14 weeks: The healing

Today marks the second trimester!  I already feel like I've been pregnant forever; I hope the next 24-25 weeks go more quickly.  Now that we're back and busy with schoolwork, I suspect they will.

When Zack first arrived, I was still scarred by the infertility, and his traumatic delivery and refusal to breastfeed made it worse.  I felt like my body kept failing.  The OB who delivered Zack said it would be better "next time," because we'd schedule a c-section.  I didn't want a next time -- I wanted a hysterectomy.  The pediatrician said I could, "breastfeed his sister."  I couldn't imagine a sister -- what were the odds, given how hard it was to get Zack????

But now ... it looks like there will be a next time.  I am sure there are other ways to find healing.  Most infertility veterans are not the urban legends who miraculously become pregnant after treatment.  But for me, the dark times are suddenly very far away.  I thought I would carry these visible scars forever.  But right now, the only visible scar is from the c-section, and that one is pretty ordinary.

Next steps

Well, I am certainly glad the last week is over! After a rough couple of days, I woke up Sunday feeling all better physically. A long night's sleep in a luxurious hotel bed without a snoring partner (love ya' babe!) after delicious alone time with my brother and his GF, my BFF, and my parents was just what I needed. Not surprisingly, perhaps, Sunday was a more difficult day emotionally. At brunch with my parents, brother, and his A, the hostess presented a rose to my mother. I LOST it and ran out of the restaurant in tears. It was the first time I had really cried about this miscarriage. It was probably good for me; my practical stoicism is not always healthy. After a hug from my dad and some whining about the unfairness of it all, a mimosa perked me right back up. And I was fine the rest of the day, focusing on my mom and grandmother.

And at Mother's Day dinner, all the women got roses. And it's appropriate, I think, because don't we all "mother" somebody or somebodies?

Then we were on to the next hurdle, having some early skin cancer removed from my back. The procedure went smoothly, though the incision now alternates between stabbing pain, burning, and itching. It's fun ... or not. The stitches will be in for three weeks, which seems interminable. But it's for the greater good, and I'm relieved to have the spot gone.

Today was my post-op visit with Dr. R. Mostly he wanted to talk about politics and the Dead Sea Scrolls. I was like, "Dude! You have other patients waiting. This is not a social call!" But we get good treatment because he likes us, so I can't complain. As I expected, he isn't particularly concerned that we've found only bum embryos so far. He said, "The class of July 2010 is different from the class of March 2010" and made an analogy to my law school students. And it's true, some years are better than others. He also reminded us that only 30 percent of fertilized eggs ever turn into babies and we just need to keep trying to find our 30 percent. He did send me for some bloodwork for autoimmune issues and an updated check on my thyroid. But none of us think that's the issue. We're just dealing with old eggs and bunk sperm and we have to be patient.

He said to call when my cycle starts again. The nurse was, again, horrified, "Aren't you supposed to wait SEVERAL months? He's bending the rules!" Aaah, yes, but it'll be fine. After all, there's a rumor that women are more fertile in the months right after a miscarriage. So shouldn't we capitalize on it? Given how quickly I'm recovering, though, I anticipate that we'll wait two months, starting the birth control in early July and doing retrieval and transfer in early August, just before school starts.

In the meantime, we bit the bullet and filled out our first adoption application, for a very old and apparently well-respected agency in Fort Worth. They have a domestic infants of color program, as well as an Ethiopia program, which are our top choices. Even if we are ultimately successful with IVF in the next six months, we are very interested in pursuing adoption for child #2, so we figured it couldn't hurt to get the ball rolling. But I think we should probably fence the swimming pool if we have any hope of passing a home study. The to-do list grows longer.

Nagging worries

Physically, recovery has been a lot harder than I anticipated. I'm still having a fair amount of pain and other discomfort. Although I haven't done anything silly like go to the gym, or even walk the dog, I did have to get right back to writing my final when I probably should have taken a day or two to sleep this experience off. I don't think there's anything wrong: no fever or other signs of infection. It'll just take time. I'm heading to San Diego for Mother's Day. I know the travel will be physically draining, but I think running away to beautiful SoCal will be worth it for the soul.

