Fertility Now!

Gonadatrippin

I know, the title is awful.  Forgive me.

We went to the RE's office today, for the first time since my post-D & C visit late last year.  My 3-day walk is just over two weeks away (!), and I wanted to figure out our plan enough in advance so that I could start treatment as soon as possible after the walk.  

A few minutes after arriving at the office, the nurse called us back.  Instead of going left, in the direction of his office, she took us to the right, to one of the ultrasound rooms.  I asked, hesitantly, if she was sure I was the right Jennifer (no one else jumped up when I did, but it's happened before).  She held up my crazy thick chart, and read off my name correctly, then started painstakingly typing my name into the ultrasound machine.

I stopped her, and said, "What are we doing?" 

"An ultrasound!  For your IUI!" 

Before she got any further, we realized that there had been a scheduling snafu, and we were sent out to wait for the doctor, pants still buttoned and ultrasound wand still firmly in its holster.  

We finally got to talk to the doctor about our current situation--it has been a year, to the day, since I last conceived--and our fears about doing IVF, and succeeding, only to miscarry.  He agreed that IUIs with injectible meds made some sense, although I always get the sense when talking to him that patients choosing to do anything short of IVF really stymies him.  He's not a salesman by any means, but as a technician, he has a bit of a hard time understanding why anyone would choose anything but the best, most effective method of conception.  There is a sense, when discussing IUIs, that we really are just delaying the inevitable.

He doesn't have any problem with me using my donated Menop*r, and we discussed injections, scheduling, the ultrasounds, and of course, the risk of multiples with such a cycle.  That part, quite frankly, scares me tremendously, and makes me wonder if we're doing something really, really stupid.    It would be hard, I think, to be more educated about the pitfalls and perils of using these drugs in this fashion, and yet, here I go, stumbling as blindly hopefully into it as a girl so new to treatment that she confuses Clomid with chlamydia.

I was scared to read that 25-35% of IUIs with injectibles result in multiple births, until I realized that my clinic has a whopping rate of 40% of live births resulting in multiples from IVF for women in my age group. Of course, I don't have a good sense of how many high-order multiples result from each, but at least the risks appear to be similar for either. 

I'm on day 6 of this cycle, so it looks like hopefully we will get to do the first IUI next month; of course, we'll be traveling over Thanksgiving, what may be the beginning of my cycle, so it unfortunately may have to wait another month.  

Amidst all the clinical discussions and ultrasound avoidance today at the doctor's office, there was a very hard moment.  I was glad, so glad, when I realized that I had gotten away without knowing the sex of the baby we lost last year.  But today, as my doctor scanned quickly through the paperwork, looking for the lab report, I felt my heart race a little, knowing that I couldn't find a way to stop him before he read it, a quiet mumble of letters and numbers that unfortunately, meant way too much to me.

It was a boy. 

This afternoon when I went to pick Andrew up from the sitter's, she told me that he'd said earlier, "we don't have any babies at our house."

No, my love, we don't.  Let's hope that changes soon. 

Unspoiled part II

Thanks for your thoughts on kids and gifts/toys.  It's interesting to see the different ways that parents deal with this. 

It's funny, because I'm quite comfortable with saying "no" (and its sometimes very ugly consequences), but the dilemma I've had lately is not what to do after I've said it, but rather, should I even say it in the first place.

The problem is, of course, that he's still in that incredibly delightful stage of treating any gift or toy, no matter how inconsequential, as The Best Thing Ever.  It's not a question of buying his love, per se, as I'm quite comfortable that I've got that already; it's just that the $2 bottle of bubbles makes him visibly happier than a $200 necklace could make me.   

And then, of course, there is the other dilemma, the great divide between what I think is appropriate, and what Steve thinks is expedient.  In my family growing up, my mother was always the rule-maker and the rule-enforcer, and we could always count on my dad to be clueless enough or genial enough to get what we wanted.  It looks like we are falling into similar patterns here, and I'm not sure how I feel about that.  (The "buying a toy because we're shopping for your friend's birthday"--not exactly my idea.) 

In other news:  not pregnant, need to make an appointment with my RE, and walking 60 miles less than a month from now!

Unspoiled

Long before Andrew came, I  spoke lightly of giving this much-longed-for child whatever his heart desired:  Whatever little Pookie wants, I thought, he surely must deserve, after all we went through to get him here.

