You guys, this picture over here is high tech coffee business happening in my kitchen. I'll get to that in a minute. I have been addicted to caffeine since I was 14... maybe younger. When I was in high school, I didn't like the taste of coffee, so I drank a can of Coke every morning - I know, sooo good for you. Wendy [for newer readers, Wendy is one of my oldest and dearest friends] tried to break me of my caffeine habit and I agreed to go sans morning Coke for a week. After two days, she brought me over to the vending machine and bought me a Coke - that's how horrible I was to be around with my caffeine detox. When I was 16, I went on a trip to Seattle and I've been drinking coffee ever since.
Last year I cut way back on my coffee intake. I read a lot of books suggesting that if you want to get pregnant, you have to cut out caffeine, alcohol, sugar, blah blah blah. I know some women who cut out coffee altogether, but the best I could do was limit myself to one small 6 ounce cup per day. I would drink it in the morning at home before I would leave for work. At that point, I was working in the morning through the afternoon, and then going to class in the evening. It's tough getting through a three hour class without another cup of coffee. The worst part was that in the summertime, people walk around with 40 ounce cups of beautiful iced coffee. I love iced coffee so very much. I look forward to it all winter, just waiting for that moment when the weather turns enough that I can get a giant iced coffee of my very own.
Coffee was the thing I struggled with the most, that I missed the most, in those many months of trying. When I would see those bastards walking past me with giant iced coffees, I'd want to knock it out of their hands.
After the miscarriage, I knew we were going to have some time off before I had to go back to being really good. So I got to enjoy some wine, and what not, but what I was really excited about was the coffee! More coffee! Iced coffee! To cheer me up, Jeeves made cold-brewed coffee so that I could have iced coffee every morning (with a little milk and simple syrup mixed in). He used this recipe to make it. The above picture is the process of straining the coffee into a container we can keep in the fridge. But I will note that he makes a much smaller portion because we don't have room for 8 quarts of iced coffee in our refrigerator. No matter, though - it is divine. It has made me so very happy.
My friend G who has struggled with infertility long ago made the transition to decaf (even though she readily admits it's not the same), and even when she's on a break from this crap, she sticks with the decaf because transitioning back and forth is so hard. I know that in September when I have to drastically cut down on my coffee intake again, I'm going to have to deal with caffeine withdrawal on top of all the other good stuff that comes with cycling. But oh, for this summertime iced coffee, it is so worth it.
Wednesday, July 24, 2013
Monday, July 22, 2013
"I think people get scared with things that look or seem different than them."
Welp, it's been a steamy week in NYC. I hate heatwaves so much more since I moved to New York from Jersey. Part of it is because I spend a lot more time outside now - I walk to and from work, the grocery store, basically any errand I have to run involves at least a 10 minute walk. As I result, I discovered a couple of years ago that I'm quite the face sweater. It's lovely, having a sweat mustache and goatee.
Jeeves and I went out to visit his parents in the suburbs this weekend. We both grew up in the 'burbs, and I've only lived in NYC for three and a half years at this point, so I really freaking love being somewhere with a backyard, a Target, and grocery stores with giant carts. I go out to the old man's house a least every other week, and when I do I get to drive around, cook in a big kitchen, and hang out with Kate's parents on their deck, watching the bats swooping down out of the dark as they snack on mosquitoes. I. Love. It. There were no bats to enjoy out in Westchester this weekend, at least in my in-laws' yard, but it was still really nice to admire my mother-in-law's (I call her "Ammie," which is a variant of "mother" in Hindi) tomato and blueberry plants and buy an insane amount of Ziploc bags at Sam's Club.
Ammie asked me at one point if I thought we would ever move out of the City. Ammie knows about our infertility issues and about my miscarriages. She's been very kind and never pushes me to talk. I know I'm very lucky because I've read so many blogs about women whose own parents or in-laws are total pills about the whole shitty situation. Anyway, I told her that we thought we'd like to move out of the City someday if we have kids. But if we don't have kids, we'd probably stay, unless a job took us elsewhere.
And this leads me to my bitch-and-moan fest about yet another crappy thing about infertility - the inability to make any sort of concrete plans for the future. Jeeves and I really hemmed and hawed about re-signing our lease this year. We both sort of thought/hoped that by this point we would have a baby, or be close to having a baby. That obviously didn't happen. So when our lease came up in May, we had to decide whether we would re-sign for one year or two. We live in a nice one bedroom, but like all one bedrooms in Manhattan, it is on the smaller side and we definitely would not want to have a baby in here for very long. We ultimately chose one year, which seemed really smart when I got pregnant this past May, but now seems a little less smart since we will definitely not have a baby before our lease is up next May.
I'm also sort of ambivalent about the idea of living in New York for the rest of my life if I don't have kids, but I see no point in moving out to the 'burbs and drastically increasing our commutes if it's just us. (I know, I know - we can adopt, and maybe we will, but I'm not ready to make that decision yet).
And then there's the job situation. I am a lawyer, unfortunately, who made the excellent decision a couple of years ago to stop being a lawyer and go back to school to get a library science degree. While I was in school, I got a part-time legal job with the City. I actually really like my job. I work with a bunch of retirees for the most part, and they are both funny, nice, and comically grumpy. The best part is that it is incredibly flexible - I can literally work whatever hours I want, whatever days I want, as long as I am there twice a month for an important meeting. The job is relatively interesting, not stressful at all, and pays fine considering all the other stuff. It's pretty much the perfect job to have if you're undergoing treatment for infertility and/or caring for a parent with cancer. Which is why this job has been impossible to give up. What I really want to do is work in a library. I have my M.L.S. degree now, and I'm really excited to be a librarian. But I just can't undertake a full-time job when I periodically have to disappear for treatment. I've considered looking into a part-time job that I could do in conjunction with my current PT law job, but I've been lazy about it. Because what I really want is to be a full-time librarian, but I can't see doing that until we resolve this infertility bullshit.
