Tuesday, January 28, 2014

Whose boobs are these?

Here follows a brief history of my boobs, which I'm sure you never wanted, but nevertheless, you are getting.   I have never been particularly well-endowed.  Sometime in high school, my mother took me to a Victoria's Secret to buy me some proper bras (I had been living in sports bras up till that point) and I fit into a 34B.  I wore a 34B from about the age of 15 until my early 30s.  Even when I gained weight, I didn't seem to gain in my boobs.  

When I moved to the City, I gained a little more weight (miraculous when I consider how much more walking I do in the City, but then again, I eat A LOT more thanks to Jeeves).   And basically none of it went to my boobs.  Well, that's not entirely true.  Not long before our wedding, I did notice that my 34Bs didn't seem to fit so well anymore, so I tried on some 34Cs, and voilĂ  - the new size fit better.  So since my early 30s, I've been a 34C.  

In early pregnancy, I didn't really notice any change to my boobs, other than that they freaking hurt a lot. [I will note that an old friend, upon seeing my bump picture that I took around week 12 exclaimed "Holy boobs!"  So apparently other people did notice them, even if I didn't.]  But maybe about three weeks ago, I started noticing that my bras were really, really uncomfortable and my cups runneth over.   The underwire was digging in, and just, no.  I hated them.  And I usually like my bras quite a bit (Calvin Klein t-shirt bras, you can get them on sale at Century 21, sometimes at TJ Maxx, and they are super comfortable).  I had read that there's such a thing as a maternity bra, but then there are also nursing bras.  But wasn't it too early for a nursing bra?  So I asked Kate what she did, but she said all she did was go buy her normal bra in a larger size.  Then I asked Penney, who has lent me all of her maternity clothes and that blessed, blessed pillow that keeps my hips from hurting.  Penney is my pregnancy maven.

I should add that in the midst of all this, my back was hurting between my shoulders, but I couldn't figure out why.  Because I'm dumb.

Anyway, Penney told me that she went to a proper bra shop and got fitted, and bought a bra to wear during her pregnancy (it's a normal bra, just a bigger size than she regularly wears), and that once she had her babies, she switched to the nursing bras.  She suggested Linda's Bra Salon, which is in the Murray Hill neighborhood of Manhattan.  I made an appointment and headed up there.  The saleslady was very nice and did not shriek in horror when she saw my bra/boobs, which I appreciated.  She measured me and brought back a bra for me to try.  True story - the bra I bought from her (by far the most expensive bra I have ever bought, but worth every penny in my opinion) is a 32F.  An F.  An F!!!!  I went from a C to an F?  Yes, yes I did.  Technically, I fit just fine in an E, but the saleslady thought that since the F also fit, I should go with that and it would give me a little more room to grow in.  Since, you know, I'm only halfway through this pregnancy and my boobs will get bigger.  Jesus.

So I want to say, to my well-endowed sisters, I never got it before, but I get it now.  All those years I spent as a lowly B, I was so jealous of your cleavage.  I did not realize the back pain, the stretched-out shirts, the fucking impossibility of finding a well-fitted, reasonably priced off-the-rack bra!  Because yeah, F cups don't come cheap.

Thankfully my back is hurting less now that I have a supportive bra.  I shudder to think about the size of my boobs by the time this pregnancy is over.  Yikes.

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And now I'm going to talk a little bit more about random pregnancy symptom stuff, so please skip if you are in a tough spot and this will be upsetting.

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Today I am 20 weeks.  It is completely surreal to me that this pregnancy is half way over.  I have a belly now.  Not enough of one that it's obvious I'm pregnant - I'm pretty sure people who don't know me would just assume I ate a really big lunch, but it is there.  The belly makes certain things hard, like sleeping, putting on socks, and squatting down to put things away in the kitchen.  I can feel Manuji moving every day, all the time.  Sometimes he squirms, sometimes he kicks.  It is really cool, and it means I no longer worry (at least not for more than a short period of time) about whether he is still alive in there.  

After 14 weeks, I got my energy back and food became fun again.  Food is still mostly fun, and I don't have any aversions (gosh, I really miss sushi.  And Italian subs.).  But I have to eat a lot more often.  I have to eat a much bigger breakfast in the morning than I typically care to, or I'll feel ill.  And I have to snack a lot.  I'm trying really hard to keep it healthy, but I'm also allowing myself some indulgences (like creamy dressings on my salad, which I never let myself have when I'm not pregnant and nightly hot chocolate). 

I have to pee all the time.  Usually it's because Manuji is sitting on my bladder.  Sometimes I think he uses it as a trampoline.

Because of my size, it's really easy to be lazy and sedentary.  I want to sit and eat and watch TV or read.  I do not want to go outside into the polar vortex.  I do not want to do laundry.  But it's a vicious cycle, the more I sit and do nothing, the more sleepy I get, and the more I want to do nothing.  I've discovered that I feel best when I force myself to go out and run errands and walk and do chores.  Then, I somehow have more energy.  I bought a couple of prenatal exercise videos - I really need to start doing those.  I also accidentally switched to a prenatal vitamin with no iron.  I think this was a mistake and was adding to my fatigue.  I've gone back to the kind with iron in and I've been feeling much better.

I so do not have a pregnancy glow.  My skin is dry and flaky, and my hair is flat.  But I'm choosing to blame this on the fact that I apparently live at the North Pole and smoosh my hair beneath a hat everyday.  Did I mention that it's 19 degrees in NYC right now?  According to the NY Times, by the month's end there will have been only 4 days in January with average temperatures, and 15 days with temps in the teens or lower.  In other words, I'm really done with winter.

Jeeves has a bad cold and I am hoping against hope that I don't get it.  Wish me luck.

Thursday, January 23, 2014

The Agony of the Feet

Warning: Ultrasound picture below.  Please skip if it will make you feel sad or bad in any way.  Hugs.

