Wednesday, December 21, 2011

Kids Having Kids

You see them everywhere:  the young fertiles.  It stings.  Why them and not me?  Recently, it got personal for me.  I found out the kids I used to babysit are now having kids.  How is that possible?  Didn't time freeze when they were 10?

I recently discovered that a former babysitting client works in my husband's department.  I grew up and babysat two states away and don't often run into people from that life.  Small world.

My husband found out this kid is married and has a child, which is perfectly reasonable and expected given that he's in his late 20's.  It kinda blew my mind, though.  I met (re-met?) him and his wife and new baby at a party at my husband's department and had my mind blown even more.

I'm supposed to have children before the kids I babysat have them, obviously.  Sure, life's not fair and everyone faces different battles, but it's so easy to get caught up in self pity sometimes.  Something releases within me a bit when I admit to myself that it's just not fair, go cry in the bathroom at work, and move on. 

I'm finding myself dwelling in pity-party land a lot lately, though.  The holidays are tough and I'm angry that I have a surgery coming up soon—removal of a uterine septum and a polyp.  Last New Year's, I was preparing for my laparoscopy.  This New Year's will be one day after my septum/polyp resection and I'll probably be on painkillers instead of champagne. 

We hope to be cleared to try again after I heal from the surgery.  My repeated pregnancy loss panel came back normal, which my doctor said bodes well for us.  I'm trying to feel good about that but secretly wishing we had a more definitive answer for our losses.  If they'd found something treatable, something other than the septum that may or may not be a problem, we'd fix it and get our baby.  I know in reality it's not that easy but the inconclusive diagnoses are so scary in their own way. 

I'm happy to be taking part in my second ICLW.  Welcome to my blog! 

Friday, December 2, 2011

Is My Grief Making You Uncomfortable?

I'm someone who wants to be asked about my miscarriages.  Ask me how I'm doing, tell me you're sorry—just acknowledge it.

On Thanksgiving Day, I saw many relatives I hadn't spoken to since my last miscarriage.  I'd initially told them about the pregnancy at 5 weeks because I couldn't contain myself when they were visiting at the time.  At 5 weeks, it was all smiles and congratulations.  Last week, 2 months after the miscarriage, it was radio silence.

I get it.  I don't know what to say to people who are grieving, either.  It's uncomfortable and awkward and there's always a possibility that they'll start crying.  Even with women who are going through losses similar to mine, I can't manage much beyond "I'm so sorry" or "You're in my thoughts." 

However, going through these losses has shown me just how much I want people to say something, even if it's the "wrong" thing (you know, like "At least you won't be pregnant during the summer!")  Yes, by saying something to me, you could make my eyes glisten or even cause a tear to fall.  It's ok.  You didn't cause me to be sad.  I'm already sad enough on my own.  I'm just touched and appreciative that you took a moment to brave a little awkwardness to show that you cared.

Once I figured this out about myself, I thought I had it all figured out.  Talking about grief = good, ignoring it = bad.  I decided to put this into practice when others were grieving—asking them how they were (at the appropriate time, of course), following up a few weeks later, etc. 

One day, I was talking about this topic with my husband and he rained on my parade.  To my surprise, he said that if he experienced a difficult loss, he would not want someone to acknowledge it, at least in person.  It would call too many emotions to the surface for him and he'd be irritated.

I get the impression that most women who have experienced miscarriage or infant loss (or another type of loss) want to be asked about it.  How do you feel about it?  What about your husband/partner?     

Wednesday, November 30, 2011

Zero Sum Game

I'm pretty sure my therapist lied to me.

She has many good qualities.  She's a lovely, highly intelligent person who feels more like a good friend, albeit one with an intimate knowledge of infertility psychology, than a therapist.  Once a year, she leads a series of group sessions based on Alice Domar's research.  I attended the series last spring and continued receiving individual therapy from her after it ended.  I cannot begin to describe the many ways she's helped me.

However, despite her extensive scholarship and experience, I can't help but question some of her nuggets of infertility wisdom.  The one that's bugging me lately is about how other women's fertility does not affect mine.  Having babies, she says, is not a zero sum game in which I have to remain childless in order for some other woman to have her baby or babies.  My scientific training tells me she's correct, but there are times I question it.  Like when I found out last week that my husband's brother's wife is pregnant with baby #5. 

