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…

Why’d we bother?

As I stood in the shower this morning, lathering up that extra layer of flab I’m pretending is all the 8oz baby’s fault, my mind started to wander.  If I am truly and brutally honest with myself, I never thought I’d see this day.  For all the invasive procedures, the doctors’ visits, the support group cheerleading, the advocacy work and fundraising – I honestly never thought we’d get here.  Failure to conceive and maintain a lasting pregnancy had become the expected outcome; dreams of baby showers, bedtime stories, and school plays had long since ceased being something I visualized.  As that realization hit this morning, I found myself asking, “Then why did you keep going?”  This post is an attempt to figure that out.  And, furthermore, an examination of why I think this story – our story – is more the fault of our society’s medical status quo, than it is of my own damaged body.

First and foremost, treatments are what we knew.  Some go to the spa, some go out to brunch, I made 5am drives to the RE for a probe and a poke.  I knew where I’d risk getting trapped behind a school bus, I knew where the roads tended to be iciest, and I knew I’d get my bagel at the bagel shop on my drive home.  The power of routines is nothing to scoff at.  In a strange way, infertility and infertility treatments provided much normalcy and structure to my life.  As I dug through my wallet this weekend looking for an under-used store rewards card, I found the “frequent customer” card for that bagel shop 50 minutes from home.  I immediately wanted a bagel, wanted a stamp on my card, but realized I’d rarely have reason to go back.  The drive to my OB (and new MFM) follows a slightly different route than the drive to the RE.  I’ve had to learn new rest stops, learn new quick food options, learn new road conditions.  Not only has the adjustment been huge, but so has the unpredictability of its coming.  A sticky pregnancy has made me learn a new routine, and this has come long before the normal new parent routine changes we’re all conditioned to expect.

And, if the daily minutiae of infertility treatments were familiar, then defining myself through heartache and resiliency was its macro-level bedfellow.  Infertility gave me a purpose that my life was largely lacking.  I found some sense of self in my career, I enjoyed my friends and family, but when we started this journey I was, like most other 20-somethings, focusing on the things that life could give me, not that I could give it.  I mean, simple case in point, I wanted to be granted the gift of becoming pregnant, delivering a healthy child, and parenting that child for the rest of my life.  I wanted life to give me something.  For all I revere it, the act of procreating is most certainly selfish and driven by a desire to get what we want.  I don’t, in any way, think that should take away from the fact that determining when and how we reproduce should be a basic human right that we all get to work out for ourselves, but making mirror images of ourselves has an undeniable element of narcissism about it.  So, when infertility struck, I was so very, very lost.  Why couldn’t I have what I wanted?  Hadn’t I earned it?  Surely I earned it more than that terrible parent I saw in Target or my cousin who said “I do” all of thirty seconds ago.  Why was the world making me suffer?

I have no answers for any of those questions, but I’m at peace because I simply stopped asking them.  No, this post isn’t going to take a turn for “If you just have hope and baby dust” territory, but I am going to be fairly blunt about the fact that asking questions about why you aren’t getting what you “deserve” is just kinda masochistically futile.  You’ll never have an answer; there is no answer; life sucks, then you die.  K?  Somewhere along the way, right around the time of my suspected ectopic pregnancy in 2011, selfishness propelled me to something amazing.  Out of a desperate attempt to feel less alone, I went to a professionally-led RESOLVE support group.  Then a peer-led support group an hour from home.  Then, finally, I started my own.  And, just recently, I’ve become a peer-led support group coordinator for my state.  At the same time, relationships I established with faceless Internet strangers on an fertility-focused support forum, transitioned away from the anonymous forums to Facebook.  These women went from familiar avatars, to close personal friends and confidants.  In 2012 we signed up for our first Walk of Hope, and we returned again in 2013 despite moving far away from the walk location.  Though this little one’s arrival will keep us sidelined from the Walk and Advocacy Day this year, my thoughts (and some dollars and constituent calls) will be with the women and men who fill our shoes.  And, finally, following my last miscarriage, I started this blog and found a new voice on Twitter.  When we started trying to conceive in 2010, I was desperately seeking an identity as “mother.”  In that time, I’ve found an identity far different than the one I expected, but one that still fills me with just as much pride and sense of accomplishment.  So, why did we keep going, even when the hope was gone?  I’d convinced myself this wasn’t just my fight, and, with the help of countless women and men, I kept on trucking.

Finally, I just wasn’t willing to give up on my health.  What started out as a drive for pregnancy, quickly turned into a battle for diagnoses, treatment, and health.  Though by no means a universal experience, my infertility has been inextricably linked to my health almost from day one.  I pushed harder than I thought I could push to get my Hashi’s diagnosis, because treating my raging thyroid disease might help me get pregnant.  I demanded a PCOS diagnosis (and the Metformin/Synthroid combo that brought me to a weight I hadn’t seen since middle school) because doing so might help me get pregnant.  I marched into my REs office and insisted on laparoscopic surgery to diagnose my endometriosis because I refused to endure another assumed ectopic.  We drove 6 hours one snowy February morning for a 45 minute appointment with a Reproductive Immunologist to investigate my wonky immune system because I needed to know I’d done everything in my power to save my failing third pregnancy.  I’m bracing myself for April’s consult with a new rheumatologist because this little man deserves to have the healthiest mama he can get.  My health was always the elephant in the room keeping me from stopping treatments, even as my ability to sustain myself emotionally through all the failures precipitously declined.  Each miscarriage was diagnostic and every failed cycle provided more insight into what was wrong with my body.  No one should have to sacrifice their children in order to improve their health, but it was a devil’s bargain I’d become accustomed to.  And, it’s a thought that’s been on my mind a lot lately, and was a central theme of my counseling appointment today.  When there’s no longer a goal in site – when the dream of pregnancy and parenthood has been achieved – what will be left to propel me toward answers to my medical mysteries?  When I no longer find myself in a practitioner’s waiting room once a week, who will be tracking my progress or decline?  When the realities of parenting a newborn hit, will I have the ability or the energy to differentiate normal new parent fatigue from complete autoimmune misfire?  These questions are also ones not worth asking in this moment, but they’re ones worth acknowledging nevertheless.  I kept turning to infertility treatments because I was afraid of turning away from treatments that might improve my health and well-being.