When I was in middle school, one of my favorite books was Remember Me to Harold Square by Paula Danzinger.  Yeah, it's not even in print anymore.  I'll spare you the details, but it's a cute book and it made 12 year-old me want to live in New York City.  Anyway, the protagonist has an annoying little brother and after a day of tromping around the Big Apple, he declares that he gets what sports announcers mean when they talk about "the agony of the feet."  I stole this joke, and I still use it.  [If you're not familiar, the actual expression is "the agony of defeat."]

I was so nervous for today's scan.  I spent a lot of time prepping myself for bad news and I was prepared to fire all sort of questions at the doctor, and then call up my OB and fire more questions at her.  The last two weeks have brought a whole new meaning to the agony of the feet.  But the other day Kasey from Stupid Broken Eggs sent me an awesome card and a gift for Manuji - an adorable little outfit and these socks.


One pair is orange - Jeeves's favorite color!  And the other has a little fox on them!  If you follow Kasey, you know she's going through her very first IVF egg retrieval and that whole process is tiring and draining and emotional.  I was so touched that she would think of me at a time like this.  Excuse me, I think I have something in my eye.

Kasey's gift, along with the little sock Jeeves found in his laundry, inspired me to wear my lucky Fighter socks that Smile from Infertility Absurdity sent to me back in November.  With my lucky socks on, I set out into the cold for my scan.

We got called back by a different ultrasound tech than last time (thank goodness, I hated that last bitch).  She asked how I was feeling, and I said fine, but nervous.  She asked me to tell her about what happened last time, so I told her about how they had trouble getting good pictures and in some of them, his feet looked clubbed, and in others they did not.  She said let's take a look then, and she immediately started with his feet.  After about a minute, she explained that he wasn't in the best position, but that from what she could tell, his feet looked okay.  She told me she'd come back to them, but that I could breathe a little.  It was really kind of her, and I appreciated it.

I had also, for some reason, worked myself up about his heart and brain (even though they looked fine at last scan).  She looked at those and told us as she went that everything looked great with his brain.  She scared me a little by looking at his heart, then looking at something else, then going back to his heart!  Why was she going back to his heart?  That scared Jeeves too.  I've heard stories about parents whose babies have heart defects and they talk about seeing "a spot" or "a bright spot" on the ultrasound - I kept wondering if I saw a spot.  Spoiler alert - I'm crazy, there was no spot, and his heart looks fine.

Then she went back to his legs and feet and spent a lot of time on them.  When all was said and done, she told us that she thought his feet were fine, but she'd go talk to the doctor and the doc would be in to see us in a minute.  I really, really appreciated that she gave us her opinion and didn't just leave us hanging like the last tech did.  She also told us that she had a case of club feet yesterday and that it was clear as day that the feet were clubbed from the moment she put the wand on the woman's belly.  

Dr. G came in and the first thing she said was "I think the feet are probably fine, but I'm going to take another look."  She looked again, and here's the gist of what she said.  One foot is definitely not clubbed.  She looked at it every which way and couldn't make it clubbed if she tried, as she put it.  The other foot was still hard to get a read on.  He keeps his feet in the same spot they were in two weeks ago, and so it can be hard to see.  In some of the images, the foot looks a little clubbed, in others it looks fine.  But she thinks that it's probably fine.  All his other measurements and organs were good.  He weighs 11oz, which is big for his gestational age, but nothing to be concerned about.  She wants us to come back to get one last look at that foot - I explained that Dr. C wants us to have the detailed anatomy scan, which is scheduled for 10 days from now - she said that would be a fine time to recheck the foot.  We talked to the tech again after that, and the gist of what she said was that even if that foot is clubbed, it's probably slight.  From my research, I know this can make a big difference - if the clubbing isn't too severe, it can sometimes be manipulated through massage and physical therapy without having to wear casts and braces.  And sometimes it requires casting, but no braces.  And the fact that there are no other markers in the ultrasound indicates that even if Manuji's foot is clubbed, it's isolated.  That is huge.

We were so relieved, not just about his feet, but that everything else looked normal.  I realize we're not out of the woods, but it did feel like a huge weight was lifted and I was so grateful.  When we walked out of the office, I poked my belly and said to Manuji, "You!  You're not even out yet and you're causing me so much stress!  Go easy on me!"

Jeeves and I felt like on the eve of his/her due date, the bean was looking out for us.  Even if I didn't have my magic ring.  Thanks so much for all the prayers, positive vibes, advice.  Thanks for pulling for us.  I can't express in words how moved I am that we have so many people who support us and our son.  And since I can't express it in words, I hope to someday return the favor in actions.  

Here's a picture of Manuji, 19w2d, waving at his mom and dad.


Tuesday, January 21, 2014

Omens

"It's a sign!"
"You don't believe in signs."
          -Sleepless in Seattle

It's a big week over here.  First of all, looks like NYC is getting it's biggest snowfall of the season today.  The view from my window:


Allegedly we're getting 8 to 14 inches.  Right now it just looks windy and cold and gross.  

Back when I had my miscarriage last June, I, like a lot of women I know, decided I wanted to do something to commemorate our bean.  One of the recommendations I had read was the get a piece of jewelry that will be representative of the loss.  There are a lot of vendors on Etsy who specialize in pregnancy loss jewelry, and while they were lovely, I wanted to get something that was a) not religious at all; and b) that no one would know from looking at it what it meant.  I also wanted something I could wear every single day.  So, I didn't want a necklace.  I'm more likely to wear a ring every day, and while I was trolling around Etsy, I stumbled across the idea of forget-me-nots.  Forget-me-nots are little pretty flowers that symbolize enduring love.  I liked that idea.  So I found Taylor, who makes awesome forget-me-not jewelry (and other stuff too) out of silver and colored, treated paper.  I picked out this ring.


I wear it everyday.  I get a lot of compliments on it, and I like that Jeeves and I know what it represents, but we don't have to explain it to anyone else.  It's our private memorial to our lost bean.  

The thing about this ring is that while you can wash your hands with it on, Taylor recommends that you remove it when washing dishes.  Last week while I was at Dad's, I took it off to wash some dishes, put it on a shelf, and promptly forgot to put it back on..... until I was on the bus back to NYC.  Obviously the ring is fine and safe and it's not that big of a deal.  It's just that the timing sucks.

