Sunday, January 23, 2011

Trying to Go from Raw to Numb

I was not prepared for how a second failure would affect me. I knew, from the kernel of doubt that I tried to acknowledge and then promptly ignore, that it was possible. I just didn't at all think it would happen this time. And now I am left with a problem. I just don't seem to know how to pick up the pieces. To be fair, this just happened day before yesterday, so I have a right to be a shattered mess for a little while. It should be expected. You don't just "get over it." You can't realistically be expected to turn that frown upside down and mourn for a day, then go back to being upbeat and hopeful. My hope stores have taken a massive hit.

The problem is, I viewed IVF as our silver bullet. And it might still be, it's just a really, really slow-moving bullet. In vitro fertilization was presented as our #1 chance to get pregnant. I just thought it would happen a little more....immediately than this. Especially since everyone on our team has been so positive about our chances with IVF, it gets more and more shocking to me when it fails. Bryce and I both said the same thing to different people this weekend--each failed cycle compounds the disappointment and loss like a Richter scale. It's not linear, it's exponential. We can't forget that we still have at best a 50% chance of conceiving with IVF, and we just keep falling in the wrong 50%. Eventually if you flip a coin over and over you will stop getting all tails and get heads. But how many flips? Three? Four? Or are we like Celine Dion, who took six IVF attempts to get her beautiful twin boys? I would hope since I'm 34 and she's in her 40s that wouldn't be the case, but it seems logic and common sense are lost on this particular scenario.

It's so hard because I want to think about and plan for our next IVF, but I just don't have the emotional, physical, or financial bandwidth to do it right now. This loss is still too raw. So instead I am left examining everything that happened--what did I do wrong? What part of my body is failing me? Are our embryos unhappy in my uterus? Is my uterus somehow toxic? Are our embryos sad little deteriorating things that just stop growing after transfer? Are my eggs somehow allergic to Bryce's sperm? Do they combine ok in the dish but then implode upon getting back to the mothership? Is there something I could have done differently, despite all the measures I took to be the model infertility patient? I took Tylenol PM when I had migraines during my two week wait. Was the PM part not embryo-friendly? Were the migraines a sign of something ominous to come? The what-ifs just keep coming. And I might not get all the answers I want...they just might not exist.

I am sad and angry. And yes, our stockings are still hanging.
Which brings me to my state of mind. I thought maybe I would be a little more ok today. I'm not. If anything I'm worse. I feel lost and helpless and and like I'm grieving a death. I feel a little like I'm dying inside, bit by bit, each failed cycle that we have. Is getting pregnant even possible? I've never been--not once. Forgive me, friends who have suffered pregnancy losses, but I almost feel like I would rather have gotten pregnant and have lost it early--then at least I would know I could get pregnant. And it would be more recognizable as a loss. Because this feels like a horrific loss. It's horrible because each time it's a little more loss of a dream. It chips away at my confidence that this will work at some point. It makes me wonder if my dream of biological parenthood is at all realistic. I cry for no reason. I cry for many good reasons. I'm angry at the unfairness of it all, and I have no one to lash out at but the people and critters who are close to me and trying to comfort me. I've been snippy and rude. I've accused Bryce of not being positive enough--of being negative as a protective mechanism but then causing the good baby juju to pass us by because we were a conflicted household in terms of attitude. (That is definitely not fair of me...Bryce was actually the most positive he's been on this cycle. He is devastated too, and all the consoling is directed at me.) It's just all so...raw. My crying is visceral. My throat is sore from the keening and screaming. My ribs hurt from the wracking sobs. I felt panicky in public today and barely survived a trip to Wegmans. I am dreading going to school tomorrow and facing people who knew I was going through this but don't know yet it didn't work out because I avoided as many people as possible on Friday once I knew. I am dreading pretending to be normal when I'm not. I am dreading feeling like I have to console other people who are disappointed for me or who are uncomfortable by my intense sadness and need to hear me say "I'm ok." I'm not. I struggle with that question: "How are you?" It seems so simple. Your knee-jerk response is "I'm ok!" and I can't do it. I pause awkwardly. I think for a minute. "I'm surviving" sounds melodramatic (but not far off the mark). But "I'm not ok" seems to elicit suicide-watch responses. Trust me, I am not going to start secretly cutting or burning myself. I'm not going to drown myself in the deep-soak tub I am now free to use without worrying about parboiling my unborn children. I am royally pissed off at my body, but I do want it to conceive and get pregnant, and self-destructive behavior is not conducive to those goals. But emotionally, mentally--I am decidedly not ok. I am not public-ready. And unfortunately, I have to be.

