Thursday, November 29, 2007

A Funny Thing Happened on the Way to My HSG

As you may have guessed from the title, I went in for my HSG today. Dr. Uterus always does these at the hospital to which his office is attached because his office doesn't have the facilities to do x-rays. The hospital, which is religious, requires you to check in even if you are having a simple procedure, like an HSG. This is why I had to show up a half an hour before my procedure (not that that in any way guaranteed that it started on time).

The last time I had my HSG here, you still had to check in, but you checked in at the older part of the hospital. It reminded me a lot of when you would go to the bank to open a new checking account. You put your name on the list and waited (and waited and waited) for your name to be called. Once it was called, you went up to a large counter that was partitioned off into small cubicles. You met the person who called your name and they discussed the intimate details of your insurance, the procedure you were having and other sordid details such as your religious affiliation (just in case you croak in the middle of your HSG and the have to perform the final rites?). In addition to the decor being seriously outdated, the cubicles were separated from each other by a flimsy little cardboard partition which let the person in the next one know your business and you know theirs. In the age of HIPAA, it's not surprising that this has gone the way of the dinosaurs.

Probably recognizing that there was a much better way of doing this, the hospital now has you check in at the snazzy new reception desk, which is tastefully appointed in granite countertops and terrazzo tile. It also happens to be right across the way from the lactation center. Thanks for that Insensitive Hospital Administrators (not to mention the maternity tour schedule right there where you check in. Double argh!). Anywho, the greatest improvement is that they now have little individual offices where you check-in. You still put your name down on the little sheet and wait for them call your name. In the category of bad planning, the reception area opens up into a huge atrium that is covered in stone and of course echoes everywhere. So, when my name was called - and thoroughly butchered - everyone got to hear it.

The person doing the calling was a perky woman in her mid-30s. She directed me to walk down a hall and meet her at the third door. I went in and she came in through another door (it reminded me a lot of the booths you see in the red light district in Amsterdam where the glass door in front showed the 'goods' and the door in the back allowed the 'goods' to leave). She took my ID and insurance card while verifying that certain information is still valid.

Then she asks the $10,000 question: what is my religious affiliation? I'm sure it stated no preference or something to that effect, which is probably what I had said in the past when there was just that little cardboard between you and someone else. But, the privacy and security of that little room made throw caution to the wind and rather than tow the party line of "no preference", I confessed the truth: "I'm an atheist", I said. At the mention of that one little word, she snapped her head up, then tilted it to the side while she asked in a very serious tone of voice with a hint of derision and accusation, "Why?" It was as if I told her I was going to move to the third world and give up all of my worldly possessions to live as one with the land.

Why indeed, my dear. Why do you believe in a deity that allows so many couples to be childless while ignorant 16-year olds give birth everyday? Why do believe in a God that allows child and animal abuse and that people kill in the name of? Why not instead put my faith in myself and hold myself accountable for my faults rather than chalk it all up to the divine? Unfortunately, she didn't seem to be able to appreciate this depth of reasoning, so I just said, "I've always been that way."

Who knows, maybe I was the first person who ever confessed to actually be an atheist. Maybe she was wowed by my manners and the fact that I wasn't carrying around a hatchet, hell bent on destruction. Maybe she was just puzzled that I chose to go to a religious hospital. I do know that it amused me greatly and made me smile as I walked the long hallway to radiology for my date with Dr. Uterus and some dye.

Tuesday, November 27, 2007

The Difference Between Wanting and Needing

There are actually very few things that I need to survive. I need food, I need shelter, and I need clothing. Arguably, I also need to work to make the money that provides the first three items on the list. There are other things that I want very much, but don't actually need. I love my husband more than life itself, but I can live without him. I love my kitties with all of my heart, but again, I can live without them.

The same holds true for children. I want to have a child with every ounce of my will, but I know that I don't need to have a child to survive. I can live without a child. I can even be happy without a child. I can have a fulfilling life without a child. I just don't want to. I want to know what it is like to feel my child kicking inside of me, I want to know what it's like to give birth, I want to know what it is like to have a little person sitting on your lap who you created with all of the love in your heart. I want all of these things, but I do not need these things.