So, finally, the crux.  Infertility and infertility treatments pose a risk to three aspects of your life: your emotional, physical, and financial well-being.  For me, the physical was surmountable.  The surgeries, the miscarriages, and the injections were worth it, as each one brought answers.  And, usually, the physical pain of infertility was nothing compared to the pain of living my life before becoming aware of and treating my health issues.  The contractions of my 9 week miscarriage were intense, but I was prepared for them after 15 years of endometriosis-related menstrual cramping that, prior to my first referral to an RE, had always been passed off as evidence that I simply had a low pain thresh hold.  The discomfort of recovery from two laparoscopic surgeries was worth it tenfold for the improved bowel function, pain relief, and sexual desire each surgery brought with it.  Taking as many as 25 pills a day in my mid-twenties was a small price to pay to regain a metabolism that didn’t translate a 1000 calorie a day diet into constant weight gain.  And, even fertility-specific medications like gonal-f and menopur were worth it since, for the first time in my life, they brought predictable-length cycles, and didn’t leave me anovulatory and searching for my period for 8+ months.

While I won’t be nearly so quick to pass off the financial as no great burden, I will note here that we were relatively “lucky.”  (And, it’s only through my close proximity to this community and my IF Stockholm syndrome that I’m even remotely able to describe our financial situation as “lucky.”)  My first insurance covered diagnostics, and, after a targeted national job search, my second insurer was required, by state mandate, to cover treatments and meds for everything up to IUI.  So, while it’s the one thing that we’ve never been insured for that has granted me this pregnancy – IVF – I was able to make my insurance work for me most of the time.  I garnered my diagnoses on the cheap, including a laparoscopy that we risked paying out-of-pocket for had I not been found to have endo.  I used my state-mandated meds/IUI coverage to stockpile extra meds for our IVF cycle.  And, we went to a clinic with some of the nation’s lowest prices for IVF when it came to that.  So, while we’ve easily shelled out close to $20,000 in the past 4.5 years, most of that is come in the form of co-pays and deductibles for insurance-covered services.  And, on top of that, we’ve maxed out (and promptly spent) our flexible spending accounts whenever possible to ensure those out-of-pocket expenses came pre-tax from our employers.  It could have been much worse.

Where the financial truly hurt us?  Where the physical really stung?  It’s where both intersected with the emotional.  The emotional toll was crippling.  The emotional stole our hope and joy.  The emotional made us decide that child-free was preferable to continuing to go around in the same circles again and again and again.  And, contrary to what you might initially expect, entities outside ourselves can be held responsible for this emotional toll.

Published in yesterday’s New York Times, Ann Carnn’s “Meeting the Cost of Conceiving” is a a relatively simple financial piece that isn’t all that groundbreaking to anyone that’s taken their turn on the IF roller coaster.  But, re-reading the article today, after first clicking over to it from RESOLVE’s Facebook page yesterday, I think that article is the reason I found myself asking this morning, “Why did we keep going?”  And, now, I can’t help but find myself rephrasing the question as, “Why did we get to the point where stopping seemed preferable to continuing on?”  My answer is hidden in bits and pieces of Carrn’s article.  In her awkwardly placed single-sentence closing paragraph reading, “Yet, just a small proportion of women who suffer from infertility use [IVF].”  In fertility specialist Dr. G. David Adamson’s opinion that, “Cost is a problem,” and, as Carrn’s continues, “not because I.V.F. itself is necessarily more expensive than other highly technical medical procedures […] but because most insurance policies don’t cover it.”  Each step along the way we were forced to ask ourselves whether we could keep it up, quite simply because the expectation of our insurers and our medical system was that we shouldn’t.  We kept finding ourselves asking at what point were we willing to trade in the routine, the identity, and the battle – the trips to the bagel shop, the sense of belonging to a community, and the path to improved health – for the path our employers, insurers, doctors, and government expected of us.  When would the emotional toll of being stuck in a perpetual fight be greater than the toll of living childfree?  We got awfully close, and I still tend to blame my country, my doctors, my employers, and my insurer for that.

