a brave face and suffered for the sake of those around me.  That is not good.

The physical scars of infertility are difficult, but without infertility my Hashi’s may never have been diagnosed, I wouldn’t have lost the pounds and gained the health that Metformin returned to me, I wouldn’t have had the laparoscopy that diagnosed my endometriosis or the autoimmune testing that has let me know I’ll need to keep a careful eye on my health for the rest of my life.

Perhaps most central to my thoughts today, without infertility I would never have met my “friends in the computer.”  These women who have done everything in their power to refuel my soul, provide me with virtual shoulders to cry on, and hold me up when all I want to do is fall so far down the bottom of a dark pit that I’ll never be able to claw my way out.  And, it’s only from having watched my mom lose her battle with cancer that I know how deep that pit can be and how important it is I never fall down it again.

Despite today’s news, infertility blogging has still been a tremendous gift in my life, and it would be incredibly stupid of me to allow anything to change that.  Through blogging I have supplemented my support network with new faces and avatars, new sources of sanity, new women that I root for.  High on that list is this year’s Hope Award winner Tracy of Just Stop Trying and It Will Happen.

And, finally, the mister.  What I need to say I’ve already felt in my heart as I put those words to virtual paper above.  Each one of those words would anger (and probably will anger) Mr. But IF if (when) he read them.  As he said last night, “I got you, and that’s all I need.”

I wish I could stop infertility from making me forget how good I have it.  I hate what infertility has made me, but I’m not, nor have I ever been, powerless.  I’m going to be sad for a long while, but the sadness won’t always be all-consuming.  I have to believe that some day I’ll stop mourning what infertility has made me and start embracing what infertility has given me.

Limbo

That’s where we sit.  Squarely in the middle of “Who the hell knows.”  I’m so tired of being such a unique fucking snowflake.

As I described yesterday, pregnancy tests (even beta blood draws) aren’t cut and dry for me.  Last month, on the eve of my BFN I explained my post-HCG booster beta scale as such:

  • <40: Abandon all hope ye who enter here. Totally not pregnant
  • 40-300: Who the fuck knows? Another round of beta hell
  • >300: How did my lab’s get mixed with someone else’s? Could it actually be…

You see, when injecting pregnancy hormone straight into one’s system every three days it’s apparently difficult to tell what pregnancy hormone is from a needle and what is (or is not) from an embryo.  One needs a scale to mentally prepare for the uncertainties involved.

My beta was today.  The result another mindfuck.  38.  I don’t even fucking know what to think about a 38.

The helpful chipper nurse on the other end of the line said, “We like to see 40, but this is a start.”  I responded, “You’re happy with a 40 even with the boosters I’ve been taking?”  Her: “Wait, you’re on boosters?  That’s not in your chart!” Me: “Yea…”  Her: “Well, don’t take any more boosters just yet.  We need to figure out if this is something or not.  Go for another blood test on Thursday.  Have a nice day!”

Since that conversation at about 11:30 this morning I’ve done the following:

  • Called my boss, said I suddenly didn’t feel good, and informed her I was going home.
  • Arrived home, ate a balanced lunch of corn chips, salsa, and an ice cream sandwich.
  • Cried.
  • Petted the kitty that immediately found my lap.
  • Slept.  Lots of sleeping.
  • Whined to my lovely friends in the computer on Facebook.  I got obnoxiously “woe is me” and I kinda want to go back and delete my most dramatic posts, but gotta mark the moment, right?
  • Thanked a billion of you who reached out to me on Twitter.
  • Slept some more.
  • Had a total fucking meltdown with the Freedom Fertility Pharmacy rep when she called to tell me there was a problem with my Crinone order.
  • Listened to the newborn across the street wail, while watching my very pregnant neighbor play with her son in the front yard.
  • Held Mr. But IF as he asked, “Why does this always happen to us?  Why is it never a simple ‘yes’ or ‘no’?  Why can’t we just have answers?”
  • Petted the kitty some more.
  • Cried a little more.

On the docket for the rest of the night?  Well, I have some Mad Men to catch up on, I have a cross stitch project I’m working on (ssshhh.. it’s a secret!  I’ll share pics when I’m done!), and I have, of course, more kitty petting, online whining, and crying to do.

How will I survive until Thursday?  Why does it have to be so hard?

One day more…

Tomorrow.

I don’t even know what I’m hoping to hear tomorrow.  That I’m pregnant?  That I’m not?  That I might just be somewhere in the middle of pregnant and not?  All options are known to me, all possible outcomes already lived.  Save the one that ends with a baby in my arms in several months’ time, that is.

This morning a Twitter friend asked, “How are you feeling?”  That question struck fear straight to the heart.  I’ve been trying mightily not to answer it even to myself.  To be honest, I’m feeling pregnant.  Having experienced early pregnancy and positive pregnancy tests three times before, I know my signs.  I feel like I’m getting a cold, I’m having some cramping, I’m having vivid dreams, and well, my pee, it just smells funny.  All are “signs” I’ve had with past pregnancies, and all are symptoms I’m trying with all my might not to notice.  Getting one’s hopes up just makes the inevitable crash down all the worse.

Another cycle down, and I still don’t know how I feel about not being able to test on my own in the comfort of my own home.  You see, due to my history of shitty betas and P4 levels during my pregnancies past, I’m on a steady diet of HCG booster injections every three days following ovulation (or, in this case, IUI).  Aside from the fact that this means yet one more injection, it also means traditional home pregnancy tests are useless to me.  They test for HCG.  I’m injecting myself with HCG.  As far as a pregnancy test is concerned I’ve been pregnant since the day before my IUI.  Thanks for nothing, right?  Ultimately, it means my D-day is my blood test day, and not a moment before.  And, it also means that it might be more of a D-ish day, because even the blood test might be partially fooled by my shoot-em-up ways (though it wasn’t last month).

The way my mind is rambling over this blood test situation is actually pretty similar to how the rest of my thoughts are going.  Somehow I’ve lost the big picture in this all.  Maybe it’s self-preservation, or exhaustion, or just not giving a damn any more, but I can’t find it in myself to get worked up over the fact that tomorrow will tell me my fate.  No, instead, I’m sweating the small stuff.  I’ve lost the forest while staring intently at the bark of one tree.  I’m nauseous at the thought of having to go back to the local hospital lab and interact with Ms. Chipper “I’ll be your surrogate!” Phlebotomist.  I’m terrified to get that phone call at work.  Again.  I’m planning the beer I’ll have at Wednesday night trivia to signal to all my friends that, yep, we failed again.

If I even allow myself to think about the possibility of a positive, I catch the same worry-train, just one headed in a slightly different direction.  I’m fretting over traveling to my work conference in New Orleans at 6-7 weeks pregnant.  I’m exhausted already thinking of yet more trips to the local hospital lab, yet more early morning drives up to the RE for scans, yet more waiting for the inevitable to happen.  And, most of all, I’m extremely frustrated that another miscarriage could totally screw up my timing.  If tomorrow’s test is positive, and if the pregnancy lingers longer than my second, that most certainly means my pre-op appointment on the 6th and, as a result, my laparoscopy on the 20th will be cancelled.  And, just as the white out is drying in the RE’s surgical appointment books I’ll probably miscarry.  It’s what I do.  But, by that point it’ll be too late.  So, instead, we’ll begin treading water again and waiting for another surgery date to open up in a few months’ time.  Because, there’s clearly nothing I like more than endless, fruitless waiting.