Recognizing this, celebrating this, I can view my struggle with infertility as one part of my life, not the only part. When you distill infertility down to its essence, this is the question you are left to answer and the answer will determine how you view the path forward. As long as I have a bed, food and clothes, everything else is as they say, just lagniappe.

Monday, November 26, 2007

Infertility Overload

I remember when the internet was still relatively new and I had only recently been introduced to it. This was in the late 1990s back in college when not everyone had a cell phone (and actually some of the old brick cell phones were still in use), there were no blogs, MySpace hadn't been invented, and it was iffy to buy things off the internet. To say that the internet was still relatively underutilized (compared to now) would be an understatement.

I didn't spend much time on the internet then - just email through my university's system. There just wasn't a whole lot out there and I wasn't particularly interested in exploring the dark corners (of which there were many). By my senior year, though, I started to get more adventurous and go places on the information superhighway. But I was immediately turned off by how impersonal and how removed you were from reality when you were online.

As the years have gone by and the technology has advanced, this feeling has all but gone away. The internet is what allows me to do my job, keep in touch with friends and do most of my shopping. It has also allowed me to connect with other people who are dealing with infertility in ways far more intimate than randomly meeting people and asking for their IF stories. When I first learned that I had infertility, I searched out other women on the internet who had infertility. Unfortunately, the first blog I encountered was the most depressing thing I had ever seen. I was such a novice at that point - we had just found out that I had blocked tubes. I now recognize that reading a blog by a hardened self-styled bitchy infertile probably wasn't the best idea at that point. So, I actually banned myself from looking at infertility blogs and bulletin boards because it was just so depressing.

After my miscarriage, though, after I had that awful experience, my desire to find other women who had experienced loss intesified. When I had my minor melt down before my expected due date, I found comfort and solace online, particularly because I found several women who had miscarriages right around the same time that I had. I was hooked again on blogs and bulletin boards.

The down side, though, is that you become engrossed in everyone else's heartache. I spent 45 minutes the other day reading a blog by a woman who lost her baby at 24 weeks. It was the most heartbreaking thing I had ever read on infertility and miscarriage (and that is saying a lot), but I just felt so bad after reading it. I felt like I was having my miscarriage all over again and the grief just wasn't going away. I hope that she finds peace but I can't bear to follow her blog because her pain is so palpable.

I also lurk on at least one infertility bullentin board and it is also exhausting sometimes seeing all of the pain that is laid bare. But again, where else would it go? It is so cathartic to send your thoughts and feelings out into the internet void, but the confessional nature belies the truth that there are people reading and following and becoming terribly invested in someone else's life whom they have never met. I will still blog for me, but I think it's time to take a breather from reading other people's pain.

Sunday, November 25, 2007

Getting Back on the Train

Big Red arrived right on time yesterday so I will go in for a baseline ultrasound tomorrow. I'm having the same ambivalent feelings that I always do at the beginning of a new cycle. I want to be invested in it so that it will work, but I don't want to be so invested that I get all caught up and totally bummed if it doesn't. I want to be positive so that I can have a good response to the stims, but not get overly so that I am again bummed in the even it doesn't work. I know that the best thing is to just take it one day at a time. But as with most things, that is easier said than done. Onward and upward.

Friday, November 23, 2007

Waiting and Waiting No More

So, I'm actually waiting to get my period (rather than waiting not to get my period). Since I was benched this month due to a cyst and Dr. Uterus pretty much dashed any hope that I would get pregnant this month, I'm just chilling, drinking my beer and waiting for Big Red to make an appearance. So far, just a couple of false alarms, but that also means that day 3 when I can go in for a baseline ultrasound will actually come around when Dr. Uterus' office is open.

I have decided to stop waiting, however, to begin stitching a Christmas stocking for a future baby. I had bought a kit to make one last year and was going to start it later on in my pregnancy earlier this year. After I lost the baby in April, I couldn't stand the thought of starting it. But, now, I realize that I am tired of putting things on hold for when I might get pregnant or when we might have a baby. And, I know, to paraphrase those sage ladies of A Few Good Eggs, that if you want it, you will have a family, although it may not be in the manner in which you had originally intended. I firmly believe this and still take great comfort in it.