When, in 2002, my mom decided to wave the white flag, cease all treatments, and allow cancer to take her, she did so because it was the path she physically and emotionally preferred.  Her insurer never told her she wasn’t worth it.  Her friends never asked her why she didn’t “just” stop wanting to be pregnant alive.  And, we, her family, didn’t doubt her when she said he mind was made up.  She was given the peace, the space, and the support to make the hardest decision she would ever have to make.  I’d be lying if I didn’t say that her decision hurt 19-year-old me, but, looking back now, I love her all the more for the strength she showed in her final months.  Our flirtation with ceasing treatment had none of those aspects to it.  Our insurance checked out, our family shook their heads and talked in hushed tones about the money we were spending, and we were asked at every turn to justify our decisions.  To reconfigure Carnn’s quote above, not because infertility is itself more difficult to treat than cancer, but because most insurance policies and random strangers don’t find it worthy.  Run your head into that wall every day for 4.5 years and, even under the most forgiving of physical and financial situations, you can see how the emotions might finally give out on you.  Or, at least, how they started to give out on us.

IVF is not for everyone, and IVF is not a guarantee.  But, as long as just a “small proportion” of infertiles have access to IVF, the emotional toll of infertility will continue to call the shots.  As long as women endure cycle after failed cycle of cheap procedures with far lower odds of success, the emotional aspect will take center stage.  As long as miscarriages are treated as diagnostic, at best, and “bad luck,” at worst, the emotions will cloud all judgement.  As long as reproductive choice (including the choice to reproduce) remains politicized, many infertiles will find their lack of choices leading them down a path of “Why do I even bother?”

Survivor’s guilt (even if pre-survival)

Three realizations converged today (well, four if you count my new awareness of what the moist parts of your eyes and nostrils do in a -35F windchill).

First, I woke feeling lost about what to do with this blog in the new year.  I’ve had checking in here on my list of things to do for ages now, and even with ample down time over the holidays, I still couldn’t muster a post.  It came to a head this morning because I did actually, in theory, have something to write about.  Baby But IF gave us our first serious scare yesterday (well, aside from the constant, skull-numbing, miscarriage fears I’ve had since the moment I saw that flash of white shoot across the ultrasound screen on the day of our embryo transfer).  I won’t belabor the point (yet? ever?) but did y’all know that it’s common to have blood pressure dips in pregnancy?  I surely didn’t as I gingerly walked down the stairs to tell Mr. But IF that I thought I was dying yesterday morning after a post-vomit check-in with his blood pressure cuff gave me a starling 86/57 result.  So yea, I thought today, there’s something to chat about.  There’s an update worth mentioning.  There’s a way to contribute something of worth that might help someone in the future.  But no, I almost immediately decided, this blog is not the place to gloat about my (totally blown out of proportion) brush with death.  That’s totally inappropriate.

A few hours after making that decision, I read Dogs Aren’t Kids’ recent post “I’m an Asshole.”  And, what can I say, it resonated.  It wasn’t until about halfway through the post that I realized that I’m the hated and not the hater in this scenario.  And, that realization stung.  Not because her words hurt me (they absolutely didn’t), but because it felt like it was taking away part of who I am, part of what I define myself as.  You succeeded, Dogs, and this post is tremendously brave.  I just feel lost because I don’t know how to be brave myself anymore.  How to morph my IF activist self into a pregnant IFer with any semblance of credibility.  I stared at the empty text box for an hour, struggling to phrase a comment, find the words to un-self-righteously convey a “Fuck yeah! Damn straight!” on her blog as I chugged my Metamucil and wondered whether those flutters low in my abdomen are what I’ve started to think they might be.  Ultimately, I closed the tab.  I ran away.  I was decidedly un-brave.

Finally, it came together when a member of another IF “grads” board I’m on posted the Huffington Post’s blog “A Twin Mom’s Post-Infertility Survivor Guilt.”  As I wrote on my wall when I shared the article on Facebook:

Nothing more to say but “Yep,” “yep,” and “yep” (and I’m not even close to delivering or even fully accepting that we’ll get to meet this little one yet)!

I’ve actually used the AA chip analogy in therapy sessions before.  A few weeks ago my therapist asked (with no hidden agenda or any other motivator but to continue our conversation), “Why does membership in the ‘infertility community,’ as you call it, matter so much?  What makes you so fearful about leaving that part of your life behind?”  I stumbled quite a bit at that one.  Me, that usually has an answer planned for every possible question, for every contingency — I just froze.  I mumbled something about being true to myself, about wanting our struggle to help other people, about how I’ll never be able to forget what we’ve been through.  Ultimately I formed my own version of the AA analogy.  Though, in my version of IF AA you would get to stay a member forever… I’m just not quite sure how that happens just yet.

Then I got to Goldberg’s commentary on her shower.  She writes, “Years later, when my mother-in-law sent out invites for my own baby shower — for twins, no less — I had to stop myself from launching a follow-up email apologizing, saying something like, please, don’t feel obliged to come. People did come, though, with heaping bags of registry loot.”  That one hit me straight in the gut.  When we were home for the holidays my MIL announced she’d be throwing me a shower.  She asked when I’d like it to be, what I’d like, and who to invite.  My first thought was, “I can’t think about this yet, we still don’t know if this pregnancy will last!,” and my immediate second thought was, “Oh God, even thinking about going to my own shower is overwhelming and filling me with dread and bitterness!”