So, in summary, keep sharp things away from me when I’m in the presence of the phlebotomist (err… needles, damn), I miss peeing on my hand and crying over negatives in the luxury of my own home, and this (as of yet to be diagnosed) pregnancy better not fuck with my trivia night buzz, my work week in NOLA, or my lap on the 20th.  Let’s face it, I guess I’m just a better me when I’m barren.  Why end this laugh-a-minute, low stress life with a pregnancy?

A whole lot of (blog) lovin’ going on

I have to say, when I started this blog I never thought it’d get much traffic.  I shared the link with my core group of infertile friends in the computer, I shared it with my support group, and I shared it with a select few real life friends.  That was good enough.

Suddenly, I’m finding myself receiving e-mails at a rapid clip with some pretty startling bits of news, offers, questions, and surprises.  First, there was the nomination.  Then, the ever-amazing Jay (@the2weekwait) wrote to ask whether I’d like my blog to be featured as Fertility Authority’s Blog of the Week.  (And, of course, the answer was a resounding “YES!”  My blog will be featured in Fertility Authority’s Daily Shot newsletter next week.)  At the same time, many of you have used my contact form to reach out and ask for assistance – tips on managing thyroid disease and infertility, questions about how to successfully run a support group, wondering how they can help fundraise for RESOLVE or become more active as an advocate.  To all of this all I can say is I’m totally not worthy.  I just wanted a place to tippy type out my measly thoughts each day.  How did that act of extreme narcissism result in such a warm and fuzzy giving back feeling?  Blogging is truly incredible.

Aside from totally flooring me, all these offers and queries have made me realize something else.  Whether I planned it or not I suddenly have a (somewhat) powerful voice in this community.  Despite my accidental activism being the topic of my NIAW post this year, I never fully realized how the act of blogging would extend the reach of my influence.  And, that’s a pretty heady realization.

You see, in my “real life” I operate in a professional world in which you always back up your sources, you always do your research, and you eat, sleep, live, and breath your research area until after years and years of immersion in this academic milieu (or indentured servitude) you might slowly start to make your mark.  You may slowly start to have influence.  And, that’s if you’re lucky.

So color me surprised that after a few months of bantering about on the Internet about my lady bits, disdain for doctors and insurers, and the advocacy of others, I’m suddenly some sort of (minor) somebody.  That’s a lot of pressure!

So, I’m going to slowly start passing along a little some of this attention and the resources that come with it on to you.  Separate from my selection as Blog of the Week, I was contacted by another person at Fertility Authority asking the following:

Would you be interested in working together to direct those visitors looking for clinic information to our FertilityAuthority services? We have a toll-free phone support system for folks looking for clinic or treatment information. It’s free, and we leverage our relationships with clinics to get folks in faster, help step them through any cost questions, etc and help all parties throughout the process.

Now, I’ve never had much trouble getting appointments with REs, but that’s out of some sort of dumb luck, or my bad choices in picking sub-standard REs (quite likely), or because with my wonky months-long anovulatory cycles its not like I’d ever be able to plan a consult for a “good” time of my cycle.  I know that plenty of others do have trouble finding and getting quality medical care in a timely manner, and if Fertility Authority can help with that, totally more power to them!  I also bopped around a bit on their site this afternoon and was happy to see reproductive immunology, childfree living, and other topics very important to me represented on the site.  I don’t know how they monetize their services or how their business model works or any other such stuff, but I don’t really want or need to know.  That’s for potential clients to figure out (and if you are a client I’d love to hear your thoughts in the comments below!).  What remains for me to do is simply to say that this service exists, it looks pretty exciting to me, and wish you all well.  If there’s one thing you can never have too much of in this IF battle, it’s support and information.  Fertility Authority offers both.  And, that’s pretty damn cool to little old me.

Slow down this ride so I can enjoy my infertility

Hello pals.  I’ve been a bad, bad blogger, haven’t I?  I never anticipated I’d be gone this long, but then again life has a way of always delivering unto me that which is unanticipated.  Dead mother?  Check.  Infertility?  You betcha!  What’s a little bit of why-is-my-life-so-crazy-right-now-of-all-times-dear-god-it’s-the-TWW-I-don’t-have-time-for-this between friends?

I honestly don’t even know where to begin.  And, I guess that’s a large reason why I’ve been AWOL.  So, we’re just gonna roll stream of consciousness style…

I’ve been doing a lot of waiting

First, there’s the obvious – my IUI was 9 days ago, and my pregnancy test is 5 days from now.  I have no idea how I feel about either of those things.  Knowing what we know now, that we didn’t know when this cycle began 29 long days ago, I have about 0% certainty that this cycle actually worked.  My endo was much, much worse than we ever knew before, my symptoms have definitely been flaring (and it’s not all psychological… because they were before righty went missing), and last month’s total fail after tons of work and effort has me sour to the whole sperm and egg make embryo make fetus make baby thing.  Since I’m so totally convinced this whole exercise has been a work of futility, I’ve been more than a bad, bad blogger, I’ve also been a bad, bad infertile.  In the past 29 days I’ve eaten tons of gluteny goodness, I’ve had a few cups of coffee, and (look away! look away!) I went to and fully participated in a brew fest last Saturday (4dpIUI for those of you who are interested).  I haven’t had a drink since we started trying again earlier this summer, but on Saturday I stopped giving a shit.  I wouldn’t be me if I weren’t stressing out about it a little bit after the fact, but all-in-all I’m happy with my decision.  I did EVERYTHING right last month, and didn’t have an inkling of a positive; maybe this minor rebellion will result in a different outcome?  I drank quite a bit around O time with my unlikely ectopic, and my February miscarriage was conceived over a Christmas break that was definitely not devoid of alcoholic delights.  Maybe my eggies are like their grandpa and just need a little booze to get them going in the morning?

Next, no, I haven’t heard anything about the Hope Award.  Ever since the voting closed last Wednesday I’ve been holding my breath each time a new email arrives to my inbox.  While it’d be totally cool to win, I’m just excited to hear the announcement so that we can celebrate as a community with the lucky winner (no matter who she or he may be!).  We all do so much endless, lonely waiting; it’s nice to know there is some positive news on the horizon for one member of our community!

Finally, I’m waiting for Mr. But IF to get home from a work trip.  He flew out Monday and is due back sometime in the wee hours of tonight or tomorrow morning.  The pattern is always the same when Mr. But IF goes out of town.  For the first few hours I embrace my new-found single-hood.  Then, likely before his plane even touches down at its final destination, I start remembering how truly much I need him in my life.  I’m not the mushiest person in the world, but absence makes the heart grow fonder and all that jazz.  When he returns I’ll be sure to remind him of all the ways I missed him – I had to take out the trash on Tuesday, I had to empty the cats’ litter boxes, and I even had to suffer the comical indignity of an oh-s0-wonderful friend assuming his nightly PIO injecting duties.  But, at it’s core, I just missed my friend.

While I’ve been waiting lots of exciting and excruciating things have been happening

Have ya’ll heard the news from our good friends Candace and Chris at Our Misconception?  So I avoid putting words in their mouths, here’s what the wrote me earlier this week:

Alright so here’s the skinny… I was contacted about a year ago by MTV for their show on Infertility. So # 1 didn’t really seek this out, but my husband and I thought ok its either going to be some young snookie type chick that started trying last week or us, the real infertiles. […]  So we put ourselves out there and shared every bit of our highs and lows that come with IF. Also something to note, we were not paid to do the show. Both of the couples (myself and another GREAT couple) did this simply for awareness and advocacy.