This Friday, January 24th, was my estimated due date for the bean.  I'm not going back to Dad's till next Monday.  Which means I won't have the ring with me on the bean's due date.  It's weird to think about that due date, when I have Manuji squirming around inside of me.  It's weird to think about how much harder Dad being in the hospital would have been if I had been a giant 8+ months pregnant lady.  It's weird to think about how a snowstorm like this would have freaked me out if I were about to give birth any day now.  And it's weird to think about how I wouldn't have all these new friends because I never would have started blogging again if I were about to have a baby.  It's bittersweet.  I told Jeeves that leaving the ring at Dad's made me so sad because it was all we have left of him or her, and I was stupid and forgot it and of all the days you want to have something tangible to remember someone by, it would be a birthday.  Jeeves reminded me that it wasn't all we have - that we have our memories of the time I was pregnant, of how happy we were for those few weeks, and how we couldn't believe our good luck.

I don't feel lucky to have had a miscarriage.  But I think that pregnancy reaffirmed for us what we were doing and why.  It reminded us of how badly we wanted to be parents.  And those few weeks of happiness sustained us through the sad months ahead.

But there's more to it than that.  This Thursday is our follow-up ultrasound to determine if Manuji has club feet.  I am nervous.  And I wondered if it was a bad omen that the scan is a) the day before the bean's due date; and b) that I forgot the damn ring at Dad's.

I realize this is all probably a bit silly.  I, like Meg Ryan in Sleepless in Seattle, don't believe in signs.  Or do I?  I don't know.  Sometimes I think I do.  What about that fortune cookie I got right before my miscarriage was confirmed?  That felt like a sign.

So, speaking of signs, last Thursday Jeeves was doing laundry and while we were watching TV and he was folding his many, many socks and undershirts, he found this:


It's a baby sock.  Not ours.  Must have been left behind in one of the machines he used and he scooped it out.  "Maybe it's a sign!"  I yelled when I saw it.  "That everything is okay with his feet!"  Then I paused.  "Or maybe a sign that everything is not okay with his feet?"  Anyway, we decided to keep the sock for now, just in case.

In many ways, I have decided to just accept that Manuji has club feet even though we really have no idea either way.  Right now, it's easier to accept that bad piece of news and be prepared for it on Thursday.  It will not be fun, but it can be corrected and if he has club feet it doesn't change how much we love him or how happy we are to have him or how lucky I think we are.  I am trying to prepare myself for how much the doctors are going to try to scare us that club feet could signal something much, much worse.  And I'm not allowing myself to think about all of the other horrible things it could be.  That way lies ruin, and there's just no point in it.  I am repeating my old infertility treatment mantra: "Don't be scared.  You're going to be scared, so when you start to feel scared, don't be scared."

Positive vibes and prayers are super welcome right now, and I really appreciate all the support.  Whatever happens, whether the omens are good or bad or just exist in my crazy head, we'll get through the week and deal with whatever happens.

Saturday, January 18, 2014

The bitch is (sort of) back

I think that the careers we choose for ourselves are partially based on our personalities, but also shape our personalities.  To wit, I am a lawyer.  [Yes, I also have a masters in library science and I really, really want to be a librarian, but I have been a lawyer for 10 years now and that's still my profession, so that's what I tell people I am].  I am a lawyer in some respects because of aspects in my personality that made that profession suitable for me - I am logical, curious, and I like a friendly argument.  The point of law school, to some extent, is to hone other aspects of your personality to make you a better lawyer.  The purpose of boot camp in the military is similar in some respects - they want to rebuild you so you always look at the world a certain way.  Even though I'm not a litigator anymore, there are things from my legal practice that shape how I look at and function in the world.  I doubt that will ever change, and that's okay with me because it can come in handy in everyday life.

This week, I decided to change my perspective on Manuji's clubfeet situation.  But to get there, I need to go a little farther back.  In 2009, I was living with my dad.  For years and years, he put off getting a colonoscopy.  He had heard the process of clearing your bowels was unpleasant and he was scared.  So he put it off.  Big mistake.  His doctor finally convinced him to do it, partially because his blood work came back as slightly anemic which can be an indicator of an internally bleeding tumor (fun).  I totally didn't expect them to find anything on the colonoscopy.  I did zero research.  I mean, he had no symptoms!  Shouldn't someone with colon cancer have symptoms? (answer: no.  My dad had stage IV cancer at the time of diagnosis and no symptoms.... it's really important to go for regular colonoscopies, guys).  As we talked to the gastroenterologist after the colonoscopy, it became clear to me that my lack of preparation meant we were really out of our depth.  He used lots of medical jargon (I would periodically stop him for definitions, but still).  Long story shortish, the doctor could not get the scope past my dad's sigmoid colon (a lower part of your large intestine) and it could possibly be the start of a blockage from something serious, or it could be nothing.  He wanted Dad to get a CAT scan of his abdomen.

A few days after that, the doctor called Dad and told him that certain markers in his blood were elevated.  Again, because I was new to this and hadn't done my homework, I didn't know what that meant, but it seemed ominous.  What I know now is that the doctor was telling Dad that his CEA tumor markers were very elevated.  This generally indicates malignant cancer (CEA is a marker thrown off typically by colon, rectal, and pancreatic cancer cells).  These tumor markers are how we measure Dad's progress with treatment when he's not getting CAT scans.  But we didn't know or understand any of that at the time.  The doctor didn't explain it and we didn't ask.

Two days after that, Dad woke up one morning with an enormous, distended belly and in excruciating pain.  His giant, malignant sigmoid colon tumor was blocking his intestine, which is obviously life threatening.  That day he had bowel resection surgery and a CAT scan that showed the tumor had metastasized to distant parts of his body.  It was the second worst day of my life, an extremely close second to my mother's death.

As I sat in Dad's hospital room, waiting for him to come back from surgery, I promised myself that I would never get caught flatfooted again with a doctor, that I would do research and I would know everything I could about Dad's cancer so I could be an informed and pushy caretaker.  When you take a deposition, especially of an expert, you need to be become an expert too.  

