PTSD

So, here’s the thing.  I’ve got a lot of crazy swirling around in my brain right now.  And, what makes it an even crazier brand of crazy that just your normal, run-of-the-mill crazy is that I don’t even know if this crazy is justified.  I vacillate between thinking I’m one small step away from totally losing it, and getting terribly, horribly angry that my totally justified fears and concerns aren’t being heard.

Ok, to back up.  Yesterday was my regular 6-month follow-up with my thyroid doc.  Let’s call him Dr. Useless.  (I much prefer his PA, Mr. Has-a-Heart, but neither one holds a candle to my old practice back in the days I lived in civilization.)

Though I was discouraged to be seeing Dr. Useless, I was anxiously awaiting the appointment.  See, things have been weird with me lately.  Where to begin?

  • I lightly bumped my knee on a chair during the last week of July.  The next morning I had a bruise the size of a refrigerator.  The bruise got bigger and badder and more painful for weeks.  It was throbby and purple well into August and now, the last few days of September, it’s shadowy remains are still visible.  This caused me to notice that I was bruising A LOT and healing at a glacial pace.  That time N clung to my arm at daycare dropoff?  Yea, did more than hurt my soul – I’m still carrying around a baby thumbprint bruise on my upper arm 3 weeks later.
  • Now, my office at the job-from-hell is inhumanely cold.  (Like averages 60 on a good day cold.)  But, even still, fingers shouldn’t go blue this easily.  Especially not when accompanied with pins and needles and numbness.  And not when it happens in a comfortable living room nearly as often.
  • My head pounds.  A lot.  Have I got stress?  You betcha.  But enough to make my ears ring and vision go wonky?  I don’t think so.  At least, I don’t get why it’d be that bad now.  I mean, dad’s dead, estate taxes filed, things are actually, gulp, calming?  Har har.
  • Oh, and my weight.  I’m 40lbs heavier than when I started my successful IVF cycle and a good 10lbs heavier than the day my water broke.  Yes, that’s super duper discouraging.  But, then again, I’m still not at my all-time heaviest pre-thyroid diagnosis.  These things come and go, no?

I enter the appointment armed with my list, in exactly the above order.  Well, if you were on Twitter yesterday you probably saw the fallout.  I’ll provide the Cliff’s notes version:

Apparently I'm a fat ass

Yes, I’m bruising, I’m turning blue and tingly, and have regular severe headaches.  Add this to already diagnosed Hashimoto’s, PCOS, antiphospholipid antibodies, and endometriosis.  And a diagnosis history that saw my Hashi’s get off the charts severe before it ever was detected.  My instinct was that yes, of course, we’d discuss my weight.  I mean, I have a mirror and an awareness that I’ve gone back to the potato sack section of my closet.  But, call me silly for thinking that we’d discuss weight in the larger context of a whole host of other unresolved questions.

Nope.  Do you want to see what my visit summary says.  (Reminder: This was a prescheduled, regular 6-month followup for a diagnosed and historically difficult to control case of Hashi’s.):

follow-up summary

Uhhh, alright then.

So, as I sat listening to the “small risk” of suicidal ideation or severe depression or risk of seizures (“Oh, you don’t have a history of seizures, do you?  No?  Great!”) that accompanied the weight loss pills Dr. Useless wanted to prescribe me, I got angry.

On the drive home, that anger turned into deep, deep sadness.  Today, I’m verging on profound hysteria?  Paranoia?  Reasonable dismay?

My mom died of gall bladder cancer at 48.  She lived for years with pain and was told to lose weight, find a hobby, and see a counselor.  She was diagnosed on my 18th birthday.  She died a few months after my 19th.

My aunt was visiting her sister, my mother, in the oncology ward.  A nurse noticed a nasty burn that really refused to heal.  She recommended she see her PCP for some testing.  A few months before she buried her only sister, my aunt was diagnosed with leukemia.  She was 50.  After years of experimental treatments – some of which made her so miserable she begged for death – she’s in remission.  For now.

My grandfather died at 62.  Heart attack.  My mom found him dead in his chair.  He’d been there all night with my grandmother, his wife, calling down for him from the bedroom.

My grandmother was in that bedroom after suffering a debilitating stroke at 61.  She lived into her 70s, but spent my entire life in a nursing home.

My dad lived longer than I can ever hope to.  He made it to 73.  We blamed his confusion on his alcoholism.  But still, he went from a little confused to softball sized brain tumor to dead in about 9 months.

Family medical history isn’t a promise.  I know that.  I truly do.  But, it does matter.  And, that history above was a small part of what drove me to find answers in my 20s to my own medical complaints.  Overcoming infertility was priority number 1, but living a better, longer, healthier life – whether with or without children – was also always in the mix.  So, I made finding answers, getting the good doctors, and securing the most effective treatments a full-time occupation.  I researched, I wrote, I questioned, I pushed, I educated myself which turned into educating others, I embraced being “that patient.”

It was utterly exhausting.  And, to be totally truthful, I never really achieved a feeling of true health and well-being until I was pregnant.  Pregnancy was awesome.  Aside from my body doing that totally average task of growing another human, it also just. plain. worked.  Like, for the first time.  Ever.  I joked with my maternal fetal medicine doctors and nurses that I would happily go through labor every 9 months for the rest of my life if it meant I could feel like I felt then.  And, now on the other side of an unmedicated, natural laboring experience, I would still say the exact same thing.

So, now I feel like I’m circling back down the drain again, but it’s even worse this time.  See, now I have the the knowledge that even an immense amount of time and effort (and, let’s be honest, time and effort I don’t really have with an adorable and mischievous 15 month old in my life) still probably won’t result in me feeling as good as I’d hope to feel.  It’s hard not to feel like well-being is always going to be elusive.

And, that fatalism mixes with the knowledge of my family’s mortality and leaves me fearful.

I don’t want to die.

Melodramatic much?  But, yea, welcome to my current headspace.

I know what I should do.  I mean, I just need to heed my own words.  Find the right doctors.  Do my own homework.  Be relentless.  But I’m just so very, very tired.  And I can’t believe I’m back here.  You know that feeling you get when your computer crashes and you lose all your work after pulling an all-nighter right before a deadline?  Yea, that.  Except I’m the computer, the operator, and the deadline all wrapped up in one.

United in stunned disbelief: A blog rec

I’ve kinda been all over the place lately.  I spent my first 3 nights away from N this past weekend.  I had to go out and start attending to my dad’s house.  (The sheer volume of mouse droppings on his countertops when I dragged myself in the door after an epically bad 8.5 hour drive assured me that the trip was necessary.)  All three of the ButIf’s, not the least of which the littlest ButIf, have been sick off and on since at least November.  The hubs and I, both still recovering from last month’s pneumonia diagnoses times 2, are struggling to identify our roles as parents, to find a schedule somewhere in this life that has absolutely refused to be scheduled.  Dealing with orphanhood has also been weighing me down.  Not just the obvious emotional toll, but also the medical bills, the calls to the estate lawyer, the drive to pick up the cremains, the arguments with water companies that expected his bill to be paid on time despite the fact that their customer died the day before his bill was due…  I digress.  But, finally, my health has also been a constant elephant in the room.  I’m in pain a lot these days.  Surely all the driving and the physical exertion at my dad’s house isn’t helping, but no 31 year old should hurt this much.  Tingling hands, aching legs, the reemergence of the hip rash, weighing 10 pounds heavier at 9 months postpartum what I did the day I delivered, a back that causes constant, sleepless pain.  Next week’s rheumatologist appointment can’t come soon enough.

