Nap time

You know that totally put together, strength of a million mighty women post I published last week.  Yea, I’m a liar.

Well, sort of.  I do think the foundation of that post holds true.  In my heart of hearts I did feel a switch flip and bring a sudden awareness, a silent peace that if I’m never a mother, I’ll make it work.  I’ll find new dreams, live in ways I’d never planned, learn to live on.  That part was true (or as true as any untested predictions we apply to our lives can be).

The lie?  It’s not bravery or strength or courage that’s propelling me, it’s exhaustion.  Granted, it was more lie of omission rather than outright “fooled you!”, but still a lie.

I’m just so tired.  The past four years of my life have been a haze of doctor’s appointments, surgeries, arguments with insurance companies, strained conversations with friends and family, shots, pills, sleepless worry-filled nights, physical therapy, counseling sessions, support groups, MRIs, X-rays, blood draws, IV infusions, driving to appointments, keeping family, friends, and strangers abreast of those appointments, fundraising, waiting to get pregnant, waiting for a new diagnosis, fighting for a new diagnosis, waiting to miscarry, waiting to pick up the pieces and try again.  And, as if that wasn’t exhausting enough I had to watch my husband and my IF friends in the computer live the same struggles and walk the same paths.  Again, and again, and again.  I’m just so very tired.

I would guess that for every minute I spend with a doctor, I spend another 20 minutes on the phone with the doctor’s office, on the phone with my insurance company, on the phone with the mail-order pharmacy, standing in line at the traditional pharmacy, going through outpatient intake to get my blood drawn again, writing out checks for co-pays and co-insurance, and filling out the same medical history form over and over and over again (number of pregnancies: 3, number of live births: 0).  I’m running out of steam.  Actually, I ran out of steam a long time ago.

Last Friday I went back to the lab for yet another blood draw.  We needed to decide whether it was time to give up on my body doing what it’s supposed to do and start a course of Provera to bring on menstruation, or whether we should let it do it’s thing and hope (har har har) for a miraculous naturally conceived pregnancy.  Tuesday’s tests were inconclusive, so I was ordered a repeat course on Friday to see whether levels were going up, down, or staying stagnant.  I hauled my bottom out of bed bright and early, went to the lab, sat through another round of “dumb things fertile phlebotomists say,” and waited.  My clinic never called with the results.  When I called back Saturday, I got an answering service.  On Monday I called at 7AM and started screaming bloody murder.

“Oh, the hospital never sent them.  You’ll have to figure this out with the hospital.”

Two hours, 5 phone calls, 2 times being hung up on, and a whole lot of lost work for my employer later, I got the (now 3-day old) results.  Body as stubborn as ever.  No change whatsoever.  Start Provera.  What’s another 3 day delay, right?

Last night I started spotting.  I started planning out our cycle, mentally scheduling the appointments, checking that I’d be in town and available around the potential retrieval and transfer dates.  I was excited.  This morning the spotting is gone and there are no signs that my period has any intention of starting any time soon.  What’s another two weeks of waiting, right?

I’ve been getting bills from my rheumatologist for a while now because they refused to collect my co-pay on the day of my appointment.  The invoice provides no way to pay by credit card (something I always do because of our flexible savings accounts through work) so I have to call.  Well, I’ve tried to call.  Apparently they are closed on Thursdays and Fridays, leave early on Tuesday, and take lunch every day from noon to 2pm.  After calling today and receiving a brusque, “This is the answering service, the office is on lunch break until 2 <you idiot!>” I lost it.  What’s another hour of waiting to pay a bill for a useless office visit that delayed my chances at trying to conceive for 4 months for no good reason, right?

I’m tired of this being the best that is out there.  I’m tired for my friends (first and foremost among them dear C) who have had to fight tooth and nail for quality of care that makes mine look like the gold standard.  I’m tired of being treated like I don’t matter by “professionals” that don’t know what they are doing, don’t respect the weight of their influence on our lives, and don’t do any more than the bare minimum (at best).

So, that peace and zen?  It’s just a scam.  In reality, I’m just ready for this journey to end.  I’m ready for nap time.

I’ll survive

It happened on my walk home from work.

landscape

And don’t I have a gorgeous walk home? Drool now, we’ll shortly be under 10 feet of snow.

With a gentle breeze blowing, the knowledge that fall is here was inescapable.  I listened to the shouts of our newly-returned students as they played club rugby and ran frisbee drills.  I noticed the new fall flowers along my path.  I noted the watchful father sitting on his front step as his little one climbed a tree.  I passed the women pushing strollers.  I walked in my own back door and instinctively greeted my two cats with the usual, “Hello, my babies!”

Today I realized I’ll survive.

For the first time in nearly 4 years I asked myself, “Will I be happy in a life without children?” and could honestly answer, “Yes.”  For the first time, that question popped up as almost an afterthought – an aside – and I answered instinctively and definitively.  For the first time I asked it without feeling physically ill and I answered it without second-guessing that answer.

I wish I could pinpoint what caused this stealth revelation.  Maybe it is because, with our IVF consult behind us, I know we yet again have a path in front of us.  The prospect of IVF has caused me to hope in way that I haven’t at any stage in our conception journey.  It comes with two kinds of hope.  First, the promise of something new, something different, something unlike anything we’ve tried before.  This, in a nutshell, is the hope I’m still partly afraid to utter.  That hope that things might go differently this time.

The second hope is a harder one to verbalize, but the one I feel most wholly in this moment.  It is the hope that, despite the outcome, IVF will bring us peace.  We may not complete our pre-paid two-cycle package with a baby in our arms, but we will complete it knowing that we did everything we were comfortable doing to achieve our elusive biological child.  (And, I should note here, just because we’ve drawn this highly arbitrary line at 2 IVFs does not mean that is the universal line at which all infertile women and men will draw this very important line.  This is, yet again, another one of those malleable demarcations infertility throws at us.)  Writing about her own recent decision to jump to IVF, Katherine over at Inconceivable! explained:

It’s amazing how once the decision was made, I could finally breathe again.  It had happened, we had survived, we had enough resources to go ahead.  The anxiety level dropped almost immediately.  Finally, we had a plan.  There was no specter lurking in the background to frighten, to wonder if we would have to cross a final frontier.  Now we will know, even if the IVF doesn’t take, that we have done everything in our power to conceive a baby.  I’m finding myself at some sort of peace at last.