So, my goal for this week is to cross over from raw to numb. I want to move from feeling everything to feeling not so much anymore. I want the question "How are you doing? Are you ok?" to not freeze my mental processes because I just don't know how to answer it. I want to be past this immense sense of loss and sadness and rage at the inequities of baby distribution in this world. I want to be able to handle walking through the picture frame section of Michael's Crafts without having an anxiety attack that leaves me hyperventilating and walking to the car with my coat wide open because I feel constricted in every way. (Why, why, why must they put babies in most of the frames? The one I bought had flowers pictured. Nice, neutral, universally attractive flowers.) I want to be in a place where the look of my face or posture of my body doesn't prompt my husband to ask, "What can I do to help you?" Because right now, there's nothing that anyone can do but take an interest. And understand when I don't know how to answer, "Are you ok?"

Friday, January 21, 2011

Test Day

The day you receive your call with your blood test results is a very, very long and stressful day. You are tied to your phone. You come up with contingency plans for what it will look like. Last time, I received my call at 1:27 pm and let it go to voicemail because I was at school. I wanted to wait until Bryce and I could listen to it together. That meant waiting until 5:00 when Bryce could get out of work and meet me at home. In the meantime, I peed on a stick after school. It was negative. I took the dog for a walk and rationalized how that negative could be totally faulty. But really, I was letting it sink in that maybe it didn't work out. When Bryce came home and we listened to the message, the second the words "I'm so sorry" came through the line I burst into tears. It was real. I wasn't pregnant, and thanks to our less than stellar embryo production, we had to do the whole process all over again. It hurt. It hurt me, it hurt Bryce. We mourned. We drank wine. We sent text messages to friends and called our parents. It just sucked all the way around.

This time, we had a totally different protocol--an aggressive protocol. My ovaries were pushed to produce lots of follicles. I went an extra day until egg retrieval. My estrogen rose to 5310 (wicked high) at my last monitoring appointment. I produced 30 measurable follicles, but 17 were 15 mm or more by trigger time. 9 were over 18mm. 15mm or more at trigger can produce a mature egg at retrieval, but 18mm or more at trigger should definitely be mature at retrieval. (The trigger shot ripens the eggs before they are surgically retrieved under IV sedation.) This time, 11 could be retrieved. 8 could be fertilized. Only 4 fertilized. 3 were good enough to be transferred. It was again a Great Whittling, but at least this time we had better quality in our corner. And three embryos--our odds were in our favor. And then, due to my high estrogen levels and large number of follicles (even though not as many were mature), I ended up having a complication: OHSS (Ovarian Hyperstimulation Syndrome). My abdominal cavity filled with fluid due to overstimulated follicles after transfer, and I had to be on highly restricted activity (basically, bed rest) and be out of work for a longer time than I anticipated. However, I was comforted by the fact that many women who hyperstimulate have higher than average pregnancy rates. I had to be pregnant, right? I had to be in the "many" group and not the exception to the rule. I felt great during the rest of my two week wait--I was convinced I was pregnant. No spotting, no PMS symptoms, just feeling calm and serene and as pregnant as I thought I could feel (since I've never been pregnant before).

This time, I opted to listen to the message on my own. Or, I opted that if the call came during a planning period I would actually pick up and talk to a live person. Then I would call Bryce and share what I was 95% sure was our finally happy news. I debated peeing on a stick in the morning, but was not sure how that would play out. I decided to lay out the cheapo strips I had purchased 20/$4 online months ago along with a cup (since they were so cheap they involved dipping instead of peeing on the strip) on the back of the toilet so I could make my decision when I got up in the morning. Because I am basically Pandora, I couldn't resist. I had to pee on the stick (strip). It said 5 minutes, so I brushed my teeth and peeked--one line. But only 3 minutes, so I went back to bed for 10 more minutes. Back to the bathroom. One line. Shit. One line? Really? I decided to chalk up the negative result to crappy, questionable online product. I felt pregnant, and so different from last time, so there was NO WAY I wasn't actually pregnant. It was obviously a mistake. But I woke Bryce up and told him anyway, and cried a little for the loss of some of my positivity. I went from 95% to 80%. But Bryce surprised me--he told me to keep up the positive attitude, because it wasn't over until the blood results. So I bumped my positive feelings up to 90%. A loss of 5 points, but still overwhelmingly odds in our favor.