As committed as I am to moving forward and doing another cycle, I have begun to have a nagging worry. In two years, we've had two pregnancies, both of which have ended in miscarriage. There doesn't appear to be anything wrong with my uterus, lining, or hormone levels; in fact, my body was showing no signs of letting this pregnancy go before the d&c, even though the fetus had passed at least a week before. Almost certainly, both miscarriages have been the result of bad embryos with chromosomal problems. I worry that maybe we can't make a healthy embryo. I worry that even if we get twice as many eggs next time, they'll still be bad and we'll have to go through this again.

I'll probably talk to the doctor about this next week. I suspect he'll tell me it's just been bad luck and we have a good chance of getting a good one next time. But I'm still curious about what he'll say.

I found a cool new blog today, with an awesome video for infertility awareness week. (Warning: if you have epilepsy or are otherwise prone to seizures, don't watch it. The choppy editing is a bit discombobulating.) The video is cool, and I love that the author named her blog after two of the barren matriarchs.

HT: Mo

Confirmed

We were able to confirm today that there was no heartbeat. And the fetus had again not grown at all. Although sad, it was also a relief to know that we can move on and get ready to try again. Unless I miscarry naturally before then, we have scheduled the d&c for Tuesday afternoon.

Our friend Brittany got lots of footage, so hopefully she'll be able to use it. I'm excited to see how it turns out!

If you're the praying kind, please send up good thoughts for our sweet friends M&J who also got bad fertility news today.

Making lemonade

After a pretty good weekend, where I felt okay with where we are, accepting of the impending miscarriage, and eager to try again, this week has been hard. Usually school is a good distraction, but I feel sluggish and tired. I'm sure part of it is normal end-of-semester exhaustion, but I also know that it's harder and harder to act like everything's normal.

But I'm determined to ensure that something good comes out of this ordeal. The state this week enacted very strict abortion laws, over the governor's vetoes. One of the laws requires women to have ultrasounds and listen to detailed descriptions of the fetus prior to having an abortion. Although emotionally painful, this may not sound particularly invasive until you realize that a first-trimester ultrasound is done internally, with a large wand. I have these done regularly to check for follicle development (and more recently, to check on the fetus). And fortunately, I have never had much discomfort. But many women find these ultrasounds to be painful and even violating. The basis of the governor's veto of the law is that there is no exception for victims of rape or incest. I just can't imagine a woman who has already been sexually assaulted being forced to have an internal ultrasound. I don't expect to change anyone's mind about abortion, but I wish my fellow citizens knew what this law actually requires. So a local politician friend of mine is accompanying us to our appointment tomorrow to videotape various aspects of the procedure (preserving as much privacy and dignity as possible, of course). She had expressed a desire on Facebook to make a video about the law, and I just happened to have this appointment already scheduled. I emailed my awesome doctor yesterday to make sure this plan was okay, and he's totally on board. I don't yet know how the video will turn out; but if I can use this experience to educate people, then I will feel like I made the best of a bad situation.

I'm turning comment moderation on. I have had an influx of readers from yesterday's posting; and I assume most of them are conservative Christians who will object to this project. If I get unpleasant responses, you don't need to read them!

An amazing journey

I have read this blog for a while, and the story has taken an awesome turn. After six miscarriages and two disrupted domestic adoptions, this family has expanded from one child (a gorgeous boy adopted from Russia) to four in 13 months! It's a reminder to keep trying and to keep our options open.

Our Dream Come True

UPDATED: The green-eyed monster

For many people, infertility causes a lot of anger. I've heard that from fellow infertiles, and we have certainly seen that in the waiting room and IVF classes at our clinics. The anger at the unfairness of it all, at the doctors for not fixing it quickly, at themselves for failing is palpable. But for me, anger is rare. Instead, my uncomfortable feeling is jealousy. It's harder and harder to feel joy for friends and family as they get pregnant and have healthy babies easily. When is it going to be my turn?

UPDATED to add: If you are one of my loved ones expecting a little one of your own, please don't be afraid to share your joy with me. I am thrilled for you; it's just more work than I'd like it to be.

Hope (or why I love my doctor even though I'm having a miscarriage)

These stories are probably not going to come across as funny in the translation as they did in the moment, but here goes:

It was clear to me from the ultrasound that the pregnancy was not viable; I didn't need the doctor to confirm it. So when we went into his office for the post-ultrasound consult, he said, "If you weren't academics, I'd talk to you about hope. But since you are, I'll be realistic."

