Thankful

I spend a lot of time on this blog whining about life circumstances. While I appreciate an having an avenue for blowing off steam, I'm also not always grumpy. In fact, thanks to this blog, I am usually even pretty happy. So as a change of pace and in honor of the upcoming holiday, I thought I'd lay out my thanks.

1. My son- thankful does not even begin to cover it. I have dreamed of being a mother for decades and obsessed over it for years. While it may not be the Hallmark commercial I envisioned, it far exceeds what I imagined. His presence in my life is a source of constant joy. I could never have anticipated a love so deep that to even attempt to describe it brings me to tears. Trite as it may sound, I would lay down my life for this boy.

2. My husband- boy, does he deserve a medal (however, lest we get too sappy, sometimes so do I). He has been my best friend for a decade, my support when life falls down around us, a better father to my son than I could have asked for. He is steady, reasonable and kind in a world that can be turbulent and mean. I could not be the wife and mother I am without him.

3. My family and in-family- for always pulling through when necessary and for the type of unconditional love that I have only come to understand in the last 14 months. We are lucky between the two of us to have 4 wonderful parents.

4. My health- ok, sure, reproductively I suck. But if that's the worst of my health worries, then I am pretty lucky.

5. For all of our creature comforts- I have never been hungry (besides self-induced hunger), live in a nice house in a nice neighborhood, sleep in a soft bed, revel in my air conditioning. I have all of the basic necessities and then some.

Ok. I could go on. But I won't. Amidst the struggle for such a basic and deep-seated human experience, the experience of family, there is much to be thankful for.

Happy Infertility Awareness Week!

So this past week was Infertility Awareness Week. As a bona fide infertile, I feel it is my civic duty to spread the news.

According to the American Society for Reproductive Medicine, about 10% of couples are infertile (that is, unable to conceive after a year of trying). Which means that if you know 10 couples, chances are that you know someone who is infertile. Which means you should stop asking people when they plan to have kids. Eighty percent of infertile couples will be able to identify a cause and of those identified, about half are due to male factor. Which means you should stop discussing in hushed tones with your family members what might be wrong with your brother's wife.

None of that even begins to speak of the emotional toll infertility takes. I have encountered a range in my fertile friends' level of understanding: from "I cannot imagine how hard this must be and I am so sorry" to "why are you even trying so hard anyway?" I could write for days... literally... on the psychology of infertility. But, I won't. If you are fertile (or assume that you are) and you think that I am taking this little issue way too far (it's not cancer, for heaven's sakes), all I can tell you is that I am not alone. Every single infertile person I know (and yes, through the miracle of the internet I know many) experiences deep sadness, intense longing, a very real sense of loss, embarrassment, isolation, frustration, fear, disappointment, and worry. I will delve more into this in later posts because I think it's important. Too many people have zero understanding of how very, very hard it is. And the unfortunate part of that is that they then say things that are astoundingly insensitive and only make the hurt worse. Which I know is never the intention. So to end this post, I am compiling a list of phrases that are never to leave your lips when speaking to someone longing for a child.

1. Why don't you just adopt?
Ah, the perpetual query. Oh, how simple the decision, right? People who say that never, and I mean never, have the slightest inkling what adoption involves. And they never, and I mean never, are adoptive parents themselves. Adoption is expensive. It is very time consuming. And it is not as rose-colored as the general population believes. Again, I could write a whole post on this alone (and perhaps will), but not now. Finally, the next time you and your friends are all sharing birth stories, consider that the adoptive parent is robbed of the experience of being pregnant, feeling the kicks, giving birth, exclusively nursing the baby if she chooses. If you hate pregnancy, just be grateful you know enough about being pregnant to hate it.

2. Just relax and it'll happen. (Alternatively, "Just go on vacation.")
This one is sure to raise any infertile's blood pressure by 20 points. If that were true, everyone would get pregnant that first fun month of trying. Relaxing can't fix two-headed sperm, polycystic ovaries or endometriosis. And trust me, we are worried enough that we are in some way causing this failure. The last thing we need is to be lying in the sack wondering if maybe this could be the time... oh, crap... I thought about it... I wonder if that's too uptight... did I just screw it up?... well, now I'm definitely not relaxed...