So, that’s right, this Sunday at 2PM EST MTV will be airing (the cringe-worthily titled) “True Life: I’m Desperate to Have a Baby.”  The God awful title aside, I really hope this will be a positive pop culture depiction of the ups and downs of the infertility journey so many of us face.  The AtlanticSlate, and The New York Times can write as many (good and horrible) IF-related articles as they want, but MTV’s target audience probably isn’t driving up those articles’ page clicks.  And, let’s be honest here, wouldn’t it be nice to have one hour free from “16 and Pregnant”?  I just wish I got MTV… well, kind of… not really…  Also, during the episode, Candace and Chris will participate in the #TRUELIFE1in8 Tweet Chat, moderated by @FranMeadows and @hopeful_journey.  Pretty cool stuff, no?

On the other side of the spectrum, I think my bloggy meltdown commenced when I read this gem (warning: read with a glass of wine and a bevy of curse words at the ready).  A few days ago I tried to blog about this, but all that came out was incoherent rage.  Today I tried again.  I hoped time and distance would allow me to form a more polished response to Mr. Saletan’s intentionally antagonistic “every embryo is sacred” diatribe, and I think it has.  This letter is all I can muster.

Dear Mr. Saletan,

In your July 16 article “The Boy Who Lived” you crassly wrote:

Every year or so, doctors herald the arrival of a new embryo test, certified by the birth of a healthy baby. But the babies you hear about are the lucky ones. For every success, there are dozens, hundreds, or thousands of embryos that failed the evaluation. You won’t see their pictures, because they’re never born. They’re flushed away.

From the start your word choice, clearly chosen for shock and awe rather than accurate reporting purposes, told me what type of article I was reading and what type of author I was dealing with.  You and so many others operate in the naive belief that reproduction is cut and dry.  Sperm meets egg, embryo results, embryo becomes fetus, and fetus becomes baby.  Any alteration of this order, any intervention in this path, is anathema to all that is “natural” and “right” in the world.  You blindly ignore that nature already ends an estimated 40% of all pregnancies completely on its own, most before a woman even knows she is pregnant.  The American Pregnancy Association reports that, “anywhere from 10-25% of all clinically recognized pregnancies will end in miscarriage.”  Or, to be more accurate with our terminology, spontaneous abortion, as this is what is used for any pregnancy that ends prior to 20 weeks.  We don’t you mourn those unrealized pregnancies?  Why don’t you write to mourn the loss of those pictures on the wall?  Four million babies are born in this country each year, meaning that a full 1 million pregnancies end in miscarriage.

Let’s compare this to the number of embryos you say are “flushed away” as a result of failing genetic evaluations.  According to RESOLVE, infertility impacts 7.3 million people in this country.  According to the American Society for Reproductive Medicine, only about 3% will resort to advanced reproductive technologies like in vitro fertilization (IVF).  That gives us a total of 219,000 infertiles pursuing procedures like IVF.  The next step gets a little trickier, so I’m having to resort to clinic-specific data.  I’ve been with two REs in two different states.  My current (a very large, very popular, very high traffic clinic that uses many advanced technologies) performed genetic testing on embryos in only 4% of their 2,318 IVF cycles in 2011 (the last year for which statistics are available).  My former clinic (a small one-man-show office) performed preimplantation genetic testing (PGD) on 6% of their 208 IVF cycles in 2011.  If we assume that these stats are about average, that means about 5% of those 219,000 IVF patients will perform genetic testing on their embryos in a given year.  That leaves 10,950 patients pursuing IVF with PGD.  In order for these patients to discard the same number of “flushed embryos” as nature does in a given year, each party would have to be individually responsible for the destruction of 91 embryos each calendar year.  If you think that sounds like a realistic estimate, Mr. Saletan, then I have some news for you…

I’ve been battling infertility for almost 4 years, and in the process have endured 3 spontaneous abortions.  The last one this past February happened at 8 weeks after seeing wiggling bits of embyonic blob and hearing the heart thump, thump, thump away.  Yet, for whatever reason, that embryo stopped growing, my body dispelled it, and my dreams of parenthood were again dashed.  Having lived through that loss, genetic testing becomes much more appealing.  Not only to avoid the pain and suffering that came along with my loss, but also to avoid the brash and offensive response I received from the medical establishment when I presented myself to the nearest ER with an OB/GYN unit on a Saturday to attempt to collect my now-dead embryo for testing.  “It’s a Saturday,” they said, “And you aren’t an emergency.”  As the tears welled up they explained with finality, “There’s nothing we can do for you.  Miscarriage is common.  Check in with your doctor on Monday.”  At my last straw I begged and pleaded for them to help me find a way, any way, to get these products of conception tested in the hope that no future embryos would suffer a similar fate.  I was handed two sterile collection jars and my discharge papers.  I flushed my embryo at home that night while waiting for a dilation and curettage that was scheduled two days too late.  I would do anything not to have to live through that trauma again, and genetic testing is one option that promises respite from future flushings of that sort.

And, finally, what of the research value these “flushed ones” have to offer?  You yourself write:

Embryo screening hasn’t made the world a sadder place. It has made it better. It has prevented cystic fibrosis and other terrible diseases. If you worry about unborn life, it’s better to catch genetic problems early, at the preimplantation stage, than to discover them in the womb many weeks later and abort the pregnancy.

And on this we wholeheartedly agree.  But you then go on to question which genetic tests are worthy and which are not.  To identify tests for genetic predispositions and certainties that don’t merit consideration because it risks, “[…] discarding embryos over the possibility of breast cancer, which rarely strikes before age 30, and early-onset Alzheimer’s, which doesn’t begin till 40 or 50.”  Nature, you say, created “genetic misfortune” and “the ruthlessness of selection,” and in this you implicitly suggest that we should comply.  Or rather, when we don’t comply, when we try to fight back, when we dare to flush, we should not “[…] hide the tragedies and the cost.”  But if nature is behind these tragedies, why do you only single out the tragedies of IVF?  Why not the 1 million spontaneous abortions resulting from naturally occurring pregnancies?  Why not an article on those flushed ones?

If I’m forced to use your overly emotional language, I myself am more stricken by the tragedy and senseless loss of those million natural miscarriages than I am those embryos discarded after failing genetic testing (no matter the type of genetic testing to which they are subjected).  And, this is for one primary reason.  Those natural embryos are the ones that are unceremoniously flushed.  Trust me, I’ve flushed a few myself.  I sought testing, I sought answers, I sought assistance, and I was told to go home and quietly miscarry like the millions upon millions of women before me who had done just the same.  When testing is performed on IVF embryos, those results matter.  They are recorded, they are used to inform patients, they are used as the basis of medical journal articles.  The embryos that are inspected via this testing are respected far more than the million silent flushes happening across this country every year.  In their 2009 article “Destroying unwanted embryos in research: Talking Point on morality and human embryo research” Thomas Douglas and Julian Savulescu highlight exactly this point.  The article is highly quotable and I struggled heartily with what to reproduce here.  Should I highlight their argument that, with over 220 million natural embryo deaths each year, “[…] we ought to do something to reduce this staggering death toll: we should try to discover its biological basis and we should prioritize the development of therapeutics to prevent it given that it would be a greater cause of human death than all other causes combined”?  Should I paraphrase their moral thought experiment of what to do if “[…] a refrigerator containing 1,000 unwanted embryos has fallen onto a small child and is crushing her to death”?  Ultimately, I’ll leave it with their final concluding phrase, the only phrase I feel that really brings solace to those of us who face these difficult decisions as I hope, Mr. Saletan, you never have to.