Remembering this, I know that I can start the project and not feel as if I'm putting the cart before the horse. I had never bought 'baby' things because it seemed like I would just be asking for more difficulty. But, I'm tired of being superstitious about this and want to just do what I want to do. And, right now I want to get started on this thing because it's going to take me forever anyway. I see now that the most important thing is giving myself permission to just start it. I just have to find where I put the damn kit.

Thursday, November 22, 2007

Giving Thanks

During my time as someone with infertility, I have done much lurking about the blogosphere and infertility bulletin boards/chat rooms. And, with a few exceptions, I have come to recognize that on the infertility specrum, our case is relatively mild. I liken it to have thyroid cancer. It sucks because you have cancer, but it could be a lot worse because it is the least aggressive and most treatable of cancers. We have infertility, which sucks, but it is very treatable (although not on the timetable that I'd like). So, I am thankful that our glass is more than half full and that we will very likely realize our dream of becoming parents, although not on the schedule that I had planned. And that's ok.

I am also thankful that I was able to have wine at Thanksgiving dinner. It made it go down a lot easier.

Wednesday, November 21, 2007

Out of Insanity, Light

I knew I was heading down a dangerous road on Monday. I was so full of anger which I acknowledged was mostly irrational, but I knew was a manifestation of some deep seated problem. My trip to the grocery store to stock up (for the second time) on items for T-Giving dinner gave me the unlikely opportunity to really ponder and question where all of this hostility was coming from and what to do about it. Dodging ill-dressed women manhandling produce is apparently great for self-therapy.

First, I admitted that I was feeling betrayed by my friend who got pregnant au natural. I don't mean betrayed in that she's another on the other side of the list. But of all of my friends, I thought that she was actually going to have problems and I was secretly happy because I would finally have someone who would know exactly what I was going through. She definitely looked like she was heading down that road. And then, poof! Pregnant with no problems, no drama.

But, in admitting this feeling, I also felt like I was flirting with that line between infertility schadenfreude and actively wishing ill on someone, particularly someone I love. I didn't cross the line, though, which relieves me greatly since I think I would then feel like a truly Bitter Infertile Woman. Once I admitted this fact to myself and accepted that it was how I felt (regardless of its merit), I was able to move on and be genuinely happy for her. Although, I'm very glad that she is in another state so that I won't have to be subjected to the expanding belly dance. A girl can only take so much.

I had also felt angry because I felt like my parents weren't really being supportive of our recent decision to move onto IVF if the next IUI is a bust. I talked about it with Sweetie who not so subtly implied that I was being overly sensitive. Maybe, maybe not. I couldn't stand thinking that my dad's questions about why we couldn't just get pregnant naturally (been there, didn't do that) were questioning whether we were really infertile and why there was such a hurry. Whether or not we can still be said to meet the clinical definition of infertile, at this point, we are ready to get out of the infertility holding pattern and move ahead. And we probably can't do that without intervention.

I decided that the best way to resolve this was to subtly remind him of why we are doing this. I told him how excited we are to move on because we had felt like we were in a huge rut for the past four months where we were just spinning our wheels. In other words, we may no longer be clinically infertile, but we are still treading water. I think he understood and told me that they are behind us and really hoping that we get our wish. Of course, this was after telling me that once I have a kid or kids, I will look back on this and question what I was thinking. Not helpful.

Once I battled through these two problems, I felt like me again. And for now, that's enough.

Monday, November 19, 2007

The 5 Stages of Infertility

If infertility is akin to getting a fatal disease diagnosis, then it stands to reason that we go through the same stages of grief: denial, anger, bargaining, depression and acceptance. I first learned about them after my miscarriage and flitted back and forth through them, constantly and then with less frequency. I had thought that I had pretty much made it through. But, I am coming to know now that even six months after my miscarriage and two more unsuccessful IUIs, I am not finished with them.