The day was hard. I felt so stupid for peeing on the stick--I was just torturing myself unnecessarily. I willed those embryos to fight back. I sent them love. I silently screamed "STAY, ok? Just one of you? Please?" My phone rang at about 11:45. I was alone in my room, so I picked up. The hesitation started the crack in my resolve. And then the "I'm so sorry, so, so, sorry Jessica" just broke my heart into a million pieces. Tiny, jagged shards of hope clattered to the floor and I sobbed. This makes absolutely no sense to me. I managed to catch Bryce on the phone and sobbed uncontrollably and messily into the phone so that virtually nothing I said other than "negative" and "so unfair" was intelligible. I just don't understand this. I did everything, EVERYTHING possible to increase my chances. I went to yoga regularly. I went to acupuncture. I pampered myself with massages. I ate organically. I stopped drinking months ago. I listened to my meditation MP3s every night. I burned red candles like it was my job. I have stupid freaking baby bibs stuffed in my pillowcases, for the love of Pete. I rested more than usual thanks to the OHSS. I was positive to the point of ridiculousness. I willed myself to be pregnant. I tried to think it true. IT DIDN'T WORK.

I am left with such a feeling of hopelessness. Why can't we catch a break in this process? What is WRONG with us that we can't do this basic human function? How many babies do I need to see born to other people before I get to experience it for myself? Will I EVER experience this myself? What if something I did made this not work? What if I didn't spend enough time in the guest room that someday (I hope) will be the baby's room? What if the sad fact that I am lapsed in dentist visits has resulted in gum disease that is preventing me from getting pregnant? How stupid will I feel if my goddamn TEETH are what are keeping us from baby bliss? Do I realize how crazy this sounds? Yes. But I can't stop it. When can we do this again? I have no idea. I am lost. We are looking at full price for our next cycle. We are officially out of the running for the refund program with 2 failed cycles under our belt. My body is exhausted. My spirit is exhausted. But my eggs are little ticking time bombs... your fertility certainly doesn't improve with age. We are left with hard questions and difficult decisions. We are left with the possibility that there are no answers for why we failed again this time. We might just be in a cruel numbers game where if we do this enough times it has to work eventually. Maybe the 3rd time will do the trick. Maybe the 4th or 5th. Will we have the funds? The endurance? The emotional bandwidth to handle this over and over and over again? I have no idea. I was so hopeful this time. I even used an online calculator and put in my retrieval date so I could figure out my due date if I was pregnant. It was September 29th. I would be 12 weeks on St. Patrick's Day and could tell the masses then. It was a date to look forward to. It was a timeline I believed in. But now I have to find something else in the future to look forward to. I am not ready to plan my next cycle yet, but will feel better when I have dates in place. Something to fill the incredible emptiness that I feel ahead of me. Something to give me hope again.

Sorry to be such a downer. I am lucky in some regards. I have a good life. I have an amazing husband. I have incredibly supportive family and friends. I have a friend who's willing to come over and drink wine in the afternoon and have an impromptu dance party in my living room (in between crying jags). I can drink margaritas tonight. I can have caffeinated coffee again. I can take Advil and/or Excedrin for my headaches. My medical team has learned even more about how our eggs and sperm behave (badly) and can use that information to improve our next cycle. We have the option of a next cycle. We are not done. We are just paused. As a support group friend wrote in a consoling email today, this is not NO. It's just NOT NOW.

Wednesday, January 19, 2011

Comparing Notes

Sometimes there really can be such a thing as too much information. When you have a support group, whether it is online or email or meeting physically or all of the above, you meet a lot of women who are also going through infertility treatments. This is great--you don't feel alone anymore, you have a community of women who hands-down "get it" from personal experience, and you can get advice or be calmed down or pumped up at vital times in your cycle. What's not so great is the tendency to compare notes with other women's cycles. Comparing can be helpful, such as if you want to know possible side effects of new medications and someone can verify that they had the same symptoms. Or if you want to survey others for tips on how to manage your first self-injections. But comparing can also be a little destructive.

Everyone's cycle is different--and even your own cycle from attempt to attempt can be wildly dissimilar. Everyone's bodies respond differently to different medications and there are varied protocols depending on diagnoses (or lack of diagnoses). It is just about impossible not to try to compare your cycle to everyone else though--especially people who got pregnant in their cycle. It becomes obsessive--were you on the same dose as the lucky lady? The same number of stimming days? The same number of follicles? How about estrogen levels? Are yours too low or too high compared to the successful women? Are there more people you know who had Day 3 transfers or Day 5 transfers that got pregnant? Is having a Day 3 transfer a bad sign for your embryos? So-and-so had a Day 5 transfer and they got pregnant, maybe I'm not getting pregnant because I can only make it to Day 3... How were you feeling in your two week wait? What was a pregnancy sign and what was a side effect of the progesterone shots? Were you crampy? I'm crampy! Is it period cramps or implantation cramps? Did you start spotting? When? Maybe if I don't start spotting by that day it means I'm pregnant. WAIT! Someone else started spotting and it was implantation bleeding...she was pregnant! It can drive you absolutely bonkers.