But, as I circle the wagons in preparation for another battle with medical professionals (albeit one that I still have some respect for), it’s causing me to reflect on my experiences with the medical field.  To put it simply, I’ve been failed just so many times.  And the cause hasn’t really mattered.  What unites my experiences navigating the medical diagnoses of infertility, repeat miscarriage, endometriosis, Hashimoto’s, PCOS, and my as of yet undiagnosed spondyloarthropathy is one thing – I’ve had some truly baffling responses lobbed at me.  The college health center MD who, upon first suggesting PCOS as the reason for my missing menses, casually stated to 20-year-old me, “You’ll be infertile, but otherwise you’ll be fine.”  The PCP who recommended a hobby and counseling would cure my uncontrollable and unexplainable weight gain.  The OB/GYN nurse who spent 10 minutes badgering me to tell her exactly which prenatal vitamin I’d been taking, even though she knew that day’s appointment was the one at which I’d be told that I needed to terminate the suspected ectopic pregnancy I’d been carrying after 18 months of trying.  The phlebotomist who offered to be my surrogate because, “I get knocked up whenever my husband looks at me!”  The other OB/GYN who, upon learning I’d relocated to the area, was infertile, and was going to be pursuing more infertility treatments, kept talking to me about the REI in the big town up the road (apparently years of medical school and residency in the field of obstetrics didn’t dissuade her of the notion that one goes to a sporting goods store to treat infertility).  The rheumatologist who told me she couldn’t help me until my disease had progressed to the point that I could no longer function.  The common thread is the sheer WTF-ness of it all.

And, I’m not alone.  That’s why I was happy to stumble upon the new blog You Need a New Doctor.  There’s a few things that sharing these truly horrifying stories can do.  They instill solidarity in those of us who have endured them, they let us know that (sadly) we are far from alone.  They give us a chance to laugh (or cry) along with a community of fellow-travelers.  They shame a system that has repeatedly failed us.  They inspire us to help make the system change.  They let external observers in on the dirty little secret that one person’s “unfortunate bad experience” is, in fact, an entire community’s burden.  We can do better.

So, please check it out.  And, while you’re there, check out my own submission about my third miscarriage – Thanks for the Jar?

Failure to Thrive

This post has been a long time coming.  It’s also going to hurt to write.  But it will also help explain my sparseness in posting since Baby ButIF’s appearance.

I’m pretty sure that if you went back and read through a lot of my pregnancy posts you’d catch me saying here and there, “if I’m able to breastfeed,” or, “I talked with my counselor about ways to overcome my disappointment if I can’t breastfeed,” or even, “With PCOS and thyroid disease I’m pretty sure breastfeeding’s gonna be a total crapshoot.”  So, yea, I knew the cards were stacked against me.  Just as surely as my F-ed up hormones made it damned near impossible to get and stay pregnant, I knew they could also make breastfeeding a challenge.

Rather than be fatalistic about it, I thought I was being rational and proactive in preparing coping strategies in advance.  Though I have endless angst over it, I’ve become used to my body not working quite right.  At least, I thought, I could put that hard-won knowledge to use and spend some time – say 9 months – setting my expectations.  So, as the months of my pregnancy went on and my breasts failed to change one single bit I was pretty certain I was getting my answer.  We’d go to the hospital, I’d deliver, I’d skin-to-skin and attempt to feed him, I’d fail to produce anything, and we’d jump on the formula train.  Easy, peasy, no?

In fact, I was so worried about setting unrealistic expectations that I – yes, Type A, research everything to death me – didn’t do a lick of research into breastfeeding.  I called our insurance just to have an idea what my breast pump benefit was, I registered for a bottle brush and a nursing pillow, and watched a BabyCenter video on breastfeeding holds, but that was literally all I did to prepare.  Just as I’d avoided all pregnancy and parenting conversations for 4.5 years, so too did I spare myself from all things breastfeeding for fear I’d never get to put that knowledge to use.

Trouble was, that lack of preparation led to some pretty uninformed assumptions on my part.  I’d assumed it would be an all or nothing scenario.  I’d either have milk, or I wouldn’t.  My body would work, or it wouldn’t.  I’d be pregnant able to breastfeed, or I wouldn’t.  Black-and-white with no room left for gray.

When the day came for what I thought was the final verdict on breastfeeding, I was anxious.  I asked for a lactation consultant (LC) as soon as we were transferred to the postpartum floor and she quickly arrived despite it being almost midnight.  The first words I said were a simple, “I don’t know if this is going to work.  My breasts didn’t change at all during pregnancy and I have PCOS and Hashimoto’s.”  She was encouraging and said, “Well, let’s try and hand express and see what’s there.”  I was skeptical but started squeezing as instructed and giggled like a silly school girl when a blob of gorgeous yellow colostrum quickly beaded up on my right breast.  “This is going to work!” I thought.  “I’m going to be able to breastfeed!”

For the rest of my stay in the hospital I followed instructions and woke him every three hours to feed.  In the 36 hours between little man’s delivery and my discharge from the hospital I saw 4 different lactation consultants and heard different versions of the same advice multiple times.  He didn’t need much right now.  It was normal for a newborn to be sleepy.  Yes, I’d need to wake him to feed until he regained his birth weight.  No, it was far too early to start thinking about pumping.  Everyone can breastfeed as long as they try hard enough and have enough support along the way.  And, yes, I was doing wonderfully.

On the morning of our discharge out little man had dropped 11% of his birth weight, but we were still cleared to leave.  They reminded me that since he’d been born in the evening and we were being discharged in the morning that a full 48 hours hadn’t passed and that was why he’d lost slightly more than their 10% upon discharge standard.  He was having wet and dirty diapers, latching like a champ (when awake), and I had the support and education I needed to be successful.  I accepted it – happy to get home to my own bed, my own shower, and start my so longed-for life as “mom.”

We were discharged on a Saturday, meaning our first appointment with the pediatrician would fall on a Monday – his fourth day of life.  When Monday rolled around he’d lost an additional 7 ounces.  Our extremely breastfeeding friendly ped felt that our problem was his sleepiness; he just wasn’t awake enough to get an adequate amount down each time.  She sent us off with hugs and words of encouragement and scheduled us another appointment for the following day.  24 hours later – despite 8 hours of active nursing logged in my baby tracking app, no matter the fact that my husband dutifully jabbed his thumb HARD into our little man’s foot every 3 hours like clockwork – he’d gained exactly 0oz.  Nothing.  The ped said not to worry.  As long as he wasn’t losing at this stage they were happy.  Keep at it, drink lots of water, keep waking him however possible, and return in a week.  You’ve got this!