And, to that, all I can say is a heartfelt ditto.  The physical challenges of IVF seem trivial – I’ve been doing the needles, the anesthesia, the probes, and the pokes for longer than I care to think about.  It was the finality that scared me the most over the past several years.  Now, surprisingly, it is the specter of exactly that finality that has brought me the greatest solace.

I often feel like I occupy an oddly privileged space in this land of infertility.  Because I’ve experienced so much pain in the past – because I watched my mother lose her battle to cancer when I was just 19 – I’ve often thought of myself as better prepared to handle the entirely different, yet entirely familiar, pain that infertility has brought to my life.  I’d never say that that tragedy dulled my pain (in fact, I’ve written before about how it has actually complicated it), but I will say that having pain as a well-known bedfellow has often helped with processing each failed cycle, each miscarriage, each new bit of bad news.  But, all that said, it wasn’t until today that I had a much-needed revelation.  It’s OK if, once our path to parenthood to comes to a close, I still feel sadness at the future we won’t experience.

For 19 years of my life I envisioned my mom videotaping my college graduation, dancing at my wedding, holding her first grandchild.  In a manner that only the naivete of youth can inspire, I never once doubted that each of those moments would form future memories.  When I lost her, I also lost that future.  Despite the drawn-out cruelty that is terminal cancer, the final blow came quickly, definitively, and inescapably that December night in 2002.  Nothing could return that longed-for future to me, and all around me knew it.  Death is final.

For the past several years, I’ve bemoaned the fact that unlike death, infertility is, in many regards, ongoing.  There’s always another cycle, another treatment, another doctor, another potential way to envision that future coming to fruition.  And, there’s always those around you who either ignore your battle (or don’t know about it in the first place) or try to minimize it.  Infertility has often felt like a never-ending torment.  “How,” I would ask,”can I ever move beyond that future version of my life that I so badly want?”  Ultimately, I believe, I was asking the wrong question.

I didn’t erase the me-with-a-mother thoughts I had for all those years.  I amended them.  My mom wasn’t at my wedding, but the single pink rose we placed on the church alter was there in her memory.  Plans not deleted, but revised.

How it has taken me so long to realize that I don’t have to erase the me-as-a-mother version of myself to move beyond this battle is beyond me.  Hearing our neighbors’ children play, watching them bike down the street as I write this (and future posts) – it’s alright if that always causes a little heartache, a little sadness, a little remorse.  I felt the same sadness when I saw that single rose up on our wedding altar.  It didn’t ruin my wedding, it enhanced it.  Like that rose, awareness of our infertility doesn’t have to destroy, it can also create.  Acknowledging, remembering, and embracing the role this battle has played in my life and our relationship can bring peace.  I’m not scared anymore.  I’ll survive.

Back in the desk chair

My, does this post feel mighty overwhelming and a good bit overdue.  What have I been up to, you ask?  A little travelin’, a little workin’, a little gettin’ sliced open.  You know, same old.

Did you notice my site went down?  Down for like a couple weeks?  Yea, that caused the jitters to set in big time.

Luckily, a few Abita Ambers in a jazz club on Frenchmen Street calmed those jitters right down.  Mmmm… New Orleans.  Mr. But IF and I went down there a couple years ago for a vacation/family wedding and have been itching to go back ever since.  Luckily, with my professional organization selecting NOLA as the site of its annual meeting this year our dream came true.  (And, came partly paid by my employer at that!)  NOLA is rapidly becoming one of my favorite cities in America, and I’m already anxious to get back again.  This time it won’t be for a wedding, or a conference, or any other sensible purpose – it will be to embrace this city I’ve learned to love so quickly.

I was a little worried that going back to New Orleans would stir up old wounds.  Our first pregnancy was conceived there in 2011.  The only thing it reminded me of, though, was the love I feel for my husband.  (Yes, even as we wandered the French Quarter cranky as all get out.)  It also reminded me of the need to embrace these in-between moments in our TTC journey and wring every last drop of joy out of them.  We played pool in a local bar with a ragtag bunch of local casino dealers, we snuck back to the hotel in the middle of the day for a non-procreative romp in the sheets, we swayed to the music.  I lived life so fully and so outside of the manner I’ve become accustomed to.  It was beautiful.

Our flight home last Monday came far too early, and our travel time was made far too long by a miserable delay in the 10th circle of hell that is LaGuardia.  We arrived at our door around 5pm, we welcomed our usual bunch of Grilling, Growlers & Buffy friends over for dinner and an episode at 7pm, and my saintly mother-in-law arrived around 9:30.  A few hours of shut-eye and my mother-in-law and I were off to the RE bright and early the next morning for my laparoscopy.  In the car by 6:30am, at the office by 7:30am, walked into the surgical suite near 11am.  I love how like molasses time becomes when you’re in the hands of a medical practice.

The surgery went well.  Actually, better than expected.  After our last lesson in “be careful what you believe when a doctor says it” I’m not going to put much stock in doc Soulpatch’s quick post-operative exclamation of “It all looked good!” but my anesthesia-cobbled mind was happy to hear there were fewer spots of endo regrowth than anticipated and that my questionable right tube looked “wonderful.”  I’m proceeding cautiously until I have my final post-op appointment with the doctor next Tuesday, but it sure was better news than I expected to wake up to seeing as Mr. But IF and I spent large portions of our transit time back and forth from NOLA discussing what life would be like if I woke up to hear they’d removed both my tubes.

This was my second laparoscopy in 18 months, so I was thankfully no stranger to what recovery would be like.  Actually, the most uncomfortable moment of the entire ordeal was probably hearing the words, “nothing in your vagina for two weeks” while sitting with my mother-in-law waiting to go back for the procedure.  (Having just flown off to NOLA for a week, Mr. But IF had to work the day of my surgery.  World’s Best Mother-in-Law drove 3 hours to our house to drive me an addition 1 hour to my doctor to sit for an addition 5 hours for my surgery, to drive home another hour with a drug-addled passenger, and, finally, drive a final 3 hours back home in time for work the next day.)  So, yea, recovery was what it was.  I watched far too much Netflix, ate too many popsicles, and slept for what seemed like a solid 24 hours on multiple days.  Surgery was last Tuesday, I took my first trip out of the house on Friday, was back to work on Monday, and threw another Buffy night for a party of 25+ on Monday.  Either I’m a masochist or Mr. But IF is trying to collect my life insurance – I’m not sure which.  Either way, I’m 1w1d removed from surgery today and feel fully myself again.