Currently, I'm experiencing anger - it even seems as if I am feeling real anger for the first time, I think in part because before, I had no specific person or thing to be angry at. I don't believe in God, so I can't be angry at Him. I was never angry at Dr. Uterus - it's not his fault that we had a miscarriage. I'm not angry at Sweetie. I know that what happened to our baby was no one's fault.

But still, I'm angry. I'm angry because my best friend is pregnant, I'm angry that she feels as if I am damaged goods and couldn't handle the news for a while, I'm angry that I probably am damaged goods and couldn't have handled the news for a while, I'm angry that none of our friends really knows or understands what I'm going through, I'm angry that I don't feel like my parents understand how difficult this is for me, I'm angry that I can't find some way to feel better about all of this, I'm angry that got dealt such a shitty hand on this. I'm just angry.

I know this is irrational anger, but I also know it's what I'm feeling and dismissing it as completely irrational won't solve anything. How do I go stop being angry? My rational half knows that it is about letting go and accepting (as we are told to do) that this is the way it is. And to do that, I know that there's not much I can change about others - I can only change myself. I can find people who know what its like to go through this, I can recognize that my parents may not be able to give me the support I need and that's ok, and I can recognize that my best friend tried for a year and a half to get pregnant and wants this very much.

It all still hurts, though. Does it ever stop or does it just ache less?

Dr. Uterus, Sweetie and I Walk into a Bar...

So Sweetie and I met with Dr. Uterus today and shared our concerns about all of the roiding of the ovaries, our frustrations with not moving forward and whether we should consider IVF. As usual, Dr. Uterus was extremely helpful in answering our questions and letting us know our options.

First, we decided to have another HSG because Sweetie was concerned that it was possible that my tubes had been blocked again since that was our original main problem. At the time, they were blocked by debris, not by scarring, so the thought is if it could happen once, could it happen again? Dr. Uterus put the chances of a bilateral occlusion (both tubes blocked) at 10%. The worst that can happen is I have an uncomfortable HSG (which I've already had) and we get more information. We decided that if the tubes are blocked, we would move straight to IVF rather than continue with IUI (what would be the point?). If only one is blocked then we'll continue to IUI but just try to make sure that the ovary corresponding to the open tube is producing enough eggs to make it worthwhile.

Second, we'll do another IUI next month, assuming my ovaries have calmed down. If the IUI doesn't work, then we'll move on to IVF. For the longest time, the idea of moving on to IVF was very difficult for me in part because it seemed to imply further failure (and we all know how I feel about failure). But, now, talking with him about it it seems doable. He said we were very good candidates for it and that we could have a good 55% success rate per cycle. It's hard not to glob onto numbers and feel as if they are really indicative of your chances, but it is so encouraging to know that it is a good option for us. He also agreed that our plan to do one more IUI was a good one and then do IVF in the new year.

It was the first visit in a long time that I actually felt better after going to his office.

Friday, November 16, 2007

The Flash

I had one of those moments today when a conversation caught me off guard and reminded me of how much I still hurt from the miscarriage. I was talking to one of our contractors who mentioned that he had not been in the office this morning because his wife took him with her to the doctor's office. She's pregnant, in her first trimester, and had started spotting. They went in for an ultrasound and saw the flash on the screen showing the baby's heartbeat. At that mention, my heart began to ache because I remembered when Sweetie and I had that amazing experience watching our own little one's heartbeat flashing on the screen. I had never experienced something so wonderful as that day, especially since we also heard the heartbeat for the first time. It is now particularly painful to hear someone else talking about having that moment because the baby whose heartbeat I heard so vividly (and can still hear) is not here and never will be. I still miss my baby.

Thursday, November 15, 2007

The Sympathetic Response

One of the easiest ways to get me to become weepy about my infertility very quickly is to tell me in that *right* tone of empathy how sorry you are about what we're going through, or how hard it must be for me when friends get pregnant. The sudden swell of grief that causes me to tear up is more of a response to the person who is showing how much they care about me to be saying these things as opposed to grief about the particular event. It's kind of like wearing your favorite sweater even though you know it generates static electricity that will shock you. You love to wear the sweater, so you deal with the shock when it comes which will never be when you expect it.

