Sunday, October 21, 2012

I'm Glad I'm Not a Salmon

Wait, what? What on earth does a salmon have to do with infertility? Today, EVERYTHING.

Today was a lovely fall day. Despite a really hot and really dry (and then at times really wet) summer, we have the most vibrant fall colors I've seen in a long time. It's gorgeous. So Bryce and I went for a walk today in a nearby nature park to enjoy the foliage and warmish fall day and get some exercise. We are lucky to have trails with waterfalls and marshes and woods within walking distance to our house. It was good to get out, because I have been (if you haven't guessed it already from recent posts) having a bit of a hard time lately, emotionally speaking. This nature park is, however, a magnet for the stroller set. So I braced myself and hoped that since it was 5, most baby-toting woods-enjoyers would be heading home for a feeding and bedtime. Little did I know the thing that would make me sad was not adorable babies in carriers, bouncing along the trails. It was a freaking fish.

The fish in question is in the photo above, bravely taken by Bryce as he balanced on a slippery, leaf-strewn rock in the middle of the Irondequoit Creek by Postcard Falls. This is a salmon. The salmon are running. For those of you who fly-fish, the salmon are running practically in my backyard. I don't fish so this does nothing for me, but apparently this sets the fisherpeople salivating. Anyway, apparently the salmon run when they are getting set to spawn. As in lay their eggs. As in procreate.

This particular salmon was stuck. It had chosen its path unwisely, and ended up in a shallow section of the brook where it was having a devil of a time launching itself up over the rock and into the deeper water. Of course once it gets to the deeper water, it has a set of little waterfalls to get over which were much more daunting than the one rock it couldn't leap over here, but I guess in deeper water the salmon can get more of a running start. This salmon was screwed in the shallow water.

We came up on it when there was quite the audience. The question was, do you help the salmon or not? Bryce valiantly took his shoes and socks off and started rolling his jeans up. He was going to be a hero to this little stuck salmon! He was going to try to snatch that salmon up like a bear, and instead of ripping it to shreds for dinner, toss it into the deeper water and give it a fighting chance for survival. Until this one guy started talking.

"You can't mess with Mother Nature," the guy said. "That fish has to get up those falls, and it probably has a bellyful of eggs. They're stronger than you think, these salmon. But, if it can't get over that rock, it probably is best to let Nature take its course." Enter an ENTIRE CONVERSATION about how if it's not smart enough (or able) to get over that rock and get unstuck, it's probably best for those multitudes of eggs to die with the salmon so that it doesn't pass on weaker offspring. Oh, and salmon do this to spawn, and it's fun to watch, and when a lady salmon can't spawn anymore, SHE DIES.

Can you imagine why this got me both pissed off and depressed at the same time? I mean, GIVE THE FREAKING SALMON A BREAK!!! Just because it took a wrong turn doesn't mean that it doesn't deserve to lay its eggs, especially if once it can't do the egg thing, its purpose in life is over. I hope that guy is wrong and the lady salmon have the chance to do some living after they reproduce. I thought about what it would be like to be a salmon and then teared up. Because man, I would make a shitty salmon. All I could think was, screw this "let nature take its course" crap! Help a salmon sister out! But I guess this is why it's good that I'm not a salmon. We left it alone, even though I thought maybe Bryce could be the equivalent of the salmon's reproductive endocrinologist by tossing it over the rock. And Bryce gave me a hug once I told him how pissed I was about the stupid fish, and said, "you are NOT a salmon." Somehow, that made me feel better.

Sunday, October 14, 2012

Why I Won't Get Pregnant "On My Own"

Yup, I know how negative this post title sounds. This is the dream, right? To strive and strive for a pregnancy only to miraculously find yourself pregnant, on your own, when you least expect it. Everyone knows someone this has happened to -- usually someone who was told it wasn't possible to get pregnant on her own, ever. I suspect everyone knows the same handful of people, or has read the same magazine article or seen the same daytime talk show about this phenomenon.

A phenomenon that gives credence to the "just relax" people -- "See--they'd totally given up, and THAT'S when it happened!" A phenomenon that backs up the asinine "adoption-as-fertility-treatment" theory--that once you put your stress over getting pregnant to bed and start the adoption process, BAM! Pregnant. Because you weren't thinking thing about it. Even though I actually know people who experienced this mythical miracle, I know a hell of lot more people who did NOT get pregnant on ther own. Or after adopting. Because that is NOT the norm.