This will be their fifth baby in 6 years.  Their children are wonderful and of course I'm happy for them.  Heck, if they keep having them at this rate, maybe they'll even loan us a kid or two.  However, it also makes me sad about my lack of babies, and it's not the first time a pregnancy of hers has done that.  The announcement of pregnancy #3 provoked a weekend-long crying jag that was my husband's first glimpse of how baby crazed I was.  We weren't even trying at the time but I was—surprise, honey!—quite ready to start.  (For the record, I only cried for one night this time!  Progress.)

My husband's brother isn't the only genetic relation of ours to be amazingly fruitful.  My sister is so fertile I thought surely by virtue of sharing half of her genes, I'd be at least half as fertile.  Are our siblings using up our family's fertility allotment?  Outside our family, am I the token infertile friend who has to fulfill some pre-ordained percentage of infertiles in my sphere?  My rational mind accepts that my fertility (or lack thereof) is independent of others', but there's still a little niggling place in the back of my brain that doesn't accept it. 

p.s.  Thank you so much for your Liebster blog nominations.  I am putting together a post about it.  Family obligations over Thanksgiving kept me out of blogging for a while.

Tuesday, November 22, 2011

It's Your Turn...Maybe

Welcome, November ICLWers!  Here's a quickie version of my not-so-reproductive history:  trying over 2 years, 2 miscarriages (1 recent), currently pursuing repeated pregnancy loss testing and a surgery to remove a uterine septum.

After a disappointing appointment with my reproductive endocrinologist last week, I gave my mom the status report:  6-week wait until surgery and some unknown amount of time to heal after that.  My mom said hopefully, "Well, after the surgery, things should go fine."  Translation:  You'll get pregnant immediately, you won't miscarry, and you'll have a baby 9 months after that.  Some people tell you things will be fine to brush you off, but I don't think that was her intention.  I think she either actually feels optimistic or is trying to use the power of positive thinking on my reproductive organs.  She had a similar hopeful reaction after my first miscarriage almost 2 years ago, telling me she thought I'd have a baby by Christmas.  Of course, the timing would have been impossible unless I'd gotten pregnant immediately (ha!) and delivered early.

How do you feel about people telling you that surely your next [vacation/surgery/IVF] is gonna result in a baby?  I used to feel hopeful right along with them but admit I don't anymore.  Miscarriage #2 destroyed my sense that everything's gonna be ok.  During that pregnancy, I was sure it was finally my turn.  I thought I'd reached my miscarriage quota, that I'd put in my time with infertility and loss.  It turns out there isn't a limit to the number of miscarriages you can have.  There's no cosmic fairness meter doling out infertility and loss evenly—it's just unfair.  Optimism and a sense that it's your turn don't get you a baby.   

On a more positive note, part of you has to believe the next cycle will be The One or you'll go out of your mind.   I want to believe that removing my septum is the magic bullet—that I'll heal perfectly, get pregnant soon after, and meet my baby 9 months after that.  I guess the difference between my mom and me is that I don't dare voice that optimism—it's too hard when it doesn't work out.  It seems naive to say "things should go fine" from this point forward.  If it was as easy as saying and thinking that, they would have gone fine many, many months ago.

Thursday, November 17, 2011

Normal Baby, Abnormal Uterus

Normal female.  It's incredible how two little words can bring back the pain of my last loss in such a profound way.  I didn't just have a random procedure that resulted in spotting for weeks on end.  There was a little girl in there.

My D&C was September 9 and we received the karyotype results on the products of conception—normal female—a few weeks after that.  (I confess I hate the phrase "products of conception."  Maybe it's the medically correct term but it's so dehumanizing.)  With normal female results, the cells they tested could have been the mother's instead of the baby's, so they performed an additional test (microarray) for me to see if they could get more info.  Yesterday at an appointment, I found out that the microarray confirmed normal female, so that's what we have to go on right now.