Wednesday, November 14, 2007

Yet Another Plan

Unwittingly or not, approximately every six months, Sweetie and I have reevaluated our plan for getting pregnant. The first iteration was determining if IUI was the right choice, the second was whether to take a break after the miscarriage and try on our own. Now, we think it is a good idea to meet with Dr. Uterus to see about whether we need to revise the treatment plan to avoid the bi-monthly roiding of the ovaries that essentially cuts our months to try in half. Who knows what he'll say, but it feels better to reevaluate and make him aware of our concerns.

Sunday, November 11, 2007

The Next Step or Overkill?

In my thrashing to Sweetie about our status as almost the Only Couple Without Children or Are Even Pregnant (it was said very dramatically), he offered that we could speed up our plan on when (and if) to try IVF. So far, IUI with stims has been our method of choice and worked for us. We have tenatively discussed doing IVF if we don't have a pregnancy in the next six months.

I know that the success rate for IVF is much higher, but I don't kid myself about the emotional, financial and physical toll that it can take. My initial thought is "why make it even more of a math problem than it already is?" We know that IUI works and we know that IVF is a huge undertaking. At the same time, I can't shake the feeling that we have been treading water these past two years waiting to embark on that next quest that we have identified for ourselves.

I'm really torn. Part of me is enticed by the success rate and that we could get this over with so quickly and not have to see Dr. Uterus for some time. The other part of me is justifiably concerned about how hard it will be to deal with if an IVF cycle fails (which is very possible). Not only will we have invested so much in it, there will be little embryos who could have become children that will not have made it. I don't know.

I do know that at least for now, I'm still content to ride the IUI train as far as it takes me. My impatience is not nearly to the level of moving on to IVF immediately, despite my thrashing. The reality is that IVF will not help my thrashing. Realizing that my thrashing is more about my need to keep up with the Joneses and less about my realistic desire to get pregnant will help my thrashing.

My Failure Complex

I am the consummate overachiever. I was in all of the Gifted and Talented classes in school, I did the AP thing (although not the sciences - I'm not crazy), and I used my SATs to get into a very good school. I did very well in grad school and am doing well in my professional life. I even aced my driver's test when I was 16. In all of my 31 years, the only thing I have failed was a test in a stupid biology class. It was a horrible feeling.

Since then, I haven't failed at anything I have tried. Except this. And I have failed spectacularly. What is so galling is what a public failure it is. Your waistline never changes, your boobs never get bigger, you don't have The Glow. People who see you week after week know that you aren't succeeding. You begin to regret telling so many people when you started because you know that you will get The Question eventually and you will have to state the obvious (since you aren't huge and you don't have a baby in tow) and wait for them to ask the Other Question (so, what's the problem?). You begin to withdraw from those who you knew, particularly your friends who have managed to succeed in this particular endeavour.

I, like many of my peers, was always told that if you put your mind to it, you can do anything (or something to that effect). That's not really accurate because it assumes that you have control over what you put your mind to. How many writers have put their mind to writing the next Great American Novel but it never makes it to an agent? How many kids go to Hollywood every year trying to break into acting and end up doing porn? How many women think that it will be easy as pie to get pregnant and then wind up amongst the ranks of the infertile?

Failure has never really been an option for me because that would imply that I wasn't working hard enough, studying hard enough or putting enough of myself toward reaching a particular goal. I am doing everything within my power to get pregnant and have a baby and I am still failing. My inner shrink is saying that by focusing on just this one aspect, I am setting myself up for failure. I am succeeding in other areas of life - I have a wonderful marriage, two beautiful and healthy furry beasts, friends, a good job, a home, a nice car, etc.

I also know that getting pregnant is actually the easiest part of the journey. Having the child, raising the child, loving the child and parenting the child until you die are really the hard parts and where the stakes of failure are not just personal but arguably involve society as a whole. The failure of a parent to effectively raise their child results in terrible things everyday. The moral of the story, then, is that the consequence of getting pregnant and having a child raises the spectre of failure much more often and profoundly than the (probably temporary) failure to get pregnant at all. And, maybe it isn't such a horrible thing to fail once in a while.