It's difficult to respond to incredibly well-meaning people who assure me that now, in the break time, I could get pregnant. "You never know! Stranger things have happened!" Sometimes all I can do is just smile and weakly nod and say, "Yup, it's not impossible..." instead of explaining how UNBELIEVABLY IMPROBABLE that is. From multiple standpoints. I guess part of me doesn't want to burst that bubble of magical thinking. They have more hope than I do on this front.

Here are the factual reasons why it's highly, HIGHLY unlikely that I will find myself magically knocked up:

  • I have PCOS with ovulatory dysfunction. I rarely ovulate without drugs. No eggs, no baby.
  • Even if I did ovulate, the ectopic pregnancy left me with only one tube--so 50% of the time that egg that would go nowhere fertilizable.
  • We have significant male factor--those swimmers are scant in numbers and floundering in inflatable swim aids. THe chances of a rogue sperm making it to an actual traveling egg are miniscule.
  • In all our attempts, our fertilization rate WHEN THEY INJECT A SPERM DIRECTLY INTO MY EGGS is anywhere from 50-70%. Not looking good for that poor swimmer and floating mystery egg on their own.
  • I typically use assisted hatching with IVF, which means my poor, sad, defective little eggs have a crusty shell and can't hatch and attach without help. Even with this modification, my embryos haven't done well implanting.
  • In 7 IUIs, 4 fresh IVFs and 2 frozen transfers, we have had 16 confirmed embryos and 2 implantations. One in my tube (less than 1% chance of that with IVF! Go team on hitting THAT improbability!) and one in my uterus that crapped out shy of 6 weeks. Not great odds.
  • My miscarriage and poor implantation rate suggest a high probability of chromosomal abnormality. Which means if I did get pregnant on my own, it wouldn't likely last long.
So, between my faulty eggs, Bryce's faulty sperm, my missing tube, my disagreeable ovarian function, and embryos that can't get their shit together despite lots of help, I think it's probably not looking so hot for a miracle. Even though a miracle is technically success in SPITE of all of these overwhelming odds against us.

Which is why, as unbelievable as it is for some to understand, the biggest reason why I won't get pregnant on my own is because I choose to be on the Pill during my break. WHY deny yourself even a chance to have a miracle during your off time? is a cry I've received more than once. It seems counterintuitive, but here's why.

I am an incurable optimist when it comes to my dsyfunctional body. Because I don't ovulate, it takes me forever (if ever) to get a period. In the meantime, if I feel remotely tired, nauseous, sensitive to passing cigarette smoke, sore-boobed, etc. -- I WILL THINK IT'S POSSIBLE I'M PREGNANT. I will mull over it for a day or two, I will worry that I had margaritas or too much wine, and imagine my poor Fetal Alcohol Syndrom baby miracle who will hate me forever for being so irresponsible. Then I will turn and imagine how I will joyfully tell people that YES, I AM A MIRACLE. I will be tempted to pee on a stick and agonize over whether it's worth the money to buy a test (it's not). I will then call the clinic and request Provera to bring on a period, since at this point I have to call and say I haven't gotten it by day 35 or 40 or something equally ridiculous, and they will send me for a pregnancy blood test. And I will be actually upset when it is inevitably negative. It is ALWAYS negative. I have literally cried over a possible pregnancy that WAS NOT POSSIBLE. It's torture. The last time I put myself through this was particularly nasty, because I stayed off the Pill for weeks and weeks after my miscarriage and had spotting, then nothing. IT'S IMPLANTATION SPOTTING!!! I thought, with more hope than was healthy. Who knows, maybe my body became normal after a short-lived uterine pregnancy and it was actually a dress rehearsal for my REAL pregnancy! Um, no, crazypants. My system just sucks. And raging PMS is pretty damn close to early pregnancy symptoms, I just forget what PMS feels like system sucks. And so, my silver lining outlook is ultimately cruel to me. Although I did actually get my period, on my own, two weeks later, no Provera necessary--which is actually an ironic miracle all its own.

Therefore, I go on the Pill. In part so I get a regular period I can plan on like a normal person, but also so I can keep the miracle pregnancy fantasy tamped down. I need my break to be a real break, where I drink coffee and wine and tequila and eat processed Halloween candy and don't worry that I'm damaging my fragile fetal (nonexistent) miracle baby. Where I can get my body into decent shape with exercise that makes me sweat and raises my pulse and my core body temperature...again, without worrying that I'm damaging a fantasy fetus.

