My sister, K., is a 3rd-year OB/GYN resident. I will give you a moment to be jealous.
Now get over it.
When I first began trying to conceive, I thought how lucky I was. Because I would be able to call her and ask all my pregnancy questions. Now, granted, she couldn't be my doctor, because of ethics and because, well, at this point she was just out of her intern year. But surely should would help, would take time to answer my questions about what I could or could not eat, wear, do...
Last February (or was is March? I honestly can't remember), I went to my own ladydoctor (or "ladynursepractitioner", I suppose), for my annual and also to discuss TTC. She ran the following tests on me: thyroid stimulating hormone test. She gave me the following prescription: expensive gelcap prenatal vitamin (which I took for 3 months, and then the "get it free" card expired and I went back to generic). She said the following, "It's normal for it to take up to two years." Two years. I was 30. I left her office nearly in tears, and fired off an email to my sister. Who said normal isn't two years, but she didn't see any reason why I couldn't get pregnant, and no, I didn't need to give up being a vegetarian.
Over the summer, I wrote my sister several more increasingly desperate emails. Some she answered. Some she said, "I don't know enough about this {this being charting temps, OPKs, and all my own natural fertility signs, lying little bastards}" Most of my emails she just ignored. She did, at one point, tell me she thought I was going slightly crazy. I was, but that wasn't exactly the diagnosis I was looking for. I stopped asking her questions at that point. I felt betrayed. I had thought that my sister would treat me...well, like her sister. That she would do everything within her power to answer my questions, to point me in the direction I needed to go. That she would want me to get pregnant as badly as she herself someday will want to get pregnant. I didn't, and still don't, understand why she isn't.
On August, my husband and I began working with an RE. When I found out I had a blocked tube, I asked my sister about it, over the phone this time. She just said, "it's not a big deal". When it was clearly evident that we'd have to do IVF, I asked her about it. She gave me the link to the SART webpage, and printed out some things for me (she was in town at the time), and that was it. When my doctor told me I could pick for my very own self which stims to be on, I called her right away. She said she hadn't learned anything about IVF. I told her they use the same drugs for IUI sometimes. She said she didn't know, but she'd look them up and get back to me. She didn't. I called and emailed, and she came to town again, but nothing. I ordered them on my own, a month later. Bravelle, the cheapest. When my cycle was cancelled, I told her. She was apologetic but not helpful. I asked her about Lupron. She repeated that she didn't know anything about IVF. I told her it was also used for endometriosis, so had she ever heard of people being unsuppressed on it? She said she'd get back to me. Never did. I called her again with my cyst, and again she repeated her line about IVF. I was asking her how to get rid of a cyst, and she wouldn't answer. Even if there is no answer, couldn't she tell me that? No.
She was in town when I had my last appointment, last Friday. I didn't even ask her if she wanted to come with. I figured there was no point.
Throughout all this, the rest of our relationship remained the same. We talked about other things. She came into town, multiple times, and we hung out, had fun. Whenever we didn't talk about my desire for, and lack of, a baby, everything went well. K. and I have been close, sisters-and-friends-cliche, all our lives. I haven't worked up the courage yet to ask her what the hell is going on. About a month ago, she told me she is going to the Philippines in January, with an outreach program. She and 2 other doctors from her hospital will be performing gyn surgeries on women who wait all year for this. Instead of thinking how noble my sister is, or what a neat program it is, or how blessed we are to live in a developed nation, I thought:
She will go all the way to the Philippines to help complete strangers but won't even answer a few questions for me.
K and her boyfriend were here for over a week. They just got on a plane back to California a few hours ago. We had a pretty good time. We did not once discuss my inability to get pregnant (except for a few snide remarks by me, and her telling me that if I'd wish on the wishbone with her, she'd wish for what I would wish for). But it was always there, in the back of my mind, the fact that this woman who actually had an honest-to-god "trust me, I'm a doctor" moment at the movies the other night (complete stranger had a seizure, my sister to the rescue), (1) still hasn't answered questions I asked her months and months ago, and (2) didn't get me a birthday present this year.
I have heard that infertility can be hard on a marriage/relationship. What I did not know, did not fully realize until a few hours ago, was that it can also cost you sisters.