I’ve had a lot of thoughts running through my brain about endometriosis lately.  Why is it so poorly understood, why are the paths toward diagnosing, managing, and curing it so under-explored, why is this debilitating disease so ghettoized within the medical, research, and patient communities?  That’s another post for another day, but suffice it to say now, dear readers, I’ve got angst.  I’ve got bitterness.  I’ve got frustration.  And I’ve got them all because even 1 week after my “it wasn’t that bad” second surgery I sit here feeling so much more human than I did 1 day before said elective surgery.  Regrowth was minimal, no serious anatomical issues were discovered, and the surgical glue is practically still drying in my three incisions, but I feel so much better now than I did just over a week ago.  No pain, no constipation, and a supremely healthy sex drive.  (Timed wonderfully, of course, to fall smack dab in the middle of my “nothing in the vjayjay” period.)  Immediate relief from a surgery I was told was unnecessary, for a disease I was told I didn’t have for so long, for a case so mild I’ve been told to be thankful.  I’m not thankful, I’m pissed.

So here I am back in the desk chair and back to reality.  A reality of waiting, of taking deep breaths, of wondering what’s around the corner.  A reality so different from my NOLA dreamland.  I’m back to counting the days.  5 until our consult with the RE.  How many until we can start IVF?  How many days of stims?  How many days past retrieval?  How many days until transfer?  How many days until the beta?  How many days until I miscarry?

Less than 2 weeks ago I was swaying in d.b.a. as John Boutté sang:

Don’t waste you time being angry
when a moment’s better with a smile
if you feel you’re time’s been wasted
waste it here a while
– “At the Foot of Canal Street”

My scarred body may be back in this desk chair, but perhaps I should leave some of my mind in New Orleans?

Up, down, all around

These past few days have been strange.  You know that thing where you feel like you are watching yourself from outside of your body?  Yea, that.  Since Friday I’ve felt sort of up, down, and all around.

The Up

I think I’m actually doing a decent job managing the TWW anxiety.  I’m just trucking on with my normal life with minor modifications, herbal tea instead of coffee, a butt shot after dinner, and a compulsion to eat all the things because the PIO and HCG booster combo have turned me into a bottomless pit.  Otherwise, life as usual.

One of the (very few) positive upshots of my cycle having been delayed three months, is that I’ve known for ages now what the protocol would be and what that would mean for my mental stability.  It was decided early on I’d start post-O HCG boosters, so the moment that decision was made I was starting to prepare myself for the fact that there would be no definite D-Day, no moment to circle on my calendar in big red marker, at which we would know with absolute certainty that I am or am not pregnant.  So, yes, my first beta is on Monday, and, yes, I’m sure I’ll worry about the result, but ultimately I know it is very unlikely that that first beta will say much of anything.  Barring the unlikely scenario that my beta comes back abysmally un-pregnant despite 4 HCG boosters over the past two weeks, all Monday will give us is a starting point.  It will be at least another week of blood draws before we know whether that starting point is the start of a few days or start of 9 months.

Honestly, I thought that this new booster head game would break me.  But, it’s largely done the opposite.  I’m not really living my life to a TTC wristwatch because I don’t know when I’ll get answers.  The timeline’s been removed from my life.  And, that’s oddly liberating.  Now, don’t get me wrong, each time my purse grazes my bruised and lumpy PIO butt, each time I decline alcohol at social events, each time I do my daily Crinone suppository, I do get the reminder that these are heady days.  Sitting at 9dpo implantation should have just happened, and I could actually be somewhat pregnant right now.  But, on we go with life as usual.

The Down

Though, not entirely life as usual.  I had actually mentally sketched out most of this portion of the post this past weekend, but something Mr. But IF said made me step away and cease writing it.  Rather than delve deep, I’m just going to skim the surface.

The weekend was hard.  Sunday was hard.  Father’s Day was hard.

A few week’s ago Mr. But IF G-chatted me the following:

random, but for some reason this year the father’s day stuff is getting to me like it hasn’t in the past

I pick on Mr. But IF sometimes for appearing more detached and less emotional about our infertility than I am.  I complain that he hasn’t raised the same amount I did for the Walk of Hope, I get cranky when he forgets and offers me coffee and beer, I roll my eyes when he doesn’t remember every doctor’s appointment.  But, you’ll notice, all my triggers are tangible things.  Fundraising, food, and appointments.  There’s a simple reason for this.  If pressed to think of examples of ways in which he’s emotionally checked out from this process, I’d be hard pressed to find any.  I’ve never once had reason to doubt his mental connection to this struggle.  I’ve seen the tears, I’ve heard the anger, I’ve witnessed the pain.  But, like many men, Mr. But IF may show his sadness, but he rarely speaks it.  Put simply, the Father’s Day comment caught me off guard.

When we talked about it later, the first thing he did was apologize for saying it.  As I said my own, “I’m so sorry,” he replied, “The last thing I want to do is make you feel worse.”  But here’s the thing, hearing my spouse speak of his pain doesn’t make me feel anything but a little surprised.  Startled because it’s not normal for him to initiate such conversations, but certainly not sadder (or even happier).  My pain is my pain and it is always here, just as I’m sure his is always there, so in no way does acknowledging a personal trigger or igniting a conversation change that pain.  I’ve been at my saturation point for a while now, so while there are peaks and valleys on the emotional line graph of my life, nothing anyone can do or say will change the unit of measure or enlarge the overall plot field.  And, I hope in reading this (if not in face-to-face conversation), Mr. But If accepts that.

As I said, I had a much longer post on this lone topic prepared, but I’ve scrapped it.  I don’t really need to belabor the fact that hearing the happy voices of our neighbors celebrating three generations of fathers in a backyard BBQ on Saturday stung my soul or waking up to the sounds of prop planes swooping overhead in conjunction with the village’s Father’s Day Planes and Pancakes breakfast resulted in instant tears.  And not only do I not need to drag on about those triggers, I absolutely shouldn’t.  I shed my tears on Mother’s Day, on Christmas, at family gatherings, on anniversaries – Mr. But IF deserves his own day of sadness, his own day of grief, his own day to hide from the world.  In frustration he said, “Don’t I get a day to be sad?” and it immediately made me realize that in expressing my sadness I’ve partially boxed out his.  The loudest and most persistent voice in the room should’t always win the battle.  I’ve got to find a way to let him eek out his own space to deal.  And, I’ll start with Father’s Day.