I have kept a journal every night of both IVF cycles, and refer back to the previous cycle to see what I was feeling at the same point in the current cycle. I didn't get pregnant last time, so I am looking to NOT feel the same way I did last time. However, last cycle was a very different cycle in terms of doses, number of embryos transferred, length of stimming, reaction to estrogen levels, etc. So can I really honestly compare the two? Could I feel totally pregnant and have none of the same feelings I had last time and still get a negative? Unfortunately, yes. OR I could have the same symptoms and actually be pregnant. Trying to make sense of all this data is dizzying. And add to it the community of women I know who have gone through this process or are going through this process and all of their data and it's even worse! It is hard not to feel like a failure if you only had 4 eggs fertilize and 3 viable embryos when you know people who had 18 embryos or 12 and had gads to freeze in a cycle like yours. However, there is the other side too--women who would kill for 3 good embryos because their eggs didn't fertilize at all or degenerated before they could attempt fertilization. It's a lot easier to feel sorry for yourself for not having a multitude than to feel grateful for having good embryos to begin with. In cases like these, the comparisons can help you gain a sense of perspective. They can help you realize that actually, you have it pretty good.

I am trying not to take into consideration other people's experiences too much during this fragile time--I am trying to listen to my body and look at the data from THIS cycle: not my previous, not my friends', not my cyber buddy in New Jersey, and definitely not the evil Google. I am grateful for my 3 embryos. I trust that one or two of them are listening to my loving internal whispers, coaxing them to stick around... and that is why I feel the way I do this cycle. Only time will tell.

Sunday, January 16, 2011

Let's Hear it for the Boys!

Bryce in his natural habitat...
As hard as women have it in the infertility world, I've been thinking that it may actually be harder for the guys. Ok, all of you who have been through the workups and procedures and injections and are screaming, "WHAT!!! No way do they have it harder!" -- hear me out. It is the woman who just about everything happens to. The woman has the bulk of the highly invasive testing. The woman takes all the drugs for the most part (although I have heard of men taking Clomid and Bryce did take a herbal supplement to improve numbers). The woman is constantly in the doctor's office for ultrasounds and blood draws and has her feet up in the stirrups and only a shred of dignity left after a cycle or two, much less years of these shenanigans. The woman has to feel every possible symptom of early pregnancy and interpret however until blood test results on the woman's phone are called in. A guy has to... get intimate with a cup.

But is that really it? I don't think so. I've been honestly thinking hard about the male perspective ever since I made a simple semantic mistake when talking about our cycle a month or so ago. I was talking about the disappointing embryo turnout in our last cycle, and I kept saying "MY embryos." Bryce very quietly stopped me at one point and said, "They're not YOUR embryos. They're OUR embryos. I think sometimes you forget that." I felt awful. I felt humbled. It is so easy to make this whole process all about me--my eggs, my hormone levels, my retrieval, my physical discomfort, my emotional why not call them my embryos? And then I thought about it. How it must be to be such an integral part of this process--you can't have embryos without the sperm to fertilize them--and to have to stand at the sidelines for so much of it.

I have asked Bryce many times how he is feeling during a cycle, and more often than not I get this response: "It doesn't matter how I feel. I'm too busy worrying about how you feel to even consider how I'm feeling. What matters is supporting you and making sure that you feel ok." Which is very noble, but a little misguided. I don't doubt that Bryce feels as much excitement, trepidation, and sadness as I do throughout the course of a cycle. There is a lot of pressure put on his contribution--if I work hard all cycle to produce some good eggs and then the sperm doesn't do the trick, then how must that feel? Not so great, I bet. When we started this process we were under the impression that it was just male factor fertility that we were facing. That was our known variable. I knew that male factor was an issue and we would face this difficulty from the beginning of our relationship--Bryce was very open and clear from just about the first month of dating that he had previously been down the infertility path and likely at some point if we had a future together, we would too. I had an out--as if I would have EVER taken it. That's actually what made me realize I was falling in love with Bryce--that I have always wanted children very badly and even knowing that that would be difficult or impossible to achieve traditionally with this person I didn't know very well at that point, I didn't care. I wanted Bryce, whether we could easily have kids at some point or not. So, when it finally came time to go start this process, I knew that it would be at least a little hard. Bryce felt terrible, like it was all his fault that we had to see doctors instead of getting busy at specific times. He held the majority of the burden. Until it became clear that I had ovulatory dysfunction and PCOS and held part of the difficulty, too. For us, that was almost a freeing experience. We were equal partners again--Bryce could stop feeling guilty for the male factor because I was also faulty. It balanced out the guilt. Sort of.