It keeps me sane, not "trying on my own." It gives me a rest from all this brou-ha-ha. Which in turn, I hope, gives me a better shot at actually getting pregnant under the expert direction of our fertility team, when it's time to go back into battle again.

Saturday, October 6, 2012

This Break Thing

I am having a little bit of difficulty with this break concept. I am trying to truly be on a break, but I am finding that incredibly difficult to do. How do you take a break from something as monumental as infertility? I can take a break from treatment, I can take a break from filling my days with infertility-focused things. But I can't take a break from myself. Infertility has been a journey filled with loss, sadness, loneliness, occasional spurts of hope and happiness followed up by crushing grief... and I don't think you can take a break from grief. It sneaks up on you. It seeps out the cracks. I don't have enough fingers to plug the holes.

See, even if you are physically taking a break, you never stop being infertile. You never stop feeling sorry for yourself when the pregnancy or birth announcements come through and you and your husband are still a household of cats, with no baby in sight. I can be happy I don't have to stick myself with needles right now, I can be happy that I can enjoy margaritas and wine. I can relish in sleeping in on Saturdays because I don't have to get up for a) a butt shot or b) a very tiny someone who needs something. The butt shot I can do without. The very tiny someone is a giant hole in our house and our hearts.

Here are the good things about being on a break:
- I can enjoy evening drinks
- I can drink pumpkin coffee (sadly not the pumpkin spice latte, the syrup isn't GF, but I've had luck with DD pumpkin coffee)
- I am not planning my schedule around doctor's appointments
- While I am carefully thinking about what foods I eat, I don't have to be militant about it. Soft cheeses are my friends.
- Bryce and I can plan little driving getaways--a fancy night away for our third anniversary, a Christmas vacation that's romantic and old-timey.
- We can save up the money we'll need for our next steps
- We have enough time that we can save up the money without feeling completely under the thumb of infertility

And here are the things that stink:
- This break is pretty long, by design but also by necessity. I am so jealous of people who can try to get pregnant on a monthly basis. For us it is now a yearly event.
- I am seemingly incapable of not thinking about our longing for a baby during this break. We are technically only a month in (I cannot count August, since we miscarried at the beginning of August and so that month was spent in thought and planning next steps and a whole lot of soul crushing grief), and I am failing miserably at not walking around with my scarlet IF on my chest all the time. I can't stop thinking about it. And I have nothing concrete to look forward to until 2013 in terms of ending this neverending process.
- Because, while I can enjoy the life that we have now, and I am grateful for everything that we share and the miracle that is our relationship and marriage together...I want this part of our life to be over. I want the "getting there" part that seems never ending (THREE YEARS of effort and disappointment and devastation with virtually no payoff) to get to that grand finale, so that we can enjoy our life without all this horrific uncertainty. We can go to dinner without feeling bitter about the family sitting behind us with the baby and the parents are easily 10 years younger than us (those parents will still be young in comparison when we're parents, we'll just have the "parenthood" part to ease the bitterness). Or overhearing people say things like "She gets pregnant if I sneeze on her" that in some other world are funny but to me is an amazingly foreign concept and a reason for incredible unfairness over why this is so easy for others and so, so hard for us.
- I don't know how to do this on a break thing. I don't know what to leave and what to keep. And I feel pretty lost about it.

Just to elaborate on that last one, I have been a terrible blogger. I have a million posts in my head, but I sit down to write them and I freeze up. I'm supposed to be on a BREAK! How can I keep writing about infertility if I'm supposed to be away from that? (Because it's impossible to leave it be, that's why.) I keep getting stuck. And because writing these blogs is a huge part of how I process all this, I am feeling emotionally constipated. I am stopped up but don't know how to fix it while still trying to be a "normal" person for a while.