Of course, while my heart was out shopping at Toys R Evil and P*ttery Barn, tossing dump trucks and DVDs  into the cart, my head couldn't quite make it out of the garage, stilled by visions of Augustus Gloop.    Whatever my own baggage may be, I do not want my kid to be that kid.

When he was very young, this wasn't an issue.  As the first grandchild, he was swamped with gifts, and Steve and I ended up buying him very little for the first two years or so of his life.  He was thrilled with packing peanuts, tupperware, and boxes, and despite our toy-strewn living room, we congratulated ourselves on not instilling in him that grasping ugly acquisitiveness we so despised.

Several days ago, we went to Target to pick up a few things.  As we walked in, Andrew mused quietly, "I want to look at the things I want.  I'll show them to you, okay?"  I just smiled, and he continued, "I want some expensive things, I think." 

I have no idea whether or not he knows what the word "expensive" means, but hearing that greedy little plan, so naive yet so heartfelt, stopped me.  We've been lazy, really, when it comes to this, and are stuck a bit now, trying to figure out a set of rules, a way to ensure that this happy little guy doesn't turn into a spoiled little monster. 

For the most part, as parents we have tried to say "yes" to as many of his requests as possible--not a difficult task, usually, as these include things like "Will you read a book with me, Mommy?" and "Can we please buy some broccoli today?"  When it's not stuff, this works pretty well, and usually the reasons for saying no are pretty clear. 

When it comes to stuff, though, we're still struggling, occasionally indulging some of his inexpensive whims ($1 bin at Target, for example), while drawing the line at more substantial things ($20 motorized garbage truck at Costco).  Lately, we've told him that he can make a list for Santa, and we'll see what Santa chooses to give him at Christmas time, and he seems to think that's okay.  What we need, though, are a set of rules, a way of dealing with the wanting throughout the year.  Do we give him chores/daily tasks and he gets a toy for completing the chores after a period of time, as friends have done?  Do we give him an allowance and make him save for things?  Do we just not buy anything (bubbles, small toy cars, $1 bin goodies) unless it's some sort of occasion, like a holiday or a trip?  When we go to pick out a toy for a friend's birthday, should he get something small, too, or not? 

What do you all do?  What have you found works for you?       

In between days

Recently, I've visited my blog site far more often than I normally do; giddy with anticipation for dear Millie and dear Sara and their astonishingly good news, I found that Bloglines was  too slow to post updates for my liking, and a quick jump from the links on my blog satisfied my curiosity much faster. 

Whenever I came across my site, though, I found myself faintly dismayed to see the same post that had been sitting there for days--or weeks.  My first thought was, "that's a really old post.  Why hasn't that lazy bitch posted something more recently?"   And then I remembered that I am, in fact, that lazy bitch, and I really have very few excuses. 

I am feeling a bit...stuck these days.  I'm not pregnant, or in treatment, or actively even trying to get pregnant, until after I finish my walk in November.  I used to feel certain that somehow, this would all work out, but that sense has drifted away, the question now not When, but If.

The longer it takes, of course, the less baby-like my boy becomes--bittersweet, but also, quite frankly, wonderful:  he is fully out of diapers/Pull-Ups/etc., for both day and night, a fantastic revelation.   He can dress himself, help with chores (laundry, dishes, yard work), and put his toys away.  Finally, finally!, he sleeps beautifully (10+ hours at night, plus 2+ hour nap), and goes to bed cheerfully and easily.  He travels well, and continues to be a delightful companion.    

I am also consoled tremendously by his utter lack of interest in babies and his general disdain for their inability to do "big boy" things.  He's grown familiar with their limitations over the past few months with his sitter's daughter--while I wistfully sniff her passing sweet head, he explains dismissively that she can't play, because "she doesn't have hands."  He is not, I am glad, the type of child to demand a younger sibling, and for that I have never been more grateful. 

I'm trying to believe that this extra time before a sibling, if that's indeed what this time represents, will only help to make him the wonderful big brother I know he could be:   strict about the rules and maybe a little bossy, but also gentle and solicitous and helpful.  I really hope we get the chance to find out. 

Do over

Last year, when Andrew started preschool, I was beyond excited.  I knew he would love school, and I had such golden memories of that time in my own life.  It was one of those things that I'd been looking forward to most about having kids:  bringing snack, packing his lunch for Lunch Bunch, going to school holiday parties, watching him make friends. 

Unfortunately, all year, it seemed,  I was The Loser Mom:  I forgot about school picture day; I had to race to pick him up on time nearly every day; I forgot we were supposed to bring snack and had to quickly go buy pricey snacks from the Whole Foods nearby; although I remembered to bring his jacket, I hadn't written his name in it; I could never remember the other parents' names and seemed to mix up other kids constantly.