The guilt resurfaced when we did injectible IUIs and the clinic finally had the magic potion that could make me produce mature follicles and ovulate. Not spectacularly, but sufficiently. That unevened the playing field, because now I had the means to get my eggs all ready for insemination, but then the sperm still had to make the (albeit a much shorter) trip. The best of the best were selected and then concentrated and then they had to swim from the top of my uterus up the tube to fertilize the egg(s) that were coming down the hatch. And then they had to fertilize it. Which just didn't happen. That must have been difficult, because I worked really hard for those eggs and then the sperm couldn't do their part. It made Bryce feel horrible, like he failed me at the crucial moment. Even though we were told that we were very, very poor candidates for IUI and it wouldn't likely work anyway, each negative was a guilt-ridden blow to Bryce. Nothing I could say would make him feel better--it was almost like he felt sole responsibility for our continued failure.

Quarter for perspective on needle size.

Moving on to IVF, Bryce's physical role shrank even more. He still provided his sample at the crucial moment. A much more high-pressure moment as they come get him to go into the porn palace as they are setting up my IV and he has to be done before I go in for egg retrieval so that they can properly prepare and select the individual sperm. But throughout the cycle, he stood by and supported me while my body and mind were assaulted by the various medications; while I cried because I had no pants that fit my new, bloated, follicle-ridden belly; while I went in for uncomfortable ultrasound after uncomfortable ultrasound. During this IVF cycle Bryce was actually able to come to all of my appointments with me, which was a great comfort. He took care of me after the procedures. But his physical part was very small--he didn't have to take the supplement anymore because for IVF you only end up with as many sperm as you have eggs to fertilize, so 100,000 is the magic minimal number per sample. They hand-picked the best sperm and then injected them into the eggs. They didn't have to swim, they didn't have to penetrate the egg's shell, they only needed to meld nucleus to nucleus once inside to fertilize the egg. Bryce has a very important duty now though--he is the wielder of the intramuscular progesterone injection. He prepares the syringes and the swabs and gauze pads and other accoutrements. I ice my hip/upper butt and then the whole nasty 1.5 inch needle business is all Bryce--and he is fabulous at it. It has yet to hurt even though it is a big honking needle going into a tender area every morning. He has a system, and is super efficient. I don't even have to look at that nasty needle. He is the injection master.

In a physical sense, Bryce's role is technically very small. He doesn't have to go to appointments except when, um, producing. But Bryce's emotional role is huge. He supports. He makes me laugh when I am sad for no reason or good reasons. He puts things into perspective. He maddeningly creates algorithms for our actual success probability on each attempt, which makes me roll my eyes but I love it. He hugs and microwaves my butt heater and brings me tea and figures out how to dart that giant needle as painlessly as possible. It must be exhausting to be so supportive when you have just as much at stake as "the carrier." It must be really, really hard to watch your wife go through every discomfort and know that there is ultimately nothing that you can do to make it right. We are playing with the cards we were dealt, and there's really no further way to stack our deck. There must be an overwhelming sense of responsibility and obligation--not in a bad way, but a feeling that somehow he has to be a rock for me and not show any sense of emotional distress himself. The sense of providing--of making sure that we have the money to do this and worrying about coming up with more money if it doesn't. The sense that we have spent so much money on this process that our savings are pretty much dumped into the Babymaking Fund and there's nothing left for the Baby Fund. It just must be so overwhelming and lonely to be a man in this process, when everything is so centered on the woman's experience. There is a support group that men are welcome to attend at my clinic, but I have never seen a man actually attend in the past year. Not once. I haven't even heard of a support group for men. Maybe because that sense of pride and responsibility and rock-ness makes the idea of going to a support group unattractive. Men aren't supposed to need support, they're supposed to BE support. It sounds miserable to me.

I am incredibly appreciative of everything that Bryce does in the course of a cycle and when we're between cycles--he is an amazing support and partner through this process that really marginalizes the man's role. Not on purpose, it's just logistically the case. Everything is in my name, because I am the host. I wish that it was somehow more even so that the burden of appearing (but certainly not being) emotionless didn't rest on Bryce. I know that he is just as scared as I am that we are not actually pregnant. I know that he is scared that we are pregnant, but that it won't last. I know that he is scared of what the future would bring if we just can't get the stars to align and a baby to result from all our massive efforts. I know that he feels a sense of responsibility for us being in this position to begin with--because I can be made to ovulate but if sperm are defective the only option is to use donor sperm or abandon the biological child quest. I know that the prospect of the donor sperm question weighs heavily and is a highly emotionally fraught issue, just as the prospect of donor eggs would be for me. I know that if we are pregnant, I will be 98% jubilant and Bryce will be at least 70% terrified of everything that could go wrong and how he can support me through that. I've said I'll be happy when we're past the first trimester, then I can relax a bit. Bryce has said he'll be happy when there's a baby in our arms and then he can sort of relax. It is a tremendous burden.