I have some confessions to make.  Namely:

  • I still loathe pregnant women.  Like give them dirty glares from across the aisles at the grocery store levels of hate.
  • I’m terrified of the day I really start showing.  It will truly be open season for talking to me about my pregnancy.  A few have tried it already, and I keep replying to all questions in hushed whispers, all the while suspiciously looking around to make sure no one can overhear me. This from a woman that gladly discussed infertility, IVF, IUI, timed intercourse, cervical mucus, miscarriage, hell, you name it, loudly and proudly in crowded bars and restaurants.
  • After four years of being anal retentive about every drug, calorie, drink, or thought I put into my head (Could this saucer of soy sauce make it less likely for us to conceive?  Will half a cup of coffee impact the effectiveness of Clomid?), I’ve been startlingly hands off about this pregnancy.  I’d love to say it’s because I’m just that cool and relaxed about it all, but, if I’m being honest, I had that sushi on December 23rd and that second cup of coffee on Tuesday because I can’t bring myself to act pregnant.  I’m still so certain it won’t last.
  • I’m ashamed to discuss the preliminary baby names we’ve agreed upon with friends and family.  Not for the usual reason – you know, the fear that someone will hate them – but more because it feels like an act of smug arrogance.  Frankly, I’d love for them to argue with me about hating the name because fighting back is something I’m pretty damn good at these days.  Having happy, lighthearted conversations isn’t.
  • And, perhaps the deepest, darkest secret of them all, I’m actually excited.  I’m fascinated with my hardening belly, the flutters I think just might be something other than gas, the sound of my doppler, and (once the sheer panic dissipated) even the threatened black out yesterday.

And, that’s what today has given me.  I don’t know what this blog is for, or even who would want to read it anymore.  I don’t know how I can live life infertile and pregnant at the same time.  I don’t know if the survivor’s guilt will fade or if I even want it to.  All I do know is that I’m here, I’m infertile, I’m pregnant, and I’ll likely be trying to figure it all out for the rest of my days.  Why else is life worth living if not for growth, reflection, and reinvention?

FB Official

Over the years I’ve had plenty of time to think about how or if Facebook will play a role in my pregnancy.  I’ve gone from loathing any thought of allowing FB into my womb, to desiring more than anything to reclaim some normalcy in this process, even if that “normalcy” is defined as blathering on about bumps on FB.  Initially my hesitations about FB announcements were twofold.

  1. I feared I’d hurt someone like me.  Someone that simply wanted to mind their business, stalk casual high school acquaintances, and blow off a few minutes of the work day with FB.  That someone that logs in happy and logs out crying after yet another “my baby is the size of a kumquat” post from a 20-year old cousin that got married two minutes ago.
  2. I was wary of the stupid comments.  The “About damn times!”  The “I told you it would happen if you just relaxed!”  The “All in God’s time!”  I’ve gotten enough of those face-to-face over the past 4 years, I didn’t want a digital jab hunting me down and hurting me in the comfort of my own home or office.  I also didn’t want to explain to great aunt so-and-so why I deleted her comment and encouraged Mr. But IF to go ahead and chug down the fifth of whisky for the both of us.

But, as the years drew on, as we proudly came out of the IF closet on FB, total radio silence about any fluke pregnancy we’d managed to trick long enough to stick around until announcement time seemed unrealistic.  And, frankly, I’ve sat through enough cutesy announcements by this point that it’s about damn time that I spew some (admittedly bitter) joy back into their smug fertile faces newsfeeds.  So, we did it.  We made it FB official.  I feel funny…

Because brevity isn’t really my forte, my initial plan of a simple photo collage quickly went out the window and was replaced with a full-on video montage.  Oh, and can I just say, I had FAR to much fun sticking stickers all over this thing to anonymize the personally identifiable content.  Enjoy!

What’s this unfamiliar peaceful feeling?

Yesterday, a co-worker told me I was glowing.  People really fucking say that?  <Scratches head>

In case I haven’t already stated this enough, I don’t really know how to write happy posts.  It’s just so out of the norm.  But, for the most part, this is a happy post.  Like imagine rainbows and glitter bombs shooting out of my fingers as they tippy-type post.  I feel sick already….  So we don’t have to belabor this, let’s roll with the bullets.

Reasons ButIF’s happy:

  • Yep, still pregnant.  11 weeks, 2 days.  Not that I’m counting or anything…
  • Last Tuesday (10 weeks, 1 day) we had our first success with the doppler.  A faint but steady 180 beats per minute.  Of course, I’ve failed to find the heart beat twice since (leading to immeasurable grief on the part of the Mr.), but I’m not worried.  I found it once, I’ll find it again.
  • That nasty, mean, no-good OB I was complaining about last week?  HE’S AMAZEBALLS!  Or, more specifically, the MFM he referred me to is.  Yea, sure, he took us back over 45 minutes late for our appointment (leading the Mr. to turn a not-so-pleasant shade of red and huff and puff through the hallways looking for an explanation), but when he did take us back (you know, right after the Mr. went looking for answers?) he was top notch.  We had a lovely two-way conversation that lasted for nearly an hour during which he treated us as intellectual equals and literally nailed every zinger question I threw at him.  When he said, “I prefer to treat based on Free T4 as TSH is a poor indicator of thyroid function” I about jumped over the desk and kissed him.  After he stated that, “In your case it is best that we follow you closely with serial ultrasounds,” I thought the Mr. was going to give him a lap dance.  Totally freaking happy….
  • When we were ushered from the MFM over to the OB we had few questions left to ask.  So, the OB started, “How are you doing?” and I responded, “Physically, well, mentally, not so hot.”  He again repeated, “With your history you won’t believe this is real until you are tucking this baby into the car seat to take them home.”  (I actually don’t mind that he’s now said this catch phrase to me at least 3 times.  Yea, it’s repetitive, but at least it means he’s consistent.)  Then, the words I wanted to hear, “Would it help or hurt to have an ultrasound today?”  HELP!!!
  • So, we saw the blob again last Wednesday.  I really must come up with another nickname as he/she’s soo beyond a blob.  The OB’s ultrasound machine totally kicks the ass of my RE’s (you’d think the folks you’re paying cash down out of pocket would have better shit, eh?).  The blob has legs.  And arms.  And fingers.  And toes.  Just as I was taking that all in, just as I was reassuring myself (as I always do) that yes, indeed, I do see a flicker of something near the center of the chest, the damn thing started waving.  There is a thing… with arms… that move… inside of me!  Gah!
  • We drove straight from the OB/MFM appointment to the inlaws for Thanksgiving, successfully avoiding the winter storm that had the Mr. in a tizzy as we sat waiting for the MFM to take us back.  The Mr.’s grandma asked for a copy of our ultrasound.  It’s on her dining room buffet.  Right next to the countless pictures of the 3 little darling great-grandchildren the Mr.’s cousin’s wife has already provided her.  You know how people get excited to be moved from the kiddie table to the adult table for holiday meals?   Well, yea, this was my own graduation moment.  I’ve made it to the fertile table.
  • As we hovered over our turkey, the Mr. his parents, his sister and fiance, his great aunt and uncle, his grandmother, my mother-in-law bent her head to pray.  As I shut my eyes and clasped my hands to give thanks for the meal and the family I was sharing it with, I heard tears from across the table.  I looked up, she looked back, and simply said, “I can’t…  I just can’t.  I’m too thankful.”  My father-in-law came to the rescue and had us go around the table each sharing what we were thankful for.  The Mr. mustered a simple, “Babies!”, the born-again great aunt thanked Jesus, my hungry sister-in-law zeroed in on, “Home cooked food!”, and my mother-in-law whimpered just a little more…

Two years ago I was actively miscarrying at the Thanksgiving table.  I had entered maternity triage for the methotrexate injection that would end my failing pregnancy on November 18, I had returned two days later after passing out in our bathroom from contractions and blood loss, and less than a week after that I was welcoming 25 people (including above mentioned cousin’s two small children and pregnant wife) into our home for a Thanksgiving feast I’d been preparing for days.  I never thought I’d reclaim the peace of Thanksgiving from that memory.  And, to be honest, I’m sure I never entirely will.  But last week’s doppler success, ultrasound pictures, and mother-in-law sobs have gone a long way to softening the pain.  This year, no matter what the future brings, I was thankful on Thanksgiving.

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.

The gift that keeps on giving

I’m 8 weeks pregnant today.  Things appear to be progressing normally.  I have an ultrasound on Wednesday, expect to be released from my RE next week, and will have a combined maternal fetal medicine consult and first (ever) OB appointment on November 27.  Really, what more could I ask for?

You see, the thing is, infertility and repeat miscarriage are gifts that really keep on giving.  Infertility is not lazy, it works hard each and every day to reassert its control over your life.  Miscarriage is not easily forgotten, but rather, like infertility, haunts my every day.  Neither is curable, eraseable, destroyable.  No matter how this pregnancy ends, no matter how future pregnancies end, I will be infertile, I will have suffered repeat pregnancy loss, until my dying day.

I also, it seems, will continue to suffer strained relationships due to the gift of my infertility.  Yesterday I may have injured my relationship with my aunt – my only surviving female blood relative – to the point of no repair.  Ever since my mom (her sister) died in 2002, Aunt L has tried to step up, tried to be there, tried to fill the gaping hole my mother’s passing left.  She’s done admirably.  Through her own immense grief and while receiving her own life-threatening/life-altering medical diagnoses, she’s been strong through graduations, engagements, marriages, and various other events that she should never have had to be the primary support person for.  Yet, her job is a thankless one.  She’s not my mom.  She’ll never be my mom.  And, for that, I seem to never be able to forgive her.

To say she’s struggled to understand my infertility is an understatement.  If it didn’t hurt so much, it would almost be comical how stereotypically wrong her responses have been to my pain time and time again.  When I became pregnant in 2011 after ovulating on vacation on day 56 of my cycle, she laughed as she replied, “I told you all you needed to do was relax and take a vacation!”  When that same pregnancy was diagnosed as ectopic she said, “It just wasn’t meant to be.”  After scheduling my first laparoscopy to investigate possible endometriosis (a condition that she herself has, that forced her own hysterectomy in her mid-30s) she told me I was being “too much of a worrier.”  Each medicated cycle after I was reminded that I’d never succeed if I was putting all those “unnatural hormones into your body,” and each negative test after negative test I was told, “It’s just not your time yet.”  When our third pregnancy ended in miscarriage last winter, she cried with me, but reminded me that the worry I had been feeling since our first bad blood draw at 5 weeks, “certainly did your baby no favors.”  She was visiting when we were approaching the end of my stimulation phase for this IVF cycle, and insisted on driving with me to my last monitoring appointment before trigger and retrieval.  On the car ride to the clinic she told me I could have avoided all this “IVF stuff if you’d just stuck with acupuncture.”