Since the fetal chromosomes didn't provide an explanation for the miscarriage and it's my second loss, we decided to move forward with the standard repeated pregnancy loss blood panel.  It's a good thing I'm getting to be a pro at blood draws.  My vein is a champ, apparently.  The nurse yesterday complemented me on how easily she stuck it and filled 9 vials in record time.  Despite my crappy mood, I was proud of my vein.  My uterus may be inhospitable but my veins are spectacular.

In addition to bloodwork, I had a saline infusion sonogram, or 3D sono for those hip to the lingo.  My doctor had wanted to check out a small septum that comes down from the top of my uterus.  The septum was potentially an issue with my losses or could become an issue later in a pregnancy.  Two other doctors have told me that it's nothing to worry about, that removing it and risking the development of scar tissue isn't worth it.  My current doctor wants to take it out and I'm (somewhat grudgingly) putting my trust in her.  I don't know what else to do at this point.

Going into the 3D sono yesterday, I knew my doctor would likely recommend removing the septum.  What I'd conveniently forgotten is that I will have to take the Pill for a cycle beforehand.  Then there's Christmas, and it turned out the earliest surgery date I could get was 12/30.  Balls. 

Before yesterday, I'd seen my share of uterine issues:  septum, fibroids, and endometrial tissue that migrates out and gloms onto my intestines.  Yesterday I got to add a polyp to the list.  At least the polyp can be removed at the same time as the septum.

I had been dreading the pain of the SHG yesterday but it turned out to be a cinch.  Way worse than the physical pain was the emotional fallout.  It was so hard hearing my doctor say that since the baby was normal, we really need to examine the uterine environment.  It brings back all those post-miscarriage feelings of being betrayed by my body.  The baby was fine, actually beyond fine.  It was a little girl.  Knowing the sex really makes it hit home.  My baby girl was fine but somehow my body screwed up.  Maybe the baby implanted too close to the septum that I had plenty of time to remove before the pregnancy.  Maybe my bloodwork will show some other way my body is screwing up.  It's so hard to forgive your body for letting you down in such a big way.     

Saturday, November 12, 2011

Embarrassing Moments

Remember those "My Most Embarrassing Moment" stories you were forced to write as a kid?   At least for "The Person I Admire Most" or "My Best Day Ever," you could come up with something without resorting to lying.  If you couldn't think of an embarrassing moment, you were screwed.  Did everyone else keep their most embarrassing moments filed away in case they were ever asked?

It turns out the scourge of having an embarrassing moment story at the ready isn't just for kids.  At a party recently, some friends started sharing their cute, hilariously awkward embarrassing moments.  My husband had everyone doubled over with his story about getting tongue-tied around a pretty realtor in his dating days--he accidentally said he was going to "pick his nose" in another room.  Everyone had their funny/cute story ready until the attention shifted to me.  Just like in elementary school, I couldn't think of a single embarrassing moment. 

If I'd been with a different crowd, specifically a fertility-challenged one, I could have thought of several cringe-worthy moments to share. Infertility is full of embarrassment, and not of the neighborhood party-appropriate "the wave took my swimsuit!" type.  We have to get used to spreading our legs for strangers on a regular basis.  Maybe mortifying is a better word for it. 

One infertility embarrassing moment happened during my first treatment cycle last summer.  I was supposed to take letrozole starting on cycle day 3, but what does "day 3" REALLY mean?  What about heavy spotting?  Heavy spotting for several days?  On a Sunday morning that could have been day 3, I paged the reproductive endocrinology fellow.  All of the RE fellows at my practice are attractive men in their early 30's--you know, just the people you want to talk to about your period.  As I described the bleeding to the hot doctor on call at the time, I had to acknowledge to myself how surreal the experience was.  I know, he's a medical professional, but it comes down to the fact that a guy my age was talking to me on a Sunday morning about vaginal crypts.

So, yeah.  Not the kind of story you'd share at a party unless all your fellow guests were infertiles.  What are your awkward, embarrassing stories about this experience?

Monday, November 7, 2011

Head in the Sand

The moral of the following story is, "Don't put your health completely in the hands of your doctors."  They might not correctly interpret your descriptions of your symptoms, and of course they don't always spend as much time considering options as you would yourself.  For me, this lesson came from my experience with a disease called endometriosis.