The All Around

Throughout the goods and the bads one thing has remained constant.  We’re busy.  Blissfully busy.  Distractedly busy.

We’ve carved out our summer into a million weekly rituals:

  • Monday night “Beer and Buffy” at our house with whatever assortment of friends wants to attend.
  • Tuesday day of rest and laundry.
  • Wednesday night trivia.
  • Thursday night game night at a colleague’s house.
  • Friday night happy hour.
  • Saturday Farmer’s Market.

I never considered myself a social or outgoing person, but having these distractions has been a tremendous blessing.  Sure, I had to have Mr. But IF give me my butt shot while our friends were eating on our back patio last night, but we’ve learned to roll with the punches.  And I’m getting good at making a mean mock-tail.  Now, if only the waitress at trivia would stop loudly proclaiming each week, “Wait!  You aren’t drinking AGAIN?”

This week promises to be particularly busy as we look forward to traveling 6.5 hours to the Walk of Hope this weekend.  I’m sure I’ll post much more on this later, but suffice it to say things got a lot more complicated in the past few days.  We used to live much closer to the Walk, so attended last year.  The combination of the amazingly positive experience we had last year, with the knowledge that a trip back this summer would provide a handy chance to visit with old friends and family, lured us back again this year despite now living over 6 hours away.  So, we signed up, we raised funds, we exceeded our fundraising goal.  Rock on.

But, as I’ve discussed before, since I uprooted us and moved us several states away from our home of the past 8 years last summer, Mr. But IF has had a lot of difficulty finding work.  I moved us to the middle of nowhere with a promise from HR that spousal hiring was “totally what we do,” and have watched my husband struggle mightily with trying to find a permanent position.  He’s currently working two jobs – a full-time temp job that ends June 30 and a permanent part-time job where they can only pay him for 9 hours/week.  The combo of two jobs leaves him working this Friday until 7pm.  No work, no pay, and with a recent bathroom renovation to pay for and having only been at the 9hr/wk job for a couple weeks, he’s not willing to take the time off.  And, I get it.  I really do.

What I wish I didn’t have to get is the fact that that means we have to somehow sleep, drive 6.5 hours, and get to the Walk between 7pm Friday night and 8am Saturday.  The best plan we could come up with?  Yea, we’re leaving here at 1am on Friday and going straight from our driveway to the National Harbor.  For those of you that will be at the Walk, I apologize in advance for my tousled hair, bad breath, and overall appearance of having slept in a car.  You’ll have to forgive me, but I will have, err, been sleeping in my car.  Sadly, this is not remotely the craziest thing we have ever done in the name of IF, so it’s all good.  In fact, what an exciting adventure!

We get to relax after that, though.  Time with family and friends including a newly engaged dear friend who I can’t wait to pamper with gifts and girl talk.  Exploring our nation’s capital (always one of our favorite past times).  And, yes, walking alongside some of the most awesome people in America.  Totally worth the drive!

Before I sign off for the day I’d be remiss not to mention that a RESOLVE supporter has agreed to match all new donations up to $5,000 to this weekend’s Walk of Hope made between yesterday (June 17) and Friday (June 21).  As I’ve said countless times before, I believe strongly in the mission of this organization, so I’d love to see a new fundraising record reached on Saturday.  If you have even a dollar to spare, please consider donating.  You can either donate to the Walk directly or send me a message to ask for the link to my personal fundraising page and contribute to my team.  Thanks in advance!

No pain head game

I never let a good thing go un-fretted about.

The protocol for this cycle is new, but largely old hat at the same time.  As I told my nurse last week, most of the meds aren’t foreign to me, but the fact that we’ve planned for them from the start and will be doing them with purpose is.  Despite my planner persona, the bulk of my prior cycles have been an incredible shit-show of changing things mid-stream only after realizing things aren’t going as they should be.  This is the first time I’ve gotten my clinic to agree that things never go as they should with me and that, in fact, an excess of caution is probably the best course of action in my case.  So, instead of waiting for terrible betas to get us to start HCG boosters, we’re doing them right away.  Instead of finding out that suppositories and Crinone do absolutely nothing for me, we’re going with PIO injections from the start.  Instead of waiting weeks upon weeks for Clomid to cause me to unexpectedly O one late-blooming follicle, we’re jumping both feet in and stimming with injects.  It’s been nice to have a plan and (more or less) be sticking to it.

One thing is brand new this time.  Lovenox.  An injectable blood thinner used for many things outside of infertility land, Lovenox is often prescribed to those with repeat losses, clotting disorders, or suspected/diagnosis immune implantation issues.  With three losses, an MTHFR diagnosis, and a fistful of autoimmune diseases under my belt, I pretty much demanded Lovenox this time around.  My RE would have automatically put it on my after another miscarriage as part of his one-size-fits-all repeat loss protocol (he, like many, don’t count my earliest loss as a “real” miscarriage), but I promised I was OK with being moved to the head of the class and skipping that waiting period.  Just give me the damn syringes already!

After a barrel-full of needles from my past and current cycle (PIO, HCG, Gonal-F, and Lupron) the whole, “Wait, you want me to inject myself?” thing faded long ago.  To be honest, I never had much of it to begin with.  Prior to my birth, my mom was a lab technician and regularly drew blood.  I like to imagine her in those days.  She worked in a large city hospital with a pioneering cancer research team in the 1970s.  I see her in her hospital uniform, working a productive day, sneaking pure lab-grade alcohol to the roof to share screwdrivers with her colleagues (true story), and partying with doctors and nurses a la Studio 54.  I’m sure the reality was much more mundane, but the photos, diaries, and overheard stories she left behind have provided fodder for my overactive imagination for a long while now.  Anyway, whenever I needed blood drawn as a child I was usually pretty chill with it.  My mom held me tight, explained what was happening, handed me my blankie, and, if all else failed, cussed out the failing phlebotomist who was hurting her daughter and just drew the blasted blood herself.  She wasn’t a shy lady.  Needles have never really bothered me.  And, once I got my Hashi’s diagnosis that was a Godsend since I started to spend so much time in the phlebotomist’s chair.