The Odd Couple

When we started our journey to have children, we were the first couple in our group to do so. Some had just gotten married the previous fall, others were focusing on being married for a while. Fast forward two and a half years, and with the exception of one other couple, we are now the only ones without children or who aren't pregnant. For someone who has consistently measured the pace of her life against others (a major flaw, I know), this has been particularly hard. I can't help but feel left behind. They are embarking on a journey that so far I cannot imagine (well, past 10 weeks at least) and they are making plans that Sweetie and I can only talk about in the abstract.

I know deep down that this is not a race and the person to cross the finish line first doesn't necessarily win. But, I find it deeply unfair that we have been trying for so long and some of our friends already have toddlers. It is even more unfair that we lost the first baby we were ever able to make and no one else we know has had to go through this. If I believed in God, I would be very tempted right now to be asking how this could happen. Given that I don't believe in God, I know that there are just some unfair things in the world. I have lead a very charmed life up until now and this is apparently my particular Rough Spot. Still, as a control freak, I wish I had some choice over which portion of my life would get the Rough Spot treatment.

I am also forced to confront another bad habit of mine. Whenever friends tell us that they are pregnant, I say the right things and ooh and aah over the pictures. But, deep down, I cut them out of my life. I can't bear to have my failure thrown back in my face everyday (at least that's what it feels like). My best friend is now pregnant (and even waited to tell me because she knew what a basket case I've been) and I know that I can't cut her out of my life. I will have to deal with this. My answer is to let her know that I am genuinuely happy, but there are just some things that I won't be able to share with her. I can't look at ultrasound pictures and I don't think I can hear about a heartbeat. It is still too painful because it brings back memories of the day that I found out our little one had died. But, I can be happy for her and let her know that I'm happy and I can hope that she won't change so much when she has the baby that I won't be able to completely relate.

I know this is selfish, but in infertility, the name of the game is self-preservation.

Thursday, November 8, 2007

The Shift

Last Tuesday found me in my therapist's office crying uncontrollably and unable to pinpoint the exact nature of what was bothering me. There were all kinds of extraneous factors, but there was no one thing. Usually when I get to the point of crying at the drop of a hat it's either hormones or there is something really bothering me that is not readily apparent. I wasn't particularly hormonal since the day before I found out we were benched due to the latest cyst and thus, not shooting up with Menopur.

That left the Unknown Thing That Was Bothering Me. What is amazing is even right after my miscarriage, I wasn't as upset as I was this time. True, it was right about the time that I was supposed to have been due had I not lost the baby, but I really think I had reached the breaking point, the point where I could no longer afford to be optimistic or to hope because each time, that hope or optimism was inevitably killed. Everytime, I went through the same grief, anguish and general unhappiness that I think my soul just said no more.

So what does this mean? It means that rather than focusing all of my energy every single month on whether this will be The Month, I'm going to try to focus on other areas of my life that make me happy. I'm going to focus on advancing my career, convincing Sweetie that we need to get a dog, learning how to sew quilts and clothes from patterns, and gardening.

It does not mean that I'm quitting. Far from it. We are still trying - optimal boning time (OBT) started just yesterday and we are on track. What I have quit doing, however, is hoping. I have to in order to save my sanity. It's the shift in thinking to accept that it may not happen, but that it would be nice if it did. It's the shift in focusing on enjoying the life that we have rather than planning for the life that we don't. I really think this is the only way that I will be able to function in a world where you will always run into someone who is pregnant, an old friend who has had a baby or the latest celebrity to beat the clock and have twins at 48.

This doesn't mean that I'm going to be successful 100% of the time in shifting my thinking. But, it's a new goal in and of itself and it is actually a relief to give up calculating how far along I will be whenever I make plans more than two months in the future or thinking that some activity will jinx my chances.

The shift did help me realize that if I had the baby I would be knee deep in screaming infant and I would not have been able to participate in the largest deal of my entire career, which was a truly once-in-a-lifetime experience. So, score one for the shift.