To me, the sign of a good doctor is someone who doesn't use medical jargon when speaking with a patient, who explains his or her rationale for whatever treatment plan is recommended, and who doesn't mind (actually prefers) an informed and inquisitive patient. I get along well with Dad's cancer team because they are all of these things.  But I never go into an important appointment without questions and information.  I trust them, but that doesn't mean I can chill out in the backseat.

This whole time in my pregnancy, I've been acting like I was the patient.  I am way too lax with my own care.  Jeeves and I were caught flatfooted when we went into that initial anatomy scan because we weren't expecting bad news.  I had lost my game.  It's not that I think I should have been an expert on clubfeet when we went into that appointment - there are so many problems that can crop up at these scans, there's no way to know about all of them.  But I should have gone in there with my lawyer pants on and I didn't.  If I had, I would have immediately started firing questions at the irritating ultrasound doctor, and I would never, ever have let her get away with that sloppy "I think there's a 30% chance that the baby has clubfeet."  Instead I stumbled out of there like some rube.  Because I thought I was the patient.  

So this week, I decided that I would stop acting like I'm the patient and start acting like Manuji is the patient, and that was the kick in the pants that I needed.  Lawyers are trained to be precise in their language - it's what makes or breaks us.  Doctors are not precise in their language (they may be precise in many other ways, but language ain't one of them).  So from now on I would start questioning anything that sounded like it needed further defining.  I wouldn't allow any more sloppy statistical bullshit without finding out exactly where those numbers were coming from.  And I was going to grill my OB about what had happened.  

I think if you're a lawyer, you would find me, my approach, my demeanor, all of these things perfectly normal and recognizable.  I think if you're not used to it, you might find me to be a little bit of a bitch when I have my lawyer pants on.  I don't really care - my doctor is hired to perform a service for me.  She is not a god.  She is not smarter than me, she's just trained in a different area.  And if she's going to use imprecise language or dumb, made-up statistics, we're going to double back to that and talk about it.  Repeatedly, if necessary, until I get to the truth or at least some facsimile thereof.

Jeeves and I went into our appointment with my OB this week with a very long list of typed up, multi-part questions.  I don't think she was expecting it, probably because I've been so laid back about my own care up to this point.  It does feel weird to be doing it for myself, and not for my dad.  But I kept reminding myself that Manuji was the patient here, and that made it a little easier to be difficult.  At one point, my OB used the term "false positive" incorrectly, and Jeeves and I jumped all over her for it.  In the end, I felt good about the answers we got.  We won't know jack until these scans are done, but at least I feel a little more confident in what's going on.

At the end of the appointment, Jeeves said, "If that had been a deposition, it would not have gone well for her."  Indeed.  But that's my job.

Monday, January 13, 2014

The Other Foot

It's been a weird day.

But before I go into that - thanks so much for your awesome comments on my last post.  They really made me feel so much better.

I was feeling sad, worrying about the baby bun for a good chunk of the morning and lamenting this damn two week wait we're in.  Prior to the crappy ultrasound from last week, I had been starting to make a list of baby products we would need, reading reviews, and figuring out what brands we would want.  But after that ultrasound, I basically stopped, because if Manuji has club feet, I'm not sure how that impacts whether we get certain products.  For instance, one woman on a message board warned not to bother with little footy sleepers because a baby with casts and leg braces can't wear them.  Which made me wonder if he might need other special things too, like a special car seat or rocker chair.  So, no point in thinking about any of the fun stuff now since we have no idea what's going on.

I did do some research into club foot treatment, so I would know what to expect.  And I did a little research into the more serious implications, but I didn't want to freak out so I tried to limit that.

One of the women in my Facebook group said the other day that due to the long, long infertility journey and all the heartache that was associated with that, she was having a hard time being happy in her pregnancy.  She was waiting for something bad to happen.  I could relate.  The pregnancy stuff that was making me happy, reading Baby 411 and Baby Bargains, I don't feel like reading them anymore because we may have a lot more to contend with.  I may be going for more tests.  I'm hopeful that we will get good news next week, and that if we don't get good news, that at least our medical team will not be a bunch of assholes about it like they were last week.  And I'm hopeful that if Manuji does have club feet, then we will find good doctors who can help him and that club feet will be his only problem.  And I hope hope hope I will go back to being happy.

I'm not gonna lie, I've been feeling a little sorry for myself.  I'm not proud of that.  I've felt bitterness towards people who have great anatomy scans and I was just wondering if I would be the cautionary tale in my Facebook pregnancy group, if everyone's kids would come out perfect except mine.  This is all the stuff that was swirling around in my head today, when I arrived at Port Authority Bus Terminal to take the bus out to Dad's.  I checked in on my group and saw a post from a woman I've mentioned on here before - she's a doctor who is currently pregnant from IVF, but years ago she had a stillborn child due to undiagnosed placental abruption and preeclampsia.  I'll call her C.

C couldn't have the MaterniT21 or other similar cell free fetal DNA tests done because she miscarried a twin around week 9.  It's very likely that twin miscarried due to a chromosomal disorder and that would mess up the results for the surviving twin.  So, she went ahead with the nuchal translucency and first trimester screening tests and got good news - 1 in 3600 chance that her surviving baby had Trisomy 13, and excellent results for trisomies 21 and 18 as well.  But C is a doctor and she prefers diagnostic tests, so she decided to go with an amnio, even though her doctor said he didn't think it was necessary. The amnio went well, but she got devastating results - her child has Trisomy 13.  She's in that percentage of women who are told they are low risk, but in actuality are carrying a child with a significant chromosomal defect.  My heart ached for her.  Trisomy 13 is very, very serious.  Many women will miscarry a fetus with trisomy 13, and if the child is born, 90% will die before their first birthday.  