I put my heart and soul into breastfeeding, while, at the same time, I felt like I was falling apart.  The morning of his 2 week appointment Mr. ButIF asked, “Do you think there’s something wrong with your thyroid?  You really don’t seem right and I know I’ve seen this before.”  I knew he was right.  The fatigue I was feeling was more than typical new parent exhaustion.  And, given my med-free birth, I couldn’t think of a single thing that could account for the all-over body numbness I was feeling.  I’d only felt that once before…

But, I knew I’d sacrificed my sleep and sanity for a good cause.  I just knew my baby had grown.  Turns out, however, he’d lost yet another ounce.  My perfectly average, 50th percentile 7lbs 6oz boy at birth was now barely on the breastfeeding growth charts at 6lbs 7oz at 2 weeks old.  Now the ped was getting a little worried.  She recommended the herbs Fenugreek and Blessed Thistle, talked about the drug Domperidone – which she couldn’t prescribe as 1. It’s not available in the US market, and 2. She’s not my doctor – and sent her practice’s LC in to teach me how to use a supplemental nursing system, or SNS.  I was barely holding it together when the LC entered the room with a jug of ready-made formula and the SNS – basically a torture device syringe the lactationally challenged mother fills with formula or expressed breast milk, tucks into her bra, and hooks up to a feeding tube she can either tape to her breast or hold with one of her 4 available hands and sneak into her fussy, hungry (and obviously endlessly compliant) newborn’s mouth when he isn’t looking.  I tried out the SNS in her presence for about 5 minutes – it took the combined power of six hands (mine, hers, and the misters) to get it working – before she sent me off, soaked through my shirt, bra, pants, and even underwear with formula, with a “Good luck, you’ve got this, use the SNS at every feeding!”  I spent the next several days (coincidentally, the first days I was home alone with Baby ButIF since the mister was back to work after his 2 week “vacation”) crying more than my hungry newborn.  I stunk of formula, I hated my body, I was lower than I ever thought I could get with my longed-for miracle in my arms.

When we returned home from that 2 week appointment I immediately called the high-risk OB who’d managed my pregnancy.  Three agenda items:

  1. Please test my thyroid, something is off!
  2. Can I got back on Metformin?  I can feel my PCOS reemerging and it might help me breastfeed.
  3. Will you prescribe Domperidone to help with breastfeeding?

I got the following three answers from the triage nurse.

  1. No, you’ll have a thyroid panel done 6 weeks postpartum, and no sooner.
  2. No, Metformin is not safe while breastfeeding.
  3. Absolutely not.  Take Fenugreek and drink water.

I cheered myself up by crying over my tiny son while I attempted to shove the SNS tube down his throat again.

Our 2 week appointment was on a Thursday, we ordered an infant scale and had it overnighted to us on Saturday, and when our precious baby boy woke up with sunken eyes and even more lethargic than usual on Sunday we weighed him.  He was now 6lbs 4oz.  From a birth weight of 7lbs 6oz.  It was time to stop fooling around with the SNS.  We mixed a giant bottle of formula and my husband fed him while I called and cried my eyes out to the on-call LC at our delivery hospital.  She assured me “true” supply problems were very rare, and that I should keep on with the bottle today and pump religiously every 3 hours for the next 48 hours just to see what we were working with in terms of my supply.  I did exactly as ordered.  Pumping through the night, through the days, pumping with one hand while trying to comfort a newborn just learning what it felt like to be well-fed with the other.  In 48 hours of round the clock pumping I pumped 5 ounces.  Total.

I did two things on Tuesday.

  1. Called my endocrinologist seeking thyroid testing.
  2. Found an amazingly supportive low-supply Facebook support group.

The support group informed me that Fenugreek – that herb that had been recommended by friends and family members, our ped, and, yes, even the high-risk OB practice who had carefully monitored my thyroid throughout my pregnancy – was, in fact, contraindicated in women with thyroid disease.  As in it could make my supply WORSE not better and totally throw off my thyroid in the process.  I immediately stopped it.

The endocrinologist consented to the retest, but wanted the labs drawn at their offices over an hour from my home.  That wasn’t happening with a 2.5 week old that needed to be forced into being fed every 3 hours, with a husband that was back at work full-time, and with a mama that was barely sleeping.  I begged them to let me do it locally.  The cheery nurse on the other end of the phone agreed and said, “OK, I’ll send off the requisition today!”  I said, “Great, here’s my email address.”  She replied, “Oh, no, we can’t email.  I’m sending it in the mail.”  I celebrated that minor victory by crying as I prepared another bottle of formula for my teeny, tiny son.

We first suspected my thyroid was off at 2 weeks postpartum.  I got my bloodwork results at 5 weeks, 1 day postpartum.  Normal range 0.3 to 2.5.  Mine?  0.07.  I forwarded the values to my husband in an email with the subject line, “I’m not fucking crazy!!!”

Things started to turn around then, but remain a challenge.  I’ve since found a fabulous IBCLC (International Board Certified Lactation Consultant) through our county health department who makes weekly home visits to help out (and, oh does she!).  I restarted my Metformin (against doctor’s orders) and saw an immediate increase in my supply.  I ordered Domperidone from a foreign pharmacy and, again, saw a supply increase.  And, most importantly, my breast AND formula-fed baby started staying awake, gaining ounces, and smiling, cooing, and doing all things happy and healthy babies should do.  On any given day he gets around 50% from the breast and 50% from the bottle and that’s a HUGE increase from where we stood a few short weeks ago.  I try to remain realistic with my goals – he’ll never be exclusively breastfed – but I know I’m doing the best that I can, and that’s all I can ask of myself.  I worry about how things may change when I return to work on September 10, but that’s a bridge I’ll have to cross in the coming weeks.  Thankfully that’s a bridge I’ll cross armed with the info and support I most certainly didn’t have in the beginning despite all the LCs and MDs and random strangers on the Internet who told me otherwise.

No, not every woman can breastfeed, but I’m thankful that I had the hard-won strength, determination, and drive that IF gifted me to accompany me on this difficult journey.  Breastfeeding is not black or white, all or none.  I’m finding my way living in the gray.

Resentment

Here’s the biggest thing I wasn’t prepared for when it comes to pregnancy after infertility.  Sometimes, while pregnant, you get depressed.  You worry, you cry, you panic.  That I was prepared for.  But the self-loathing and shame that can result from those worries and tears and panics?  Not so much.  I’m not going to lie.  I’m a total mess right now.  And, I think it’s been made worse by the fact that I haven’t felt like I could write it here.  I haven’t felt I could express it anywhere.  Not to friends, not to my husband, not to my therapist.  I hate myself and who I am right now, and not the least of which because I know I should be better, I should cope better, I should be grateful.

This little man’s been breech at every. single. visit. since the NT scan at 13-some weeks.  I was proud of myself for not worrying too much about it, because I knew it wasn’t a cause for concern until some far off, distant “later.”  It appears later is here.  Or, so it would seem from the simple one-page letter I unexpectedly got in the mail on Saturday telling me the date and time of my c-section.  The date and time of my son’s birth.