His (or maybe the hospital's?) policy is not to do a d&c until the fetal heartbeat stops naturally. This is probably a good thing, even though I was ready to march on over to surgery then and there. So we return in a week for a follow-up ultrasound to be sure. He said that normally he wouldn't plan the d&c until then, but since it was us, we should stop by the nurse's desk on the way out and get on the surgery calendar for after next week's appointment. Her jaw hit the floor and her eyes bugged out when we told her this; even though he's still not going to do the d&c until after the heart stops, I guess he doesn't usually concede that there's virtually no hope and that the patients should go ahead and plan for the d&c. I was like, yeah, but he's never had us as patients before.

And finally he said, "I suspect I'm preaching to the choir, but we should definitely do this again." And normally he'd say, wait two months and then we'll figure out where to go from there. But since it's us, he told us to go across the hall to the clinic and get on the IVF calendar for our next cycle (late June/early July start date). The nurse over there was also not prepared for us to show up before the miscarriage, but she took it in stride.

All in all, the doctor hit all the right notes with us. He was frank, realistic, practical and gave us a plan. But he was not insensitive: I got a pat on the cheek when he came into the exam room and a big hug on the way out of the appointment. I know CCRM in Denver is the best, but I can't imagine a better doctor for us. It helps that he thinks Brent's scholarship is fascinating. Plus, we get to see his benevolent face smiling down at us from a billboard each time we drive south on I-35, and that amuses us.

As for next time, the tentative plan is to switch me to the 35-and-over protocol. I've always been something of an old soul, so that makes sense. You may recall that we had roadblocks at each step of the way this time: I didn't suppress, then I over-suppressed, and then I under-stimmed (two weeks to get 7 eggs instead of the >10 he expected). Frankly, it's amazing that we got pregnant at all. The over-35 protocol basically works with the natural cycle and the natural hormones. Among other benefits, it's about two weeks shorter than the normal 7-week cycle, and there's a lot less loopyron involved. I'm excited to try it.

As Dr. R said yesterday, we swung the bat and made contact, we just didn't hit it out of the park. (See, he can read me like a book: a baseball analogy!) Brent and I are feeling really optimistic about cycling this summer.

7 weeks, 5 days: The day of days

It has been a long, hard week. I have been hunkered down, hiding out, avoiding phone calls (yes, that's you @msharp -- forgive me!) and emails. I had every intention of sending personal replies to all the sweet messages I've received over the last couple of weeks. But instead, I've been focused on remembering to breathe and putting one foot in front of the other. Perhaps if I stay curled up in a little ball, I can keep bad things away from me and the baby. I feel this way now; how will I feel when I have a real, live little baby to love and protect?

The ultrasound-of-truth is today at 3:15. It will be a long day, but since it's a teaching day (as is every weekday this semester), at least the teaching will be done before we get the results. For most of the week, today couldn't get here fast enough. But now that we're hours away, I'm thinking maybe I'd prefer not to go to the appointment. If bad news awaits us, I'd rather just not know.

This has definitely been the hardest week, days, hours of this infertility story.

6 weeks, 6 days: The Day After

Thank you for all your sweet, supportive messages yesterday, here on the blog and over email. I haven't written back personally to everyone yet. I'll try to do so over the next couple of days. But if I don't get to it (I have a final to write!), please know how incredibly grateful I continue to be for your love and support.

Although yesterday morning was awful, by evening I was feeling much better. Having been raised by an engineer and a math teacher, I need data. So even though the data we got yesterday morning wasn't what we were hoping for, I am happy to have some information so I can calibrate my expectations realistically. I know there are people (maybe some of my readers?) who can handle uncertainty with hope, but I have a really hard time with that. I'm more secure knowing exactly where we are, what has to change, and what our chances are. I took a restful nap yesterday afternoon and slept well last night, for the first time since Saturday.

Don't get me wrong: I am hope, hope, hoping that we get surprisingly good news next week, that the fetus has perked up and gone through a tremendous growth spurt. But I am not expecting it; it is one thing to overcome slow growth OR a slow heartbeat, but being faced with both is a significantly higher hurdle. And I'm mostly okay with that. This is the best we've ever done in two years of trying. Seeing the heartbeat was awesome; if nothing else, it was a signal that we can do this!