Aside from hurting for C, who has already been through so much, her news also scared me and chastened me.  It scared me because while I've had all sorts of screening tests, including the cell free fetal DNA test, those tests can be wrong, and what if there's something really wrong with my baby too and I won't know it because I don't want an amnio?  What makes me so special?  Why wouldn't it happen to me?  And chastened for complaining at all about club feet.  And then after all that, I felt like an asshole for making any of this about me when it's not about me, it's about C and her family.

So, I felt pretty down when I got off the bus.  I told Dad about it, and we talked about how in a lot of ways things are harder now because we have a lot of information, but not all the information.  We have enough information about our bodies to be dangerous, but not enough to fix everything.  And after awhile, it was hard to be too down because Dad is doing so much better and is so much more cheerful than he was one month ago.  

So that's where things are for me.  The baby has been squirming around today, which always makes me smile.  Sleep is getting hard.  I can't sleep on my stomach anymore because when I do, Manuji squirms like crazy (I'm probably smooshing him).  So I have to sleep on my side, but my hips are starting to hurt from that.  So Penney is lending me her pregnancy pillow which will hopefully do the trick.

As for Kate's baby shower this past weekend - it was a huge success.  And Jeeves is amazing.  The most amazing husband ever.  He helped me with absolutely everything and I couldn't have pulled it off without him.  I'm so lucky.   

I checked out a non-baby/pregnancy book from the library, so I'm going to try to distract myself.  And I'm also going to let myself read Baby 411 because we don't know anything yet and life's too short to mope about club foot.

Thursday, January 09, 2014

The Other Shoe

I'm talking about my pregnancy, though today's news isn't necessarily happy.  But if any sort of pregnancy/baby talk is upsetting to you right now, please skip this post.  There's going to be an ultrasound pic at the end, too, so I just want to warn you.

I'll start off with a funny story and then get to the shitty part of today.  Last weekend Jeeves and I visited his brother and family and we got to tell our nephews J & A that we are expecting and they are going to have a little boy cousin this year.  They were very excited and sweet.  J told me he thought I would make a great mom (awww, he's 8!  How cute is he?) and he later told his dad that his favorite present he got (we had exchanged Christmas gifts) was the news of a new cousin.  A was just really excited that he won't be the youngest anymore.  J & A brainstormed names and here is what they came up with: Manuji (pronounced Ma-NOO-Jee), Matrugio, Cousin, and Tom Brady (please note that neither Jeeves nor I is a Patriots fan).  Jeeves and I thought Manuji was pretty funny, so we have taken to calling the tiny bun Manuji.  Don't worry, we're not going to name our kid Manuji.

Now to the shit.  Today was my initial anatomy scan.  Early in my pregnancy, I thought that I would just get one anatomy scan around 20 weeks.  I guess that's what they do if you're younger, but apparently my OB's practice is to send older moms who don't get diagnostic testing done for an initial scan at 16 to 18 weeks and a detailed scan at 20 to 22 weeks.  Today I am 17w2d.  And shame on me for letting my guard drop.

It's not that I let it down completely.  I'm currently in the window where most women with incompetent cervix will have a miscarriage.  A good friend of mine had a miscarriage at 17 weeks from incompetent cervix, so I have been a little on edge about it this week.  But in terms of Manuji himself, I felt like things were good.  I've started to feel little flutters of movement, my MaterniT21 came back great, my Nuchal Translucency and accompanying blood work were good.  I thought we were maybe okay.

So, the scan.  The tech exclaimed that the baby was in a great position for her to see his heart, so she did that right away.  We could see all four chambers pumping away, which was super cool.  And we got to hear his heartbeat.  Heartrate was good.  She moved onto other things - she was able to find his kidneys, he doesn't have a cleft palate, the placenta is far from the exit, and my cervix is nice and long (huge sigh of relief from me).  His umbilical cord has two arteries.  His arms looks fine (amusingly, he was lying with his right arm behind his head and she had to poke him repeatedly to get him to move it... which he finally did, and waved at us).  His brain was fine.  But she complained a lot about the positioning of his legs.  He had his feet tucked up in a corner between the placenta and my uterine wall.  It didn't seem to matter what she did, he wasn't interested in moving them out of his little nook.  She had me go to the bathroom, do squats, roll over onto my left side, then my right.  Twice.  Then more squats.  He just didn't feel like moving them.  She also had trouble getting a shot of his spine, but finally managed to get a shot of his tooshie which showed that his spine has sealed, so that's good.  

But yeah, she was obsessed with getting a shot of these feet, and I couldn't understand why.  We knew from the NT scan that he has two legs, so what's the problem here?  I soon found out.

The tech said he was measuring well, and weighed 7oz.  She wanted to go see the doctor, and the doc might want to check me herself.  At this point, I was worried it had to do with his spine, because she had only managed to get him to roll for a second and there was just one shot of his spine.  The doctor came in, and she explained about wanting to look at his feet.  I asked about the spine and she said the shot of the spine was fine, she was satisfied it was closed.  The doctor spent a long time silently looking at his feet, trying to get shots.  She finished and told us to come in a see her in her office, but explained that it was possible our baby has clubfeet.  Fun!  Dickensian!  Thanks, Doc.

Anyway, here's a rundown of what the doctor said.  Basically, little Manuji is sticking his feet in a place that makes it hard to see.  In some of the pictures, his feet look normal, in others they look clubbed.  She explained what clubfoot is, you can read about it here.  She said based on the pictures, she would say there is a 30% chance he has clubfoot.  I know I should find that comforting, but I'm pretty sure she just made that number up and she was not a comforting person by any stretch.  I regret not asking her where she pulled that number from.  Sigh.  She recommended I come back for yet another fucking scan in 2 weeks when his feet will be a bit bigger and theoretically easier to see.  I pointed out that my detailed anatomy scan is in 3.5 weeks - early February.  Could we just wait till that?  No, she'd rather I came in 2 weeks.  So you see, despite her somewhat reassuring words, her demeanor and her insistence that we return in 2 weeks leads me to wonder how straight she is being with us.