This woman loves me deeply, wholly, and completely, but seems incapable of saying or doing the right things.  And, believe me, I’ve taken my own advice – the advice I dole out so often at my RESOLVE group.  I’ve told her how her words make me feel.  I’ve asked her to respond differently.  I’ve told her what I need from her.  Each time I’ve been ignored, or, worse, corrected.  “More negativity is not what you need,” she explains, “you worry so much it makes no sense to make everyone else around you be just as miserable!”

So, for the past couple weeks, I’ve taken the coward’s way out.  She calls, I don’t answer.  She texts, I don’t reply.  It snowballs out of control.  My anxiety gets higher, the inevitable confrontation gets worse.  Finally, yesterday, Mr. But IF made me answer her call.

Apparently she thought I had died in a ditch.  You see, I do all those ridiculously long drives to the doctor and surely I got in an accident and no one noticed or told her.  (What that says about my husband and friends we’ll just ignore for now.)  I’m pregnant and she wants weekly updates, she demands weekly updates!  I told her that was just too much.  With a shaking voice I explained (again) that I just can’t keep calling and saying, “Yes, still pregnant.”  That even those three words leave me in a complete panic.  That just saying them seems like tempting fate.  That in my mind it’s not three words, but five.  It’s “Yes, still pregnant, for now…”

Again I was told that response is silly.  That my emotional needs are irrational.  If only it could have ended at that.

As her voice turned from stern talking to to chipper happiness, she said, “Well, fine, then we can talk about some other happy news at least.  Your cousin S is having a little boy, so you need to have a little girl.  I’ve told everyone you need to have a little girl so that your kids can play together!”

And, then it crashed.  The tears started flowing, the anger formed a lump in my throat the size of a softball, I couldn’t form words through the shaking.  My young cousin got married a few days after my most recent miscarriage.  After weeks of my aunt going on about how fun it will be to be pregnant at her wedding, I couldn’t manage.  I skipped her wedding.  A well-timed snowstorm gave me the excuse I needed to back out of the 6 hour drive home to the wedding of a cousin I barely know.  A cousin that is apparently very much NOT infertile.  A cousin who’s pregnancy and future little boy are just another on the long list of living reminders of all that infertility has stolen from me, of all that miscarriage has closed my heart to.

I think I’ve done fairly well at avoiding the constant comparisons and the what could have beens.  But hearing of the easily conceived pregnancy of the cousin that (I kid you not!) was on a television dating reality show when Mr. But IF and I first started trying to have our first sucks.  Having my aunt ignore my pain and replace it with joy for the niece who will give her her first grand-nephew sucks.  Having this all happen in time to coincide with the week when we lost our last child, when that heart beat stopped without apparent cause between 8 and 9 weeks, is cruel and unusual.

At least, as I said to Mr. But IF, I have something to talk to my counselor about on Thursday.  If I’m able to get out of bed on Thursday.  If Thursday isn’t the first day of grieving and moving on from a bad ultrasound on Wednesday.  But, it seems, I should just stop with the negativity and celebrate the gleeful naivete of friends and family and cousin’s named S.  Surely it’s my bad attitude that’s done this to me all along.  I’m constantly made to feel that I caused our struggles, I made my misery.  Why does this seem like rational logic to those that love me?  Why don’t they, by extension, remind me that positivity and yoga could have cured my mom’s cancer?  Why, when I speak of the pain of missing her, am I not reminded of a cousin, a friend, a stranger that has two living parents?  Shouldn’t celebrating living parents cure the lack of my own?

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.

Today I am grateful

Today an old online friend sought me out to congratulate me on the news.  She wrote, in part:

I completely get why you left FF.  I read a blog of yours that kind of explained why you left and could sympathize with the need and want to kind of turn to blogging over forums. I think you do a great job at capturing how this journey is going for you. It ‘s probably the least fluffiest blog I’ve read and I like that. I like the realness and rawness to your writing. I’m sure you have to realize those who have found your blog have found comfort in your words and that you’ve helped them in some way or another.

(I really hope you don’t mind I stole your words A!)

Honestly, that was probably one of the biggest compliments anyone could have paid to me.  I suppose I take a sort of sick pride in being the Debbie Downer of the IF blogosphere.  Not because I’m at all interested in one-upping anyone in the overdone pain olympics (I know my story isn’t the saddest or most painful out there by a long shot!), but more because it means I’m doing a decent job at conveying the way that *I* am living infertility.  Hope and optimism have been absent from much of my infertility experience, and pain and suffering familiar bedfellows.  If my writing is raw, if my words sometimes ache and hurt, then I’m succeeding at what I set out to do when I started this blog.  I’m putting some fraction of the emotions I’m feeling out into the ether, and hopefully freeing myself of some of them in the process.

That said, I’m well aware of how one note that often makes this blog.  Yep, But IF’s worrying again, cursing doctors again, depressed again.  The monotony is accurate, but I’m sure it also feels oppressive.  So, today, let’s try something different.