I don't want this whole post to be whiny doom and gloom. There's plenty of good stuff to report. Good old AF showed up this week - huzzah! Honestly, for the last 14 months, AF's arrival was depressing.... until I had a D&C and feared that I'd never see her again. So I'm glad that I've got a cycle again. It makes moving forward more real. And this week I get my blood drawn for Recurrent Pregnancy Loss (RPL) testing. That's the last thing I have to get done post-miscarriage. And it looks like Jeeves and I are going on vacation to Belgium the first week in September. So that's pretty exciting.
One of my main goals for the year was to read 52 books. I did great for the first six months of the year, but when we found out about the miscarriage, I started having trouble focusing on novels. I can start a book, but I can't seem to finish it. I'm 35 books in, and I know I'll get to 52, but it's been a bit of a struggle lately. So I was pretty excited when Ammie lent me her copy of Far From the Tree by Andrew Solomon. I've heard great things about it. I actually skipped right to the autism chapter, since my middle nephew, Cooper, is autistic. The title of this post is a quote from Carly Fleischmann, who is autistic and is able to communicate through typing. I'm looking forward to reading the rest of it. Non-fiction can be a great palate-cleanser for me. After that, I can go back to reading too much dystopic sci-fi and epic fantasy.
Jeeves and I went out to visit his parents in the suburbs this weekend. We both grew up in the 'burbs, and I've only lived in NYC for three and a half years at this point, so I really freaking love being somewhere with a backyard, a Target, and grocery stores with giant carts. I go out to the old man's house a least every other week, and when I do I get to drive around, cook in a big kitchen, and hang out with Kate's parents on their deck, watching the bats swooping down out of the dark as they snack on mosquitoes. I. Love. It. There were no bats to enjoy out in Westchester this weekend, at least in my in-laws' yard, but it was still really nice to admire my mother-in-law's (I call her "Ammie," which is a variant of "mother" in Hindi) tomato and blueberry plants and buy an insane amount of Ziploc bags at Sam's Club.
Ammie asked me at one point if I thought we would ever move out of the City. Ammie knows about our infertility issues and about my miscarriages. She's been very kind and never pushes me to talk. I know I'm very lucky because I've read so many blogs about women whose own parents or in-laws are total pills about the whole shitty situation. Anyway, I told her that we thought we'd like to move out of the City someday if we have kids. But if we don't have kids, we'd probably stay, unless a job took us elsewhere.
And this leads me to my bitch-and-moan fest about yet another crappy thing about infertility - the inability to make any sort of concrete plans for the future. Jeeves and I really hemmed and hawed about re-signing our lease this year. We both sort of thought/hoped that by this point we would have a baby, or be close to having a baby. That obviously didn't happen. So when our lease came up in May, we had to decide whether we would re-sign for one year or two. We live in a nice one bedroom, but like all one bedrooms in Manhattan, it is on the smaller side and we definitely would not want to have a baby in here for very long. We ultimately chose one year, which seemed really smart when I got pregnant this past May, but now seems a little less smart since we will definitely not have a baby before our lease is up next May.
I'm also sort of ambivalent about the idea of living in New York for the rest of my life if I don't have kids, but I see no point in moving out to the 'burbs and drastically increasing our commutes if it's just us. (I know, I know - we can adopt, and maybe we will, but I'm not ready to make that decision yet).
And then there's the job situation. I am a lawyer, unfortunately, who made the excellent decision a couple of years ago to stop being a lawyer and go back to school to get a library science degree. While I was in school, I got a part-time legal job with the City. I actually really like my job. I work with a bunch of retirees for the most part, and they are both funny, nice, and comically grumpy. The best part is that it is incredibly flexible - I can literally work whatever hours I want, whatever days I want, as long as I am there twice a month for an important meeting. The job is relatively interesting, not stressful at all, and pays fine considering all the other stuff. It's pretty much the perfect job to have if you're undergoing treatment for infertility and/or caring for a parent with cancer. Which is why this job has been impossible to give up. What I really want to do is work in a library. I have my M.L.S. degree now, and I'm really excited to be a librarian. But I just can't undertake a full-time job when I periodically have to disappear for treatment. I've considered looking into a part-time job that I could do in conjunction with my current PT law job, but I've been lazy about it. Because what I really want is to be a full-time librarian, but I can't see doing that until we resolve this infertility bullshit.
I don't want this whole post to be whiny doom and gloom. There's plenty of good stuff to report. Good old AF showed up this week - huzzah! Honestly, for the last 14 months, AF's arrival was depressing.... until I had a D&C and feared that I'd never see her again. So I'm glad that I've got a cycle again. It makes moving forward more real. And this week I get my blood drawn for Recurrent Pregnancy Loss (RPL) testing. That's the last thing I have to get done post-miscarriage. And it looks like Jeeves and I are going on vacation to Belgium the first week in September. So that's pretty exciting.
One of my main goals for the year was to read 52 books. I did great for the first six months of the year, but when we found out about the miscarriage, I started having trouble focusing on novels. I can start a book, but I can't seem to finish it. I'm 35 books in, and I know I'll get to 52, but it's been a bit of a struggle lately. So I was pretty excited when Ammie lent me her copy of Far From the Tree by Andrew Solomon. I've heard great things about it. I actually skipped right to the autism chapter, since my middle nephew, Cooper, is autistic. The title of this post is a quote from Carly Fleischmann, who is autistic and is able to communicate through typing. I'm looking forward to reading the rest of it. Non-fiction can be a great palate-cleanser for me. After that, I can go back to reading too much dystopic sci-fi and epic fantasy.