Before leaving, my sister gave me the email address for the REI (that's reproductive endocrinology/infertility, not the outdoorsman store of the same name) fellow, saying maybe she would have some answers for me. I eagerly emailed her...and it bounced. My thought? "Figures." I have no desire to call my sister, to email her, to ask her for the real email. I do think this was an honest mistake, but I just don't have the emotional reserves to navigate these waters. The facts are: I can't get pregnant. Someone who is supposed to love me very much has access to information (and does, I know, possess some of that knowledge, because for god's sake, it's not like ovarian cysts are some huge rare thing that only result as complications from IVF) and doesn't want to do what it takes to get that information to me. For whatever reason, she would rather fly around the world to perform hysterectomies on women she's never met than look up a few journal articles for the sister who taught her to tie her shoes, taught her math, went to bat for her countless times, flew across the country to comfort her when she didn't get into the program she wanted...all of those things.
It blows my mind (and aches in my heart), and I don't know that our relationship will ever truly recover.
Saturday, November 27, 2010
Wednesday, November 24, 2010
A Tale of Two Nightmares
I had two nightmares last night.
In the first, I was checking my cervical mucus. It was eggwhite, and as I stretched it between my fingers, I noticed a speck in it. I kept stretching, and the speck grew and grew, and began to resemble a baby. I knew I had to be very careful, to stretch this baby into existence. I slowly widened my fingers, holding my breath, and the baby began to grow. It was a fully-formed baby, with a perfect face, perfect everything. I slowly kept stretching, and the baby grew and then my fingers couldn't stretch anymore (I was using one hand). But I knew the baby wasn't big enough to live, so I needed to stretch more. I began to transfer the sticky mucus end from my thumb to my left hand, so I could stretch the baby between both my hands. I was too scared to even breathe. I'd almost made it, when the mucus fell off, and the baby snapped like a rubber band into nonexistence.
I woke up crying, knowing I'd lost my baby. I'm sure this dream comes from the fact that, well, I've lost any chance at even trying for a baby for at least 2 months. And I am heartbroken over it.
I was able to fall asleep again. In my 2nd nightmare, my older sister (C.) was getting married. (She actually got married this June, however, the rest of the details of the dream, specifically the fact that her husband, R., has been living out-of-state for this semester while he finishes his PhD, and so they only see each other a few days a month.) All of the women in my family were upstairs at my mother's house, getting ready. I was putting on my bridesmaid dress, and needed a pin, so I went to the bathroom, where I heard C. confiding in my younger sister K. that C. had just found out she was pregnant. I went back to the room, sat on the bed, and pulled out my phone to text my husband, to tell him he needed to come now. K. and C. came out of the bathroom and C. began saying, "I don't know how to tell you this..." and I interrupted her with, "I know, I heard." She began jumping up and down and clapping her hands, crying "Isn't it wonderful? Aren't you so happy for me!" and I said, "No, I am furious, some of us can't get pregnant at ALL, it is so totally unfair that you get pregnant when you hardly ever see R and he doesn't even want kids yet anyway!!" And then my mother starting yelling at me, and soon all the women in my family were telling me how horrible I was, how I was ruining her day, how I should just be happy. I finally said, "Well, I'm not, and D. and I are moving anyway, to a state that has mandated infertility insurance coverage and so I will not throw the baby shower!" And I ran out of the room.
That one...well, C. told me a few months ago that, when her husband gets back (middle of December), she wants to start TTC. Last I heard, he did not want children yet. In fact, last I heard, he was uncertain he wanted them at all. C. and I have not been getting along very well lately. When I told her in June about my troubles getting pregnant, she told me she thought it was funny. Because I'd tried to plan a pregnancy around work and school and it had backfired. I didn't know what to say to this, so I stayed silent. C. has always been very socially inept. However, when she told me a few hours later that she wanted to have a baby while she and R still lived in Utah, because her work throws such great baby showers, I about lost it. The notion that planning a baby around work and school (I had a 6 month window where I would only be working, not doing both, so I wanted to give birth then. It didn't happen, obviously.) is ridiculous and that it's hilarious when it backfires, but planning around a baby shower, well then.
But I know that my sister will likely start TTC this month or next. And that she will likely get pregnant before I do. And that I will not be able to deal with that in a nice, mature fashion. That jealousy will eat me alive. That when my unsympathetic mother tells me, as her sister, that I have to throw the baby shower (which she will, she tried to make me throw a baby shower for my step-brother's wife last winter, but thankfully my step-sister took on that task), I will break down.
And lastly, D. and I have considered moving. We've only lived in our house for 18 months though, and we got the new home buyer's credit, so we have to live here another 18 months or else pay it back. And if we had $8,000 just lying around, it would disappear into my RE's wallet, not the coffers of the IRS.