Part of the problem also included one of Andrew's teachers, Anna--the school director, a woman in her 50s, great with the kids, but as became apparent throughout the year, not so good with the parents.  She was impressively rigid, with a fantastic gift for making me feel like I was doing everything wrong. 

We got off on the wrong foot when she told me that my (then) not-yet-potty-trained son could not do the extended care I'd planned to have him do, the two hours of care I absolutely needed to have for my work schedule.  She dropped that bombshell on me the night of the Open House, two days before he was to start classes.  On the first day of school, I persuaded her that it was a non-issue, and Andrew went ahead and attended, but that got us off to a bad start.  (Seriously, if your only written school policy on extended care says:  "All children are welcome to attend!", what makes you think  it's okay to tell a parent the night before school starts that, in fact, her child is NOT welcome to attend?)

It didn't help that throughout the year, she greeted me with friendly little reminders about everything I'd done wrong.  On the next-to-last day of school, for the very first time, I forgot to sign him out of extended care.  The next day, signing him in, I apologized to the person who had been in charge.  She laughed it off, and told me it was no problem.  I took A. to his class, and as I was heading out, Anna stopped me: "You forgot to sign him out yesterday.  Make sure you do it today." 

So when I found out that Anna was resigning from her position, I was a bit giddy.  I had noticed, when I was filling out a year-end evaluation, that in addition to my own personal Loser Mom failings,  many of those things I'd hoped for had never come to fruition:  there were no field trips, the Thanksgiving party totally left the younger kids out of the festivities, there was no parent group (like a PTA), and I never felt like I fully fit in.  Andrew loved his classmates and the activities, and even liked his teachers (though he confided in me that he liked the other teacher a LOT more than he liked Anna), but I just wasn't feeling like the experience was what I wanted it to be. 

This year, though, we have a new director, and I am very hopeful.  It's Andrew's music teacher from last year; as she taught him the delightful "Higgeldy piggeldy, bumblebee" and "Skinamarinky dinky dink" songs, she is already one of my favorite people.  Already, it seems, she is returning some joy to the school.  They've restored a patio for a tricycle area; they've started up a parents' organization; they are doing a really neat photography project with a local studio. 

So, once again, this year I am excited about Andrew starting school on Monday--about him seeing old friends and learning new things, and about the possibility of maybe, just maybe, getting a do-over on this whole Preschool Loser Mom thing.  

Donkey in the mud

When I was 13, I asked my dad to give me the Rorschach. 

He's a psychologist, you see, and for whatever reason, had his test set at home that day.  (Side note:  it was not unusual for him to have such artifacts in our home; the frightfully accurate model of the brain housed in a hall closet gave me years of nightmares.)  I was curious, and he was game, so he pulled out the cards.  The first card was this one, which I instantly identified as two donkeys in mud. 

I don't remember the rest of the test, but I clearly recall my dad's reaction at the end, his face slightly astonished at  the results, dismayed by what was supposed to be a fun little experiment.  "But Jen," he said, "these results say you're depressed.  Are you?"  I said, "I'm 13, dad. Of course I'm depressed.  I'm in middle school, for God's sake.  Of course I'm depressed."

I've thought of that image lately, twin mirror-image donkeys slogging through the mud.  As I've found myself almost bursting into tears on a nearly daily basis, it's hard to shake the feeling that I am, apparently, at least a little bit depressed.  

It's been, I think, a combination of things.  On that day when I found out about my cousin (and my lack of success that month), I also found myself having to explain, several times, our situation.  We haven't told people anything, really, unless they've asked outright.  When people ask if we want to have another child, I answer, honestly but enigmatically, "we'd like to."  Most people stop there, but for some reason, that day, two people--people I like, even--kept poking.   Stumbling through the words, the gibberish of "well, we have some trouble with that" twice that day, on top of everything else, left me with a weariness that has not yet passed.  (It was especially unhelpful that one of these conversations occurred in the context of "we're going to try to have a second, how about you?" with a friend whose first child was conceived on their first month trying.)   

Nor does it help, of course, that Andrew's sitter's daughter is about 6 months old, blue-eyed, red-haired, chubby and utterly delightful, that her face lights up when I come to the house and that she bounces happily in my arms when the sitter hands her to me for a moment.  Or that I never got a positive OPK this month, and I am now feeling things slip further and further away.