Embryos have a special moral value when they are a part of a plan to form or extend a family. When they are not part of a plan to form or extend a family, they can still have a special moral value: as a means of extending knowledge and saving or improving the lives of people.

Posts I’d planned to write

Blogging has been good to me.  And, not just because recent accolades have fueled my (potentially overfull to begin with) ego.  (Oh, and PS, voting apparently ends tomorrow – 6/17/2013 – so get your votes in!)  I’ve discussed before how important it is to find community (whether virtual, in person, or some combination of the two) when you are going through this battle to conceive, and blogging (along with Twitter, online forums, and my in-person RESOLVE support group) have all played a major role in decreasing the sense of isolation I’ve felt as the years have rolled on.  But, there’s another positive aspect that only blogging has added to my life and that was missing for so many of the early years.  Some might call it the freedom to be selfish or the luxury of self-reflection.  Namely, blogging has provided me with the time, the space, and the reason to actually explore what’s rambling around in my mile-a-minute head.  I can’t express how helpful that’s been and how profoundly that’s changed my life, my relationship, and my sense of clarity.

You want to know a dirty little secret?  I’m kind of a lazy blogger.  You all only read about one quarter of what actually flows through my brain.  Easily another quarter I do write about, read back, assess, revise, and, ultimately delete.  These thoughts weren’t fully formed, they weren’t quite what I wanted, they didn’t fit within the larger scope or arc of the post that I wrote them for, or, often, simply the act of writing them fulfilled the need I had to express them.  Whatever the reason, they never appear hear.  Finally, over half of the posts I plan to write, I never write.  I think of the theme of the post, I work it over in my brain for half a day or more, I think of visuals, useful related links, and start writing key passages in my head.  But, ultimately, virtual pen never makes it to paper.  My work day runs longer than expected, friends ask us out to dinner, or something much more important happens that needs to be addressed in a timely manner in this space.  And, ultimately, those posts are lost to the hollows of my mind along with the others sacrificed to the delete key.

Even though you don’t read them here, however, all that upfront intellectual effort is so tremendously worthwhile.  It allows me to view my life and live each day with a greater sense of clarity and some separation from the stresses of the day to day.  It’s almost like reading a self-help book or practicing visualization or centering my being or some such other nonsense that would totally not normally be in my vocabulary.  Except, instead of reading a book of someone else’s words, I’m embracing words of my own divining.  I’m reading the story of my life in a new and exciting way.  I’m not just tied to the here-and-now thoughts I’ve expressed in the past on online forums, Facebook, or Twitter.  I’m no longer reading chapters wholly composed of “IUI today on CD20” or “Follie check this morning was a disaster.”  Rather, I’m both writing and reading a story that delves much deeper.  And, that holds true whether pen actually makes it to paper or not.

So, that’s a long lead up to this.  Life’s been busy.  A friend asked us out to dinner.  Work’s been all-consuming.  The two-hour round trips to the RE for 3 of the past 4 days have taken their toll.  This blog has been left languishing.  But, it’s not for lack of effort.  As a way of catching you all up, here’s a sampling of the posts I’d planned to write:

  • Saturday, July 13
    • Title: If you find righty… Tales of an AWOL ovary
    • Description: In which I recount the second follie check in a row during which the NP cannot find my right ovary.  My immediate panic that it’s left on a relaxing beach vacation without me.  My more realistic panic that the constipation I’ve been having combined with her disappearance means the endo is back in full force.  The news that lefty’s still only sporting a 14mm.  The realization that Mr. But IF leaves for a work trip next Monday and that could royally screw, well, our screwing schedule.  The not knowing if the cycle will be cancelled.  The silent wonder over which option (cancellation or moving slowly and steadily forward) is actually my deep-down longed for option.  The familiar feelings of failing.
  • Sunday, July 14
    • Title: I’m totally the most amazing person ever
    • Description: Seriously, is a description even required?  Har… har…  But, no seriously folks, I answered a text from a friend that wanted to go out to dinner with me on Saturday night.  A friend with *gulp* a 4-month old.  A friend whose said 4-month old should have been besties with my little one due this September.  A friend whose dinner I cooked a few days after her and baby A had come from home from the hospital.  A dinner that I cooked less 3 weeks after my D&C.  And, who is the most amazing person ever?  This girl!  My ovary may have been hiding, but I didn’t!  Went to dinner and, oh hell yea, held that sweet-cheeked little bundle of that-which-I-can’t-have for freaking ever while the slowest restaurant in the world made our dinner.  And, I actually had a good time.  Look at me, all emotionally strong and shit!
  • Monday, July 15
    • Title: Premature insemination: Tales from the clinic that always says “no”
    • Description: Returning for my 6th follie check of the cycle.  Repeating silently to myself as I laid down to sleep, as I washed in the shower, as I drove in the car, “Please let them find righty.”  Preparing for cancellation, anticipating cancellation, accepting cancellation.  Discovering that righty’s back (back again!), and sporting a matched set of 14mm follies.  Exhaling for the wait ahead, before finding that lefty’s lone 14 from Saturday, is now a juicy mature 18mm.  Doing a different type of exhaling as I realize the game’s afoot and I’m about to trigger.  Getting the instructions to trigger at 9pm.  Getting thrown for a loop when asked what my schedule is for the following morning (less than 12 hours after trigger).  Being informed, after I questioned the abbreviated time frame, that, “We always do IUIs 12 hours after trigger!”  Leaving with an IUI appointment 10.5 HOURS after my trigger shot!?!?! (when the “normal” is more like 24-36 hours).  Being a bad girl and triggering a few hours early.  Spending the day frustrated at a that clinic only does what the clinic always does as the clinic is always right, silly girl!
  • Tuesday, July 16
    • Title: Well and Truly Basted
    • Description: In which I recount my first ever IUI.  Mr. But IF’s 6:30AM wank-job, my frantic drive to the clinic with deposit in tow, my realization that my hurry mattered little as I waited, and waited, and waited, and finally had my date with the turkey baster 2.5 hours after, ahem, “collection.”  My luck at arriving to find no NP or doctor available to assist me, and instead winding up inseminated by a friendly and apologetic surgical nurse.  The two hours of foreplay with my emulsified fat milkshake before the unlubricated speculum and catheter got frisky.  The unanticipated pain of the procedure itself (way worse than two HSGs, including one I failed), followed by a worry about how much post-IUI spotting is too much post-IUI spotting.  The wonder.  The worry.  The waiting.  The far too much time laying in the procedure room after wondering, worrying, waiting.

So, righty’s back, I held a baby, my IUI was both quite painful and likely quite pointless, but I’ve got 66 million swimmers on board looking for my wayward egg (which may or may not arrive in time).  Oh, and don’t hold your breath for more posts soon.  My fears over the timing of my IUI will mean Mr. and Mrs. But IF have dates with each other naughty bits for the next couple nights.  I totally believe in multi-tasking, but I still don’t know what Mr. But IF would think if I asked him to stop bouncing the laptop so much because I’m trying to blog.  Naw, scratch that.  I know exactly what he’d think.  “Just make sure you tell them how good I’m doing!”