Thursday, July 18, 2013
My optimism wears heavy boots and is loud*
I went to visit my dad this week (the Old Man, which yes, I do call him to his face), and we started talking about his brother and his brother's wife. The Old Man is going to turn 78 in August, and his big bro is 82. He's in very good health now, but he's a cancer survivor. Unlike Dad, they caught my uncle's cancer before it metastasized and he's been cancer free for over five years now. My aunt, on the other hand, is in very poor health, has been mostly confined to a wheelchair for a number of years, and just had her leg amputated. Although she seemed to be doing well, was getting fitted for a prosthetic and was doing physical therapy, she has since fallen a few times and seems to be doing worse than she was before the amputation. Anyway, Dad was telling me that sometimes it's hard for him when he talks to his brother because his bro is such a positive person - he's always so upbeat no matter how poorly his wife is doing. He always believes it's going to get better. And then Dad gets on the phone with his sister-in-law and she's so negative (understandably) about everything. Dad feels badly for her, but he really worries about his brother, whether he'll be able to maintain his optimism, how he would react if his wife dies, and the physical toll caring for his wife might have on him.
You'll have to bear with me while I get to my point. I was never a very optimistic person, and I always used to focus on the worst case scenario. It just seemed to me that it would be best to expect bad things to happen because then you wouldn't be blindsided if they did actually happen, and if they didn't, you could feel pleasantly surprised. A therapist I went to years ago once asked me how it feels to dwell on poor future outcomes and I told her it felt crummy. She asked if it made the bad thing less awful when it actually happened. I said, no, I still generally felt really miserable when the bad thing happened. Her point being that I was wasting a lot of emotional energy expecting and dwelling on the worst case scenario when it didn't really gain me anything. That's not to say that I wander blindly around in a peppy, Pollyanna-ish fog, but I do try to limit how much I hang on to those negative thoughts.
When Dad was diagnosed, I went from a general pessimist to more of an optimist. I'm not entirely sure why. The statistics have always been stacked against us - the five-year survival rate for stage IV colon cancer is currently 6%, but it was even lower when the old man was diagnosed over four years ago. We had no reason to be optimistic. But I just felt really confident that the chemo would work for him. But I also sort of felt like I had to be positive and upbeat for Dad, because sometimes it's tough to do that for yourself. None of this upbeat thinking stopped me from bawling on the day we found out the first round of chemo was actually working - I still felt the intensity of that relief acutely, and I was still (am still, actually) nervous before every CAT scan result. In fact, before each CAT scan result, I think about how to buck up Dad if it's bad news. But I still feel optimistic for Dad, even though we both know that someday he is going to die from his cancer.
None of this optimism has really translated to our infertility treatments, especially when it came to the IUI. When Jeeves and I started our first IUI cycle, I was so sure it would not work for us, that we were wasting our time. Right after the cycle started, I went out to dinner with Roo and another friend and told them about what was going on with us and the IUI. Roo said, "I have a really good feeling about this!" (the eternal optimist, that Roo). I said, "I'm glad that somebody does." She asked what I meant and I explained how I was kind of down on the whole thing. I said I had thought for awhile that I was an optimist, but now I wasn't so sure. Basically, I still feel optimistic for other people, I still believe good things are going to happen for other people - I really do. I've just been struggling to feel that way for myself.
Which is why, when my dad told me about my uncle and aunt and his concerns, in my self-centered way I related it back to my own situation. Jeeves is such a positive person, he totally believes that we will have our own baby someday. And he has to spend a lot of time bucking me up, reassuring me, lifting me. On the one hand, that's kind of how marriage goes sometimes. But on the other, I realized that it's not fair to always put him in that situation. I need to work at being more optimistic for myself. If I could believe in my heart that my cancer-riddled father was still going to be around a year after his diagnosis, and then a year after that, and a year after that, then I can believe that in some way, we will be parents someday.
*that's a Henry Rollins quote
You'll have to bear with me while I get to my point. I was never a very optimistic person, and I always used to focus on the worst case scenario. It just seemed to me that it would be best to expect bad things to happen because then you wouldn't be blindsided if they did actually happen, and if they didn't, you could feel pleasantly surprised. A therapist I went to years ago once asked me how it feels to dwell on poor future outcomes and I told her it felt crummy. She asked if it made the bad thing less awful when it actually happened. I said, no, I still generally felt really miserable when the bad thing happened. Her point being that I was wasting a lot of emotional energy expecting and dwelling on the worst case scenario when it didn't really gain me anything. That's not to say that I wander blindly around in a peppy, Pollyanna-ish fog, but I do try to limit how much I hang on to those negative thoughts.
When Dad was diagnosed, I went from a general pessimist to more of an optimist. I'm not entirely sure why. The statistics have always been stacked against us - the five-year survival rate for stage IV colon cancer is currently 6%, but it was even lower when the old man was diagnosed over four years ago. We had no reason to be optimistic. But I just felt really confident that the chemo would work for him. But I also sort of felt like I had to be positive and upbeat for Dad, because sometimes it's tough to do that for yourself. None of this upbeat thinking stopped me from bawling on the day we found out the first round of chemo was actually working - I still felt the intensity of that relief acutely, and I was still (am still, actually) nervous before every CAT scan result. In fact, before each CAT scan result, I think about how to buck up Dad if it's bad news. But I still feel optimistic for Dad, even though we both know that someday he is going to die from his cancer.
None of this optimism has really translated to our infertility treatments, especially when it came to the IUI. When Jeeves and I started our first IUI cycle, I was so sure it would not work for us, that we were wasting our time. Right after the cycle started, I went out to dinner with Roo and another friend and told them about what was going on with us and the IUI. Roo said, "I have a really good feeling about this!" (the eternal optimist, that Roo). I said, "I'm glad that somebody does." She asked what I meant and I explained how I was kind of down on the whole thing. I said I had thought for awhile that I was an optimist, but now I wasn't so sure. Basically, I still feel optimistic for other people, I still believe good things are going to happen for other people - I really do. I've just been struggling to feel that way for myself.