This walk happens in a little over two months.  Despite my anxiousness to do whatever I need to do to have another baby, I have decided to commit to the walk fully, and not start any treatment until it's done.  It is hard to delay things further, but I don't want to get in the trap of putting my life on hold again, and this is something I really want to do.  I am hopeful that by focusing on this, the fog will lift a bit.  (Also helpful:  little boys who slide into my bed to give me kisses and snuggle each morning, and who greet each day as a fantastic adventure.)     

So for the next few months I will be walking a lot, icing my bum knee, avoiding my cousin's F*cebook updates about her morning sickness, enjoying baking in the cooler weather, taking A. to school and delighting in his post-summer reunions with friends, eating caramel apples at the State Fair...and steering clear of donkeys in the mud.      

Walking Backwards

The other day, in preparation for talking to our doctor next month, I decided to find out more about IUIs with Menopur as the injectible medication.  When I did IVF four years ago, it was not very widely used, and I was curious to see if this new drug represented any great advances, especially with IUIs.   

The first site I stumbled across took me back several years:   a message board full of sparkly banners, blinking HPTs, signature lines longer than their authors' posts.  What assaulted me the most, though, was the tone:  that desperate cheerfulness, the manic, naked hopefulness, that rah-rahing you're compelled to spew even when it feels for all the world like that bitch just stole your chance at pregnancy.  Looking there, at tales of IUIs and BFPs and BFNS, I felt--despite the noisy, messy, beautiful evidence to the contrary--that I hadn't moved forward at all in the past 5 years.

Next month, it will have been two years of trying for #2.  I had hoped for an easy time of it, but I also expected that the problems that plagued our attempts for A. would continue after his birth.  So when I got pregnant after just a few months--even when it ended poorly--I felt oddly consoled that at least I'd made some sort of progress.  Even if the end result was the same--no baby--it felt like I was doing graduate studies in infertility, advancing somehow beyond the undergrad-level coursework I'd toiled through before A. came.

Now, though, it's been 8 months since my D  & C:  5 cycles of concerted, well-timed efforts, and it seems that garden-variety infertility has decided to join forces with recurrent miscarriage.  I can too easily imagine that the endometriosis that apparently caused my primary infertility has been busily winding its dark tendrils through my uterus and tubes again, the beneficial effects of pregnancy and breast-feeding depleted completely.  If this next month on our own fails, I will talk to the doctor about using my insurance coverage and donated drugs to do injectible IUIs.   

Unfortunately, as that blinky bulletin board reminded me, I really don't want to have to go back in for sperm-washing and catheters; for ovarian ultrasounds and frequent blood draws; for trudges through that awful parking garage at ill-timed intervals.  I've been there and done that, and it ended up being several months of petty annoyance for no pregnancy.    

I am frustrated by this not only because it means backsliding into treatment, but also because I know that from a medical standpoint, this is probably not a treatment that will work.  If I had insurance coverage for it, I would do a cycle of IVF tomorrow.  As I don't, having achieved three free (if ill-fated) pregnancies recently makes me parsimoniously unwilling to pay 12 grand for the dubious privilege of miscarrying again.  So instead, we will toil through a few--free!--IUIs until it appears that IVF is the next logical step.  

At least this time, I should be able to stay away from the message boards, knowing with a certainty I lacked last time, that  holding my hips up, taking Robitussin or chanting mantras while lying on the IUI table will not make a damn bit of difference.   Margaritas, on the other hand...

Sick sense of humor

Thanks for the kind words on my Week O' Crap. 

My parents and I are so upset with my cousin that we could spit.  I'm not quite sure how I'm going to be able to face her, as all I want to do right now is punch her in the face. 

This cousin had a rough time growing up, her mother often more child-like than she, but we'd hoped in recent years that she was going to be able to rise above her difficult childhood.  My parents were paying for her tuition at the community college; last spring, she announced her intention to continue at the university to get an accounting degree.  My parents were also paying her health insurance, which did not include maternity coverage.  We all were hoping that she would finish school and create a life for herself that was far better than the dysfunctional, impoverished nomadic life she was raised in. 

Now, of course, everything is up in the air.  While she may yet finish school, we can also see this easily becoming a reason to quit.  What bothers us the most, I think, is the clear implication that this was not an accident.  By 5 1/2 weeks, she had known for over a week, and was making thrilled phone calls to relatives around the country, as well as sharing it on Facebook--not exactly the actions of a scared or troubled young woman.  Our extended family, of course, is acting as though it's the best thing ever--her mother is thrilled, and there is nary a whiff of reprobation even from our Fox-news-loving grandparents. 