Of course I went back to work and spent a lot of time googling clubfeet.  I want to say that if the baby has clubfeet and that's all it is, of course I will be upset, but it's theoretically correctable.  I don't love the idea of my newborn son having to wear casts and braces for the first 2 years of his life, but it's certainly not the worst thing in the world.  But my concern and anxiety over this has more to do with what more it could indicate.  Some kids have unexplained clubfoot.  But others have it because they have trisomy 18 or any number of other serious conditions.  I started to get nervous that the reason the doctor wants me back in 2 weeks is because of these more serious conditions, and that I'm going to be strong-armed into having an amnio.

Later on, I talked to my OB, Dr. C, who had spoken with  the ultrasound doc.  Basically she said, "we just don't know."  It could be something, it could be nothing.  This is the problem with early ultrasounds, Dr. C, explained - stuff is too small to get a good picture.  Which begs the question - why did she send me for one?  I sort of said as much, and near as I can gather, because of my age and the lack of diagnostic tests, they think it's good to go early for the initial scan, and then do the detailed, so if there's a problem, they can get more testing done sooner.  Whatever.  According to all the screening tests I have had, the odds of the baby having trisomy 18 are low (and I looked up the other ultrasound markers for it, and I don't have any of them).  But hey, these tests are just screening, not diagnostic, so who knows.  Doom and gloom alert ahead.  If it is trisomy 18, in all likelihood I will have a second or third trimester miscarriage or stillbirth.  In the unlikely event that the baby is alive at birth, he will in all likelihood die within his first year of life.  I mentioned my concern to Dr. C about getting pushed into an amnio and she assured me they would not do that.  But that if the next scan indicated clubfeet, she would want me to get a fetal echocardiogram because a heart defect and clubfeet would strongly indicate a chromosomal disorder.  FML.

It should come as no surprise that talking to Dr. C and the ultrasound doctor did not fill me with positivity and smiles.  I appreciate that they aren't blowing rainbows up my ass, but I'm also kind of frustrated with their response.

Did I mention the part where ultrasound diagnosis of clubfoot has up to 20% rate of false positive?  Yeah, there's that too.  Awesome.  So basically there's no real way to know anything until the baby is born.  

I haven't been crying or anything.  Mostly I'm just angry.  Angry that after the year we had, there's still more bullshit.  Angry that our little bun might have to go through a lot in his first two years.  Angry that I had top-of-the-line screening tests which indicated a ridiculously low likelihood of chromosomal disorders and those tests might be wrong anyway.  Angry at people who have no worries like this.  Angry that I didn't question my doctor about why I was being sent for two scans instead of one.  And most of all, angry at myself for letting myself be happy for one damn second, for thinking for a minute that this was going to be okay.

Okay.  Rant over.  We did get a really great ultrasound picture of the babe, posted at the bottom.

Tomorrow Jeeves and I are picking up the rental car and driving down to the DC area to host Kate and Bart's baby shower.  Wish me luck.

Dad update - he's feeling much better and looking like his old self.  Dr. T is putting him back on a targeted chemo drug called Vectibix - Dad responded very well to its cousin, Erbitux.  This means weekly infusions, which means I'll be back to going out to NJ to take Dad to the doctor every week.  Not thrilled about that, but nothing to be done about it.

So I'm in another two week wait.  What else is new.  Please know I realize there are so many worse things you could be told at an initial anatomy scan, that I know in many ways we are so, so lucky.  I do know that.  When I was on Facebook today, looking at all my friends' beautiful kids, I didn't, not for one second, wish my kid was like their kid.  Whether Manuji has clubfeet or not, I wouldn't trade him for anything.  No, the only person I was jealous of on Facebook today was a friend who posted a picture of his pretty gray cat.  I miss my cat.


Tuesday, January 07, 2014

Strength for the task ahead

I read two posts this week that really affected me and I wanted to talk about them a little.  But if you'd like to read them, they were Adi over at The Second Bedroom in "What I Lost" and Marcy at Sensitive Ginger in "Another Twist."  Adi is dealing with the aftermath of her miscarriage in late December and for me, she perfectly encapsulates what I felt after my miscarriage.  And Marcy just had IUI#3 canceled when it was discovered that they had just missed ovulation.  Adi wrote, "But I feel beaten. I don't feel equal to the task. I feel far lesser, far smaller, than this." Marcy talked about having to muster strength in the waiting room of her clinic moments after the cancellation of her cycle when another patient came in with her three year-old daughter, and how she had to fight to keep from crying.

I'm a pretty big Downton Abbey fan, and if you've never watched it and you don't want it spoiled, I'll try to avoid doing that here.  We'll just say that at the start of season 4, one of the main characters, Lady Mary, has had to deal with something devastating.  Mary is normally a tough lady, but this blow has set her back and has her walking the house like a spectral, black-clad presence.  No one really knows what to do or what to say to her.  But she is a shadow of her former self and it is a surprising turnaround for the naturally prickly, iron-backed lady.  At one point, she breaks down crying to Carson, the butler, and he tells her to have a good cry, and when she's ready she can get to work, "because you are strong enough for the task."

Infertility is great at making us feel weak and powerless.  Because we are powerless.  Powerless over the outcome.  Powerless to make our bodies do what we want most.  And once we get pregnant, powerless to ensure that the pregnancy will last.  But if it makes us feel weak, we do that to ourselves.

I've dealt with tough things in my life, most of us have.  Those tough things are ultimately what made me strong.  I don't think I was particularly strong before my mom died.  When she died, apparently Kate and Wendy had discussed that they were worried I would have a nervous breakdown and have to be hospitalized.  I was offended when I heard that.  "You think I'm that weak?" I asked Kate.  [This is a very silly thing to say, as though having a nervous breakdown and being hospitalized is a result of weakness, which I absolutely know it is not.  It's not weakness at all.].  Kate assured me that she did not think I was weak, only that my mother and I had been very close and she and Wendy were worried about how I would handle it.  My friend Roxey, who is also very close to her mother, called and told me she just didn't know how I could function, that she just wouldn't be able to do it.  I bit back what I wanted to say, which is that someday she would have to deal with it.  But instead I just said, "You keep breathing, you get up, and go to work, and you put one foot in front of the other because that's what you have to do."  This is not to suggest that I handled my mother's death in stride.  It was awful and I was a mess for a long time.  But there's no right or wrong way to grieve and I did the best I could with the tools I had.