Which is why, when my dad told me about my uncle and aunt and his concerns, in my self-centered way I related it back to my own situation. Jeeves is such a positive person, he totally believes that we will have our own baby someday. And he has to spend a lot of time bucking me up, reassuring me, lifting me. On the one hand, that's kind of how marriage goes sometimes. But on the other, I realized that it's not fair to always put him in that situation. I need to work at being more optimistic for myself. If I could believe in my heart that my cancer-riddled father was still going to be around a year after his diagnosis, and then a year after that, and a year after that, then I can believe that in some way, we will be parents someday.
*that's a Henry Rollins quote
Sunday, July 14, 2013
Arrange your face
I'm not a cryer. I used to be. But not anymore. When Dad was diagnosed with cancer, I sort of came to the conclusion that as his primary caregiver, I wasn't going to be allowed to cry anymore. That doesn't mean I never cry at stuff, I definitely do, but it's more to prove a point that I don't get weepy anymore over "silly" things the way I did when I was younger, and I'm much more able to talk myself out of tears when I feel them coming on.
In the days following my D & C, I found myself on the verge of tears a lot. I know that kind of sounds like a "well, duh, you had a miscarriage and it's sad" sort of thing, but that's not what I was crying about. I was crying about really dumb stuff. In the days before the D & C, I cried, and I sort of made my peace with the situation. But I later learned that after a miscarriage - be it natural or medically-induced - your hCG levels start to plummet and that can cause moodiness and other good stuff. So that's the background.
I read Wolf Hall by Hilary Mantel earlier this year. It's the first book in a planned trilogy, historical fiction with Thomas Cromwell as the main character. I loved it, it was one of the best books I've ever read, and I'm very much looking forward to reading the sequel, Bring Up the Bodies. I like to listen to NPR podcasts when I walk to and from work, and on the Monday following my D& C, I was pleased to see that Terry Gross of Fresh Air had posted an interview with Hilary Mantel. The first half of the interview just deals with Wolf Hall and Bring Up the Bodies, Mantel's thoughts on Cromwell and Henry VIII in general, and so on. In the last ten minutes of the interview, which I was listening to on that hot day as I walked home from work, Terry Gross asks Mantel to discuss her lifelong battle with endometriosis. Mantel explained what endo is and then in her typical, matter-of-fact, British way, stated: "I suffered from it, I think since I was 11 years old. It wasn't diagnosed; I kept getting sent away and told that it was all in my mind. When I was 27, the whole thing came to a crisis, and I had surgery, big surgery. I lost my fertility. I didn't have any children; I don't know whether I would have been able to have children. Unfortunately, that surgery didn't cure the condition. It came back, and I lived with it for the next 20 years. It's now died back, it's quiescent, but it's done a lot of damage to my body."
I knew that Mantel was married, had been married for a long time, and I knew that she didn't have children. But I never realized that she suffered from endo and infertility. And by this point on my walk home, I'm snotting all over the place with big fat tears running down my cheeks. And the real reason, the real thing that was making me cry, aside from how frankly she spoke about her problem, was that Hilary Mantel has led a really interesting life, she is an incredibly gifted writer, and her work means something to me and to other people. And long after she is gone, it will continue to do that. Of course I logically know that if I never have children of my own, my life will still have value and meaning. Of course. But if I'm being honest, I don't always feel that way. I worry that if I can't have children, my life will mean less, will be less fulfilling. But hearing Hilary Mantel talk, it made me feel a little more like my life can still be full and rich and worthwhile not just for me, but for other people even if I don't have kids.
Then she started talking about her personal feelings on religion, and I teared up again in the middle of Duane Reade because I agreed with so much of what she said. But that's neither here nor there.
Thomas Cromwell of Mantel's telling would totally not have approved of my weepiness - that's the point of this post's title. Cromwell is always instructing himself and his underlings to "arrange your face" so as not to give anything away, to keep from looking shocked or angry or pleased when negotiating. Ultimately, though, my hormones stabilized and I stopped crying while walking to work listening to podcasts. And now I'll leave you with a little Wolf Hall. In this scene, Cromwell is talking to his wife about Queen Katherine, whom Henry VIII is trying to divorce:
"He doesn't like her crying."
"Men say," Liz reaches for her scissors, "'I can't endure it when women cry' - just as people say, 'I can't endure this wet weather.' As if it were nothing to do with the men at all, the crying. Just one of those things that happens."
"I've never made you cry, have I?"
"Only with laughter," she says.
Friday, July 12, 2013
Okay for now
I'm stealing the name of this post from an excellent middle grade/YA novel by the same name. The novel has absolutely nothing to do with the theme of this post, but I always like to plug a good book.
Watch out, this one's a doozy. Thanks to Ned Ryerson for that.
I haven't written on this blog in just over a year, and I have obviously fallen way off in recapping Jeeves' and my adventure in France which was (jeez) almost two years ago now. Since that trip, we've been to Italy and Portland/Seattle/surrounding PacNW environs. Also little trips to Chicago and Cincinnati. I may get back to recapping the Paris trip at some point, but for the time being, I want to talk about something else.
Not sure what inspired me to start writing on this blog again, although the number of blogs I have been reading lately probably has something to do with it. Yeah, I've been reading a lot of blogs kept by fellow infertiles lately. But I have no desire to keep a blog solely focused on that aspect of my life. I understand why people do it, but when I'm in the middle of a treatment cycle, I really don't want to share the details of it with others, with the exception of my acupuncturist and a close friend who has dealt with infertility (and therefore knows what all the numbers mean and all the slang and abbreviations, and knows how I feel about everything before I even have to voice it because she's already been there). And since my miscarriage, I feel even more sure that when we eventually start treatment again, I'm not going to want to talk about it.