I was hoping to have her feed our cats while we are out of town next weekend, but I know that I won't be able to have a conversation without it coming up, and I really don't think I can congratulate her.  I don't want to be unkind, but at the same time, I'm having a hard time finding this worthy of celebration.  

I'm sure that I will get tired of playing the role of the judgmental old barren crone after a while...but for now, it's strangely satisfying. 

One Hell of a Morning

Two weeks ago, July 20, would have been my due date. 

I tried, with these brief pregnancies, not to focus on such things.  With the first two, it was relatively easy--while my brain instantly worked out a due date (my savant skill, thank you very much), the pregnancies did not last long enough for the doctor to bestow an "official" date.  With the last one, though, there were ultrasound pictures, crinkled black pages with a laboriously-typed EDD, a date which also happened to be the day we conceived Andrew, 4 years ago.  A day we thought imbued with luck was transformed into something more ambiguous with December's loss.  

I dreaded the day, but when it came, it was unremarkable, another day, excruciating only in the way that Mondays tend to be.  My friend who had been due three days after me spent the day busily caring for her 8-week premature twins, further proof of the folly of  the foolish hopes I'd harbored when we learned of our pregnancies together.

I was distracted, too, hoping that this month would be our month to conceive.  For the past several years, I have believed, with little support but a full heart, that if I have a little girl, she will be born on April 17.  It's odd, but on my mother's side of the family, in the pattern of the oldest girl's birth dates, the 17th of April would be the next date.  (Given a due date of April 12th with Andrew, I thought that would be it; when I was induced in early April, I knew, with certainty, that it was not a girl I was carrying.)  This cycle, my due date would have been April 17th.  It was, I thought, the best omen I could find. 

On Friday, though, this friend went into the hospital to be induced.  Saturday morning, I woke up to a blank HPT and her birth announcement for her son.     

That was hard, and I was a bit numb all weekend, but was getting it together, when I checked Facebook quickly before work...

and saw that my 20-year-old (unmarried, student) cousin is pregnant (5 1/2 weeks, ecstatically).

Higgeldy piggeldy

Hello again, my lovelies.

It's 8:00 a.m. and I've been home for a little over 7 hours, and my mother has already called three times, wanting to know which fruits and vegetables I'd like from the store and whether I want eggs from her friend's chickens.  I don't think she wants to hear my response, which involves neither produce nor protein, but instead about 14 Advil and going back to bed for about 3 more hours.  Steve has already managed to accidentally microwave the fresh sourdough bread I brought home from San Francisco, and Andrew has happily ripped through his presents.  There's already been an Incident with the blueberries on the kitchen floor; when I got upset that they'd fallen, Andrew told me that "it's okay, you didn't do it on purpose." 

Our home computer is still broken, still hostage to my brother's ineffective ministrations.  It's been about two months since we asked him to look at it, and his busy schedule and ADD have meant that not much is going on with it.  On the other hand, when I had to order a new operating system disk from D*ll, my new BFF Sanjit called me no fewer than three times to enquire whether I'd received the disk yet.   (One call, received while I was in the lovely gardens here, was especially bizarre.) 

I'm about 5 dpo, after thankfully ovulating while I was still, you know, in the same town as my husband.  (I seem to have astonishingly terrible luck whenever I am going on a trip out of town, my body bending its schedule to ovulate on day 9 or 17 for the sole purpose of ensuring that I'm nowhere close to any sperm during the right days.) 

If this cycle doesn't work, then we will talk to the doctor about our Plan.  I don't know exactly what it will involve, but a friend sent me some of her leftover drugs earlier this month, and I think I will talk to the doctor about doing a few cycle of injectible IUIs.  Normally, I would forego IUIs, as I think they tend to be significantly less effective than IVF, but I think this time, this makes sense.  If I didn't have the miscarriage issues, I would go straight to IVF, but with them, it seems like a terribly expensive way to lose another pregnancy.  The IUIs would be covered by insurance, and there would be less pressure and less at stake if I miscarried again.

I was lucky enough this past weekend to spend an idyllic afternoon with the lovely Bugs and her beautiful family, eating cheese and watching her sweet children pick fresh blueberries in the back yard.  It was such a perfect day, so restorative and comfortable.  It is a shame that we all cannot have such sweet reunions more frequently.