Happy birthday little one…

On October 30, 2011, I saw this:

Positive pregnancy tests

I was pregnant.  I was stunned.  I was overjoyed.

The reason that there are so many tests is that I literally couldn’t believe it.  My lovely IF friends in the computer encouraged me (aka pee-pushed me) into taking dozens of tests in the hopes of getting me to accept what was so very clear to their eyes.  I was pregnant.

My disbelief stemmed partly from the sheer newness of a positive test after over a year of negative ones, as well as the unlikely scenario that led to that second pink line.  For that pregnancy cycle, my period started on August 26, I flew to New Orleans for a family vacation/family wedding combo on October 17 (CD53), enjoyed oodles of vacation sex, ovulated on my own on October 19 (CD55), rang in my 28th birthday in a NOLA jazz bar with plenty of libations on October 20 (CD56), returned to plain old life and home on October 24 (CD60), and saw those lovely lines on October 30 (CD66/11dpo).  To say the result was unlikely is an understatement.  And, this was long before knowing all I know now about my endo-riddled organs.  I couldn’t help but laugh (or at least “LOL”) when I wrote to my IF friends in the computer, “I guess all I had to do to get pregnant was take a vacation afterall!  Grumble…”  For once, it seemed, the odds were in my favor.

As I welcomed the constant parade of trick-or-treaters in our family-friendly neighborhood, from the front porch of our first house that we bought to hold our future family, all I could think about was how the following year I’d have a little pumpkin of my own.  So, on Halloween night as I went to the bathroom in the spare quiet moment between fueling hordes of candy-craved princesses and monsters, I was startled to see a bit of pink on the toilet paper as I wiped.  I’d been in the TTC game long enough to know it’s premature to fret over small amounts of blood in the early days of pregnancy, but I was terrified.  I called my OB the following day and, after pleading with the nurse on call, they agreed to draw a beta.  Then there was more blood, more frantic calls to the OB nurse from the broom closet of my former work space, and more betas.  Then the cramping picked up, my fingers started turning blue, and I made a few more calls.  My betas were initially good, but then started acting strangely.  They rose, but not enough.  The OB nurse was nonchalant throughout it all.  When she did bother to return my calls, she’d offer me helpful advice like, “Start getting used to the little pains of pregnancy!” or “Spotting is totally normal at this point” or “We don’t believe in testing progesterone, supplements won’t do anything anyway.”  When, in the fifth week of my pregnancy the cramping escalated and the bleeding continued, I started asking for the nurse to discuss my case with the doctor.  As I entered the sixth week my beta was just shy of 500.  The ever on-again/off-again (and currently off-again) betabase.info lists the median beta for that stage of pregnancy to be 10,936.  Something was wrong, and the odds weren’t in my favor.

After what must have been my 7th or 8th “please help me I’m worried” call to the OB, she agreed to send me for an early ultrasound at a local imaging facility.  I was just around 5 weeks. As Mr. But IF and I sat there anxiously, the tech poked my overfull bladder with the abdominal probe since my ultrasound had been ordered in the same fashion as one would be for a woman much further along in her pregnancy.  Not surprisingly, nothing was visualized abdominally, so we switched up to trans-vag.  It was my second ever trans-vag ultrasound, with the only prior one coming when I forced my GP to send me for testing for PCOS in 2009 in an attempt to help us decide when we should start trying to conceive.  But, that GP sent me for an ultrasound while on birth control (“It doesn’t matter, they can tell either way!”), so visit #1 with Mr. Wandy was a total waste of time.  This would be the first that really mattered.  And, she saw nothing.

At some point between the end of my fifth week and the start of my sixth, the combo of my empty uterus and abnormal betas finally started to concern my OB.  She went from failing to return my calls to scheduling me in for an emergency appointment in the matter of two days.  When we arrived to the busy OB waiting room for my “we’ll squeeze you in” mid-day appointment, we had no clue what the visit might entail.  As incredibly pregnant woman after incredibly pregnant woman went back for their visits, my heart raced, my hands shook, Mr. But IF scowled.  When we were finally taken back over an hour late for our appointment, the nurse got in a fight with me over the name of the brand of prenatals I’d been taking (“I need the name to enter it into your chart!”).  I cried as the pictures of plump and happy babies stared down at me from the exam room walls.  When the doctor entered she matter-of-factly outlined our options.  “It’s an ectopic pregnancy,” she said.  “You’ve got three choices, but there’s really only one I’d recommend.  First, we do a D&C, but that’s probably pointless because I don’t think we’re going to find anything.  Second, you wait and continue to do betas.  I will only do them once a week and I won’t be held responsible if your tube ruptures and you lose it.  I don’t advise this option, but it’s there.  Just go to the hospital with any pain if you choose this route.  Finally, we can send you to maternity triage for a dose of Methotrexate.  This is the only option I’d recommend.”  We asked for a beta the following day, and promised to go to triage if the number hadn’t risen appropriately.  As the doctor walked out the door she said, “Don’t cry.  I’ll see you back here soon enough!”  That was the last time I ever saw that doctor.

On November 18, 2011, I walked into the women’s health wing of our local hospital pregnant.  I left a few hours later with chemotherapy flowing through my veins.  The same drug that is used to kill rapidly growing cancer, was being used to kill my likely wayward embryo.  Two days later, after passing out on our bathroom floor, I was back to maternity triage.  I was bleeding heavily and experiencing my first miscarriage.  As the nurses got an IV started in an attempt to correct my barely perceptible blood pressure, I started having contractions.  After I passed a large sac, it was scooped up and deposited in the nearest biohazard container.  I wish I knew then what I know now.  That passing a sac like that would be highly unlikely with an ectopic.  That I could have requested to have those products tested.  That an empty uterus via an ultrasound done at the 5-week mark couldn’t conclusively prove an ectopic.  That the Methotrexate would curb all trying to conceive attempts for three full months.  That in those months I’d find my tubes were blocked, that I had endometriosis, that I was far more fucked than I ever thought.  That that embryo was my miracle child, forged out of the unlikeliest of scenarios and the last true pregnancy I’d see for a long while.  But, we can’t live our lives through what if’s.

Save for one, that is.  Today I find myself thinking, “What if things had gone differently?  What if that embryo had become fetus had become baby had become my longed-for child?”  Today would be my son or daughter’s first birthday.  Happy birthday little one.

First birthday cupcake

Total fucking breakdowns have their perks

So a (not so) funny thing happened at this morning’s monitoring appointment.  But, since I’ve largely been AWOL lately, let me back up.

We’re in the midst of a Gonal-F injectables IUI cycle.  This, of course, comes on the heels of our most recent failed Gonal-F timed intercourse cycle.  And, in the midst of our decision that we’re finishing out the year with treatments — IUI and then one IVF — and then we’re calling it quits for good with the whole TTC ballgame.  So, to say the pressure is on a little is a bit of an understatement.  After responding decently on low doses of Gonal last cycle (2 follies created in response to 7 days of 75IU and 4 days of 112.5IU), this cycle has been a total mindfuck.  I’ve done 5 days of 75IU and 5 days of 150IU and still have no lead follie(s).  My estrogen is going up and down like a yo-yo and my LH is being predictably unpredictable.