Since “the letter” I’ve been a disaster.  I cried for most of the rest of Saturday, managing to haul myself out for a few hours that night for a going away party for one of my closest friends here who will be moving to the other side of the country in a few short days.  Sunday I struggled to hold it together, but was still mostly in a daze.  Monday found me losing all composure throughout my morning ultrasound, non-stress test, and consult, and going through the motions of the rest of my workday, only to come home and snap.  I stayed awake long enough to do my 7:20pm lovenox injection, before going to sleep without dinner, without stopping the tears, without emerging from the darkness that had become my new mode of being.  I do remember my husband begging me to reassure him that I wasn’t thinking of “doing anything stupid” before I stumbled up to bed.  I remember waking 12 hours later, remembering the look in his eyes as he asked it, and starting to cry again.

I feel trapped between two worlds right now.  The “what should be’s” and the “what is,” the “I know better’s” and the “I’m tired of knowing better’s,” the “gratefulness” and the “jealousy.”

When I try to be rational, I eek out the following:

  • Holy shit I’m pregnant.  Really, REALLY pregnant.  Like, I may very well get to meet this child pregnant.
  • There is a nursery.  In our house.
  • You’ve got bigger things to worry about.  Like him surviving you coming off your meds.  Like him surviving.  Period.
  • The method of his delivery doesn’t matter, just that he gets here safely.
  • Seriously, read the above, you know better you fucking twat.

But, 99% of the time my thoughts are more of the variety of:

  • I’m tired of being understanding.  I’m tired of accepting what life throw’s at me.
  • I’m done with being the minority.  The 1.5% of births from IVF in the country.  The 2-4% of the general population with antiphospholipid syndrome.  The 1-3% of women who have scheduled C-sections due to a breech presentation.  The list goes on.  I’m a walking, talking ball of “This is SO UNFAIR!” right now.
  • I’m over surgery.  The C-section will be my 6th in 4 years.  Everyone assumes I’m upset because I’m “scared” of surgery.  No, I know surgery intimately by this point.  There is no fear there.  Just a lot of anger.  And, a lot of knowledge of what recovery will look like and physically and mentally feel like (especially given how much my body detests analgesics).
  • I’m sad I’ll never get to experience what my mom did to bring me into this world.  The only labor pains I’ll ever know are those that accompanied my three miscarriages.  I’ll never have the chance to turn that pain to a positive in my mind.  I needed that chance, I’ve been longing for that chance.
  • I feel robbed.  It’s not so much that I feel vaginal delivery is “normal,” but it’s certainly less invasive.  My child was conceived in a petri dish, this pregnancy has been sustained by tons and tons of drugs, procedures, and doctor’s visits, and now the birth will be more of the same.  It will be a timed transaction – place, date, and time preset by the convenience of my medical providers.  It will be another procedure written in my calendar.
  • I’m sick of an entirely new set of reminders from the fertile masses that I’m different.  Each well-meaning moron that tells me, “Labor isn’t what it’s cracked up to be,” or “you can always VBAC with your next one,” or “it won’t matter once he’s in your arms,” leads me one step closer to homicide.  I knew I would kick labor’s ass, and I’ve been longing for the opportunity to for 5 years.  I have the pain tolerance of an ox, and I’m ready to have it come into play when something positive can come from it.  And, speaking of “the next child” just reminds me that may likely never happen.
  • While I’m not scared of surgery, I am scared of the possible health implications.  Since I continually win the medical complication lottery (seriously, who gets diagnosed with 6 different diseases/conditions all before they’re 30?), I find myself certain that this C will result in endometriosis adhesions growing out of my uterus.  Yes, it happens.  Or that major abdominal surgery will set off my clotting disorder.  Or my yet-to-be-determined spondyloarthritic disease.  Or that, when you’re as infertile as I am, more scarring in the uterine cavity is never a good thing.  Especially when the combo of endometriosis and a clotting issue mean you’re in for a lot more laparoscopies down the road.
  • I’m frustrated that this birth feels like just another in a long line of confrontations with unhelpful, risk-averse, blanket statement doctors.  I haven’t seen an MD since February, and my case hasn’t been looked at in all that time.  (And, clearly, a lot has changed since then.)  Yet, the NPs and midwives continue this game of telephone.  Gathering my questions, presenting them to “some doctor” (one who may or may not have ever met me), and then coming back in the room and poorly communicating their answers.  For 6 months I’ve been told it would be dangerous for me to remain pregnant past 39 weeks, but now that they must schedule a c-section it’s been scheduled for nearly 40 weeks.  The NPs helpful response?  “Well, we’d sure like to do it sooner, but we don’t have any surgical availability.”  After one doctor told me in February that my lovenox was the only thing sustaining this pregnancy, now they’re taking me off of it without a second thought on Monday.  No discussions, no explanations, just a simple, “Your chart says for you to stop at 36 weeks.”  And, to my question of whether or not we could try an external cephalic version to flip him?  The friendly nurse replies, “Absolutely not.  Not with your history!” Oddly, that’s not remotely OK, but delaying delivery and taking me off my meds is totally fine.  This is not how I pictured my end of pregnancy care.
  • And, I’m angry that this is the end of the line.  I want to meet him more than anything, but I’m not ready to be once again un-pregnant.  Aside from the fact that I have physically felt the best I have felt in 10 years during this pregnancy, I’m also not ready to let go of him.  Especially since I’ve wasted so much time lately hating each kick that reminds me he is breech.  Especially since the medical system has been the only one to weigh in on when he arrives.

Clearly, one list is much longer than the other, but that doesn’t mean that the first list isn’t on my mind.  It is.  Constantly.  And, it’s why I’m such a mess.  Where do I get off feeling like I have any right to be upset over a c-section?  I know better.  I mean, I know better women than I who just lost wanted pregnancies, who failed yet another cycle, who’ve moved on to a life sans children, who’ve suffered more heartache and pain than anyone should ever endure.  Yet these past few days have sunk me lower than I’ve been since the death of my mother.

I have no answers.  This is hard.  And overwhelming.  And terrifying.  The risks are so high, and the territory so uncharted.  For me, infertility always had an element of misery.  Misery’s not all bad.  It unites the community, it can make the highs feel higher, it can be powerful and reaffirming to let it wash over you.  But, I’m so frightened to be spending these last few weeks of pregnancy in misery.  What does it say about me?  What does it mean about my ability to successfully parent?  What does it foretell about the future if I can’t ever get past these few final road bumps?  I’ve often bought in to the normative language that the ALI and PAIL communities frequently use – the phrases “finding a resolution to infertility” and “living after resolution to infertility.”  I doubt the accuracy of those phrases now.  I doubt that resolution will ever be possible.

On the verge…

… of parenthood?  Of breakdown?  Of both?