For all the men going through infertility out there, I salute you. You have a tough job, if not physically then emotionally. Thank you for being an amazing support system. Just remember, us ladies are tough cookies--we can go through all the physical and emotional wreckage and still support you when you need it.

Thursday, January 13, 2011

Pleasantly Surprised or Bitterly Disappointed?

I have put a lot of stock into being positive for this IVF cycle. I have honestly had very good feelings about our chances this second time around. I have done just about everything I could do--I have filled my body with good things and eliminated the "bad;" I have nourished my body and soul through yoga, acupuncture, and meditation; I have followed good luck rituals and advice from friends who have succeeded in their fertility quests ahead of me.

So why do I still feel a little terrified? As much as I am feeling good and confident that this is it, that 2011 is The Year of the Baby, that this is the best chance we've had so far, there is that little kernel of doubt and fear beneath it all. I am trying to smother it with wanton positivity, but there is a part of me that needs it there. If I know that it's possible that this won't work, then maybe my disappointment won't be too horrible if it fails. I used to be a firm believer in "It's better to be pleasantly surprised than bitterly disappointed." This was my protective mechanism that has served me well through the years--if you don't expect much, you can't be disappointed in the result. But if you think that that thing you're really hoping for will absolutely happen, man will you be sorry when it doesn't.

Now, though, I am trying a different take. I acknowledge the kernel of doubt so that I'm not totally in a fantasy of Yes Yes Yes, but I've decided to convince myself of the best possible outcome. In hopes that a super positive outlook somehow influences cell division and implantation and healthy pregnancy maintenance. Maybe it does, who knows? I told Bryce that until I have evidence to the contrary, I am pregnant. During my last cycle, a friend said, "If you have embryos in your uterus, you're pregnant. Even if just for a short while, you are there." (Not entirely true biologically speaking, but a beautiful thought.) Bryce was horrified at my declaration of positive thinking on first. Why set myself up for such a letdown, if our test ends up negative? The higher the hopes, the greater the fall into why set yourself up to possibly be devastated? His instincts are to protect me, to protect us from further pain.

I see the point. But after I explained, he saw mine, too. This process is hard. The outcome, no matter how many positive elements you have brought to the table, is still 50/50 at best. An incredibly high-stakes coin toss. So, if for the two weeks when those embryos are in utero and you have no idea if they are snuggling in or floating aimlessly to their doom, you want to decide that you are pregnant and enjoy those two weeks, why not? It may be the only time I get to feel the joy of being pregnant. Why wouldn't I want to enjoy that precious time? A call with negative results at this point in our game is going to be utterly devastating whether I doubt and assume failure or I feel the promise of the embryos inside and assume pregnancy. I choose enjoyment, and I leave that pesky seed of doubt deep beneath the positive layers of earth. May it never get the chance to push up and unfurl again.

Friday, January 7, 2011

Stealing Back Control

If there is one lesson that I have yet to learn in this process, it is that infertility is completely uncontrollable. I have done my best to do away with Plans, but I still want to feel like SOMETHING could be somewhat predictable. It can't. So what can you do when you feel at the center of a world that is totally out of your control, especially if you a colossal control freak like me? Find ways to steal it back. It IS possible.