When Dad got sick, the experience toughened me.  It toughened me in the same way that infertility has toughened me.  But there have been so many moments along the way with Dad's illness where I felt weak, lost, like a 10 year-old in a 35 year-old's body.  

The conclusion that I have come to from all this is that strength, real and true strength, is not constant and unflagging.  It doesn't mean no tears.  It doesn't mean unwaivering confidence and optimism.  Real strength comes from what you do in those moments when you feel defeated and ground down.  It comes from putting one foot in front of the other.  And it comes from people who love you and tell you that you do have the strength for the task ahead.  It comes from repeating that until you believe it yourself.  I have yet to meet a woman dealing with infertility who is weak.  It's okay to feel weak and have those moments of doubt.  It's okay to feel lost and adrift and to struggle to find the strength to move forward.  But please don't doubt that you have the strength.  You do.

Sunday, January 05, 2014

In need of some Facebook advice

I think most infertiles find that Facebook can be the bane of their existence on any particular day.  For me, there were more than a few pregnancy announcements on there that made me cry sad, snotty tears.  The toughest was when a close friend of Jeeves, K, and his girlfriend (partner?  I guess partner is appropriate - they have no intention of ever getting married but they live together and intend to stay together for the rest of their lives, etc.) announced they were expecting on Facebook.  They didn't tell Jeeves ahead of time (and I should add that they had no idea we were infertile) and even though I shouldn't be so old-fashioned, I guess I didn't see it coming because they're not married.  I don't remember how they announced it, only that the news itself was very depressing for me (even though I was happy for them).  There have been others, but that was the one that stung the most.

I know a lot of people struggle with the baby pictures and what not on Facebook, but it was always the pregnancy announcements that were toughest for me.

I'm 17 weeks this Tuesday, going for an initial anatomy scan on Thursday.  At 13 weeks we sent out a large e-mail to our friends, telling them our good news.  I included in that e-mail that we had struggled with infertility and early pregnancy loss because I don't ever want to pretend that we were just like everyone else.  If anyone I know winds up going through this down the road, I want them to know they aren't alone and I want them to feel like they can ask me anything.  My IRL friends who are infertile knew before we sent that e-mail.  My cousin who has dealt with infertility and recurrent pregnancy loss and is expecting twins also knows already.  This is a sort of roundabout way of explaining that I have not gone Facebook public yet with my pregnancy, but it's getting to the point where I would like to.

But.

I don't want to be that schmuck who makes someone cry, who ruins someone's day.  I'm starting to think that might be impossible.  Which leaves a few options.  

The thing is, I do have friends that I primarily communicate with through Facebook.  And while I don't really care if the kid who sat in front of me in US History in high school knows that I'm pregnant, I do care if Karina, my former administrative assistant, knows.  And I primarily communicate with her through Facebook.  Same goes for all my cousins, a few former co-workers, that sort of thing.  These are people I like and care about, but wouldn't call up or necessarily send an individual e-mail to.  I do know that another cousin is having fertility problems, but I'm not supposed to know that, so sending him an individual e-mail would be weird.

I guess I could choose to never announce it on Facebook at all.  I've known people who do that, and then one day a baby picture shows up.  I know a lot of infertiles find the announcement via ultrasound picture very painful, so I would never do that.  While I generally feel very open about everything we've been through with infertility and pregnancy loss, I'm not sure I really want to put that out there on Facebook, especially since it would be linking Jeeves and he has a lot more random "friends" on Facebook than I do.  

The flip side is that I've always posted big life events on Facebook - jobs changes, going back to school, graduating, getting engaged and married.  I like social media and I like sharing those events with people in a communal way, so never saying anything at all seems kind of sad to me.  It breaks my heart that so many friends are still battling infertility, I hate hate hate it when I hear about a miscarriage or the failure of a cycle.   But that doesn't mean that I feel guilty that at least for right now, I am pregnant and happy to be pregnant.  

So what do you guys think?  What's the best thing to do?  Never say anything?  Wait till my belly gets really big and let someone post a picture of me, but never mention being pregnant (I've seen that once or twice)?  Keep it simple?  Take a picture of a onesie?  Have you ever seen an announcement of a pregnancy on Facebook that wasn't painful, or is that just an impossibility?  Am I totally overthinking all this?  I noted that none of the women in my pregnancy group (all of whom did IVF and struggled with infertility for a long time) thought twice about posting their pregnancies in adorable and creative ways.  How do you balance having sensitivity for anyone out there that is still dealing with this shit, while also celebrating your own happiness?  Your advice would be so appreciated.

Wednesday, January 01, 2014

Reflections on a new year, and some books

It's the new year!  I know lots of people think it's silly to feel like anything really changes from one day to the next, but I always liked the idea of a new year and the possibilities it brings.

This post is going to be a hodgepodge, so bear with me.

I was thinking yesterday about what was happening one year ago on New Year's Eve.  I was at the end of a long two week wait.  It had been a really bad cycle and I had ovulated super late and was pretty sure we had missed our window.  We had already undergone all our testing and our RE had told us it wasn't impossible for us to get pregnant on our own, but that we would probably need help.  I had just finished finals for school and I think the stress just totally threw my body off.  So I had low expectations, but that morning when I woke up, I took my temperature and it had dropped, signaling Aunt Flo's imminent arrival.  And I was depressed. Jeeves and I had decided we would give it one more month before we started IUI.  In the afternoon, Phil videochatted me with his daughter to wish me a happy new year.  His daughter, at that point, was about 10 months old.  I know babies can be tough for some infertiles, but for me it's never been a problem.  Pregnancy announcements were a problem (and weirdly, I still get a twinge from them now, even when I'm expecting too), but once the baby is here, I usually roll with it.  But on that day it was tough to deal with another failed cycle and a cute baby via videochat.  I wondered if we'd ever be parents.