In the first, I was checking my cervical mucus. It was eggwhite, and as I stretched it between my fingers, I noticed a speck in it. I kept stretching, and the speck grew and grew, and began to resemble a baby. I knew I had to be very careful, to stretch this baby into existence. I slowly widened my fingers, holding my breath, and the baby began to grow. It was a fully-formed baby, with a perfect face, perfect everything. I slowly kept stretching, and the baby grew and then my fingers couldn't stretch anymore (I was using one hand). But I knew the baby wasn't big enough to live, so I needed to stretch more. I began to transfer the sticky mucus end from my thumb to my left hand, so I could stretch the baby between both my hands. I was too scared to even breathe. I'd almost made it, when the mucus fell off, and the baby snapped like a rubber band into nonexistence.
I woke up crying, knowing I'd lost my baby. I'm sure this dream comes from the fact that, well, I've lost any chance at even trying for a baby for at least 2 months. And I am heartbroken over it.
I was able to fall asleep again. In my 2nd nightmare, my older sister (C.) was getting married. (She actually got married this June, however, the rest of the details of the dream, specifically the fact that her husband, R., has been living out-of-state for this semester while he finishes his PhD, and so they only see each other a few days a month.) All of the women in my family were upstairs at my mother's house, getting ready. I was putting on my bridesmaid dress, and needed a pin, so I went to the bathroom, where I heard C. confiding in my younger sister K. that C. had just found out she was pregnant. I went back to the room, sat on the bed, and pulled out my phone to text my husband, to tell him he needed to come now. K. and C. came out of the bathroom and C. began saying, "I don't know how to tell you this..." and I interrupted her with, "I know, I heard." She began jumping up and down and clapping her hands, crying "Isn't it wonderful? Aren't you so happy for me!" and I said, "No, I am furious, some of us can't get pregnant at ALL, it is so totally unfair that you get pregnant when you hardly ever see R and he doesn't even want kids yet anyway!!" And then my mother starting yelling at me, and soon all the women in my family were telling me how horrible I was, how I was ruining her day, how I should just be happy. I finally said, "Well, I'm not, and D. and I are moving anyway, to a state that has mandated infertility insurance coverage and so I will not throw the baby shower!" And I ran out of the room.
That one...well, C. told me a few months ago that, when her husband gets back (middle of December), she wants to start TTC. Last I heard, he did not want children yet. In fact, last I heard, he was uncertain he wanted them at all. C. and I have not been getting along very well lately. When I told her in June about my troubles getting pregnant, she told me she thought it was funny. Because I'd tried to plan a pregnancy around work and school and it had backfired. I didn't know what to say to this, so I stayed silent. C. has always been very socially inept. However, when she told me a few hours later that she wanted to have a baby while she and R still lived in Utah, because her work throws such great baby showers, I about lost it. The notion that planning a baby around work and school (I had a 6 month window where I would only be working, not doing both, so I wanted to give birth then. It didn't happen, obviously.) is ridiculous and that it's hilarious when it backfires, but planning around a baby shower, well then.
But I know that my sister will likely start TTC this month or next. And that she will likely get pregnant before I do. And that I will not be able to deal with that in a nice, mature fashion. That jealousy will eat me alive. That when my unsympathetic mother tells me, as her sister, that I have to throw the baby shower (which she will, she tried to make me throw a baby shower for my step-brother's wife last winter, but thankfully my step-sister took on that task), I will break down.
And lastly, D. and I have considered moving. We've only lived in our house for 18 months though, and we got the new home buyer's credit, so we have to live here another 18 months or else pay it back. And if we had $8,000 just lying around, it would disappear into my RE's wallet, not the coffers of the IRS.
Tuesday, November 23, 2010
In Other Words: Numbers
MFI:
total count: 1.7 million
motility: 7% at 1.5 (on a scale of 1-4, where 1.5 is, more or less, "ok, so it twitches, but it's not exactly moving")
morphology: 1%
reasons: Lord only knows. All hormones normal, only an itsy bitsy varicocele (sounds kind of like a type of pasta) that I never noticed on my handling of said equipment. However, it is worth noting that my husband is adopted, and knows nothing of his family medical history. And also nothing of his prenatal care, except that, well, his mom was a college student and he was born shortly before Roe v. Wade was handed down. And he also grew up right next to a military base, complete with the not-so-occasional "test" during the Cold War. So, you know, possibly some pre- or postnatal exposure to some nasty shit that FertilAid just can't cure.
FFI: (because, whatever)
hormone levels: absolutely stunning for a near-AMA chick (31). Which sounds lovely, doesn't it? Too bad no one told my ovaries that a CD3 panel with E2 at 26, AMH at 2.7, and FSH at 5.6 all meant I should have babies by now already, jesus can't I just relax.