  1. Keep a record of all of your appointments and conversations with doctors. I have a pretty flowered notebook that I have kept since the beginning of this insane phase of my life. It has three sections--the first is for general information (consultation notes, background information on doctors in the clinic, alternative therapy information and notes, books I have read or will read at some point, etc.). The second is for recordkeeping--I write down all blood values, all follicle sizes and counts, everything for every cycle in this section. It is a little sad because I am running out of space, but it helps me feel more in control to have this information at my fingertips. I have run comparisons from cycle to cycle with my estrogen levels or follicular growth that have helped me to be a well-informed questioner at appointments. I can talk to others going through this experience and have hard cold data on what my cycles look like. Just writing down the follicles gives me a sense of peace at the end of each monitoring appointment because I am getting to do something constructive--I am not passively sitting on the table and relying on others to maintain my records. Being well-informed about my own responses has been incredibly helpful. The third section of my notebook is for dreaming. It has baby name lists (all very private, preliminary, and totally NOT agreed-upon between the two of us). It has bedding sets that I like and the stores that I saw them in (online of course, I am not a glutton for punishment and have not set foot in a baby furnishing store since beginning this process). It has our thoughts on parenthood. It has future blog post ideas. It is my 1/3 I allow myself for planning for a future that doesn't yet exist, my optimistic section of a cold hard data notebook. That also gives me a sense of control. I also have a notebook that I keep during each IVF cycle that chronicles each day from Lupron to pregnancy test--how I am feeling physically and emotionally. It is very helpful for comparing notes to see when I can expect to have my jeans disappear to the bottom of the drawer, or when I was particularly emotional, or how I felt during different ultrasounds. Knowledge and reflection are power. 
  2. Be well-read and well-informed. It is possible to go through this process and not know what the medications you are taking are actually doing to your body. But then, you are definitely giving up all control. I must know what my protocol is, what the medications do, what is happening (or supposed to be happening) in my body and out for each cycle. I need to know the intricate details of what the cycle looks like and why. I have read countless books and articles on infertility, well beyond the list on the sidebar of this blog. I need to know what is out there and what is happening in my body every step of the way. If I can't control the outcome, I can at least control the information I have about what's leading me to that outcome. 
  3. Be a tireless self-advocate. Points 1 and 2 lead up to this one--if you read about a new protocol or medication, or if you see something in your notes that lends itself to a pattern, do NOT be afraid to ask your doctor or team about it. Do not be afraid to challenge what is said to you about your best course of action. Your doctor may see hundreds of patients in a year and you are just one of them--it is possible to forget something or fail to thoroughly review a chart. It is possible that a test could be overlooked that you need to rule out possible treatable issues and you will only get that test in a timely manner if you ask for it. Being well-informed lends credibility to your challenges and requests. Listen carefully and take notes--everyone is human, including highly educated and experienced fertility specialists. Never, ever take something at face value because it came from someone with authority. Trust your instincts and question what is going to be done to your body, because ultimately it is your body.
  4. Do things for your body. I can't control my body's response to medications, but I can control what goes in my body and how I nurture it. I have been lax on the super healthy eating front because I just can take so much restriction at this point, but I will not compromise on some things--my produce, milk, eggs, and red meat MUST be organic. I now take Ultra OPC (a grapeseed oil and vitamins A & C supplement that helps circulation, joint health, and possibly follicular development and egg quality) and high-quality fish oil in addition to my prenatal vitamin and vitamin D. Fish oil was a big compromise for me because I hate fish burps like crazy, but these (while expensive) are triple-distilled and lemon-flavored, so that you get lemon burps instead of fish burps if you burp at all. But, in addition to heart health and fetal brain development, fish oil can improve your lining quality. So while the burps are gross, they are worth it. I go to yoga for fertility almost every week and nourish my body with restorative yoga that lengthens my spine and increases blood flow to my pelvic region. I go to acupuncture for fertility that realigns my energy and has even decreased the bloat that comes with stimming for a time (amazing!). I go for Maya massage to realign my reproductive organs and make my uterus happy. I go for relaxation massages to keep my muscles relaxed and happy. These are all time-consuming and expensive, but worth it for the sense they give me that I did something that contributes to my cycle outcomes. Even if the outcome is the same, I was a contributor, not just a passive meds-taker. 
  5. Do things for your soul. The yoga and massages definitely fall into this category, and even the acupuncture. They force me to relax and to have time to visualize what is supposed to be happening in my body. The guided meditation MP3s that I've mentioned before definitely fall into this category. The more I can direct my subconscious power, the more power and control I have (or at least feel) over the process to some degree. Support is definitely part of this. I have surrounded myself with support networks--online communities; community through my treatment clinic; and community through the holistic center where I do yoga, massage, and acupuncture. I have met more amazing, strong women who I believe will be lifelong friends through support groups than I ever expected. Through online communities I have people I have never met who live in different states who are rooting for me and I am rooting for them. Support nourishes your soul. It destroys the sense of isolation that this process can give you, because you can talk about it with people who have been there, who are there, who are going there. You are not alone. It amazes me how many people do not take advantage of support groups or networks--it can be hard to take that first step to share and be open even in a small and protected setting, but the effects it has on your well-being and sense of connectedness are so great. Utilize your friends who are not battling infertility, too. Tell them what you need. Limit time with those who do not seem to know how to support you during this time or who leave you feeling badly. Sound harsh? This horrible time is all about YOU. If ever there is a time in your life to be selfish, this is it. You need to nourish YOU. Take advantage of family supports, too--and remember that this is not just your infertility. Your parents want grandchildren too and are surrounded by people celebrating new grandchildren just as you are surrounded by people celebrating their pregnancies, babies, and small children. This awful process and disease is robbing them of a dream, too. Be a team if you can, and again if people cannot be supportive, limit time. I am extraordinarily lucky to have amazing family but have heard horror stories of unsupportive and insensitive family members. You can control how much time you spend with people who are not adding to your sense of support, even if they are family.
  6. Think in terms of gratefulness. Feel lucky for the things that you can feel lucky for. This process sucks, there are no two ways about it. I would not wish infertility on the most evil person on earth. It has robbed me of so many things and swallowed up so much of my life. BUT, in the midst of all this crap, there is still plenty to be grateful for. It can really help to make a list of the things that you have learned or discovered or have because of or in spite of infertility. For me, I have a lot of gratefulness in my heart. I have an amazing husband who is an excellent caretaker when I am down for the count with procedures, an incredible emotional support even when he is struggling with his own infertility-related emotions, takes on responsibilities and never complains when I am out more nights than not at all of my assorted appointments and groups, and always appreciates me. Couples divorce over the stress of infertility and we have spent our first year and change of marriage deeply embroiled in this stress--and we are stronger for it. I have gotten to see how strong we are in strife, so imagine how nice it will be when we are in more halcyon days! I am grateful for my friends, who call me unasked to see what I need and send me funny text messages like "Go eggs gooooooooooo!' at just the right times. I can always find someone to talk to, whether they've been down this road or not. I am grateful for the new friends I have made through support groups--people I likely would have never met otherwise but who are turning out to be close advocates, cheerleaders, and laugh-inducers. I am grateful for family who have risen to the challenge of supporting without being intrusive and respecting information boundaries set up for our emotional protection. I have never had to gently let a family member know that they have hurt my feelings. Well, once I did but I had misheard the offending conversation and then felt like a big jerk. But I had the courage to address it in the first place, which is huge for me. I am grateful that if not for infertiity, I wouldn't have a beautiful downward-facing dog (which I have been after for years!). My yoga practice has definitely improved. I am grateful for the strength that has risen to the surface during this difficult time--I can face so many obstacles and horrible phone calls and disappointments and devastations and survive them. I am capable of anything. I am (sort of) grateful for new skills I never knew I'd have--I can give myself subcutaneous injections in my own tummy with no help at all and no crying. And I can receive the dreaded intramuscular progesterone in oil shot in my ass without flinching. I am impervious to needles now. Bring on that epidural! I am also grateful that I have realized that my store of hope is a deep one. I have faced setback after setback and disappointment after disappointment, but we just keep moving forward because we have not lost hope. I am so proud of that, because it is incredibly hard to do in the face of what we are challenging. I have my moments of tears and hopelessness, and dramatic statements like "Hope isn't a thing with feathers, it's a thing with teeth!" and "My stupid 2011 bunny is a tangled mess on the side of the road!" -- but I spring back from them and keep the battle going with my sword of hope and shield of resilience in each hand. (Not to be dramatic again...)
It is possible to maintain a sense of control in this crazy, uncontrollable world of infertility. It is not easy to do--but it is possible. And I will take every chance I get to exert my personal, inner power over the Infertility Dragon. You can too!  