Also, I started going to Fertility Yoga again. I went three times. I don't know if I can go back anytime soon. The yoga itself is very relaxing, and I like feeling like I'm preparing my body. But do I need to prepare my body months and months in advance when I am surrounded by reminders of just how infertile I am? The first time I went was surprisingly hard. Probably because the last time before that I got to share that I was pregnant and everything was looking great, and I was looking forward to my first ultrasound. So coming back with my tail between my legs, UN-pregnant and devastated, was not easy. So, at the beginning of class when everyone goes around and says something about where they are and what they need out of the practice that evening, I kept thinking "What am I going to say?" And then it was my turn. And I couldn't say anything. I said "My name is Jess, and..." I burst into tears. I was not expecting that. It took me a minute to get it together and then I sobbed, "I'm sorry, last time I was here I was pregnant and now I'm not and I'm on a break, on a break, on a break, and it will be good and I will get better and we will try again next year since 4 fresh and 2 frozen IVF cycles have not exactly worked out for us so far. I need shoulder-opening poses, please." It was interesting, because while I felt bad about exposing the raw grief of years of losses and doing everything I can to make this work and having it not result in a happy ending because there were so many first-timer Clomid IUI ladies joining up, at the same time I felt kind of like it wasn't so bad to let people know that there is the possibility that the path will be long and arduous regardless of effort. I feel like a jerk saying that, and it's not that I wish that on anyone at all, but I know that I am not alone in having a trip to the baby aisle in Target that has one hell of a gauntlet involved. And it's not a bad thing for people to know that.

I did have a good practice that night after the tears, and I did see a few people I hadn't seen in a while which was nice. So I decided to go back again. The next time I just said "I'm Jess and I'm on a break" and left it at that. Which was a little liberating. But then, someone announced a pregnancy (very exciting--it's wonderful when that happens, especially for someone who's had a very rough go of it herself), and it was fine during class but after class all these people were asking about ultrasounds and when you see the heartbeat and when you see the fetal pole and what to expect from the first weeks of pregnancy and I booked out of there like the place was on fire. Because I know what early pregnancy feels like and I know how exciting it is to go to your first ultrasound. And there it stops for me. Because my ultrasound experiences have been "Hmmm, there's nothing in your uterus, OH SHIT it's in your tube, let's get you into surgery tonight!" or "Let's do an ultrasound and see a sac but a few days earlier than your scheduled viability ultrasound because you are BLEEDING--oh look there's a sac! [go on bedrest, try to keep said sac from leaving, several days later...] Hmmm, I'm so sorry, there's nothing but debris in there." NO HEARTBEATS. No joy in either viewing. So listening to everyone talking hopefully about what their first ultrasounds would be like was very painful for me because I have never had an ultrasound that didn't result in horror.

Still, I tried again this week. And it was the first time that there was no one from the first three waves of people that I have gone to yoga with--there were people I've met very recently, but no other "veterans." I thought I would feel better somehow if it turned over completely. I didn't. I felt worse. I felt like a dinosaur, I felt very alone, and I cried all evening when I got back. I don't think I can do Fertility Yoga anymore, not when I'm on break. There's a waiting list, so maybe I shouldn't be going anyway since my procedures aren't for a while. But ultimately when I go the yoga part is great, but before and after makes me feel awful. And doesn't make me feel like I'm on a break. It keeps me in it.

So instead I'm going to go to regular yoga classes. I'm going to a crazy Yoga Sculpt class on Saturday mornings that is NOT fertility related at all and incredibly challenging. The only disadvantage is I am a chubber in that class and some poses make my hips hurt. Because, believe it or not, my progesterone butt shot sites STILL HURT. Amazing. My body doesn't want me to forget, apparently, either. But, I am trying to beat it into submission with weighted balance poses and side planks and pilates moves.

I am going to try my best to be on a break for the next couple of months. I may not always talk about my infertility during this time, but it is always there, lurking not far under the surface. I can do a better job of dealing with things that while in treatment would send me into a tailspin, but don't forget--I am still infertile. I am still grieving the loss of a baby that should have been. I am grieving the loss of years of treatment that has failed us, and coming to grips with our next steps. I may have a drink in my hand and be able to hold other people's babies at family functions, but inside I am still hurting. It doesn't go away. And so when I remove myself from conversations that can be painful (announcements, baby name conversations, etc.) please know I'm not rude, I'm just still infertile. And not superhuman. I will do what I need to to protect myself. And I will try my best to enjoy this break and not perseverate on the grief, but it is definitely there. Sometimes I need to sit in it. But sometimes I can just sit back and have a glass of Bordeaux and a dry aged steak with my husband on a Saturday night and be truly happy where I am, right now, despite all the mess we trudge through to get to this elusive goal of parenthood.