5 weeks, 5 days: Still here, still anxious

One week since the last blood test, one week to go until the u/s. As far as I know I'm still pregnant. But I sure would like some reassurance that things are progressing! I'm just a bundle of anxiety all the time. I wish my nonstop exhaustion could be reassuring, but worrying causes exhaustion just as much as pregnancy, I suspect!

But I will continue to distract myself with brainstorming baby names and imagining nursery decor. There's a fun Motherlode post today about picking the wrong baby name. Oh the pressure!

5 weeks: Thank you

Just a quick note to say thank you for your joy and support yesterday. We feel so blessed to be surrounded by so much love. And we're a little overwhelmed by how lucky this little bean is to be so loved already.

Of course, after 22 hours of the giddy, I woke up this morning to abject terror: why do I have no symptoms? did something go terribly wrong overnight? This is going to be a long, long six weeks. I know from reading other IF bloggers that this fear is normal; but it doesn't make it any easier!

Isn't it ironic?

I'm actually feeling better, saner, happier in the last 10 days since going public and admitting that I'm *not* doing so well with all of this. Thanks for reading!

On the dark side

I caught Barbara Ehrenreich on Jon Stewart the other night, talking about her new book, Bright-Sided: How the Relentless Promotion of Positive Thinking Has Undermined America. I haven't actually read the book, so what follows is based on the Jon Stewart interview and the press release from her publisher. The book stemmed from Ehrenreich's breast cancer diagnosis and treatment, a period in which people told her to stay positive, visualize the cancer shrinking, repeat affirmations about her strength and health. Her theory is that "the relentless push for patients to maintain a positive attitude is often psychologically devastating."

I couldn't agree more, especially with regard to infertility. The bane of every IF's existence is someone saying "just relax." First, it's impossible, what with the constant monitoring, timing sex, giving up wine for two weeks out of the month, waiting to test, waiting to test again after the first BFN each cycle, popping pills or injecting shots, early morning trips to the doctor for ultrasounds that could reveal good or devastating news. There's nothing relaxing about any of it. Second, it doesn't work. Relaxing is not going to get me pregnant. Yes, we've all heard the stories about women who adopt a baby, only to discover they're pregnant and end up with Irish twins or women who, after multiple rounds of IVF finally produce a baby, suddenly get pregnant on their own. But in truth, it happens quite rarely. (And I suspect that the latter -- post-IVF surprise pregnancies -- result from the IVF finally shocking our systems into submission, an actual biological change, not from relaxation).

But is the "just relax" mantra (along with saying positive affirmations about my womb being a warm and welcoming place and visualizing the swimmers and eggies doing what they're supposed to do) actually, as Ehrenreich posits, "psychologically devastating"? Yes. Infertililty is a dark and lonely place. Despite knowing so many other women going through this right now, I often feel very alone. All the happy pregnancy announcements and adorable baby photos on Facebook crowd out the knowledge that there are others just like me. And when we are told to "just relax" and be positive, it feels like a denial of our reality, which is, frankly, "dark and twisty." It's okay that we are desperate and depressed. We feel betrayed by our own bodies; the one thing we are supposed to be able to do, we can't. Meet us where we are.

I think the positive thinking approach is really for the benefit of the "friend," not the patient. By telling us to remain positive and think good thoughts, the "friend" gets to avoid the dark and twisty. That's only more isolating for the patient. We're made to feel like we're wrong for feeling like we do.

But if you want to say affirmations and visualize for us, that's okay! I don't know if prayer works, in the sense that G-d hears our prayers and then intervenes in our lives. But I do know that circles of prayer -- as well as circles of affirmation and positive visualization -- can make us feel loved and supported. So feel free to pray or affirm or visualize for us; we'll draw on that strength. But don't expect us to do the same, and be willing to listen and accept it when we can't.

What it's like

I've never been terribly self-reflective. I was a terrible journaler; psychotherapy, though incredibly valuable, was like pulling teeth. I don't often just sit down and think about how this feels. But I am contemplating a post about it. It sucks, not being able to do the one thing I've ever wanted to do. But there's more to it. And hopefully some day soon I'll write about it.