However, Lovenox is supposed to be a real bitch of a shot.  So much so that it had even me worried.  “It’ll burn like hell while injecting,” a friend in the computer warned.  “You’ll get a lot of nasty welts, lumps, and bruises,” my nurse cautioned.  For years I’ve read about the hell that is Lovenox.  I was armed with the knowledge that pushing the plunger slow is best, that the needles feel dull when entering the skin, that the air bubble at the top of the syringe shouldn’t be pushed out before you begin, that icing the spot would be my favorite curative, and that my stomach will look like a horror movie before it’s all said and done.  Last night was my first date with Senor Lovenox.  How’d it go you ask?

I kinda feel like I got left on my doorstep on prom night.  All dressed up and fully prepared for a moment to remember, only to feel confused and left behind.  After all that worry, all that preparation, all that time spent telling Mr. But IF he’d be scooping me a giant bowl of ice cream when it was all said and done, it was totally underwhelming.  Yea, it stung a little as it entered, but much less than your average bee sting.  Honestly, the Lupron injection site itch was much more annoying.  And the bruises I was guaranteed?  So far absolutely nothing.  Now the appearance of my ass after last night’s PIO injection is another story, but I’ve done PIO before and I know what that’s like.  All-in-all I guess I’m one lucky girl!

Except, now I fret anew because I’m a total loon.  As soon as I mentally uttered my, “That’s it?” with needle still in flesh, I jumped straight to, “Wait, did I do it wrong?”  Yes, dear readers, even when things go peachy keen and better than anticipated I find something to worry about.  I did the same with the PIO before this and the Clomid before that.  I was convinced for the longest time that my ass was so fat (it really isn’t) that the freaking huge PIO needle wasn’t long enough to get the intramuscular purchase it requires to do its thing.  And, when the Clomid didn’t make me totally bat-shit crazy and result in 5 million mature follicles I instantly worried.  Welcome to the land of IF, where things going right results in worried sleepless nights.

Well, not exactly sleepless nights.  Between the PIO, Crinone, and tonight’s first HCG booster I’ve got enough pregnancy hormones floating through my system right now to drop an elephant for a 2 week uninterrupted siesta.  I fell asleep on the couch last night at around 8 and slept straight through to the morning.  Sleep, it appears, is not a problem.  Oh shit, am I sleeping too much?  Is this a problem?

Clawfoot tub

New tile, new trim, new walls, glorious old tub (refinished).

So, that’s about that.  I’m in the boring early days of the TWW (3DPO today), I’m shooting up, I’m sleepy, my mom is my ’70s icon, needles don’t scare me, my over-analyzing everything does scare me, and I had vanilla ice cream last night.  Oh, and I have a bathroom again.  I plan on getting in this tub and never leaving.  Ok, I’ll still go to the Walk of Hope, but can we get someone to come take my beta on the 24 from this tub?  After a month and a half without a bathroom I need to make up for lost time!

Crossing one finish line and preparing to pull the trigger

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

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

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

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

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

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

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

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

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

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

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

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

Needles and numb

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

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

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

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

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

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

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

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

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

Commence the crazy

Why hello CD1!  My lady-bits they are a shedding and it’s time to get this cycle on the road.

Of course, that “getting the show on the road” thing requires my RE.  Or, should I say, my RE’s minions.  You might have heard me say this before?  I NEVER FUCKING SEE THE RE!!!  I guess that might be for the best since Mr. But IF almost decked him the last time we saw him.  And, of course, there’s also the fact that I always have the strong urge to pee on him mid-probing just to see how his little east-meets-west, hippie, self-love and positive thinking self would respond.  OK, so maybe it’s a good thing we rarely see the man we not-so-lovingly call Dr. Soulpatch.  (And, I mean, I sometimes cannot remember his actual name.  Heaven forbid someone ever steal my phone and peruse my address book.  “Paging Dr. Soulpatch!”)

So, anyway, I called the office bright-eyed, bushy-tailed, and bleeding first thing this morning to schedule my baseline appointment (and, no, that’s not my clinic).  Baselines are usually done on CD2 or, most commonly, 3, and include routine blood work and a trans-vaginal ultrasound.  Before each treatment cycle the doctor must ensure that blood hormone levels are about where they should be and that no abnormalities exist on ultrasound (cysts, unusually thick endometrial lining, etc.).  I’ve baselined more times than I care to count in the past several years so it’s old hat.  What’s not old hat is being able to accurately predict CD1, but due to the wonders of better living through chemistry and my past two months of birth control use, I knew it was coming this time.  I mean, I planned her arrival to the minute and, as such, planned my busy Saturday in the city an hour from home where my RE is located.  Early morning probing, drop off the sewing machine at the Singer repair center, get paint for the bathroom, go antiquing for a medicine cabinet.  I’ve been looking forward to this Saturday.  My clinic doesn’t do baselines on Sunday, and I knew my period would arrive on Friday, so my baseline would have to be Saturday.  How convenient!

Of course, we’ve already seen how much my clinic cares about convenience.  These are the same folks that asked “What do you want us to do about it?” when I started miscarrying and needed a D&C on a Saturday.  Why I have any reasonable expectations left for them remains to be seen.  Ah, the joys of working with doctors who have no competition within 200 miles.

Turns out Saturday is “busy,” Sunday is “impossible,” and Monday?  Burly voice on the other line of the phone indignantly said, “You know Monday is a holiday right?”  I replied that, yes, I knew it was a holiday, but apparently my uterus didn’t so they would most certainly be seeing me either Saturday (preferably) or Monday and if they wouldn’t they’d have me to deal with.  My appointment is on Monday at 8:15am.

I felt so thrilled that I won my little battle that it wasn’t until I got off the phone and did the math that I realized that’s a CD4 baseline.  Now, seriously, it’s probably not that big of a deal, but there are miles of difference between “not that big of a deal” when you forget to get the milk at the grocery store and you are commencing an invasive, expensive, emotionally-charged, long-waited for fertility treatment cycle.  You can all feel free to talk me off the ledge – tell me it’s not that strange to do a CD4 baseline on an injects cycle – but I totally reserve the right to be well and truly pissed the fuck off.  Not the least of which because I will now spend the next 4 days considering all the many things that could happen as a result of my late-ish start of meds.  Will my PCOS-self recruit too many follies?  Will one start to take off?  Will I still be adequately suppressed?  Will my hormones be in check?  Aaargh….