Just to make life more exciting, it seems I’ve suddenly developed strong side effects to either one or both of my current meds (Gonal and Lupron) that I didn’t really have last time around.  Last cycle I had a bit of a headache, this cycle I want to carve my brain out with a mellon baller just to get the pain in my head to quiet for a moment.  Last cycle I felt a wee bit emotional, this cycle I literally go from calm to catastrophe in a matter of seconds.  On Friday, I had what I presume to be my first ever panic attack.  I couldn’t get the lid off of my sharps container, I threw it across the room, and started crying and convulsing uncontrollably.  As I felt my mind leave my body and began to watch myself from outside the hysteria, Mr. But IF dutifully packed me into the car as we started our long drive down to the in-laws for the holiday weekend.  Slowly, everything went numb.  I couldn’t feel my lips, it felt like a million tiny needles were ballet dancing across my skin, I couldn’t catch my breath no matter the effort I put into breathing, and the tears kept flowing.  It was terrifying.  Totally fucking debilitating.  And, the entire time, I was powerless to stop it or to stop the growing panic setting in for dear Mr. But IF.  A little over an hour into our drive I caught my breath, found a teensy bit of mental clarity, and Mr. But IF bought me ice cream.  And, like that, it was over.  But I’ve been clinging to the edge of a cliff ever since.  Not ever the best place to be, but even worse when you have no idea what you’ll find at the bottom.

And, in a nutshell, this was the baggage I brought to my monitoring appointment this morning.  So, when my least favorite NP walked in I braced myself and suppressed the inner grimace that was fighting to come to the fore.  As she went about aggressively probing around in an attempt to find my right ovary, the grimace surfaced.  I’ve had hundreds of trans-vaginal ultrasounds over the years, but never once have I felt as much pain as I felt today.  She pushed, she pulled, she twisted, she angled… she even took the wand out and tried to find it abdominally.  Nothing doing.  So, at the end of it all when I was informed I had two 11mm follies (barely worth measuring) on the left and a completely missing right ovary to show for 10 dutiful days of injecting myself with psychosis-inducing crap, I lost it.  And, by that I mean I totally fucking went bat-shit crazy.

As I’ve explained before, I have issues with my clinic.  Actually, I’ve had issues with both of my clinics.  My first RE – a one-man-show sort of practice – redefines the word arrogance and had an office staff that was so totally inept that they ultimately caused me to leave the clinic in a blaze of curse-laden voicemail messages, canceling my first planned IVF and accepting a job 2 states away in the process.  As awful as that sounds, I’ve been finding myself missing that very same clinic as I’ve endured the trials and tribulations of my new mega-practice.  I had come to view my old RE as your local neighborhood Hallmark franchise.  Yea, they are over-priced, but you keep going back for the nostalgia (I always got a Hallmark Christmas ornament growing up) and the desire to support the familiar group of little old ladies that work there.  The new practice?  It’s Wal-Mart.  Equal measure “Always low prices,” “Why can I never find someone to help me?,” and “I totally know I’m going to leave here wishing I’d gone somewhere else.”

As I commenced the world’s finest showing of shit flipping this morning, I let all my frustrations out.  What started with a simple, “So when do we actually cancel this pointless cycle?  I’m sick of wasting my time and my meds on this train wreck!” became (a likely much less coherent version of) the following:

I’m totally done with your practice and the revolving door of NPs I’m constantly subjected to.  I’m sick of none of you knowing shit about me, ever explaining a damn thing to me, and constantly asking inane questions and offering demoralizing, uninformed, trite advice.  I’m convinced that none of you have ever once looked at my chart and, as long as I keep paying, you’ll keep running me through this conveyor belt until I loose my mind, give up, or die.  And, I don’t even think you care which one of those comes first.

Did I mention I threw a tantrum?  Cause, yea, I did.  And, lest you think that my assertive, often emotional blog voice is the same as my often reserved but skeptical and analytical feet-in-the-stirrups voice, I should probably say I never act like this with my doctors.  I often don’t trust them, but I do acknowledge how totally dependent on them I am for my care and treat them with a level of professionalism and calmness that, quite frankly, they don’t often deserve.  All this is a very long way of saying that what transpired this morning was abnormal.  Really, really out of character.

As my rant continued my formerly least favorite NP transformed before my eyes.  This woman I’ve quietly hated for months due to her rushed and nonchalant approach to my situation, suddenly changed.  I swear her face softened, her voice lost its usual sharp edge, and she physically relaxed as she stopped her mad rush to get out the door and onto probing number 20 of the day.  She turned back around and sat on the stool to talk to me.  And, even more importantly, she started to listen to me.

Through the tears I recalled my history for what felt like the hundredth time.  But this time, she started to hear it.  She opened my chart and started going through it – commenting on what tests I’d done there, what tests I’d done with my old doctor and asking questions about prior diagnostic procedures and the paths that led me to all my diagnoses.  Somewhere along the line I told her that both my emotional stability and my fears of a resurgence of my mild endo were playing into our decision to be done come 2014.  I explained what I’d been thinking but barely able to express even to my husband in the past months.  Namely, that my hallmark endometriosis symptoms (chronic constipation, pain, heavy bleeding, intense menstrual cramps, etc.) appear to be coming back and that has me terrified.  I told her what I remembered from my post-op report with my old RE, the one who had excised my endo in February of 2012, and explained that surely the records the old clinic had sent to them contained more detail than my recovery-room, drug-addled mind could ever recall.  She went into my historical records, found the post-op report, and started to read.  Despite the gigantic three-ring binder I maintain that comprises the whole of my medical history for the past 4 years, I’d never seen the surgical report.  I wasn’t remotely prepared for what came next.

She read it aloud.  I recall phrases like, “right fibria obliterated,” “right ovary encapsulated in adhesions with evidence of torsion,” “cul-de-sac decimated,” “extensive scarring,” “retroverted uterus,” and “bowel affixed to left pelvic side wall.”  I wish I had requested a copy of the report, but I was in the midst of having my world turned upside down.  I still don’t feel like I know which way is up.  You see, my old RE, the same RE I’d been sorely missing these past many months, had simply told me my endo was “quite mild” and posed no cause for concern moving forward.  Following my lap we happily did two clomid cycles (1 BFN and 1 chemical) and it was only our declining patience and his refusal to do injects without IVF that actually prompted us to move down the IVF path this time last year.  He didn’t recommend IVF, he basically said Clomid may work, but if we cared more about getting pregnant quicker than getting pregnant cheaper then IVF would be a good option.  After all, my endo was “so mild,” my tubes “completely clear,” and my prognosis “nothing but positive,” that there was no medical cause for concern.

The report I had read to me this morning – a full 17 months after the surgery that generated it – doesn’t even exist in the same universe as those unfounded, optimistic platitudes I had lobed at me back then.  The NPs jaw started to drop as she formed the words to read them aloud.  When she was done she turned to me and said, “Honey, your entire right tube and ovary are completely shot.  I’m not surprised I couldn’t find your ovary this morning.  I’m afraid your adhesions are back.”  She continued with, “Knowing this, your pregnancy in December was so unlikely.  You must have ovulated on the left and had one stubborn embryo.”  And, finally, she said, “I’m so very, very sorry.  You are right.  Someone should have caught this; someone should have read this before now.  Had we seen this we never would have pursued the treatments we’ve been pursuing.  You need another lap.  And you need IVF.”