3. Maybe it's just not in God's plan for you to have children. (Alternatively, "Maybe it's just not meant to be." or "Everything happens for a reason.")
A. Do you have a direct line to God? Because if so, I have some questions for Him? B. It's not in His plan for me, and educated loving person with plenty of resources for raising a happy, healthy child to have kids, but it was in his plan for that woman who was on the news last night because she killed her five children to have them? Do you really think God works that way? C. How is it remotely helpful to my faith to be told that God is withholding such a basic, deep-seated desire from me?

4. You want kids so bad? You can have mine!
First of all, you are making light of something deeply painful to someone. How would you feel if after your mother died, I offered you mine whenever you wanted to borrow her? I don't want your kids. I want my kids. Second of all, do you really not want your children? Really? Watching them grow, hearing their "I love yous," having a front row seat to their accomplishments doesn't bring you joy? Because if that's all true, perhaps you should consider adoption...

5. Have you tried ____________? (pillow under your bum, various positions, etc.)
Believe me. We have tried EVERYTHING. Do you really think that we have left any stone unturned? And now, please, for the love of pete, never ever tell me how to have sex again.

6. I know just how you feel. I tried for six months with my third.
No, you haven't the foggiest how it feels to stare at a negative pregnancy test every month for three years. You have no idea how it feels to have the most intimate part of your marriage invaded by medical personnel. You have no idea how it feels to inject your body full of hormones. You have no idea.

7. There was probably something wrong with the baby anyway.
While it may very well be true, that doesn't mean that the baby wasn't wanted. His or her family was excited, dreaming of tiny fingers and toes, feeling kicks, decorating the nursery. And now those dreams are gone and the would-be-parents are scared it will happen again. Future pregnancies will be marred with fear. They are mourning the loss of their dream.

8. At least you have one.
This is my new personal least favorite and one I probably would have actually said a couple of years ago. The problem is that we wanted three... or four. And sure, at least we have the one (though there is no least about him), but now we also know how great it is. Please, especially don't say this if you have more than one or only want one yourself. Because you really don't understand.

9. This is the last one, I promise. Don't leave your infertile friends in the dark when you get pregnant. Is the news going to hurt them? Yes and no. Yes, they will wonder why they can't experience pregnancy too. And no, they are genuinely happy for you and don't want you to experience pain. Not telling them only isolates them more and you can hardly hide it forever. And just because you should announce your pregnancy to them does NOT... I repeat NOT... mean you should complain to them about your discomforts. You certainly have a right to complain, but for heaven's sakes, not to the very person who would give a left leg to experience those discomforts. Let them take the lead in discussing your pregnancy. You have lots of other friends and family to talk about your joy and discomforts with. Don't torture the one who wants what you have more than anything.

So Happy Infertility Awareness Week, all. May you all have the families you desire.

Enough. No, seriously. Enough.

Do you remember those clown punching bags that used to be around when we were kids (and by we, I mean children of the 80's)? You punched them down and they popped right back up again? Well... meet the human clown punching bags. The universe smacks us down and we pop right back up, idiotic smiles on our faces, waiting for the next blow. And it always comes. Sometimes the universe gets a new toy that occupies it for awhile and we get a reprieve, but it always comes back eventually and hits us again. And we just ask for more.

Our dog is dying. He has some mass (we think) compressing some nerve or his spinal cord and he is losing neurological function in one leg as a result. Three-legged dog minus one leg. It looks like we have weeks left. Someday in the near future, I will have to choose the day my dog dies. (Smack!)

I went to have the HSG done that should have been done before we got pregnant this last time (except that we didn't know we could get pregnant so we didn't have the test done). We were looking to see if the uterine scarring that resulted from OOPS! forgetting to take out the whole placenta when my son was born was resolved. Wanna guess what the result was? Come on. Guess. RIGHT! Not gone. At best, that means more surgery to try to correct the problem. At worst, it means no more babies. Ever. (Smack!)