So, yea, the cycle-related head games and constant question asking have begun in full force.  I made it, oh, 1 hour from start of menses to freaking the fuck out.  That’s actually pretty good  for me.

Well, that isn’t even entirely true.  The head games started immediately.  Has anyone else every noticed the tendency of nurses at RE offices to think all patients are total idiots?  Like, I think they assume that because you are infertile you aren’t able to talk and walk at the same time.  I may be barren, lady, but you’re the moron. >:-(  Each and every time I’ve called to report a day 1 (and, again, this has happened MANY times) the nurse gets all high and mighty and doubts me.  “Is it really a full flow?  You know, it only counts if it is full flow, right?”  Yea, I learned that 3 years ago, but thanks for giving me another thing to fret about.  It never fails.  Even though I’m damn well sure this is CD1 (I mean, even more so this time around since, you know, it’s been totally controlled by the artificial hormones of oral birth control), I still hear that question and think, “Oh my fucking God!  What if this isn’t CD1?  What if I’ve been wildly incorrect all this time?  What if that’s why I’m infertile???”  So, I stammer, I mutter, I try to politely explain the size, texture, color, and consistency I’m witnessing on my pad.  Then I get more flustered.  Honestly, someone need to invent a cycle tracking app that hooks in with your eIVF chart that allows the patient to snap a quick pic of a used pad, removed tampon, or wad of toilet paper and send it along.  No more calling with day 1, just text-a-tampon.  Brilliant I tell you!  Alas, I must still call.  And mutter.  And melt into a puddle of uncharacteristic uncertainty.  Joy!

And, this was just the first phone call I had to make.  The lead up to call #2 in and of itself was awash with crazy.  Do I call the RI?  Do I need the RI?  Am I willing to send more money to the RI?  Why the hell can’t the RI be less cryptic and more capable of writing in plain and decipherable English in his emails?  Ultimately, I decided it was worth the $350 to give him a call and get him back on the team for this cycle.  So I call the office, listen to the oh-so-familiar phone directory, press 1, and explain the whole confusing thing to the receptionist on the other end of the line.  As usual she doesn’t sound remotely surprised that the doctor left me with no clear instructions, as always I must explain I am on the other side of the state and no I can’t just bop in tomorrow for a baseline, and as I expected I got my usual, “I’ll talk to him about this and have him give you a call back.”  So I wait.  Luckily, waiting is one thing I’m totally used to doing.

As I wait, I remain in my total emotional tizzy that began yesterday.  In my post yesterday I questioned whether my sense of exhaustion and stabby rage was the result of impending menses.  I casually suggested that PMS was at the root of my foul mood.  What you didn’t see, however, was that in draft 1 of that post I went on a loooong tangent (have you noticed I’m good with the long tangents?) about how I absolutely hate it when women – especially those of us in the infertility community – exclusively blame hormones for their feelings.  I’ve been known to engage in a little bit of a throw down on infertility message boards when I feel like women are taking advantage of the PMS card.  Not because I want to be dismissive or make anyone feel uncomfortable expressing what they are feeling or exploring the reasons behind those feelings, but exactly because I feel expressing and examining these feelings is so very important for those of us bogged down in a protracted battle with our reproductive systems.  We are doing ourselves a disservice if we always default to, “I’m in a terrible mood and it’s because of these injections.”  Yes, the injections most certainly aren’t helping, but you know why else you are in a terrible mood?  Because life as an infertile mother-in-waiting is really fucking hard.  We all need to collectively cut ourselves some slack and be able to say, “Yes, I’m pissed off and I don’t need to justify that.  I’m just pissed off.”  But, there I went dismissing my own sentiments on the matter and blaming PMS.  Why wasn’t I remotely surprised that, after reading my latest post, Mr. But IF sent me the Slate’s XX Factor’s recent “Is PMS All in Our Heads?”  Maybe because, again, I have no idea what a “normal” cycle is like or what “normal” hormonal fluctuations can do to your psyche, but I totally buy it.  Though I’ve never been nearly as good at expressing it as this article, I can accept PMS as a, “‘culture-bound syndrome,’ a disease of societal expectations, not biological influences.”  And, I think that concept is actually pretty empowering if you get right down to it.  Why are we blaming our bodies for our moods?  And, even more so, why are we tacitly accepting via that logic that we only get to be moody at certain times of the month?  When Mr. But IF has a bad day at work, or a difficult conversation with his mother, or notices our next-door neighbor is pregnant he’s allowed to be emotionally impacted, why do I have to wait until I have a bloody hoo to do the same?  I reserve the right to be in a foul mood whenever I damn well please because you know what?  Rarely are my hormones the only thing to blame.  As screwed up as my body is, as certain as I am that my PCOS created some crazy, and as negatively influenced as I was in the brain by my years of overt hypothyroidism, the number one precursor to my crappy moods are the words, thoughts, and actions of ignorant people.

And, finally, speaking of ignorant people, have you seen this Slate gem?  In a rebuttal to Amy Klein’s recent “I Should Have Frozen My Eggs,” Miriam Zoll writes:

When I first signed up for IVF treatments in my forties, I never thought the science would fail, and it never, ever occurred to me that the ‘reputable’ donor egg agency our clinic referred us to would promote egg donors who were infertile.

Yea, read that one again.  Wait, what?  I think I’m circling back around to stabby rage.  So you signed up to go through the emotionally, physically, and financially taxing process that is IVF and never once thought to ask about your chances of success?  It infuriates me enough when Mr. Average Joe doesn’t comprehend that IVF is far, far from a guarantee even under the best of circumstances, but you – a patient undergoing IVF – “never thought the science would fail”?  To quote SNL, “Really?”  And this, ladies and gentlemen, is why, as difficult as it sometimes may be and as nasty as the politics sometimes get and as depressing as the outcomes may sometimes be, I’m so very glad that I work in academia.  Even more so, I’m glad that (at least in the sunshine and rainbows idealistic sense) I work at a small liberal arts college where great emphasis is placed on encouraging critical thinking, question asking, and information literacy.  I just can’t accept that it’s alright to walk through life acting without first questioning.  I can’t accept that you’d do IVF without first learning the very real odds of failure.  On the flip side, maybe I am starting to understand why all nurses treat me like an idiot if this is their typical patient base?