I keep trying to figure out why it is that I’m having such a hard time writing about my pregnancy here.  The posts flowed so much easier when I was under the influence of Gonal-F and endlessly waiting for the next laparoscopy, the next cycle, the next miscarriage.  At first I thought it was the inevitable IF guilt.  That deep-seated uneasiness with the fact that I was “moving along” while others were left to do the same things over and over again in the hopes of a different outcome.  Or left to rightfully rail against the very concept of hope itself.  And, yes, that guilt did factor in; but, I think, less than I initially thought.  Ultimately, the primary issue is I don’t know how to live and write equally in the lands of fear and joy – a skill that pregnancy after IF requires.  I’ve known what I felt, what I’ve wanted to say, what I’ve secreted away in my mind these past many months, but I just don’t know how to put it to paper.  Or even if I can put it to paper.  I’ve returned to the realm of the bogeyman, where it feels as if what I think, what I say, what I write will automatically land me in the bad graces of those unseen beings who decide my fate.  The simple act of sporting this belly feels like a daily act of hubris, for which I’m constantly sure I’m in for a rude awakening.

In trying to decide why this all feels so, I’m struck by how similar the IF and PG-after-IF emotions I’m feeling are.  Top of the list at the moment is the seesaw.  With twice weekly non-stress tests at the perinatal center I feel like I’m, once again, living from appointment to appointment.  Every three to four days my psyche is formed by the lines on the NST ribbon and the words of that day’s nurse practitioner or midwife.  One day I’m told how grand I’m doing (“minimal weight gain, stellar 1-hour glucose screen, you’re a rockstar!”), and the next I’m discussing the possibility of a looming c-section (“he’s still breech and, since we’re taking you off of the Lovenox at 36 weeks anyway, we might as well just do a c around that time!”).  A week ago one of my favorite midwifes poo-pooed the early c idea (“you’re still so early, and there are things we can try!”), only to have another preferred practitioner inform me this Monday that I had suddenly developed polyhdramnios (too much amniotic fluid) and we, “desperately need to get to the bottom of this!”  In a few short hours I trek an hour north again for a full afternoon of ultrasounds, NSTs, blood tests, and consults.

I’m exhausted.  Even at its best spending 5-6 hours each week in the car on the way to and from appointments is tiring.  Another 3-4 hours each week in waiting rooms and on exam tables doesn’t help.  Adding in the need to keep up with my full-time job during one of the busiest times of our semester brings me close to the edge.  When you factor in the frequent Braxton Hicks chipping away at my physical and mental stability I’m pretty much done for.

But all those stressors are the easy ones.  The ones that aren’t that hard to write.  The ones I start my therapy sessions with.  The ones that get me pity from most ffergiles and justifiable dagger-eyes from those still waiting to parent or finding peace in the decision not to.

Then there’s the much louder chorus of other concerns for which I have a private concert.  Most days I wake up waiting for the first kick or rumble.  As I pray for it to come, I run through what life post-still birth would look like.  I watch it play out from outside my body; me, sitting in silent grief and despair in our darkened bedroom, the mister bringing me food and handling the obligations of daily life as he cries alone in the shower.  Our families not knowing what to say and, likely, taking it even harder than we do.  After all, we’ve walked these halls before.  The failed cycles, the dashed dreams, the early losses go, if not unfelt by those in our inner circles, at least a lot less felt than for those of us with front row seats.  Soon, these morbid morning thoughts are replaced with anger, nearly all of it directed solely at myself.  What have I been doing for the past five years if not running and screaming from medical office to office demanding something was wrong?  Insisting I was sick?  How could I relentlessly pursue diagnoses in one breath, while doing everything in my power to become pregnant in the other?  I often feel shamefully selfish, and that’s really hard to admit.  For 4.5 years I’ve allowed the words “brave,” “determined,” and “driven” to shelter, protect, and uplift me.  Now I often feel like a fraud and a failure.  If we lose him, I am to blame.  My body did it.  And, most of all, I should have known better.

But, then he kicks.  Or he hiccups.  I catch a glance at the nursery.  Or I sit down to work on my shower thank you’s.  The mister gets misty in the eyes looking through the story books his parents gave us.  Or I find myself subconsciously rubbing my belly.  And it all melts away.  I’m quite easily the happiest I have ever been in my life.  I love my husband beyond words as he talks to our son and dreams of the future.  I miss my mom desperately, but I’ve never felt as connected to her as I do in these on-the-verge-of-mothering moments.  The contractions and kick counting are often overwhelming, but they always remind me that I’m living a moment in time I truly never thought I’d see.  For all that I’ve dreaded showers over the past five years, my own were beautiful and surprisingly cathartic.  And, not the least of all, I feel the healthiest I have in my adult life (no “unknown rheumatalogical condition” back pain or rashes, no endo constipation or crippling cramping, no Hashi’s fatigue or brain fog, no PCOS weight gain or hunger pangs).  Life is really, truly, deeply wonderful.

And, at the same time, life keeps on moving and fear keeps on sneaking in.  In the past week I registered for daycare, set up an appointment with our desired pediatrician, started really putting the nursery together, and continued planning for my maternity leave from work.  Yet, each time I cross one of these items off my to-do list I can’t help but feel like I’m adding them to a “what we’re going to have to undo” list.  I feel like I’m laughing at fate by planning for a child that may or may not arrive safely.  I can’t help but see myself un-registering, appointment cancelling, un-prepping the nursery, spending the summer in my desk chair.

The seesaw keeps rocking at the peak of a mighty mountain and I know I’m destined to fall off.  I’m just not sure which tranquil valley or cursed forest I’m perched above…

A year ago today…

A year ago today…

  • We woke early, bundled into our car by 4am, and headed out into a snowstorm.
  • We drove 230 miles to Woodbury Long Island to meet with the reproductive immunologist who offered our last hope.
  • I was 8 weeks pregnant with our third pregnancy.  I was still pregnant, but the news had been rocky from the start.
  • I saw our little one’s heart beating for the last time in Dr. B’s exam room.
  • We heard the verdict of “This may work out, this may not, I do not know…”  We left with a plan (lovenox, prednisone, IVF, and, possibly, PGD) should the pregnancy end (which, of course, it did the following week).
  • We drove another 230 miles home, buying a wedding gift for my cousin along the way.  We’d ultimately miss her wedding as I was 6.5 hours away miscarrying in my bathroom.  She’s currently set to pop out her first next month (yea, that didn’t take long).
  • We digested the news over a prime rib special we devoured during old people dinner time.  460 miles on the road for a 45 minute appointment that left us with more questions than answers can stir up an appetite.
  • We rejoined our friends, our normal life, at our weekly Wednesday night trivia game.