In an odd way, it all was kind of comforting.  This is a dance I’ve become so familiar with over the years.  I report my concerns to my doctors, they dismiss me with the lowest common denominator answer, I do my best dutiful patient act and follow their orders, I become increasingly miserable, I reach my breaking point (physically, mentally, or both), I push the issue, and I finally start getting answers.  This is my Hashi’s diagnosis all over again.  Hell, this is the path that led to my initial lap all over again.  In late 2011 I terminated a suspected ectopic, in early 2012 we were blindsided by the news that both of my tubes were blocked.  At my consult after that failed HSG the doctor suggested that it was likely a “false positive” initiated by cramping or “casual debris” and merely suggested another HSG (this time under sedation).  I went home and pondered my options, discovered my aunt had endo (thanks for telling me earlier!), went back to the office, demanded a lap, and found I indeed had (supposedly mild) endo.  Present problem, languish with problem, be ignored, reach breaking point, demand more than simplest answer, find validation in being right, and welcome in new anger and disgust at the fact that you’ve been left languishing for so long.  Rinse.  Repeat.  It’s odd when joy becomes a prevailing emotion in response to repeated discoveries that yet another part of you is broken.

Mr. But IF is furious and quite possibly planning a murderous rampage down to our former home state to “chat” with our former  RE.  It will likely involve a baseball bat, or hammer, or maybe one of my bruiser cousins.  (And, to any law enforcement types reading this, please consult the definition for hyperbole.)  I, on the other hand, feel more hope than I have in a long time.  I’m angry, but I’m angry and armed with answers.  And those answers are more empowering than even Mr. But IF can fully appreciate.  Today someone gave me a window into my fucked up body and acknowledged my pain, confirmed what I thought to be idle worry, and validated our path moving forward.  My anger stems from the fact that, yet again, it was a totally uncharacteristic, unprofessional meltdown of epic proportions that initiated these revelations.  But, as far as the other elements of the story, I’m oddly zen in this moment about it all.  Talk to me in an hour.

So, what’s the plan?  We’ll continue this mindfuck of a doomed IUI cycle because, after the shit these meds have put me through, I’m totally not willing to pull the plug just yet.  I go for another (fifth) follie check Saturday morning.  We’ve scheduled my next laparoscopy for August 20, and we’ll commence our first IVF as soon as I’m recovered from the surgery.  And, with the toll my work has been putting on me lately, I’m almost happy for the lap.  It’ll be a vacation that even my boss can’t talk me out of taking (which has happened to every other vacation day I’ve tried to plan this summer so far).  And, my amazing mother-in-law will come up for the surgery since the hubs will have to work and be unable to drive me to and from.  I really am amazingly blessed in some ways.

The even bigger picture plan moving forward is that I’m going to stop accepting half-assedness (hell, quarter-assedness) on the part of my new clinic.  Every visit I have moving forward will specifically be with my formerly hated, now much respected NP from this morning.  (Apparently, I should have magically known all along that I could “simply” request an NP by name each time I appeared at reception if I wanted to have the same one every time!)  I also have been assured that the doc is always at my disposal whenever/however I need him, and that if anyone ever gives me a hard time or doesn’t treat me with the patience I need and deserve I’m to report it to my new BFF NP.  Fences aren’t totally mended (I mean they did totally fucking practice medical negligence for the past 8 months!), but for once I actually feel like we are moving in a positive direction.  You have no idea how good it felt to hear the NP say to me, “We dropped the ball.  I’m so very sorry for this and you have every right to be furious.  I know it makes none of this feel any better, but I think sometimes we detach ourselves from all that is going on with our patients as a coping mechanism.  I know I do.  It’s hard to remember sometimes when you are doing 20 or 30 or 50 monitoring appointments in a given day, that this appointment is your only appointment and you need us to be there for you 100%.”  The latter part of that paraphrasing does go a long way toward making the “we fucked up” part of the statement a lot more palatable.

Or, maybe the Gonal’s made me soft?  I mean, it’s certainly been adding fluff to my mid-section, so why not my heart as well?

In which I brag

So, I have a whole lot of catching up to do.  Officially pregnant neighbor due a month after I should have been; another child-free, child-obsessed holiday in the books; a weekend with the in-laws spent discussing baby names and pregnant (teenage) relatives; and, perhaps the most fun (?!?) of all?  Apparently I have a new Gonal-F/Lupron side effect.  Holy panic attacks, Batman!  Totally terrifying, btw.  But, I’ll save all that for the post in which I recount my steady march toward hormone-induced insanity.  Something to look forward to, eh?

Today’s post serves a much more exciting purpose.  Today, I finally get to tell you my wee bit of news that I’ve been dangling out there for, oh, more than two weeks!  And, here it is in graphical form:

Hope Award Nominee

That’s right!  I’ve been nominated for RESOLVE‘s Hope Award for Best Blog for the post I wrote back in April to commemorate National Infertility Awareness Week.  My Join the Movement post joins four others (Almost a Father, Fertile Healing, Inconceivable!, and Just Stop Trying and It Will Happen — go, read them, now!) in the running for the Best Blog title.  The winner will be selected via an open online vote occurring from now until the end of July.  (So, yea, after you’re done reading, go, vote, now!)  Then, come early November, one lucky lady or gent gets to get all dolled up and attend RESOLVE’s swanky Night of Hope gala in Manhattan to accept the Award.  And, who says infertility removes the glamour from your life?

On a more personal note, I remember voting for this award in past years and thinking, “Wow, how amazing is it that these brave women have opened up and laid it all out on the line (online) for those of us grasping for some sense of normalcy and belonging?”  Can I just say how incredibly surreal it is that I now find myself among that number?  Seriously, just pinch me already!

And, the timing of this announcement couldn’t really have come at a better time for me.  I first was notified of my selection via email during another endless Friday afternoon work meeting.  A work meeting, I should add, during which I was mentally running through my checklist of things to pack for our whirlwind trip down to the Walk of Hope just a few short hours later.  Talk about reinforcing to me the accuracy of what I wrote several months ago.  Speaking of the many new endeavors and distractions I took on in the months following the termination of my ectopic pregnancy, I wrote:

All these avoidant behaviors, these selfish distractions, they did a lot more than help me pass the time.  They did something that no amount of openness with fertile friends and family members could have ever done.  These activities normalized my experience, they let me know I was most certainly not alone in my feelings of pain and powerlessness.

As I sit here, newly returned from my second Walk of Hope, looking forward to tomorrow’s peer-led support group meeting, and still feeling the deep sting of our latest failed cycle, receiving this nomination reminded me yet again that infertility does not need to be a solitary battle.  It’s sure as hell a whole lot easier when it isn’t!

So, congrats to my fellow nominees and to the many, many others who contributed posts to this year’s Bloggers Unite Challenge.  You may not always feel like (I know I often don’t), but your words matter more than you can ever know.  From a former anonymous reader, thank you from the bottom of my heart for helping me find my own voice and put it to good use.

My silly quest for normal

As if I hadn’t already noted all the many things that pissed me off about my latest baseline appointment, there’s still one more thing hanging over my head.  Maybe I’m being ridiculous, maybe I just enjoy being miserable (highly possible), but I haz a gripe.  And it all comes down to my silly quest for “normal.”

I accepted long ago that nothing about getting pregnant would be normal.  Despite what health class taught me, getting pregnant hasn’t been as easy as just removing the condom from the banana.  My conception story will not involve candles, bubbly, and seduction.  It takes pills, probes, and pricks (needles, not the fun kind) to get me knocked up.  And, we’re still working on the keeping me knocked up end of the equation.

All this has left me with a strong desire to have as “normal” a pregnancy and delivery as possible.  That is, if we ever get to that stage.