And, to that second point.  Did anyone else feel like a leper when they read that next little line.  How dare she be forced to work with “egg donors who were infertile.”  I mean, seriously guys, she might have “caught” infertility by coming in contact with those eggs!  In my experience, individuals like this author are often the ones on infertility message boards that start every post with “I’m not infertile, I’m just of advanced maternal age.”  Guess what sweet cheeks?  You are one of us now, whether you like it or not.  (And, believe me, I know I don’t like it.)

Aside from the way that statement rang in my head, the way I envisioned that word “infertile” hanging scornfully from the author’s lips, there’s also the fact that, once again, where is the critical reasoning?  Where were your questions in this process?  First, if it mattered so much to you that you weren’t getting icky infertile eggs, why didn’t you learn more about these eggs?  Why didn’t you demand more information about your donor?  About how the eggs were created?  Second, why would you assume donor eggs from infertile women automatically pose a problem?  Perhaps it’s because you appear to know so little about the process of assisted reproduction in the first place, but did you ever think about the fact that certain causes of infertility may actually enhance a potential donors’ egg-making potential?  For example, most of the estimated 5 million women in the United States with PCOS would be rockstar egg donors if only for the fact that we so often over-respond on even extremely small doses of stimulation medications.  My old RE called it “a basket full of eggs for the price of one.”  Don’t get me wrong, you have every right to decide what conditions you are willing to accept in the woman that will comprise half the genetic makeup of your offspring, but please understand that infertility comes in many shapes and sizes and does not always a bad donor make.  Similarly, you have every right to be outraged if your agency promised you these eggs were from women with no history of infertility.  But to dismiss these eggs as defective in the same breath you admit your total ignorance of the nitty gritty of infertility treatments leaves you standing in a very hard light.

And lest I be seen as the judgmental infertile casting stones at glass petri dishes, you all have every right to disagree with me.  In return, I get to remind you I’m bleeding, I’m waiting, I’m stabby, I’m crazy.  And that’s alright… just don’t blame the hormones.

Stabby

Seriously, someone bring me someone something to stab.  It’s been a long week.

Now, of course, I’m trying to be kind to myself and remind myself that this foul as fuck mood may be, just maybe, the result of my hormones doing what they’re supposed to do for once.  I mean, CD1 should be right around the corner (tonight or tomorrow I ‘spect), and “normal” women do get a little, uh, affected prior to their monthly blood bath, no?  And, yes, I honestly need to ask.  I’ve spent most of the past 19 years either on birth control or having my period once every 6 months.  I have NO IDEA what “normal” is in terms of this hormonal woman stuff.

But, yea, I’m cranky.  Work sucks, infertility sucks, my mood sucks, the world sucks.  And, here are some reasons why…

I work at a college.  The semester has ended, graduation has happened, the kiddies are gone.  Friends, family, and even colleagues outside my department are congratulating me for job well done, asking about my vacation plans, and inviting me to endless barbecues, film screenings, birthday bashes, game nights.  But, you know what?  My job just got a whole lot harder.  You know what I do when the students aren’t around?  All that other stuff that is a HUGE part of my job that I can’t do when the students are around.  As the days get longer and the sun outside my window taunts, my workload just tripled.  It doesn’t help that this isn’t the case for many of those around me.  I’m starting to feel like the Rodney Dangerfield of my University and of my department.  No one understands what I do and, as a result, I get no respect.  As I sat through 3.5 straight hours of pointless meetings this morning I almost reached my limit.  Good thing I have a work dinner to look forward to, right?  And 12 straight days of work obligations starting next Monday, eh?

And this work stuff is really eating into my sanity-saving dives into this blog and Twitter.  That’s been made all the worse because infertility’s been getting me down majorly recently.  I’m tired of seeing good people get put through the ringer, and I’m tired of feeling broken.  I’m also tired of doctors, and appointments, and cryptic emails, and perky nurses, and clueless insurance call center employees, and all the rest.  I emailed both my reproductive immunologist and my reproductive endocrinologist to inform them of the rheumatologists’ “findings” and to confirm we’d start to cycle again as soon as I get my period.  The RI responded:

Ok so again this ANA may be a result of a loss not a cause , but now may be playing a role since no other autoimmune issue has come up.  Ok call me with your next menses. What did we discuss we were going to do with you.

Ok, fine, I’m a grammar Nazi, but I seriously don’t know how I feel about getting probed by someone that ends a question with a period.  And, all that aside, let’s take a look at that question.  What did we discuss we were going to do with you.  Wait, what?  Isn’t that what I’m paying you (a lot) for?  Don’t you have my chart?  Or, wait, even better yet.  Why don’t you look through this very email thread.  I’ve intentionally continued to reply to this single chain of emails to keep all my correspondence with you in one place.  I’ve included it all for you right in your inbox.  I’m feeling a little stabby.

The RE’s NP (because, seriously, I can count on one fist how many times I’ve spoken to the RE himself) was not even that verbose.  She replied:

Yes you can call with your period to schedule a baseline blood work and US to start the cycle.

Uh, ok.  Thanks for the permission.  May I have the hall pass to go to the ladies’ room now?

You know what’s going to be fun?  Having a period and starting injections without a bathroom.  It’s been 17 days since my last shower and I’m totally not handling it well.  Don’t get me wrong, coming home yesterday to, you know, a room with walls was pretty nifty (seeing as we had no walls before), but my patience, like my checkbook, is wearing thin.  And, the whole remodel thing is starting to eat away at my brain, I think.  You know why?  Same answer that’s at the root of so much else in my life – fucking infertility.  I only just realized this when replying to Mel’s appropriately timed Shower or Bath post.  Because I’m cranky and lazy I’m reposting my response to her shower or bath question here:

Currently? Please, I’d take either one!!!

We’re 2 weeks in to the total gutting and remodel of our only full bath (thankfully we’ve got the necessities – toilet and sink – in our downstairs bath). Save a few trips to friends’ houses and the gym, I’m totally sans-shower and bath. I’m not being nearly as zen about it as I’d hoped I’d be.

When the room finally has walls, floor, and plumbing again? We’ll have both a tub and a shower, but I suspect I’ll almost always use the shower.