Today…

  • I leave in 10 minutes to drive an hour to the regional perinatology center.  I will meet my new practice for the first time.  I will wait in a waiting room with fellow high-riskers for the first time.
  • I’m 20 weeks, 3 days pregnant with our darling son.
  • Our son is kicking me as I write this.
  • I’m putting the finishing touches on my list of questions for the MFM.  I’m making modifications and additions based on the mock-appointment my therapist and I held last night.  I’m reminding myself I have agency in this pregnancy, I have knowledge, I have power.
  • I’m getting a stomach ache at the thought of starting all over with a new unknown practice.
  • But, that stomach ache is eased by my insatiable appetite and little man’s jabs.
  • If all goes well with the appointment, I hope to take advantage of being in the “big city” and stop off at a Hallmark to buy thank you cards to send to the amazing men and women who have ALREADY showered us with baby gifts.
  • I hate that I just prefaced that with, “If all goes well.”
  • Ultimately, though, today is so much better than a year ago…

The (wow that went) quickening

What a difference a week makes, eh?  Sorry I’ve left y’all hanging, but even when I’m totally zapped of time and energy and incapable of updating here, I still try to give the play-by-plays over on Twitter…

So, what we’ve learned in a week:

  • Baby But IF has a winkie.  The Mr. smiled from ear to ear as the ultrasound tech proclaimed proudly, “No doubting this one, that’s a big old boy right there!”  Momma hen came out a bit as I stifled the urge to reply, “Stop staring at my son’s penis!”
  • I’m half way through this pregnancy.  How in the HELL did that happen?  I mean, I know I’m probably saying this because I have yet to reach any sort “OMG I’m huge and miserable and uncomfortable” phase, but seriously can we slow this down a little bit?  It took us 4.5 years to achieve a sticky pregnancy, it seems kind of cruel to know I’ll only get to be pregnant for about 1/8th of the amount of time it took us to get and stay pregnant.  (On the flip side, I so desperately want to meet this little man that the prospect of our meeting on the horizon is probably enough to get me to stop the chorus of “That’s so unfair!”)
  • Stubborn boy doesn’t like kicking when daddy is within reach.  As I was settling into a good book in bed on Sunday night I felt a sudden something.  A passing moment, I buried my mind deeper into the book.  Then again.  And a split second later I thought, “Whoa, wait just a damn second!  You idiot!  You know what that was!  That was most decidedly a kick Mrs. Always-Late-to-the-Party!”  Of course, Mr. But IF was sound asleep so missed out on the tiny pitter patter I could feel both inside and outside of my tummy.  And, the following day, when baby boy decided to vent his Monday morning frustrations by attacking the front of my desk, daddy was a few buildings away at work in his own office.  The movements are still very minor and fleeting, but they’re there.  And, just thinking about that brings uncontrollable tears.  I was so very certain I would never see (and feel) this day; that it has come has melted me into a pool of topsy-turvy emotions.
  • My (now former) OB is amazeballs.  It’s not that I learned this this week, obviously, but more that I’m confirming it.  I had my last visit with him yesterday.  I peed in a cup, listened to little man’s heartbeat, had some blood drawn, and that was that.  Off to perinatology I go next week to face an entirely new unknown.  The departure was bittersweet.  Dr. T had a med student with him, so it prompted him to explain to her how 1. I was a complicated case, and 2. That I was a dream patient.  Though no one likes to be a medical students introduction to when to transfer a patient off to a higher level of care, it melted my heart to hear him say, “She’s a dream patient, this one.  She knows her stuff, and it’s important for all new doctors to learn when it is time to listen to a patient who knows what she is talking about.”  And, then he hugged me goodbye and threatened to hunt me down if I didn’t send updates.  It’s strange, for over a year I cringed as RE#2 and his ridiculous soul patch hugged me in his impish, condescending, zen-master manner; this single hug from an OB I met just a few months ago elicited a wholly different reaction.
  • The regional perinatology center may more closely resemble Alcatraz than medical nirvana.  As Dr. T said his goodbyes he warned me (and the med student) that “Things aren’t so cushy over there, but you’ll be in good hands.”  This really wouldn’t startle me, except he said it as I stared at the exam room’s peeling wallpaper, broken vertical blinds, and as Dr. T perched gingers on a stool meant for 4 wheels that, for whatever reason, now only had 3.  If my former office is “cush” I’m not quite sure what to expect from the new one.  That said, if 4.5 years spent running like a lab rat through a maze of medical offices has taught me anything, it’s that the dingier the office, the more amazing the doctor.  And I’ll keep repeating that philosophy as I try to avoid being shanked in the new doctor’s offices next Thursday.
  • Referrals move quicker when you’re pregnant.  A new rheumatologist will see me April 17.  That’s less than half as long as it took to get a referral last year after my third miscarriage.  I still don’t have much hope that we’ll get anything useful out of the appointment, but at least it’s something else to look forward to.
  • And, finally, I have amazing friends and family members that I totally don’t deserve.  The mother-in-law has been nudging me with shower planning questions since the New Year holiday and, while at first the thought struck fear straight into my heart, I’m now more and more on her side as it looks more and more unlikely that I’ll be allowed to make it to my due date thanks to all these new medical issues.  I finished my registry on Sunday, posted it on Facebook in response to a few questions I’d gotten earlier in the week, and, to date, I’m humbled by the response.  While things most certainly don’t equal love, all I gotta say is this little guy is so beyond loved it’s incredible.  He has no idea what’s about to hit him when he makes his grand appearance!

The breakup

Last night I tweeted:

Welp, another bad blood test result. My OB is transferring my care to regional perinatology center. So fucking terrified right now…

I could probably just save myself a lot of time and leave this post at that.  It pretty much sums it up.  But, I won’t.  Mainly because I’m, well, fucking terrified.  And pissed.  And numb.  Somehow all at the same time.  And whining on this blog is usually something that helps with those feelings.

If you missed my post from earlier in the week, you should probably catch up there before going any further.  I don’t have the energy to review it all again.  I don’t have the willpower to make myself reread and recount a post that ended so (relatively) hopeful and optimistic.

At Tuesday’s reassuring appointment, I also talked the doctor into running a few additional blood tests that my old reproductive immunologist has recommended.  Again, the OB happily consented, but felt it was unlikely the antiphospholipid antibodies would be elevated since they’d tested normal so many times before.  Last night he called back to inform me that, while only one of the two antibodies he’d tested was back, it was, in fact, very elevated.  And so were my complement levels.  After reviewing the results he placed a call to our regional perinatology center seeking advice.  (Have I mentioned I love this man and his teensy, tiny ego?)  They reassured him he was doing all the right things – steroids, lovenox, careful monitoring – but, also informed him that it was probably time for my case to be transferred over to their center.  Put simply, a crisis is going on in my body for an as-of-yet unknown reason, and there’s no way we can continue the charade any longer that I’m just a normal pregnant lady.  I need the highest level of care around, and that comes from the center that serves the 9 counties in my part of the state.  I’m lucky, it seems, to only have to drive an hour to see them.  Though, “lucky” isn’t really a word I’d use to describe myself and my situation right now.  Lucky, it seems, is something I’ll never be.