So here's my thought on the matter - I will periodically be posting about infertility here. I won't always be posting about infertility. I'll hopefully be posting again about books and articles and movies and restaurants and food (glorious food!) like I used to. I won't be posting details about my treatment cycles, although I'll surely still post about my feelings and thoughts and what not. For those of you who read this blog because you know me in real life and you're just following along, I promise I will try to limit the gory details.
Here is how we got here, if you don't already know: Jeeves and I have been together for over 7 years now, we've been married for just under 2. We both always knew we wanted kids. I went off the pill in April 2012. Got my first post-pill period in May 2012. In June, I started "charting" (that means taking my temperature when I wake in the morning every day and putting it on a little chart to determine if I am ovulating and how long my luteal phase is). Everything looked pretty good on my chart, it seemed like I was ovulating. In July, I started using ovulation predictor kits (OPKs). I was indeed ovulating properly. And if you're a fellow infertile, yes, I read Taking Charge of Your Fertility cover to cover.
By early September, still not pregnant despite everything appearing fine, I started to get really nervous. I was 34 and time seemed of the essence. My aforementioned friend who has dealt with infertility for many years wasn't far from my mind. I've never been one of those people who assumed I'd just get pregnant without any problems. So I made an appointment to go to a reproductive endocrinologist (RE). She recommended a battery of tests: general blood tests for both of us, a hysterosalpingogram (HSG) for me, a semen analysis (SA) for Jeeves, and a variety of cycle-specific tests for me (estradiol, FSH, progesterone) and anti-mullerian hormone (AMH) which can suggest if you have diminished ovarian reserve. Long story short - every one of my tests came back just fine. Totes normal. I was shocked. I was so sure if anything was wrong, it would be with me. Jeeves's SA showed an issue - fine volume, count, motility, but very low morphology. A follow up a month later showed the same thing.
Our RE told us it wasn't impossible for us to get pregnant without help, but that it might not happen without assistance. She diagnosed us as "unexplained infertility with mild male factor." She recommended we try three cycles of intra-uterine insemination (IUI), and if that didn't work, move onto in vitro fertilization (IVF). If you're wondering why I'm spelling everything out and linking, it's because I've found that the majority of people in my life honestly did not know the difference between IUI and IVF before I told them about it. We were okay with this because IUI is covered by our insurance, but IVF is not. Still, I've read several studies that indicate in women over 35 (I wasn't there yet, but close), with partners who have poor morphology, there was absolutely no benefit to IUI. I asked our RE about this and she said she still thought it was worth a try, but no more than 3 cycles.
We decided to take a couple more months and try on our own. Nothing happened. Beginning of February, I did IUI #1. Exactly 14 days after my insemination, I got my period (good old Aunt Flo, or AF to anyone who spends time on infertility boards). I was still charting at this time and had seen my temperature dip, so I knew it was coming. I went in for my day two baseline (for the non-IFers, when you are in treatment, you usually go in on day 2 or 3 of your cycle for a "baseline" blood test and ultrasound to make sure you don't have cysts, check your uterine lining, get blood drawn, and get your marching orders for meds). That afternoon, while shopping for baby clothes for other friends (Super fun. Not depressing at all. Right.) I got a call from my clinic - I could not start my clomid (that's the medicine I take to make sure I ovulate some pretty eggs) because my pregnancy test came back positive. "That's not possible," I told the nurse. "I have my period - and it's not spotting, it's a real period." Nevertheless, I would have to come back in and get my blood tested again in a few days. I realized immediately it was probably a chemical pregnancy. On the one hand I was sad, of course, but on the other, I thought - hey, my egg and Jeeves's sperm actually DID something! That's a change! Over the next two weeks, they tracked by hCG levels (aka betas). In a normal pregnancy, your hCG doubles every 48-72 hours. My next beta was in these parameters - could it be that this could possibly work out? Ha ha. No. Two days later, it had only gone up a a few points and my RE called to tell me this was not a viable pregnancy. Next beta then did double normally! Could my RE be wrong? No. After that, they fell. It was disappointing, but not crushing since I had always known having a full-on period, low basal temperatures, and crappy low betas was not a good thing.
IUI #2 was just a plain old big fat negative. Nothing to see here, folks.
IUI #3 started out disappointing - my follicles developed much more slowly than they had the previous cycle. We got through the insemination, and I tried really hard to not feel hopeless about the whole thing. In the meantime, I started researching IVF protocols so I would be prepared when meeting with our RE when this IUI cycle surely failed. But something happened - my temps didn't fall like they usually do before I get my period, and I started having pregnancy symptoms. At 12 days post IUI (12dpiui), I took a home pregnancy test (HPT) and it was positive! Jeeves and I were so happy. I took one every day after that, hoping it would get darker, and it did. My first beta at 14dpiui was 118! That's great! Great great great! My next beta few days later was 476! Beautiful! A doubling time of 48 hours - perfect! I should note that most clinics only require 2 beta tests and then they schedule you for an ultrasound a couple of weeks down the road. Not mine - mine requires, like, 4 or 5. Beta #3 was 856 - a 56 hour doubling time, so that's okay. At this point, Jeeves and I were feeling pretty good. I hate the beta roller coaster, but it seemed like we could maybe be happy now.