Today, I am grateful.  Grateful for so many things.  Things I should spend more time appreciating, documenting, and celebrating.  Why not take a moment to celebrate some of them now?  So, in no particular order, today I am grateful for…

  • My husband.  His unfailing support, his intellect, his humor.  The joy he’s brought to my life, the sorrow he’s helped me weather.
  • My life.  These 30 years.  Another happy birthday celebrated with friends and family, old and new.  The phone calls, the party goers, the Facebook messages, the cards.  The yearly reminders that I matter to many, even if I often feel that I’m invisible to all but a very few.
  • This pregnancy.  Today, I am pregnant.  No amount of past heartache or struggle should dull the beauty of that simple sentence.  I know all too well that these moments can be fleeting, so I should also know better than to deny the power of these moments.  Once again, today, I am pregnant.
  • My infertility.  Yes, today I am grateful for it.  This month, this year, and this decade I am grateful for it.  Infertility has brought me my LFP ladies, my FF friends, my Twitter buddies, my blogging pals, my support group gals.  How one disease that wreaks so much havoc, can also add so much to one’s life is beyond me.  I’m grateful for my day with C and R on Saturday.  For friendships with women I’d never have met if infertility hadn’t entered my life.
  • My friends.  The text messages, phone calls, and emails from three friends named A.  Celebrating weddings past and planned.  I wish I was better at staying in touch sometimes, but know I love you all and you’re regularly in my thoughts.
  • My cats.  Yes, even when they wake me at 3AM wretching in the carpeted hallway.  (I most assuredly have crazy cat butt parasites.  C’est la vie.)
  • Sunshine on my birthday.  And the marshmallows roasting over our fire pit it enabled.  And, yes, even the sugar crash that hit later last night.
  • The Internet.  Without the support it has offered I would have lost my mind long ago.  Without it, I wouldn’t have met YOU.  That’s definitely something to be grateful for.

Help! I need somebody!

And, not just anybody.  I need a doctor who will treat my thyroid.  Who knew it could possibly be this hard?  But, I’m getting ahead of myself.

I waited with a fair amount of restless impatience on Wednesday for my latest round of beta results.  And, not just beta and progesterone, either.  I was pretty annoyed on Monday when I discovered my first beta draw didn’t also include a TSH check.  It’s been a standard part of my workup with every other (negative) beta for the past 6 months, so why they left it off this time is beyond me.  So, when my blood was drawn at 7:30am I requested that a TSH be added.  I got minimal push back from the nurse, but I’m used to fighting.  Anyway, blood exited the veins, and I was told I’d hear something by 11am.  At noon I hadn’t heard a thing so I gave in and called.

That phone conversation is hard to paraphrase, so let’s just do this Shakespeare-style.

Me: Yes, I’m calling for my blood work results from this morning.

Nurse: Uh, yea.  Still pregnant.  When do you want your ultrasound next week?  Wednesday, Thursday, or Friday?

Me: Wait, what?  What was the value?  What was the TSH?  How’s the Progesterone?

Her: Um, I gotta open your chart back up. Gimme a second. [Gum smack, gum smack.]  HCG was 256.  That’s fine.  When do you want your ultrasound and who is your OB?

Me: [Doing the math on the fly] But, that didn’t quite double from my 139 on Monday.  Are we really not doing another beta?  I won’t get anything else until over a week from now?  What about the other values?

Her: I don’t know what to tell you.  Everything’s fine, so there is no reason to retest.  You can see the rest of your results in the portal later today.  I already closed your chart again.  Call your OB.

Me: I don’t have one!

Her: Well, that’s silly.  Get one.  We will release you at 8 weeks and won’t help you from that point on.

Me: But I’m barely 4 weeks!  I’m not calling one.  Not yet.  I’ve had to cancel three OB appointments before due to miscarriage.  I’m not doing it again.

Her: Well, I don’t know what to tell you.  How about next Thursday for your ultrasound?  7:30?

Me: [In tears] Wait what?

Her: We’ll see you next Thursday, October 24 at 7:30am.  Call an OB!

After I was hung up on I sent an email to my boss saying I suddenly didn’t feel good and would be going home for the rest of the day.  I stayed home in my pajamas crying for the next 36 hours.  The Mr. and I spent an additional 90 minutes screaming at one another last night about how many more miscarriages we can possibly handle.  He said things like, “I just don’t have the energy to watch you miscarry 9 more times with 9 more perfect embryos!”  I heard things like, “Why did I marry this barren shrew who keeps killing my children?”  It was good times.

Equally good was what I found when I logged in to my patient portal teary eyed on Wednesday night.  Yes, the HCG went from 139 to 256.  Perfect is doubling in 48 hours or less.  Mine was on pace to double at 54 hours.  Not remotely terrible or doom and gloom depression-worthy, but that’s still the emotion it evoked.  After 4 years and 3 prior losses anything less that absolute perfection generates worry.  I’ve been full of worry ever since.

But, it turns out, the beta was just the tip of the worry iceberg.  My amazing progesterone on Monday of over 40?  Yup, dropped to a pathetic 19 despite daily Crinone suppositories and PIO injections.  Oh, and that TSH they had no intention of running?  Yea, about that…

Co-sponsored by the American Association of Clinical Endocrinologists and the American Thyroid Association, 2012’s “Clinical Practice Guidelines for Hypothyroidism in Adults” recommends the following course of action for pregnant women with elevated TPOAbs or Hashimoto’s:

When a woman with hypothyroidism becomes pregnant, the dosage of L-thyroxine should be increased as soon as possible to ensure that serum TSH is <2.5 mIU/L and that serum total T4 is in the normal reference range for pregnancy. Moreover, when a patient with a positive TPOAb test becomes pregnant, serum TSH should be measured as soon as possible and if >2.5 mIU/L, T4 treatment should be initiated. Serum TSH and total T4 measurements should be monitored every 4 weeks during the first half of pregnancy and at least once between 26 and 32 weeks gestation to ensure that the requirement for L-thyroxine has not changed. [Emphasis mine]

When I started this cycle, my thyroid was well controlled on my usual Synthroid dose.  On 9/18 my TSH was a beautiful 0.49.  My redraw on Wednesday?  5.69?!?!?!