Stay tuned for "Why 'At least you have your son'" is not the correct response.

And We Have Tears...

Well if I was feeling bad about not feeling bad, I am feeling bad enough now to feel better. We got the results of the karyotype back today. At the lab that did it, 60% of karyotypes from miscarriages come back abnormal. Of those, 2% have more than one abnormailty. Meet the 2%. Our baby girl had both one X chromosome (Turner's syndrome) and 3 chromosome 21s (Down's Syndrome).

One one hand, this is good news. It means that it's not the uterine scarring that caused the problem. Yet it raises as many questions as it answers. Considering that it took 13 embryos and 2 chemical pregnancies to finally have my son, and now this, it makes me wonder if we have an egg quality or sperm quality problem. Of course, both of those can be overcome easily by using donor gametes. This is not to say that the decision to use donor gametes is an easy decision. But, the most important things for us right now are having another pregnancy and another child.

Still, receiving the news has turned on the waterworks. I am sad for my poor baby girl who never had a chance at life, but happy that she did not have to suffer. I am sad for the loss of a dream and a desire. I am sad that this likely means facing more invasive therapies rather than the chance at another freebie. Which makes me sad for our bank account. Today I am sad.

Decisions to never have to make

Our very-loved 9-year-old Labrador is sick. It's really bad. He was diagnosed with osteosarcoma of his ulna. By the time of diagnosis, 90% of these have metastasized to the lungs. Nothing showed up on his lung film, but that means little. With no treatment, we are looking at 2-4 months. Our options: 1. Control pain as well as we can with oral meds. 2. Amputate and chemo to increase life expectancy to a year. 3. Amputate for pain control. 4. Radiation for pain control.

After speaking with a trusted vet, radiation was ruled out as an expensive form of voodoo therapy. We also ruled out chemo because he will likely die of lung mets regardless of the chemo, so why put him through that? That left us with 1 and 3. We opted for 3 because he was just in so much pain. The surgery happened yesterday. As of this morning, his vet reported that he was in a LOT of pain and requiring sedation and multiple pain meds. I was racked with guilt thinking we'd done something cruel to our guy. By this afternoon, he was faring some better and learning to walk again.

I can only hope that he gets the hang of it soon, heals well and goes on to enjoy a playful and happy end. My heart breaks to think of the decisions that will have to be made in the upcoming months, and the decisions we've already made. I hope we've chosen the right path for him.

Too Happy Too Soon?

The D&C was one week ago today. My reaction to this whole thing is confusing for me. I thought I could never handle a miscarriage- that after all of the other crap we've been through, it'd do me in. So how is it that today, after 7 short days, I feel better than I have for weeks, maybe months? Though it makes little sense, losing the baby has sprung me into action. I have enrolled my son in music, Gymboree and swim classes. I have started pulling our house and lives together. I am more organized and that makes me feel better. I am sure that it seems like I am busying myself to hide from the pain and maybe I am. But these are all things that I've been wanting to do for a long time.

I've been paralyzed into inertia for so long and I don't really know why. Maybe it was the bad feeling I've had all along about this pregnancy. Maybe, like everything else in life, the fear of the thing is worse than the thing itself. And I know that my son has a lot to do with it. If we had no children when I lost this pregnancy, I am sure it would have crumpled me. I think that because I never felt good about this one, I never became attached to it. With my son, I rubbed my flat tummy and talked to him from the beginning. I never did that this time around. And now, I don't feel so much like I lost a potential child as time. I feel guilty even for not being more sad.

Don't get me wrong. It's not that everything is totally status quo. I belong to an online support group for IVF pregnancies and moms and I can't go back there. I have a friend due 4 weeks before I should have been and I don't want to see her. I don't want to hear about others' pregnancies. I don't want to congratulate them. I am bitter and it may be awhile before I can fight my way out of that. And it would not surprise me at all if one day with no warning, sadness crashed down on me. But for the moment, I am surprising even myself. I am happy. I am ok.