Of the antiphospholipid antibodies tested, the anticardiolipin has yet to come back, but the hexagonal phase phospholipid nuetralization is sky high.  Like any good patient experienced with chronic illness I immediately Googled “lupus anticoagulants and pregnancy.”  Of the seven results that appeared above the fold on my laptop monitor, five included some combination of the words “negative pregnancy outcome,” “intrauterine deaths,” “miscarriage,” or “still birth.”  So, yea, there’s that.  Basically, the ANAs let us know that antibodies are attacking my body; the positive APA lets us know that at least some of these antibodies are attacking fats – or phospohlipids – including those fats in my cells and cell membranes, including blood cells and the lining of blood vessels.  The theory goes that as blood vessels are attacked, tiny clots can form, and those tiny clots can take a trip to the womb, get stuck in the placenta, and block the flow of nutrients from mother to baby.  Basically, my body may suffocate my healthy, happy kid.  Because, you know, that isn’t remotely fucked up or unfair in any way.

So, despite all odds, I have a happy, healthy baby inside me, grown from a crop of happy, healthy embryos, in a petri dish that made a much better home than my fucked up body ever could.  No one is willing to speak in certainties with these things, but we’ve got pretty strong evidence at this point that my last loss at least (and perhaps others) was from exactly this scenario playing out, but earlier on in the pregnancy when the embryo had no placenta to protect it from my immune system.  Turns out it was probably a pretty good call for me to demand dexamethasone and lovenox be added as part of my IVF protocol as the combination of steroids and blood thinners in the first trimester may have helped stop an immune flare that could have taken this pregnancy just like it took the last.  But, as I weaned off the dex as instructed at 9 weeks, my body was suddenly free to fuck up once again, and a flare of some sort began.  So, now we’re back to square one.  But, further along in so many heartbreaking ways.

I can’t control my thoughts.  They flit and float from once thing to the next without warning.  Overall, yes, I’m fearful for our baby.  For the innocent that my body might destroy.  But, then there are times I sink into a sea of self-pity.  WHY is this happening to us?  How have I not given enough already?  Why am I ringing in my 30th year with yet another health scare, yet another series of doctor visits and tests, yet more questions without answers?  And then, I get angry.  So very angry that this is my life.  That I spent so much of my 20s battling for health, and now it appears my 30s will be more of the same.  Angry that I know so much about the medical system and medicine despite being in a totally unrelated field.  Angry that I’ve given my husband a chronically ill wife, after he had to spend so much of his time surrounded by a chronically ill father.  Angry that I don’t even have my mother to cry to because cancer took her from me.  Angry that, should we succeed and bring a child into this world, my health may keep me from being the mother I always wanted to be.  Angry that my body may kill my child.  And then I feel selfish.  Selfish for wanting a child so badly that we ignored these warning signs.  Selfish for fearing for my own health when my child’s life is at risk.  And selfish for crying about the risks to the growing being inside me when so many others would give anything to have even a high risk pregnancy when the only other option is never experiencing pregnancy at all.  And from this flitting and floating (and likely also the all-out war that is going on at the cellular level within me) I end up exhausted beyond belief.  I now know why I never received the long-promised energy boost of the second trimester.  I now know that even this pregnancy will be a battle; that our fight didn’t end after conception, after the heartbeat, after a beautiful NT scan and quad screen.  Our fight, in many regards, is just beginning.

And of all these emotions, the one tiny pin that dropped and broke that giant pane of glass?  Hearing that my doctor was dumping me.  The doctor that listened and cared and has called me more times than I can count on evenings, on weekends, on holidays.  That was it.  That was the moment it all tumbled down.  For all my independence and doctor-loathing, I’d somehow come to need this man for strength and guidance and reassurance.  Now, we start all over.  Sure, my new doctors will be the tops in their field and have the health of me and Baby But IF front and center, but I’ve had too many bad doctors to be fooled into thinking that they’ll certainly care as much (if not more) than Dr. T. did.  And all that just makes me all the more exhausted.

Insidious IF

It’s been six days since I was released from the RE.  Six days since we saw that undeniably human-shaped fetus wiggling around in my womb.  Six days since I had some reassurance that something might go right for once.  Apparently six days is about all the unassisted hope I can muster.

I’ll start by adding that (thankfully) I have an appointment with my therapist this afternoon.  Seems we’ll have plenty to discuss.  And here’s an additional caveat that if you’re in a fragile mental space this post is not for you.  If negative thoughts, frank discussions of miscarriage, and angry rants are not in your best interest right now, then stop reading here.  It’s about to go downhill quickly I’m afraid.

Dear Lord how do you survive the constant worry?  Since being released from the RE last Wednesday, I’ve already come to feel mentally battered and beaten into a pulp.  After becoming accustomed to the weekly reassurance of good-looking ultrasounds at the REs, the prospect of no more ultrasounds any time soon is enough to push me over the edge.  These past few days I just can’t stop reliving each of my miscarriages.  I can’t talk happily about this pregnancy (though I’m trying for the mister’s sake).  I can’t even allow myself to do anything about the fact that my pants are starting to get too snug.  All I think about is what it would feel like to have a new pair of maternity pants or a belly band arrive the day I start miscarrying.

I know the worry will never completely go away (like, for the rest of my life), and I know that is normal.  That one of the few things fertiles (including my therapist and OB) have said to me in the past several weeks that hasn’t immediately made me want to punch them.  It’s true, in the worry regard I’m likely as normal as the mister’s kid-spouting cousin.  All new parents worry about the health and well-being of their children.  As much as I’d like to argue that the fact that I have three children I’ll never meet makes my worry worse, that’s just not productive and, most likely, not true.

I guess, more than anything, I’m just frustrated with the medical industry and it’s total disregard of worry as a treatable medical complaint.  After starting to embrace a future where I would NEVER have to look an OB/GYN in the eyes again (GPs can do a regular pap, people!), the piss-poor hands-off attitudes of these “specialists” have me irate.  If one more medical “professional” tells me something is not “medically necessary,” I plan on sending them all my counseling bills.  Nickle and diming me on a 5 minute ultrasound is just costing me and my insurance company that much more for mental health services.  Infertility is an insidious ass and invades each and every aspect of your being; to deny me an NT scan, additional blood work, or an extra ultrasound because I don’t fall on the right side of their actuarial tables is a daily middle finger.  Where were these medical professionals when I was diagnosed as infertile at 25? Where have they been the last 4.5 years, the last 3 miscarriages, the last tens of thousands of dollars?  I was breaking their projection models then, but instead of extra testing I got a swift kick in the behind and a “good luck, you’re on your own.”  And, what doctor thinks I WOULDN’T gladly pay out of pocket for extra monitoring after all the time, money, and heartache was have put into IVF?  WHY do they insist that I must come off Lovenox because, “ouch, those bruises look painful, you really don’t need to keep doing that!”  You know what is painful?  Miscarriage.  And I’m not even talking the mental pain…

I’m a mess because of tomorrow.  It will be my first (and likely last) appointment with the maternal fetal medicine doc, and my first true OB consult with my OB (previous visits have been coded as GYN).  I’m expecting a several round knock-out fight, and don’t quite know which of us will come out on top.  My RIs plan got me PG, my RE takes the credit and calls the RI a “witch doctor,” the OB tells me I’m normal and on “crazy” and “unnecessary” medications, and the MFM (who I’ve not yet met) will almost surely tell me I’m wasting his time by being there.  So much for the added peace of knowing you have a whiz-bang team of experts there to guide you through the bumpy ride.