Sunday, January 2, 2011

Happy New Year

I love the New Year. It's a fresh start, full of possibilities. Some years are decidedly good, some are downright bad, and others are a mixed bag. I'm going to shoot for 2011 being a spectacular year. A friend sent me a note that this will be The Year of The Rabbit, which sounds good to me--a calmer and less crazy year than 2010's Year of the Tiger. Not crazy about Tigers. Tigers don't breed well. BUT, rabbits are ridiculously fertile. That's got to be a good omen...lots of little 2011 baby bunnies hopping about and spreading baby dust around the land! (Maybe I've got my holidays mixed up, but I'm liking this fantasy anyway.)

2010 was a very tough year. Not a totally awful year--I had a very good year at work, Bryce got a well-deserved promotion, we celebrated our first wedding anniversary, we had a lovely trip to Bar Harbor. But not a great year either--we spent the entire year in the pursuit of high-tech, high-stress, high-cost, low-yield babymaking. 2010 was a bust in that regard despite some really, really hard work on our part. It still amazes me that we have spent our entire first year as newlyweds embroiled in this process. The good thing is that it has made us stronger instead of slowly cracking us apart. So, in a way, 2010 showed us how strong, resilient, and determined we are as a couple and as a future expanded family unit.

2011, you are going to be the Year of the Baby. I just know it. Our Future Baby is just biding his/her time, waiting for just the right moment and just the right year to grace us with the unbelievable joy we have been searching and striving for.