Thank You

To my husband, who pushed aside his own grief to dance around mine, never knowing whether to hug or get out of the way, but never getting angry with my unique and supremely selfish and frustrating way of dealing with bad news.

To my son, whose very existence is the best reminder that my life is not bad just because the current circumstances are unhappy.

To my mom, who came and stayed despite her own schedule, and never showed hurt when I aimed my pain in her direction.

To my mother-in-law, who made and sent a card saying that she didn't know how to comfort me, but was praying for us as we navigate through the aftermath.

To my best friend, who has left countless messages on my cell phone and continues to call in her support, even when she knows I probably won't pick up.

To my aunt and uncle, my in-laws, and 2 different friends who sent flowers to let us know that they are thinking of us.

To my husband's friends, who have called to comfort him when I have been unable to do so.

To the anesthesiologist who patted my hand while he spoke to me and didn't look at all uncomfortable when I burst into tears because of his kindness.

Thank you to all of the people who have offered support, prayers and love. Your words cannot take away the loss of the baby, but your presence is helping us to find our way through it.

My Five Stages (props to Kubler-Ross)

1. Denial: I'd be surprised if many infertile people experience this one. It's really hard to deny years on end with no baby. When you are infertile, you expect heartache, you don't deny it. Plus, there's really no denying a motionless, heartbeat-less blob that should be an active human baby.

2. Anger: Now this one, I excel in. I am pissed. Why us? Why does reproduction have to be such a struggle for us? We can afford kids. We love our son endlessly. Is it really so much to ask just to have the family we want? And if it is, then WHY did I even have to get pregnant in the first place? We weren't trying. We didn't ask. Couldn't it just not have happened (like it didn't for the last FOUR years, for chrissake)?

3. Bargaining: Got this one too. Not for this pregnancy, but for the future. Fine, if you took this one from me, you owe me twins next time. (Wait... TWINS?!? I don't want TWINS!) Ok, God, take this one if you must, but just let me have another eventually. And let it be ME. I want to be pregnant again (for more than 12 weeks). I want to give birth. I want to nurse my baby. Please, God. Don't you owe me?

4. Depression: Now this one I definitely hit again and again during our infertility years. I'm not there yet. We shall see. I think that waking up to my beautiful boy each day will be the best antidepressant I could have.

5. Acceptance: I'll get there. Probably sooner than anyone expects. I have my son. I will have another child, whether through adoption, surrogacy or pregnancy. I will. If my body can't give me my family, I'll get it elsewhere. But I will get it. And one day soon, I will wake up looking forward to the day and ready to jump in with both feet.

Myself is Getting Sick of Myself

I am convinced that the baby is dead (the in-utero one, that is... happy to report that the ex-utero one is alive and active). I keep telling my husband that I killed another one (that is in addition to the 10 embryos we transferred that never took and the 2 that did, but never became babies, and whatever unknown others there were while we were trying on our own). He's not a fan of the terminology. The fear is not totally unfounded. I've been spotting off and on since 6 weeks. Blood+Pregnant=Badness. Now I am cramping to beat the band. I've been doing that all along too, but it's worse now. Blood+Cramps+Pregnant=Bad Badness. All my pregnancy symptoms have vanished. And the coup de grace for my sanity: we rented a doppler and have yet to hear the tiniest hint of a heartbeat. Certainly, there are many quaint little anecdotes: "Oh my OB had a hard time finding my baby's heartbeat until 37 weeks!" But, really. Two doctors should be able to find it by now. And we can't. Because it's not there?

I have tried to convince myself that I'm ok with this. After all, if we'd had the choice, we wouldn't have chosen a 19 month spread between our kids. And the newborn period utter exhaustion scares me. But the truth is that... well, of course I'm not ok with it. Who ever is? (I don't need an answer to that, thanks.)