Ultrasound at 9w 2d

The human-shaped blob, complete with placenta and umbilical cord.

All the while, I’m terrified.  I look at my latest ultrasound, I see the human-shaped blob, I recall what it looked like to see the blood flowing through the umbilical cord, and all I can think is, “Wow, it’s big.  This miscarriage will surely hurt worse than the last one.  Especially if they send me home from the ER with a collection jar again after declining to do an ‘elective’ D&C on a Saturday.”

And then, other times, I look at that ultrasound and it all melts away.  Yes, I’m furious that it’s all I have to hold on to.  I’m concerned it is all we will ever get to see and hold of our little one.  I worry that this is as good as it will get.  But, some small part of me still squeals with delight to see that blob with a head and flippers.  Am I really justified in my rage, or am I just becoming an overbearing mother that wants to order the million-pack of school pictures already?  And then I sigh and scold myself for thinking too far ahead.  For opening up to hope.  For too easily dismissing insidious IF.

Meet the blob

Not gonna lie, kinda feel like I’ve been snorting sunshine and unicorn shit.  I’m so high on life right now I don’t even recognize myself.  This happiness thing is a total mindfuck.

First, I’d like to introduce ya’ll to Blob.

ultrasound of gestational sac

Say “hi” Blob!

That, ladies and gentlemen, is a fucking gestational sac.  A sac IN my uterus (and not my tubes).  A sac measuring 5 weeks 1 day (pretty damn spot on to my 5 weeks 2 day reality).  And a sac that has a rockstar 5,306 beta value to keep it warm at night.  Did you seriously catch that beta?  Last pregnancy my beta at 7 WEEKS was just 2,083.  Blob here is a total overachiever.  I’m smitten already.

I don’t even know where to start with how the rest of my day went.  I mean, the rest of the day pretty much comprised of me floating from moment to moment on a cloud of euphoria.  Have I said this happiness shit feels weird on me?

After meeting the Blob, I “worked” for a few hours before heading to my first counseling session with a new counselor.  I’d scheduled the session to help me cope with what I thought would be, at best, inconclusive news, and, at worst, well, you know what news I thought I was getting today.  Instead I flitted into my appointment a happy person.  What exactly does one do in therapy when they’re happy?  I’ve totally never had that problem before.  Anyway, Dr. H appears to be a brilliant sweetheart.  She actually reminded me so much of my dear friend A, herself a budding psychologist.  Unlike the previous IF counselor I consulted, she didn’t immediately dismiss me for wanting to have a sense of control in the process – to be informed of my lab values, to have a say in my treatments, to keep in close contact with my doctors.  Instead, she said exactly what I’ve always found myself saying.  She explained:

If you know you are a researcher by nature, having all the data points can be a great source of comfort!  I don’t think you are harming anything by recognizing what type of person you are and what type of relationship you need to have with your physicians.  I just wish you could find one that would listen to you a little better and not belittle your coping mechanisms.

Shut the front door!  45 minutes together and this gal already “gets me” more than most people I’ve ever met.  Score!  I return in two weeks, but have her cell number should a crisis arise in the meantime.

Next it was off to my first ever OB/GYN appointment in a very long time.  I mean, I’ve scheduled many OB appointments, but I’ve never actually made it to one.  Imagining having to go to this appointment a few mere hours after hearing, “I’m sorry, I can’t find anything in your uterus” or “I’m sorry, your beta just isn’t rising” literally kept me up last night.  Visualizing walking into an office chock full of giant bellies and murals of newborn pics made me sick to my stomach this morning, and had me shaking uncontrollably as I rode the elevator up to their sixth floor offices.

When I walked in, no bellies.  No pictures.  An empty waiting room with a few no-nonsense receptionists that were immediately attentive to my presence.  (What?)  I had barely sat down when a nurse scooped me back (an OB that’s on time?), and my 2:40 appointment started promptly at 2:40.  Aside from the nurse being unable to find PIO in their computer system (for which she was highly apologetic and did not blame me like so many other nurses before for having the gall to take such unusual medications), my interactions with Anne the nurse were pure gold.  Not once did she say, “Just relax” or “I had a friend who..” (both phrases that were tossed at by my RE’s nurse just this morning).  Instead, she smiled throughout, congratulating me, fawning over the pic of Blob I brought with me, and told me to call whenever I needed anything.  (Wait, what?)

When the doctor entered the room he had the same genuine smile across his face.  30 seconds in his phone went off (oh no!  I’m going to get rushed and ignored again!).  He told his intern he was with a “very important new patient” and he’d have to call her back.  He then apologized for ignoring me for a total of 15 seconds and explained, “Ah, you know, teaching hospitals.  Everybody always wants you NOW NOW NOW!”  We talked my history, we talked my thyroid, we talked his philosophy, we talked me RE.  He kept reassuring me I was in the drivers’ seat, that no questions were silly, that he’d worked with many of my RE’s (who he kept referring to by his first name) before, and that he will never forget the journey that’s brought us here and always respect the unique challenges our IF has created for us.  He said, “I know there is no ‘normal’ for anyone who’s had to go through infertility.  You won’t believe this baby is here until you’re loading it in the car seat, and that’s fine.  Just promise me you’ll let me know how I can help make it a little easier.”  (OMG, am I on candid camera?)

I told him a bit about this year’s ANA drama (see, for example, here and here for the beginner’s guide).  He was downright annoyed at the way the whole thing was handled.  “You mean, they just sent you away with their hands in the air saying ‘Who knows?'”  Pretty much, yea, that’s what they did.  That did not abide Dr. T.  He ordered a full autoimmune workup for me and drew the blood right there and then.  Another more advanced ANA panel, DNA something, Sedimentation rate, C-Reactive Protein, Lupus Anticoagulant, etc., etc.  If anything comes back abnormal, he’s getting me in with their sister Perinatology clinic.  I have found the only proactive doctor left on this planet.  Holy shit did I hit the jackpot!  He also will be monitoring my thyroid (with both TSH and Free T4… woo!) every 4 weeks and adjusting meds as necessary.  He said he’d find a way to get me in for as many ultrasounds as I needed to feel comfortable (OMG!) and that he’ll be there with me through it all.  He gave me his fucking cell phone number!  Yea, my 2:40 appointment?  I left the building at 4:00.  Not one bit of that was me waiting alone in a room.  What the what?

I will follow up with him in 2 weeks (November 7) to go over the findings of the blood work and give him an update on how things are going with the RE.  Assuming all is well (oh, please let all be well!) I’ll be scheduled for my initial OB appointment about a week later.  Someone pinch me.  Is this actually happening?

So, now, it’s off to see the hubby.  I’ve been running all day, he’s been working all day, and we haven’t seen each other since I rolled out of bed at a crisp 5:30am in order to get to my RE appointment on time.  We’ve texted and had brief phone chats, but now I’m off to meet him, hug him, and gush endlessly at a celebratory dinner.  Good night my lovelies, and thank you so much for helping to hold me together all these past months.  You have NO IDEA how much you’ve all meant to me.