After Memorial Day weekend, I went for beta #4 and knew I was in trouble when the doctor called instead of the nurse. My beta was 2146, which is a 95 hour doubling time. Not so hot. The RE was worried about a possible ectopic pregnancy (that's when the embryo implants in your fallopian tube, or anywhere else other than the uterus). They wanted me to come in the next day, when I would be 5 weeks and 5 days pregnant (5w5d) for an ultrasound to rule out ectopic. That day was one of the crummier days of my life. Don't get me wrong, it's not up there with the day my mom died or the day Dad was diagnosed with cancer and had emergency bowel resection, but it was definitely crummier than most other days of my life. Definitely crummier than when we got bedbugs. Our RE (it's a group practice so on this day, the doctor I saw, who is very nice, was about 6 months pregnant herself.... the irony of that was not lost on me) basically was concerned that what turned out to be my corpus luteum was possibly an embryo attached to my ovary. In my uterus, she saw a small gestational sac, but she couldn't rule out that it was just a hematoma. So she sent me down the road for a high resolution scan at the snazzy high risk ob/gyn. The high risk OB thought it was stupid that I was there, said it was clearly a corpus luteum, agreed that he couldn't see anything in the gestational sac, but also said it was really too early to know anything.
Thus followed an awesome ultrasound roller coaster. At 6w5d, after making peace with the fact that this would probably be a blighted ovum (where the embryo implants but then never really forms, thus leaving an empty sac), our RE saw a yolk sac! Could it just be that my tilted uterus (yeah, found out I have one of those) was preventing us from seeing the bean? Possibly! No, dopey Megs, but it's cute how hopeful you get sometimes. At 7w3d, our RE could see the fetal pole, but there was no heartbeat and it was measuring at only 6 weeks. She was pretty sure this was not viable. She sent us back to the high resolution scan people and they confirmed at 7w4d - I had what is called a missed miscarriage, which means the embryo died, but your body is too dumb to do anything about it. I talked to my RE at length about what to do and in the end decided to have a D & C at 7w6d. It went fine. I'm glad I did it instead of waiting weeks for it to happen naturally.
Unfortunately, genetic testing of the product of conception (POC) was cross-contaminated with my awesome cells, and so we will never know if it was a chromosomal issue (most likely) or something else. In the mean time, my RE is having Jeeves and me karyotyped to make sure there is nothing wonky with our chromosomes, and I am having a whole bunch of blood tests soon to make sure I don't have an immune or clotting disorder that makes me more susceptible to miscarriage (aka, a recurrent pregnancy loss, or RPL, blood panel).
Today, just over 4 weeks since the D & C, my hCG level finally dropped down to 8, which is not quite negative (anything below 5 is negative), but means I can stop being a pin cushion at my RE's office for a couple of months until we start this bullshit over again.
Hopefully in September, we'll try IUI again. As you may have noticed, I have had 3 of these IUIs and my RE had said she would limit it to 3. But since I got pregnant 2 out of those 3 times, she thinks we should stick with this rather than move onto IVF. Works for me.
That is the story. I have been feeling all of the feelings since then. I know that if Jeeves and I get pregnant again, we will never get to be one of those happy pregnant couples. We will always know that one positive home test is meaningless, that two or three good betas are meaningless. Maybe if we get a heartbeat on an ultrasound I will feel happy, but I know too many other women who got that far and had miscarriages. We know how the sausage gets made now, there's no turning back.
The truth is, I am okay. I was really sad for awhile, and really jealous of every pregnant woman I saw for several weeks. The hardest part has been feeling like we can't move forward - we are stuck in this waiting room until my tests are done and I have a period or two. On the other hand, I realize that having a break is probably the best thing for me.
I had a couple of minor epiphanies about this whole situation this past week. I was reading an article in the Times about women in Ohio who were recently freed after a decade of captivity. They made a video to thank people for the support, and Michelle Knight said, "I will not let the situation define who I am. I will define the situation.” My first thought was, wow, that's a great sentiment. And it got me thinking about the labels we wear and how they define us. My husband and I are experiencing infertility and early pregnancy loss. But that does not define who we are. For me, I define myself as a wife, daughter, sister, auntie, friend, ginger, New Yorker, New Jerseyan (in my heart), erstwhile litigator, hopeful librarian. Those labels define me. Infertile does not define me. Does it influence how I feel and think about certain things? Sure. Will I remember all this stuff if we ever get pregnant? Definitely. Will I be honest about how hard it was for us to have a child, if we ever have children? Absolutely. But I am going to define this situation, not the other way around.
The other epiphany involved my mother. Mom died very suddenly of what we assume was a massive heart attack over seven years ago. We were very close. Her death was very hard on me (and did indeed define me for awhile). At the time she died, I was 27, which is still a pretty young age to lose your mom, even though I was an adult. I had only one other friend, Roo, whose mother was dead. And actually, seven years later, although I do know other people in my age-group who have lost their mom, Roo remains my only actual friend who is motherless as well. When you are in your late twenties and thirties and your mom is dead, life is different than it is for other people who still have their moms. When my mom first died, I was jealous of other people who still had their mothers. It passed. Of course I still wish my mother were here, but she's not. For better or worse, I am in that crappy exclusive club of people whose moms are dead. And our path is different. Lots and lots of people get pregnant with no trouble. Lots and lots of people never have a miscarriage. That's not my life. And there's no use pouting about it. My path is different. This realization made me feel a little less angry at every pregnant woman I saw. My friends who still have their moms? They didn't steal my mom. My mom isn't dead because those other moms are still alive. And I don't want someone else's mom - I want my mom. Likewise, those women aren't pregnant with my baby and their success is not my failure. And I don't want their baby - I want my baby. This doesn't mean I won't have bad, jealous moments, days or even weeks. But I realize my path to having a child is different, and hopefully we'll have better luck next time.
Watch out, this one's a doozy. Thanks to Ned Ryerson for that.
I haven't written on this blog in just over a year, and I have obviously fallen way off in recapping Jeeves' and my adventure in France which was (jeez) almost two years ago now. Since that trip, we've been to Italy and Portland/Seattle/surrounding PacNW environs. Also little trips to Chicago and Cincinnati. I may get back to recapping the Paris trip at some point, but for the time being, I want to talk about something else.