Now, I’m an academic.  I know as well as the next person how nebulous a term such as “normal” is.  I’ve spent years of my life in classrooms as both teacher and student arguing away the concept of some monolithic, inherent normalcy.  But, when it’s pregnancy we’re talking about, I have a very clear sense of what is normal.  I don’t want a high risk pregnancy, I don’t want a pre-term birth, I don’t want constant appointments with high-risk OBs (maternal fetal medicine doctors – MFM).  I want to finally make it past the first trimester, I want to complain about my swollen ankles, and I want to fucking glow.

Yes, so much of this is out of my control, and in some ways the high risk ship may have already sailed.  My autoimmune issues have killed at least one viable fetus; my prior ectopic puts me at risk of another; my questionable ANA findings in the past months may indicate an AI disorder that could put me and any baby I carry at risk; PCOS and Hashimoto’s both carry increased risks of miscarriage, pre-eclampsia, placental abruption, low birth weight, and all kinds of other fun things; and, then there is just the simple fact that, as the regular loser of infertility Russian roulette, I can’t help but think that if something bad could happen, it will happen to me.  Let’s set aside for the moment any questions of why, if all these things are true, I’d ever think in a million years it’s a good idea to become pregnant.  No, not for any good reason, but mainly because that’s the one question that haunts me day in and day out.  It’s the one question I have no good answer for.  My general answer is still about as well developed as the response, “Babies are cute.  I want one.”

But, returning to the matter at hand, there is one very real, very tangible thing I can do to try and prevent an unnecessarily high risk pregnancy.  And, it’s something my RE office does not seem to want to help me with.  Put simply, I don’t want multiples.

Now, let me clarify (back-pedal?) a bit, before anyone starts to take offense (which is so totally NOT the point of this post).

First, I know not all twin pregnancies are super high-risk/abnormal, just as surely as I know a singleton pregnancy can have oodles of unforeseen complications.  Living in the land of IF for as long as I have, I know many, many women who have had happy, healthy twin pregnancies.  I don’t have as much personal experience with triplet or higher pregnancies (see, we aren’t just all out to be Octomom!), but I’m sure there are some wonderful stories to be shared there.  (And, please do share them if you’d like in the comments below!)  But, a twin (or higher) pregnancy will just always be different from a singleton pregnancy.  I’ve had enough “different,” I kind of want “boring.”

Second, I know that there is no way to totally control for the possibility of a multiples pregnancy.  Interestingly enough, the highest-risk multiple pregnancy I’ve encountered among my IF friends was one that was naturally conceived without the assistance of fertility meds.  An IF friend in the computer was blessed with dear daughter (DD) #1 after over a year of trying in 2011, and when it came time to try for #2 was blindsided by a naturally conceived monoamniotic-monochorionic (“MoMo”) twin pregnancy.  I’m thinking about her regularly these days since she was admitted as an in-patient last week at 25w for regular monitoring throughout the remainder of the pregnancy – a plan that had been in place since the twins were first found to be MoMo’s.  The babies and mom are doing wonderfully, but they do serve as yet another (much needed) reminder to me of that so trite, so overused, yet so accurate expression, “If you want to make God laugh, tell him your plans.”  I know I cannot totally control for the possibility of a multiple pregnancy, but when you are being monitored as closely as I am and are so highly aware of the number and size of follicles you brew up any given cycle, it’s hard not to have the, “how many follies are too many follies?” refrain echoing through your mind.

Third, if we’re being entirely honest here, I (OMFG-deepest-darkest-secret-don’t-tell-anyone-kthanksbye!) really want twins.  And, the reasons are many:

  1. My dad’s dad (my paternal grandfather) was a twin.  I never met him (my dad barely new him — he was killed in a plane accident when my dad was 7), but I still found this incredibly cool.  Telling a little girl that twins run in her family means said little girl starts planning her future as a mother of twins.  Course, I didn’t know then that I’d grow to hate my fertile forebearers.  Flaunting their fecundity while I sit here and fail repeatedly…
  2. As an only child, I always planned on having at least two children of my own.  Now, I doubt that will happen.  And, not just because we’re perilously close to giving up this whole having kids thing altogether, but also because if we do succeed in the coming months, I can’t see myself wanting to spend the first 4 years of my child’s life going through this all again in the hopes of #2.  So, two at once?  Instant family.
  3. I’ll totally go there.  For what we’ve paid to have these fictitious future children of ours?  We totally deserve a two-for-one deal!
  4. This might be the weirdest reason of all, but I totally want people to ask me whether my (future fictitious may-never-happen) children were from fertility treatments.  Infertility is such a huge part of my life that I can’t see myself being willing to stop talking about it once I have children.  I’d like to think I’d welcome the ignorant comments about how my bundles of joy were conceived as they’d provide yet another invitation to educate the idiotic fertiles all around me about what’s what.  I know every time I see a set of twins I silently go, “I wonder if she’s one of us?”  I’d be happy to walk up to someone like me in the future and gladly say, “I’m totally one of you!”  

But, ultimately, a singleton pregnancy comes with fewer risks than a multiple pregnancy, and I’m done being a sky-diver after nearly 4 years of falling out of the sky.  If we’re going to have to go through so much hell just to get pregnant, I can’t help but feel that we should actually get to *gulp* enjoy it.  Once you’ve earned your IF card you should totally be able to give birth painlessly, at exactly the most convenient time, once the baby is well and fully cooked, and with a minimum of drama.  I spent far more of my young life with doctors in a steady stream of exam rooms than I ever anticipated, I’d be totally chill if pregnancy were one of the few times where I could confidently tell all the doctors to fuck off and let me body do what it’s supposed to.  Will that happen?  No. But a girl can dream…

And, it also won’t likely happen because my RE seems hellbent on making me the next Kate Gosselin.  Last cycle had it’s ups and downs, but it started off with a very simple argument.  The nurse wanted to start young, PCOS-stricken me off on 150IU Gonal-F.  I wanted to not have my ovaries explode.  We agreed to disagree, she agreed it was my body (no kidding?), and I started on 75IU instead.  Seven days of 75IU later, they finished me off with 4 days of 112.5IU, and I produced two plump follies of the same size.  One from righty, one from lefty. I was supremely happy.  Odds of one fertilizing seemed strong, the outside chance of twins was worrisome, but, as we all now know, I’m totally (secretly) down with twins.  Sure, there was the small chance that one (or both!) could split resulting in a triplet or quad pregnancy, but that seemed about as likely as me actually getting pregnant in the first place so I dealt.  Of course, just as I was mentally preparing myself for a long, protracted beta hell and nightly conversations about how long this one will last, we got the news that I wasn’t remotely pregnant.  Silly me.  Silly hope.

So, this time, I entered the clinic saying we were willing to be more aggressive.  By that I meant I’d consider an IUI and would love to talk to someone (anyone!) about a future IVF, but apparently the nurse heard instead, “Sign me up for my own reality show!”  So, no arguing this time.  I’m on 150IU Gonal-F which I started on Monday night.  I did get her to agree I could drop down to 75IU tonight and tomorrow so that we didn’t totally screw ourselves over before we could get back in for monitoring on Friday.  So, we’ll get the verdict on Friday.  Did 2 days of 150IU and 2 of 75IU cause a follie boom, or am I just a total paranoid freak hanging on far too tightly to the hope of a normal anything on this bumpy road to baby?  The Lupron headache and my tighter-fitting pants are backing me up at the moment, though…