I am making myself insane and I am tired of it. My next OB appointment is on Tuesday. I am simultaneously relieved and terrified. I only hope I can stand myself until then.

On the Greener Side

The greener side of the fence. You know, where the grass is... well... greener. I spent 3 1/2 years peering through the chain links watching friend after friend after friend get pregnant, sail through pregnancy, give birth to pink-cheeked cherubs and talk about how wonderful it was. I know that the point of that saying is that the grass really isn't greener over there. But in this case, I was sure it was. For heaven's sakes, how could having a child not be better than monthly devastation, needles, hormone-induced psychosis, and spending more intimate time with my physician than with my husband? Three and a half years of trying, nine rocky months of pregnancy and one scary birth later, here I am. The greener side of the fence. And not only is it better (duh); it is beyond what I ever imagined. On the off chance that any fellow infertile ever reads these thoughts, let me add something here. Being a parent is the best thing I have ever done. However, that does not mean that it is a Hallmark commercial. This seems to be a common theme among infertiles (there are many). You spend so much time putting parenthood on a pedestal that it can be a major jolt when the baby is born and you are tired, and frustrated by the crying, and overwhelmed by the demands of a newborn. Being infertile does not protect you from the daily rigors of parenthood. And the very unfortunate part is that many infertile parents feel like they don't have the license to discuss the frustrations that every other parent discusses. After all, they asked for it, they took drugs for it, they paid for it. That being said, for every whine, mess and tantrum, there are a hundred magical moments: learning something new, kisses, snuggles, becoming an individual. And it is my firm belief that while most parents cherish their children, those of us who have worked so hard to bring those children into our lives cherish those moments just a bit more, knowing how close we came to never having them at all. It is greener indeed over here: glowing technicolor green.

The wrong thing to say

Ah, the pressure. The first post. Must be eloquent. Must be funny. Must be intelligent. Likely will be none of the above. I would start at the beginning, but that was too long ago. So instead, let me start with the facts.

1. I am the mother of a 1-year-old boy who is the result of 3 1/2 years trying to conceive, multiple failed Clomid cycles, multiple failed IUIs, multiple failed IVFs, multiple miscarriages and finally one successful IVF cycle.

2. Four months ago I graduated from medical school, but I am not a resident, nor do I think I ever will be. But that still remains to be determined. By the way, the reason I'm not in residency is by my choice, not my rejection.

3. I am 10 weeks pregnant with a very surprising surprise.

The "surprise" is not surprising because we were doing anything to prevent pregnancy (we weren't), but because of #1 above. We had no idea that we could conceive without involving a third party, heavy medications, multiple procedures, some petri dishes, stirrups and porn in a doctor's office. This baby (if it indeed turns into a real baby... pessimists don't give up easily) is what is referred to in the world of IVF as a "freebie," meaning that it didn't cost a cent to conceive (save that bottle of wine). As every fertile person knows, there are two ways for infertile people to get a freebie: "just relax," or "just adopt." In the case of those of us who have children through ART (Assisted Reproductive Technologies), once we get past the hurdle of that first baby, we "just relax" and get pregnant on our own. Which brings up two interesting points.

1. I don't recall any fertile people in my bedroom when we trying to conceive our first. So how is it that they know that I was uptight? Why do they assume that they were so emotionally superior during attempted conception?

2. Since when is having sex with a baby in the house is relaxing? "ShhhHHH! Hurry! Are you done? Shhh... I think I heard him crying. Hurry! He's going to wake up."

I know. I'm being rude. People mean well. The years of infertility have taught me a lot, both good and bad. And one of the unfortunate side effects is that after listening to years of "well-meaning" insensitive comments, I have lost patience for them and have a hard time taking them for what they are: an attempt at support. So here's my helpful guide to the right thing to say, gleaned from years of hearing (and yes, saying) the wrong thing.

In a happy situation: Congratulations! That is absolutely the best news. I am thrilled for you.

In a sad situation: I am so very sorry. You are in my thoughts.

Simple as that.