A quick side note for readers who aren't familiar with endometriosis:  Endo occurs in some women after endometrial tissue from the uterus migrates through the fallopian tubes and out into the abdomen during menstruation. All women experience this retrograde menstruation, most without ill effects. In women with endo, for some unknown reason, the tissue attaches to the outsides of organs in the pelvic cavity. Resulting symptoms include pain during menstruation, sex, and bowel movements.

The first time I heard about endometriosis, I was a high schooler working at a natural foods store.  My coworker told me she had it and I felt a twinge of panic as she described her symptoms.  They sounded so similar to mine, but I was a little comforted that hers sounded worse. Her pain was debilitating throughout the month, whereas mine was "only" debilitating during my period. Sure, I couldn't sleep or move when it was bad, but that was normal, right? My aunt used to experience pain so bad she vomited and I hadn't vomited yet. That became my benchmark for how much pain was too much. Not puking? Suck it up! Furthermore, after I found out that endo ran in families, it was comforting to know that my aunt had never been diagnosed with it.

The worst pain in high school always happened late at night.  To attempt to fall back asleep or think about something other than the excruciating pain, I'd listen to a cassette tape of U2's The Joshua Tree. If I didn't fall back into a heavy sleep before the tape ended, the loud click when it reached the end would jar me out of any dozing state I'd managed to achieve. Particularly bad nights were when side 1 didn't put me into a sound sleep and I had to get out of bed to switch to side 2.  Standing up was guaranteed to make the cramps worse, not to mention that the music on side 2 was inferior.  (Why did it never occur to me to move the boom box closer to my bed?  Another smart move would have been to graduate to a CD to save myself from those awful clicks.)

My cramps decreased when I was very physically active. During the school year in high school, they were manageable when I was dancing all the time. Summertime brought less physical activity and family vacations when my period would inevitably hit. Cramps hit me hard at the beach, the mountains, and a summer afternoon in New Orleans when I had to curl up on a bench in a museum.

In addition to exercise, going on the Pill in my 20's alleviated my cramping somewhat. However, I didn't fully understand that it was helping at the time and found the side effects troublesome. In my late 20's, I stopped taking it. I was a vegetarian with vegan leanings who'd worked in a natural foods store, so eschewing medications wasn't out of character.

Even when my symptoms weren't intolerable (ie, rendering me unable to move and wanting to die), they were disruptive.  High levels of physical activity ceased to help and periods dictated my training schedule for half marathons. Ready access to tampons or The Keeper wasn't enough to keep me exercising on my heaviest days. If I dared to run even a short 3-4 miles, cramps would inevitably paralyze me halfway through. I would limp my way home, doubled over and feeling foolish for daring to run on a heavy day.

In my 20's and early 30's, I described the pain to each gynecologist and nurse practitioner I saw for annual exams.  Their response was always the same: take ibuprofen or naproxen and use a heating pad. Their implicit suggestion was to suck it up. Massive doses of ibuprofen took the pain from a 10 to an 8 and I was still incapacitated. NSAIDs also gave me horrible heartburn as I got older. As for the heating pad idea, well, my cramps laughed at them.  After I stopped taking the Pill, doctors suggested I get back on it to ease my cramps. I had decided I was a Natural Woman, though, medication-free and indulging my OCD tendencies by charting my temperature every day. I wasn't fully convinced at that point that the Pill helped my cramps, anyway.

Doctors never mentioned endo and I got used to the standard "800 milligrams of ibuprofen" suggestion.  Although I knew a little about endo and thought I might have it, I trusted my doctors to let me know if further action was needed.  Finally, after we had trouble conceiving last year, a doctor suggested a laparoscopy to look for endo. Years of telling doctors about pain before we started trying hadn't prompted any discussions of surgery or prescription pain relievers. Although they had offered the Pill with the ostensible purpose of decreasing cramps, they failed to mention that the Pill could quiet down a disease that most likely compromised my fertility.

It's obvious that I wasn't assertive enough. I'm not usually shy about telling doctors what's going on with my body, but it seemed almost shameful to complain about cramps. Didn't every woman have them to some extent? The "it's not bad 'til you puke" mentality had stuck with me. Having pain that made me nauseated and wanting to puke wasn't enough. Instead of inwardly rolling my eyes at the heating pad and ibuprofen suggestions, I should have described exactly how much pain I was having. Instead, I missed work every month and ignored a disease that was probably impacting my fertility.