Not sure what inspired me to start writing on this blog again, although the number of blogs I have been reading lately probably has something to do with it. Yeah, I've been reading a lot of blogs kept by fellow infertiles lately. But I have no desire to keep a blog solely focused on that aspect of my life. I understand why people do it, but when I'm in the middle of a treatment cycle, I really don't want to share the details of it with others, with the exception of my acupuncturist and a close friend who has dealt with infertility (and therefore knows what all the numbers mean and all the slang and abbreviations, and knows how I feel about everything before I even have to voice it because she's already been there). And since my miscarriage, I feel even more sure that when we eventually start treatment again, I'm not going to want to talk about it.
So here's my thought on the matter - I will periodically be posting about infertility here. I won't always be posting about infertility. I'll hopefully be posting again about books and articles and movies and restaurants and food (glorious food!) like I used to. I won't be posting details about my treatment cycles, although I'll surely still post about my feelings and thoughts and what not. For those of you who read this blog because you know me in real life and you're just following along, I promise I will try to limit the gory details.
Here is how we got here, if you don't already know: Jeeves and I have been together for over 7 years now, we've been married for just under 2. We both always knew we wanted kids. I went off the pill in April 2012. Got my first post-pill period in May 2012. In June, I started "charting" (that means taking my temperature when I wake in the morning every day and putting it on a little chart to determine if I am ovulating and how long my luteal phase is). Everything looked pretty good on my chart, it seemed like I was ovulating. In July, I started using ovulation predictor kits (OPKs). I was indeed ovulating properly. And if you're a fellow infertile, yes, I read Taking Charge of Your Fertility cover to cover.
By early September, still not pregnant despite everything appearing fine, I started to get really nervous. I was 34 and time seemed of the essence. My aforementioned friend who has dealt with infertility for many years wasn't far from my mind. I've never been one of those people who assumed I'd just get pregnant without any problems. So I made an appointment to go to a reproductive endocrinologist (RE). She recommended a battery of tests: general blood tests for both of us, a hysterosalpingogram (HSG) for me, a semen analysis (SA) for Jeeves, and a variety of cycle-specific tests for me (estradiol, FSH, progesterone) and anti-mullerian hormone (AMH) which can suggest if you have diminished ovarian reserve. Long story short - every one of my tests came back just fine. Totes normal. I was shocked. I was so sure if anything was wrong, it would be with me. Jeeves's SA showed an issue - fine volume, count, motility, but very low morphology. A follow up a month later showed the same thing.
Our RE told us it wasn't impossible for us to get pregnant without help, but that it might not happen without assistance. She diagnosed us as "unexplained infertility with mild male factor." She recommended we try three cycles of intra-uterine insemination (IUI), and if that didn't work, move onto in vitro fertilization (IVF). If you're wondering why I'm spelling everything out and linking, it's because I've found that the majority of people in my life honestly did not know the difference between IUI and IVF before I told them about it. We were okay with this because IUI is covered by our insurance, but IVF is not. Still, I've read several studies that indicate in women over 35 (I wasn't there yet, but close), with partners who have poor morphology, there was absolutely no benefit to IUI. I asked our RE about this and she said she still thought it was worth a try, but no more than 3 cycles.
We decided to take a couple more months and try on our own. Nothing happened. Beginning of February, I did IUI #1. Exactly 14 days after my insemination, I got my period (good old Aunt Flo, or AF to anyone who spends time on infertility boards). I was still charting at this time and had seen my temperature dip, so I knew it was coming. I went in for my day two baseline (for the non-IFers, when you are in treatment, you usually go in on day 2 or 3 of your cycle for a "baseline" blood test and ultrasound to make sure you don't have cysts, check your uterine lining, get blood drawn, and get your marching orders for meds). That afternoon, while shopping for baby clothes for other friends (Super fun. Not depressing at all. Right.) I got a call from my clinic - I could not start my clomid (that's the medicine I take to make sure I ovulate some pretty eggs) because my pregnancy test came back positive. "That's not possible," I told the nurse. "I have my period - and it's not spotting, it's a real period." Nevertheless, I would have to come back in and get my blood tested again in a few days. I realized immediately it was probably a chemical pregnancy. On the one hand I was sad, of course, but on the other, I thought - hey, my egg and Jeeves's sperm actually DID something! That's a change! Over the next two weeks, they tracked by hCG levels (aka betas). In a normal pregnancy, your hCG doubles every 48-72 hours. My next beta was in these parameters - could it be that this could possibly work out? Ha ha. No. Two days later, it had only gone up a a few points and my RE called to tell me this was not a viable pregnancy. Next beta then did double normally! Could my RE be wrong? No. After that, they fell. It was disappointing, but not crushing since I had always known having a full-on period, low basal temperatures, and crappy low betas was not a good thing.
IUI #2 was just a plain old big fat negative. Nothing to see here, folks.
IUI #3 started out disappointing - my follicles developed much more slowly than they had the previous cycle. We got through the insemination, and I tried really hard to not feel hopeless about the whole thing. In the meantime, I started researching IVF protocols so I would be prepared when meeting with our RE when this IUI cycle surely failed. But something happened - my temps didn't fall like they usually do before I get my period, and I started having pregnancy symptoms. At 12 days post IUI (12dpiui), I took a home pregnancy test (HPT) and it was positive! Jeeves and I were so happy. I took one every day after that, hoping it would get darker, and it did. My first beta at 14dpiui was 118! That's great! Great great great! My next beta few days later was 476! Beautiful! A doubling time of 48 hours - perfect! I should note that most clinics only require 2 beta tests and then they schedule you for an ultrasound a couple of weeks down the road. Not mine - mine requires, like, 4 or 5. Beta #3 was 856 - a 56 hour doubling time, so that's okay. At this point, Jeeves and I were feeling pretty good. I hate the beta roller coaster, but it seemed like we could maybe be happy now.