On Thursday morning, I wrote my endocrinologist asking what to do.  On Thursday afternoon they left a message on my work voice mail (good thing I skipped work given my hysterical I’m gonna miscarry again crying fit, right?) saying they couldn’t go on what I told them, but needed to have my RE fax lab results to them.  My RE closes at noon on Thursday.  Last night at midnight I wrote a hysterical email to my RE’s nurse basically saying, “Why isn’t anyone paying attention to me?  Why won’t you help me?” (Yes, it was about that eloquent.)  This morning she wrote back saying calm down, we’ve faxed your results.  Later this morning a message arrived from my endo’s nurse saying, “We don’t treat pregnant patients, you will need to talk to your OB.  Who are you seeing?”  I wrote back with the same damn, “I don’t have an OB and I don’t plan on having one!” I gave my RE’s nurse on Wednesday.  And, that was that.

So, basically, by 2 this afternoon, I was left with the following:

  • RE won’t treat my thyroid since I have a thyroid-specializing endocrinologist.
  • Endocrinologist won’t treat my thyroid because I’m pregnant and that’s an OBs job.
  • OB won’t treat my thyroid because, well, I don’t have one.  But, even if I did, my experience has been that OBs won’t see patients this early anyway, so what good would it even do to have one?
  • Oh, and my rural PCP (who isn’t even in the office on Fridays) thinks any TSH under 10 is hunky dory.

Whee!!!

I escaped home from work and started making phone calls again, desperate to get some sense of resolution before the weekend (my 30th birthday weekend!) began.  It went something like this:

  1. Accept I must call a fucking OB at all of 4w4d pregnant.  Hyperventilate.  Explain situation.  Sound like a crazed woman.  God bless the patient receptionist who listened and cared.  Unfortunately, listening and caring doesn’t solve the fact that I’m not their patient, they’ve never seen me before, they don’t have my blood work, and it’s far too early to book an OB appointment with them.  She encouraged me to push my endo a little harder, but, after I told her I was seeing the thyroid center attached to the same teaching hospital their practice is attached to, she acknowledged they tend to not want to treat pregnant women for fear of liability.  Good thing I haven’t had about 5 conversations with my thyroid doc in the past 18 months saying I was specifically there so that they’d manage my care through pregnancy, eh?  Anyway, sweetheart scheduled me in as a new GYN patient (NOT an OB patient) for next Thursday.  Yes, the same day as my ultrasound.  But, at least since it’s a GYN appointment I won’t have to cancel it if I find out that morning I’m miscarrying, right?  Always looking on the fucking bright side.  That’s me alright!
  2. Try and call endo and get an answer that isn’t simply “Talk to your OB.”  Dial.  Press 0 to speak to a member of the staff.   Silence.  Dial back, press 0, silence.  Dial back, press 1 “if you’re a physician or a physician’s representative” (what the fuck do I care at this point?), receive error message that the extension is not available so try another extension.  Cry.  Give up.
  3. Call RE’s nursing line.  Get “Why don’t you have an OB?” heartless bitch nurse on the line.  Simply ask for the slightly less bitchy nurse I sent my emotional breakdown of a portal message to last night to call me back when she has a chance.  Hang up.  Cry.
  4. 30 seconds later, slightly less bitchy nurse returns my call.  She says, “Honey how are you?”  I cry.  And, then cry some more.  She orders me a prescription for 150mcg to replace my 112mcg of Synthroid.  She assures me there is nothing I can do (or that they are really willing to do) between now and next Thursday.  She tells me to always feel comfortable asking for her directly.  As I whimper out a, “Sorry I’m being so unhinged and irrational,” she responds back, “Honey, you have every reason to be irrational right now.  You’ve been burned enough times before and you won’t feel alright until you are holding this baby.  What else can I do to help make this better?”  I just start sobbing even harder.
  5. I call and set up an appointment with an infertility counselor.  Yea, you guessed it, it’s scheduled for next Thursday…
  6. Endo calls back.  He’s ordered a prescription for 137mcg and apologizes for the inconvenience.  He just, “Doesn’t like the confusion of handling pregnant women since usually OBs want to make those calls.”

So, I’ve gone from self-medicating by cutting my pills in half, to shortly having an arsenal of Synthroid prescriptions in different doses in my bedside table.  Not quite sure what the pharmacy is going to make of me, but that’s a call I’ll make for another day.  I can’t handle more phone battles right now.

But, let’s look on the fucking bright side, right:

  • I theoretically have an OB/GYN again for the first time in a while.  (Talk to me about whether this is a bright side when I have to face sitting in that waiting room again on Thursday.)
  • I will shortly have a full party array of Synthroid in all it’s beautiful colors.
  • My RE’s nurse has once again underlined that gold star next to my name denoting, “This chick is batshit crazy, handle with care!”
  • I managed to stop thinking about miscarrying for nearly an entire day since my focus instead was directed toward my thyroid.
  • It’s Friday.
  • I always wanted to have kids by 30, so at least I’ll be able to say I was technically pregnant on my 30th birthday this Sunday.  Close enough, right?