Dr. Google is a blessing and a curse (hello, paranoia), but I hope young women today use its power for good. Maybe instead of living in denial like I did, they'll google "endometriosis" and insist on getting checked out.

Wednesday, November 2, 2011

This Is Your Life

Do you sometimes get the feeling this can't possibly be your life? That at some point you'll pinch yourself, wake up, and be free of pain from infertility or loss? This sadness and yearning wasn't part of The Plan, the rough timeline of how you expected your life to turn out. It certainly wasn't part of my plan, which included easily popping out at least one kid before age 30.

I started babysitting in middle school. I was the neighborhood babysitter, the one parents trusted with their colicky newborns and large broods. Some of the kids were so special to me that I was a little jealous of their parents. How amazing would it be to parent this child and be around them 24/7?

I never doubted I would have children of my own. When I was 28, everything seemed to be in place to realize that dream. I was engaged to a nice man who wanted to start trying to get pregnant right after the wedding. We fantasized about which features our mixed-race children would inherit. To my great disbelief, our relationship fell apart 6 months before the wedding. I cried to my sister that looking at her children filled me with fear that I wouldn't get married and have children. They reminded me of everything I might not be able to have.

I met my husband a quick 2 months later and we were married within a year and a half. I gushed to my friends that my husband was the first man I'd ever dated. The rest were boys. From a non-romantic standpoint, I was thrilled to be back on track with The Plan.

Unlike my ex-fiance, my husband wasn't on board with trying to get pregnant immediately. He wanted to take a couple of years to enjoy life as a twosome. I suspect that after 36 years of going it solo, he needed some time to get used to one major life change before making another.

When we first got married, we were renting a spacious apartment that happens to be only a mile from my current infertility clinic. I would drive by the clinic's prominent sign on my way to work and think about the women who were patients there. What were their lives like? How did they deal with one of the toughest problems I could imagine? Thoughts would sneak in telling me I could be one of those women in a couple of years. It seemed too awful to contemplate.

I'd always had horribly painful periods and they seemed to be getting worse during those first years of marriage. I was somewhat aware of endometriosis and suspected I had it, but I had other things to worry about. Getting my doctorate, getting married, buying a house--big changes were going down.

The last year of waiting before we pulled the goalie was a long one. I felt like we'd never reach the next chapter, the one I'd looked forward to my whole life. We finally started trying in August of 2009 and I was giddy with excitement. During the first two week wait, I was absolutely, 100% convinced I was pregnant. The sharp twinges I was experiencing were my fallopian tubes cramping up as the zygote traveled to its resting spot. Despite the fact that I'd never heard of fallopian tubes cramping, I was certain mine were. The first period was devastating because I'd been so sure I was pregnant.

Luck came to us very early on when our fifth cycle resulted in a pregnancy. It all fell apart when we found out at 7 weeks that I would miscarry. After the miscarriage, the months of trying started adding up and eventually put us into the infertile camp.

No one thinks they'll become an infertility patient. I'm sure it's the same for other hardships. How did I end up here? How do I go on and cope with the way my life is turning out? Now that I'm the infertility patient I dreaded becoming, I have an answer that mostly works for me. It involves taking Prozac, making myself get up to take a shower in the morning, and finding support from friends. I still have plenty of moments when I think this can't possibly be my life, that it's not possible for me to be in my mid-thirties with no children. It's scary not knowing how this will turn out.

What keeps you going as you deal with infertility and/or loss? How successful have you been at throwing away your timeline of how you expected things to go?

Thursday, October 27, 2011

Pregnancy #2: What I'll Remember

I found myself driving to Walmart at 6:15 on a Friday morning to buy pregnancy tests. A cheapie at 4 a.m. had shown a faint line, much to my surprise. After a year and a half since my last pregnancy, I hadn't counted on it happening again. Going back to sleep was out of the question. I finally figured out that our Walmart was open 24 hours and was off and running.