Antral follicle counts: 17+, usually, unless we're talking one huge cyst and a handful of hopers
tubes: left one was forced open in my HSG. Right one wouldn't budge. Repeated inquires have perhaps satisfied my RE that no, I never, ever, ever had a tubal litigation.
...also, I seem to be Lupron-intolerant.
Previous attempts at getting pregnant:
Happy honeymoon sex
Happy "it'll happen soon" sex
Slightly worried sex
Slightly worried sex complete with BBT charts
Really worried sex complete with BBT charts, cervical mucus, "cervical position" exploration leading to figuring out all by myself that my uterus was oh-so-totally-retro (this was confirmed at the HSG, when it took over an hour to insert the damn cath).
This-isn't-fun-anymore sex, complete with elevated hips, calculated positions, and all sorts of timing plans (every day! every other day! Sperm-Meets-Egg (no, no he doesn't)! Like-hell-are-we-having-sex-now-I'm-not-even-close-to-my-window sex...
and finally the RE, the hormones, semen analysis, ultrasounds, scoffed laughter over IUI...
IVF/ICSI attempt #1: September/October of this year. Cancelled.
IVF/ICSI attempt #2: November of this year. Cancelled.
Number of lines ever, ever seen on a home pregnancy test: 1.
True story.
total count: 1.7 million
motility: 7% at 1.5 (on a scale of 1-4, where 1.5 is, more or less, "ok, so it twitches, but it's not exactly moving")
morphology: 1%
reasons: Lord only knows. All hormones normal, only an itsy bitsy varicocele (sounds kind of like a type of pasta) that I never noticed on my handling of said equipment. However, it is worth noting that my husband is adopted, and knows nothing of his family medical history. And also nothing of his prenatal care, except that, well, his mom was a college student and he was born shortly before Roe v. Wade was handed down. And he also grew up right next to a military base, complete with the not-so-occasional "test" during the Cold War. So, you know, possibly some pre- or postnatal exposure to some nasty shit that FertilAid just can't cure.
FFI: (because, whatever)
hormone levels: absolutely stunning for a near-AMA chick (31). Which sounds lovely, doesn't it? Too bad no one told my ovaries that a CD3 panel with E2 at 26, AMH at 2.7, and FSH at 5.6 all meant I should have babies by now already, jesus can't I just relax.
Antral follicle counts: 17+, usually, unless we're talking one huge cyst and a handful of hopers
tubes: left one was forced open in my HSG. Right one wouldn't budge. Repeated inquires have perhaps satisfied my RE that no, I never, ever, ever had a tubal litigation.
...also, I seem to be Lupron-intolerant.
Previous attempts at getting pregnant:
Happy honeymoon sex
Happy "it'll happen soon" sex
Slightly worried sex
Slightly worried sex complete with BBT charts
Really worried sex complete with BBT charts, cervical mucus, "cervical position" exploration leading to figuring out all by myself that my uterus was oh-so-totally-retro (this was confirmed at the HSG, when it took over an hour to insert the damn cath).
This-isn't-fun-anymore sex, complete with elevated hips, calculated positions, and all sorts of timing plans (every day! every other day! Sperm-Meets-Egg (no, no he doesn't)! Like-hell-are-we-having-sex-now-I'm-not-even-close-to-my-window sex...
and finally the RE, the hormones, semen analysis, ultrasounds, scoffed laughter over IUI...
IVF/ICSI attempt #1: September/October of this year. Cancelled.
IVF/ICSI attempt #2: November of this year. Cancelled.
Number of lines ever, ever seen on a home pregnancy test: 1.
True story.
Monday, November 22, 2010
My Left Ovary
I think every infertile woman (or fertile woman married to an infertile man, who still owns the infertility in the most tender spot of her heart) has a list of “please Gods”, a list of “if onlys”. Please God, if you give me a baby, I promise I will…If only I have a healthy child, I swear I won’t…If only I never find myself sobbing on the bathroom floor, clutching yet another negative home pregnancy test, if only I have a child who learns to say ‘mama’, I will be a better person, never ask for anything again, be worthy, please, how can I be worthy?
Oh please, I won’t: complain about my pregnancy symptoms, use “do you have children” as an icebreaker, post ultrasound pictures on Facebook, tell people without children how ‘lucky’ they are because they can (pick one or more from sleep in, go on vacation, have sex in the living room, just enjoy each other, go out without worrying about a babysitter), give unsolicited advice on getting pregnant (relax! get drunk! go on vacation! try this position!), try to tell anyone it’s God’s will or the timing just isn’t right or that it’ll happen when it’s meant to happen, be smug about my children and assume they are a testament to the wonderful love my husband and I have…
Please God, I will: be the best mother ever, be so patient with my child, teach my child how to read, write, spell, buy the safest crib and car seat, be grateful every day, keep up to date on vaccinations and well-child checks (please god give me a well child), clean the spare room, anything it takes.