The tub has remained for 2 reasons – one publicly discussed and the other silently fretted about. First, we live in an 1870s Victorian that has a turn-of-the-century clawfoot tub. Who in their right mind would toss a freaking clawfoot tub? Add in my degrees in history and history-related fields and the decision was kind of an obvious one. I may never use the thing, but the tub stays.

Second, though, was further evidence that, after 3.5 years of infertility, that diagnosis permeates every single aspect of your life. “Do you intend to have children?” the contractor politely asked as we noted our desire for a stand-alone shower. “If you intend to have kids, I’d encourage you to get a combo shower/tub for those early years,” he helpfully added. So, just as vacations have been cancelled for theoretical treatments, job moves have been delayed due to the potential pregnancies of the future, we have a tub. My only hope is that tub doesn’t become a daily cast iron reminder of what we don’t have…

And I’m serious about that last bit.  I’m gonna have a freaking 350-pound cast iron reminder of my childlessness staring me in the face each and every day.  No, that’s not terrifying at all. On the flip side, I have considered how convenient it will be to have a tub to miscarry in.  Next time I am NOT missing the chance to collect the “products of conception” and have them thoroughly tested.  Yay?

Oh, and our neighbors with the nicely remodeled house and adorable toddler?  Yea, wife’s definitely pregnant.  We chatted on the porch for a while last night and, God bless him, the first thing Mr. But IF said once they were out of earshot was, “Yea, bitch is definitely knocked up.”  So, a) Mr. But IF’s a terrible judgmental spiteful person, b) it feels so good to have company, and c) I can’t wait to see that baby bump grow from the comfort of the porch swing cushion I spent all of last weekend (and the final moment’s of my dead mother’s now-dead sewing machine) making.

But, it could be worse, I could be stuck at home instead of spending hour upon hour at my currently infuriating and overwhelming job.  I could, in fact, be Mr. But IF.  I could be forced to watch as my term-limited job I do very well at comes to an end on June 30; I could be forced to listen as my big boss tells me I’m amazing but that I don’t have the pedigree they are looking for so I won’t be considered for the vacant permanent position; I could have to console my heartbroken and pissed off immediate supervisor who is about one step away from putting strychnine in the guacamole after big boss’ decision to pass me up for an unproven, unknown external candidate; I could have an overwhelmed and stressed out wife who moved me to the middle of nowhere with no job prospects and who’s so emotionally shut down that she won’t let me vent about the unfairness of life; I could be stuck watching a belly grow from the isolation of my home/prison where I’ll spend every waking hour applying for jobs I’ve come to (erroneously) believe I’ll never get.  So, yea, it could be worse.  I could be Mr. But IF.

But, no, I’m just hormonal, overworked, under-appreciated, barren, tub-fearing, soon bleeding me.  Someone find me something to stab.

* P.S. – Many thanks to my infertile friends-in-the-computer who taught me the multitudes of uses for the word “stabby.”  Clearly a valuable add to my vocabulary.

To-do lists

I’m a planner.  I make my to-do lists, I check things off, I feel great accomplishment.  (We’ll ignore those times that go more like, “Make my to-do list, look at to-do list, start hyperventilating about to-do list, build blanket nest on the couch and watch hours upon hours of trashy television while eating straight from the carton/bag/box/packaging and forget about to-do list, and feel totally fucking overwhelmed.”)

Infertility totally fucked my to-do list.  That whole “have two perfect children by thirty” line on the master to-do list of life?  Yea, thanks for that.  If you want to make God laugh, tell him your plans and all that…  I love when my life is the punchline.

But, while my big picture to-do list remains irrevocably undone, my day-to-day to-do lists can be kind of funny.  Like today’s –

1. Vacuum car so job candidate you drive around tomorrow doesn’t think you are a total cat-lady stereotype.
2. Get gas for said car so, again, candidate you drive around tomorrow doesn’t think  you are both a slovenly cat-lady and a totally non-functioning adult.
3a. Email reproductive immunologist, rheumatologist, GP, and reproductive endocrinologist about upcoming cycle.
3b. Wonder why you bothered because no one listens to you, acknowledges you, remembers you, or cares at all about you or your cycle anyway.
4. Answer that work email that you’ve been putting off since February for awhile.
5. Write check to contractor who you haven’t seen in a week.  Stare into empty shell that was once your bathroom and try to remember what it felt like to shower.
6. Try to convince Mr. But IF (again) that the thought of visiting his parents this weekend is totally overwhelming.  I mean, you love them and all, but the potential of a three-day weekend at home is so very, very enticing.
7a. Find nearest Singer repair store to replace the sewing machine you broke… again.
7b. Find somewhere to store those cushions that you will now never finish due to said sewing machine.
8. Take a picture to commemorate that last birth control pill going down the hatch tonight.

Am I wrong, or is number 8 pretty damn exciting?  I’m promising here and now I’ll upload a photo of that last active pill later tonight to mark this Kodak moment.  For the third and (hopefully) last time in this journey toward parenthood I’m ditching the birth control.  Exciting!

Also, a little terrifying.  I’m gonna try and stick with exciting.

I don’t know my full schedule yet, but I’ll roll with the to-do list theme of this post and provide a brief overview of my upcoming protocol.

Tonight: Last active birth control pill.

Late Thursday/early Friday: Period start.  Call RE to set up baseline.

Friday/Saturday: Baseline blood work and ultrasound.  Start stimulation meds (Gonal-F), Lupron, baby aspirin, Lovenox, and (if RE stops being a jackass) Prednisone.  Continue existing meds (Synthroid, Metformin, bio-available folic acid, vitamin B6, vitamin B12, prenatal vitamin, vitamin D).  Three injections and 10 pills a day.  Woot!

7-10 days later: Based on results of blood work and ultrasound monitoring (every other day, hour drive each way) trigger with 10,000 units HCG.

After ovulation: Continue all meds but Gonal, add HCG booster (2,500 units) every three days, Crinone 8% every day, and progesterone in oil every day.  So, still about three injections, 10 pills a day.  Woot.

14 days later: Freak the fuck out because I have no idea whether the pregnancy test is positive because I’m knocked up or because of the HCG boosters.

A few days after that: Final verdict.

I honestly have never been more excited to be a human pin cushion than I am right now.  Here I am Aunt Flo, come and find me you wicked bitch!