Two pink lines showed up immediately. My husband, hater of mornings, pulled off his eye mask and snapped to attention as soon as the words left my mouth. I spent the day on top of the world. Of course there was reason to keep my joy in check, just in case, but I'd worry about that later. I wondered if my coworkers could somehow tell that I was pregnant from the aura of fertility I was radiating.

We had a gift certificate to The Cheesecake Factory and decided to go that night to celebrate. I kept asking myself if the salmon I got was making me feel sick--maybe? We were both so ecstatic that my choking on a fish bone, gagging repeatedly, and nearly throwing up on my plate didn't dampen our moods. Afterward, we wandered into Crate & Barrel and cuddled like newlyweds on their couches. We started calling each other "Babymomma" and "Babydaddy."

I started writing this post intending to talk about the entire 3 weeks of the pregnancy after I found out. The beach trip when I was able to look at toddlers playing in the sand without getting a lump in my throat. The beginnings of horrible nausea that forced me to eat Saltines in the middle of the night. Buying new shirts to attempt to hide my humongous boobs. The anxiety of that first week of knowing about the new pregnancy combined with work stress.

But right now, the memories that stand out most for me, more so than even the nightmarish first ultrasound, are the ones of that first day. The euphoria of getting there again, of starting to grow a new life inside me, was part of it. A bigger part, though, was sharing the joy with my husband and connecting through our excitement. Feeling his giddiness combine with mine and draw us closer. Maybe I'm subconsciously choosing to remember the good and forget the bad, but I'll take that for now.

Wednesday, October 26, 2011

Me 101

Since this is an infertility/loss blog, I'll dive right into where I am with the process. I'm 34 and subfertile. Been trying to get pregnant for over two years, with two miscarriages along the way. This will be our first baby. My amazing husband is 40.

We found out I was pregnant for the second time a few days after my husband's 40th birthday. He was so happy that it looked like things were turning a corner for us, and thought it was pretty special that it was happening at such a milestone birthday for him. I know he was excited for the first pregnancy, too, but this time was different. We'd been trying for an additional 1.5 years, a surgery (laparoscopy), lots of fertility tests, lots of fertility sex, and finally, a medication to promote ovulation (letrozole). I'm sure the extra time had given him space to settle into the whole baby concept.

After going through many cycles with no pregnancies, we knew we were very lucky to get pregnant our first cycle on letrozole. To only have to take a few pills and not do a more invasive treatment was a huge gift. There was a fetus this time, an actual baby on the ultrasound. Our first pregnancy had resulted in a blighted ovum, which was a big fake-out. It's like the sac is playing this cruel joke about growing something inside it--"I'll give you all of the pregnancy symptoms but there's nothing going on in here!" After finding out there was no heartbeat this time, I started sobbing while the doctors continued trying to find something on the ultrasound. There was a little part of me under the shock and devastation that was happy I could see a baby this time. My self-congratulations were short-lived. The ultrasound doctor said that this type of miscarriage is more worrisome than the last. Once there's a fetal pole, stuff is less apt to go wrong.

But it did. And I'm dealing. It's been one and a half months since my D&C and I'm ok. In some ways this one has been easier to deal with. In my less confident moments, I attribute all of the difference this time around to the Prozac I started taking several months ago. But I think it's also easier because I've changed. My psychiatrist said recently that she doesn't think I'm avoiding the grief from this miscarriage, which was my concern. She thinks I'm making healthy adaptations to the heightened level of stress in my life.

I guess. I do feel better prepared to handle what life throws at me these days. I feel stronger, more resilient. But I also feel battered. And cynical. Like this will never work and my biggest fear will be realized: I won't be a mom. I keep reminding myself that chances are good that we'll get there somehow, but the fear still lurks under all of the reassurances I channel its way.

I'm brand new to writing like this. I'm a medical writer by trade, which gives me just enough understanding of medicine to pepper my doctors with a million questions at every visit, but not enough actual medical knowledge to really know what's going on. I guess we all have to eventually just trust the doctors, but it's so difficult. Anyway, blogging and writing about myself in a creative capacity is entirely new to me.

What am I looking for with this blog? A place to be a little creative. To express my frustrations and joys. To find and give support. Thanks for reading!