After Memorial Day weekend, I went for beta #4 and knew I was in trouble when the doctor called instead of the nurse. My beta was 2146, which is a 95 hour doubling time. Not so hot. The RE was worried about a possible ectopic pregnancy (that's when the embryo implants in your fallopian tube, or anywhere else other than the uterus). They wanted me to come in the next day, when I would be 5 weeks and 5 days pregnant (5w5d) for an ultrasound to rule out ectopic. That day was one of the crummier days of my life. Don't get me wrong, it's not up there with the day my mom died or the day Dad was diagnosed with cancer and had emergency bowel resection, but it was definitely crummier than most other days of my life. Definitely crummier than when we got bedbugs. Our RE (it's a group practice so on this day, the doctor I saw, who is very nice, was about 6 months pregnant herself.... the irony of that was not lost on me) basically was concerned that what turned out to be my corpus luteum was possibly an embryo attached to my ovary. In my uterus, she saw a small gestational sac, but she couldn't rule out that it was just a hematoma. So she sent me down the road for a high resolution scan at the snazzy high risk ob/gyn. The high risk OB thought it was stupid that I was there, said it was clearly a corpus luteum, agreed that he couldn't see anything in the gestational sac, but also said it was really too early to know anything.
Thus followed an awesome ultrasound roller coaster. At 6w5d, after making peace with the fact that this would probably be a blighted ovum (where the embryo implants but then never really forms, thus leaving an empty sac), our RE saw a yolk sac! Could it just be that my tilted uterus (yeah, found out I have one of those) was preventing us from seeing the bean? Possibly! No, dopey Megs, but it's cute how hopeful you get sometimes. At 7w3d, our RE could see the fetal pole, but there was no heartbeat and it was measuring at only 6 weeks. She was pretty sure this was not viable. She sent us back to the high resolution scan people and they confirmed at 7w4d - I had what is called a missed miscarriage, which means the embryo died, but your body is too dumb to do anything about it. I talked to my RE at length about what to do and in the end decided to have a D & C at 7w6d. It went fine. I'm glad I did it instead of waiting weeks for it to happen naturally.
Unfortunately, genetic testing of the product of conception (POC) was cross-contaminated with my awesome cells, and so we will never know if it was a chromosomal issue (most likely) or something else. In the mean time, my RE is having Jeeves and me karyotyped to make sure there is nothing wonky with our chromosomes, and I am having a whole bunch of blood tests soon to make sure I don't have an immune or clotting disorder that makes me more susceptible to miscarriage (aka, a recurrent pregnancy loss, or RPL, blood panel).
Today, just over 4 weeks since the D & C, my hCG level finally dropped down to 8, which is not quite negative (anything below 5 is negative), but means I can stop being a pin cushion at my RE's office for a couple of months until we start this bullshit over again.
Hopefully in September, we'll try IUI again. As you may have noticed, I have had 3 of these IUIs and my RE had said she would limit it to 3. But since I got pregnant 2 out of those 3 times, she thinks we should stick with this rather than move onto IVF. Works for me.
That is the story. I have been feeling all of the feelings since then. I know that if Jeeves and I get pregnant again, we will never get to be one of those happy pregnant couples. We will always know that one positive home test is meaningless, that two or three good betas are meaningless. Maybe if we get a heartbeat on an ultrasound I will feel happy, but I know too many other women who got that far and had miscarriages. We know how the sausage gets made now, there's no turning back.
The truth is, I am okay. I was really sad for awhile, and really jealous of every pregnant woman I saw for several weeks. The hardest part has been feeling like we can't move forward - we are stuck in this waiting room until my tests are done and I have a period or two. On the other hand, I realize that having a break is probably the best thing for me.
I had a couple of minor epiphanies about this whole situation this past week. I was reading an article in the Times about women in Ohio who were recently freed after a decade of captivity. They made a video to thank people for the support, and Michelle Knight said, "I will not let the situation define who I am. I will define the situation.” My first thought was, wow, that's a great sentiment. And it got me thinking about the labels we wear and how they define us. My husband and I are experiencing infertility and early pregnancy loss. But that does not define who we are. For me, I define myself as a wife, daughter, sister, auntie, friend, ginger, New Yorker, New Jerseyan (in my heart), erstwhile litigator, hopeful librarian. Those labels define me. Infertile does not define me. Does it influence how I feel and think about certain things? Sure. Will I remember all this stuff if we ever get pregnant? Definitely. Will I be honest about how hard it was for us to have a child, if we ever have children? Absolutely. But I am going to define this situation, not the other way around.
The other epiphany involved my mother. Mom died very suddenly of what we assume was a massive heart attack over seven years ago. We were very close. Her death was very hard on me (and did indeed define me for awhile). At the time she died, I was 27, which is still a pretty young age to lose your mom, even though I was an adult. I had only one other friend, Roo, whose mother was dead. And actually, seven years later, although I do know other people in my age-group who have lost their mom, Roo remains my only actual friend who is motherless as well. When you are in your late twenties and thirties and your mom is dead, life is different than it is for other people who still have their moms. When my mom first died, I was jealous of other people who still had their mothers. It passed. Of course I still wish my mother were here, but she's not. For better or worse, I am in that crappy exclusive club of people whose moms are dead. And our path is different. Lots and lots of people get pregnant with no trouble. Lots and lots of people never have a miscarriage. That's not my life. And there's no use pouting about it. My path is different. This realization made me feel a little less angry at every pregnant woman I saw. My friends who still have their moms? They didn't steal my mom. My mom isn't dead because those other moms are still alive. And I don't want someone else's mom - I want my mom. Likewise, those women aren't pregnant with my baby and their success is not my failure. And I don't want their baby - I want my baby. This doesn't mean I won't have bad, jealous moments, days or even weeks. But I realize my path to having a child is different, and hopefully we'll have better luck next time.
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