I don’t believe in God. But oh, I believed in science. I had faith in science. I did not doubt science, I did not need to touch science’s wounds, science would give me my heart’s desire, for how could it not? Science is cold and objective, if this then that. If I inject the following drugs into my ass and abdomen, I will walk away with a baby. I injected, and science let me down. I injected, and I did not even get to the good part, to the sperm and egg part. The ovaries (my ovaries!) laughed at science and did their own thing. My left ovary said, “science, you are telling me not to recruit a follicle, not to start the maturation of an egg, not to release estradiol, not to signal the uterus to develop a thick, nourishing lining, but I’m sorry, that’s simply not the way we do things around here.” And it did its own thing, it did the right thing to get me pregnant under normal circumstances, but didn’t science tell it that these are irregular circumstances, that “the right thing” does not work.
And then the Provera, for 10 days, and then days and days of me begging my uterus to shed its lining, keenly aware of the irony, since I've spent the past year hoping for anything but. And it did, and so science began again--this time with added birth control pills! And Lupron the last week, and then a period, right on time. What could go wrong??
My left ovary. And a grape-fruit sized cyst concealing it. A week of tears, a week of Lupron, an "outside chance". And my ovaries this time just laughed again. The cyst, present. My antral follicles? Somehow growing! Oh yes, I am the proud owner of 3 12mm follicles, and 2 at about 10. But an e2 of only 90, a lining of 8mm...how did this happen??
I mean, really. How could science let me down, how did science not get the message to my stupid ovaries? How do my ovaries not know that there is no baby, there will never be a baby, if they do not stop doing their thing. Please ovaries, have faith in science, please release control, please I know you think this is how it works, but trust me, it’s not, not for us.
Hopefully an antagonist will be enough to send the message. But not for months. Until then, the cyst and I battle.
Oh please, I won’t: complain about my pregnancy symptoms, use “do you have children” as an icebreaker, post ultrasound pictures on Facebook, tell people without children how ‘lucky’ they are because they can (pick one or more from sleep in, go on vacation, have sex in the living room, just enjoy each other, go out without worrying about a babysitter), give unsolicited advice on getting pregnant (relax! get drunk! go on vacation! try this position!), try to tell anyone it’s God’s will or the timing just isn’t right or that it’ll happen when it’s meant to happen, be smug about my children and assume they are a testament to the wonderful love my husband and I have…
Please God, I will: be the best mother ever, be so patient with my child, teach my child how to read, write, spell, buy the safest crib and car seat, be grateful every day, keep up to date on vaccinations and well-child checks (please god give me a well child), clean the spare room, anything it takes.
I don’t believe in God. But oh, I believed in science. I had faith in science. I did not doubt science, I did not need to touch science’s wounds, science would give me my heart’s desire, for how could it not? Science is cold and objective, if this then that. If I inject the following drugs into my ass and abdomen, I will walk away with a baby. I injected, and science let me down. I injected, and I did not even get to the good part, to the sperm and egg part. The ovaries (my ovaries!) laughed at science and did their own thing. My left ovary said, “science, you are telling me not to recruit a follicle, not to start the maturation of an egg, not to release estradiol, not to signal the uterus to develop a thick, nourishing lining, but I’m sorry, that’s simply not the way we do things around here.” And it did its own thing, it did the right thing to get me pregnant under normal circumstances, but didn’t science tell it that these are irregular circumstances, that “the right thing” does not work.
And then the Provera, for 10 days, and then days and days of me begging my uterus to shed its lining, keenly aware of the irony, since I've spent the past year hoping for anything but. And it did, and so science began again--this time with added birth control pills! And Lupron the last week, and then a period, right on time. What could go wrong??
My left ovary. And a grape-fruit sized cyst concealing it. A week of tears, a week of Lupron, an "outside chance". And my ovaries this time just laughed again. The cyst, present. My antral follicles? Somehow growing! Oh yes, I am the proud owner of 3 12mm follicles, and 2 at about 10. But an e2 of only 90, a lining of 8mm...how did this happen??
I mean, really. How could science let me down, how did science not get the message to my stupid ovaries? How do my ovaries not know that there is no baby, there will never be a baby, if they do not stop doing their thing. Please ovaries, have faith in science, please release control, please I know you think this is how it works, but trust me, it’s not, not for us.
Hopefully an antagonist will be enough to send the message. But not for months. Until then, the cyst and I battle.
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