I had the whole year planned out - we'd try one last pass at getting pregnant on our own (spoiler alert: it didn't work), then we'd just get through the 3 IUIs which I was sure would not work, we'd take a month or two off from treatment, and we'd start IVF in July.  I figured by the fall we would know if this was going to work or if we should move onto adoption.  None of it went that way and I'm trying now to remember that when it comes to my body I should maybe not make any assumptions or long term plans.

A lot changed in a year, and even though we went through 4 IUIs and 2 miscarriages, on this New Year's Eve, I was exactly 16 weeks pregnant with our son.  I thought of the women who read my blog who had a rough 2013, failed cycles, failed pregnancies.  It doesn't mean much, but I hope and believe that by next New Year's Eve you'll be in the same spot I am now.

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Dad is doing much better and has gained over five pounds since I took him to the hospital 10 days ago.  I didn't respond to the comments that some of you left me following my initial post about my frustration with my sister and the cleaning lady.  I just want to thank you and say that it was really comforting to hear that my reaction to all that stuff wasn't crazy.  I'm thankful for a lot of things in 2013, even though it was crummy year in many ways, and one of the things I am most thankful for is the new friends I have made.  Thank you thank you thank you.

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Last year I decided not to set a New Year's resolution for myself, but instead a New Year's goal - to read 52 books over 2013.  And I did!  I actually got through 53 books (maybe more, actually, since I did not count any of the pregnancy books I read).  I actually feel like I could have done better, but I pooped out in December - I got stressed over the holidays and family stuff and had trouble focusing.  Anyway.  I had wanted to do a year end list of what I read this year, but I'm going to simplify it.  

My Top 5 Books of 2013 (in no particular order; these are books I read this year, not necessarily books that were published this year)

Billy Lynn's Long Halftime Walk by Ben Fountain (literary fiction)

Funny, poignant, insightful, short, not hoighty toighty.  This is the kind of award-winning book that I find easy to read.  It doesn't mean that I don't love wordy books (hey, I chose Wolf Hall and that book is damn wordy), but let's just say I feel like this is the kind of critical darling that would appeal to most everyone.  Billy is being celebrated as a hero for his bravery in battle, but as he puts it, it feels weird to be celebrated for the worst day of your life.  


Wolf Hall by Hilary Mantel (historical fiction)

This books is not for everyone.  It's historical fiction about Thomas Cromwell, chief advisor to Henry VIII when he was trying to divorce Queen Catherine and marry Anne Boleyn.  It is not a page turner (although I did find it very readable).  This is the kind of book that will make you jealous of Mantel's literary skill.  Her writing is flawless, and I love how she creates a well-rounded, tough, and yet loving Thomas Cromwell, a historical figure who usually gets crapped upon in favor of Thomas More.  

The Coldest Girl in Coldtown by Holly Black (urban fantasy)

I know, I know.  It's about vampires and you are so sick of vampires.  Trust me, Holly Black is sick of vampires too, so she turns the genre on its ear.  This book is at once a love letter to genre standards like Dracula and Ann Rice's books, and also wholly different.  It is scary, it is gothic, it has a tough, pragmatic heroine, and awesome world-building.  It's beautifully layered and constructed and it stayed with me long after I finished it.


The Golem and the Jinni by Helene Wecker (fantasy/historical fiction)

Chava is a golem, a mythical being made of clay and meant to serve a master.... until her master dies leaving her stranded in lower Manhattan in the last 1800s.  Ahmad is a jinni, a being born of fire freed from a lamp by a metal smith, but still imprisoned.  The two are complete opposites, but form a friendship due to their outsider status.  When I first read this book, I could not believe that it was Helene Wecker's debut.  It is so well written.  New York City at the turn of the century feels like a character in its own right.  And best of all, I love one of the central themes - that true friends love you as you are, but also encourage you to be the best version of yourself.  It also plays with themes of free will and community, which I very much enjoyed.  

The Legend Trilogy by Marie Lu (science fiction/dystopia)

I cheated a little - this is three books, not just one.  But I read all three this year, and the latter two both came out in 2013.  People talk a lot about the Divergent trilogy, but they should be talking about Legend.  Unlike Divergent, which is a great series opener, followed by a middling second book and a total clunker of a finale, Legend gets better with each book.  It's dystopia, which has kind of been done to death, but the two main characters (who trade narration) keep it feeling fresh.  It's impossible not to compare Legend to The Hunger Games and Divergent.  So I will just say that I thought the final book of the Legend trilogy kicked Mockingjay and Allegiant's asses. This is how you end a trilogy.  This trilogy also features my favorite sci fi heroine, June Iparis.  She's kind of like Sherlock Holmes or Spock, but with a little more heart.  I loves me some Katniss, I really do, but if Katniss had had to face June in the Hunger Games, I'm pretty sure Katniss would have died before the middle of the book.  And it's not because June is big and tough (well, she is tough), but it's because she's so damn smart.  I also like that June is not instantly loveable (Day, her counterpart, is the immediately likeable character), she does some shitty things in book one, but her actions are always understandable and she learns from her mistakes and then fixes them instead of wallowing around in it.

Honorable Mentions

Written in Red by Anne Bishop (urban fantasy)
The Name of the Wind by Patrick Rothfuss (epic fantasy)
The 5th Wave by Rick Yancey (science fiction)
Angelfall by Susan Ee (urban fantasy)
Fangirl by Rainbow Rowell (YA/realistic fiction)
Graceling by Kristin Cashore (epic fantasy)
Far From the Tree by Andrew Solomon (nonfiction)
Crown of Midnight by Sarah J. Maas (fantasy)

I read plenty of other great books, and some disappointing ones, too.  I decided not to set a formal reading goal for myself this year, and I'll just do my best.

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That's it for me.  I have a cold, and the only thing I can really take for it is saline spray and tea.  So I'm going to make some minestrone soup and see if that helps things out.  What about you, dear reader?  What was your favorite book that you read in 2013?  If you're not a reader, feel free to tell me your favorite TV show or movie of 2013.  Anything you're excited to read in 2014?