Remember This Day - September 19, 2011

This was the day you were convinced wouldn't happen. You were expecting this day to be the day that officially started your "break" from fertility. You had forgotten to take you prenatal vitamins, you barely kept up with your prometrium, and you drank. Like a fish. For the last two weeks. You walked into the doctors office this morning, confident that it was the last time in at least four months that you would be there. You were in and out, in a record ten minutes. You came home, made a 3-egg white omlette with mushrooms, spinach, and onions. Drank a cup of coffee, and started to weed through a flood of emails. At noon you went downstairs and you got on the treadmill, you did the week 2 of the couch to 5k app, plus an extra 25 minutes of walking and running. You burned 376 calories, pounded out 3 miles, and you felt proud of yourself as you pushed through the last five minutes of running straight. You took a shower, you came upstairs, and you heated up lunch. Grilled chicken, 1/2 a cup of black beans, and 1/2 a cup of brown rice. You had just finished that lunch, when at 1:23 the phone rang.

It was a nurse, Shirley, calling from the doctors office (your regular nurse is Italy). She told you you that she had good news, and that test confirmed the one thing you never expected...that you are pregnant.

You are pregnant............

And you broke down and cried, and over and over you said 'oh my God are you serious.' And she said she was. And you exclaimed "but I did everything wrong this time!" And that utter disbelief and flood of emotion washed over you, into the pit of your stomach, and you cried. The news-bearing nurse then told you that you need to come in to have your blood taken again on Wednesday, and then again on Friday, and to continue to take the prometrium for four weeks? Seven weeks? (who knows) how long.  And you hung up. And you cried a few tears, your hands trembled, and you said a silent prayer of thanks to God for hearing all those that came before.

And you called your husband, and told him that he was going to be a father. And you let it wash over you...and you went upstairs to take a pregnancy test just to see for yourself.

For the first time in your life you saw what you always hoped you'd see.

Two lines.

Le quatrième fois

It's funny really, how isolating infertility can be. In all my life, I don't think there were many more occasions to need people, need encouragement, or need to get out of my head than I've needed since January. But for some reason, no one wants to talk about it. Friends. Family. Me. Who would want to talk about it?

I've found mostly, that people don't really know what to say, so they just don't say anything. When questions or the subject is posed in the course of conversation, it's quickly dismissed as "I don't get all that stuff," or "it'll be fine." Jokes are made to the effect of "is your uterus ready?", or even being told that all of precise calculation, the hormone injections, the measurement and counting of your egg follicles that you endure over and over is just "weird." That's usually right before the subject is changed. Or, you're simply wished good luck, as if the mere mention of your reality is so uncomfortable that it's best just to stop talking. Most of the time now, I wish they would stop talking. It makes me uncomfortable, too.

People don't talk to you about how you're feeling or what it was like to lose your normalcy. They don't think to not take "I'm fine" for face value, or ask another question. In fact, it seems the silence just continues to grow evermore. At some point you become the pink elephant--that unrelateable freak in the corner who everyone pretends isn't there. Slowly, you begin to realize that your new reality has forged a wedge between a world that once existed, and a whole new time and place and person  that no one wants to acknowledge. Its just as if you are disappearing. On most days, it feels more like you already have.

So the silence grows, because one can't understand that it's alright to ask and the other no longer cares to tell. It grows and grows to the place where the expectation is inflated, on both parts, and the hurt festers into monumental proportions. At times the grief and the despair, and the sadness, and the isolation are so overwhelming, that you're not sure if you're sad because you're facing your fourth time going through this, or because the people you always needed most in your life are no longer really in your life at all.

And you think, and you think...are you wrong for keeping to yourself, for fostering the silence? For building expectations and for wondering what kind of person you must really be if no one stops to ask, or listens to what you're not saying when they ask how you are? If you broke your own silence, who would want to be the recipient of someone who suddenly stops protecting their own heart? What would it mean if you unleashed the tears that come so easily behind your blue eyes, to let them flow, to cry out in a gutteral voice this pain and disappointment you are harboring down inside. Would they want to hear that?

Would they want to hear how desperately you love your husband, and how the only thing in the world you ever knew you wanted was his child, and how after you were told that his child was not possible, how the only thing you could think about for months was if he dies, not being able to see his eyes, or nose, his gentle hands in the resemblance of another human being? Would they want to know that kind of sadness?

If the silence was broken, could you tell them how painful it is to inject hormones into your skin. What the burning feels like as it melts into your abdomen, or what the bruises look like? Would you tell them how on the days after your Ovidrel shot, you feel like you can't get out of bed and really, don't want to. That it takes at least four days to feel human after you've been laden with FSH. Would they want to listen about that first time you went to inject sperm of some man you've never laid eyes on into your body, what not being able to turn back really felt like, what the parking lot of the medical office looked like as you cried and cried like the scared little girl that you really were. Would they want to know how scared you really are?

Maybe they'd want to know about that first, second, or third negative test result and knowing that you were going to go through it again. You know, the getting up at 7:00 a.m. on a Saturday to get your blood drawn and your egg follicles counted, in a town 45-minutes away, only to do it the next day, and the day after that. Would they laugh when you tell them how you now know not to ever do an IUI after emptying your bladder because the pain you felt was excruciating...or how it sounds to have your donor's ID number stated, restated, and restated again just to remind you a final time of why you're here before lying back on a table wondering if this would be the time it worked? Maybe you'd tell them that what you have to look forward to if the fourth time doesn't work, is going to be twice as hard. I'm pretty sure they wouldn't understand when you tell them without the slightest shudder, how normal all this has started to feel.

Perhaps you'd tell them about the email you got, about the donor you first chose, and how an offspring had been born with a cleft pallette, and how you could continue to use that sperm, or you could find a new donor. Not over wine and laughter, but a Friday afternoon at your kitchen table and a Monday at your desk. Could they understand how it feels to pick your future out by nothing more than sifting through height requirements, the color of someones eyes, the sound of a voice, a childhood photo, a silouette, and a great answer to who do you want to be when you grow up?

Would it make sense then, if to that person you also told, that on some days you harbored a glimmer of hope and resilience. That there were a handful of days that you allow yourself to think that perhaps one day you would see two lines on a pregnancy test strip. That the level of disappointment you feel because there will never be the accidental surprise you'd always hoped for, would actually be a surprise of epic proportions. Would they want to know about the way you bury that down inside, so as not to let yourself think about it too long?

So you sit and you sit, and you think and you think, and you wonder and wonder about all the silence that surrounds you. And the result is that you make a choice and your choice is to continue to sit silently...all the while, waiting.

Waiting for the question of how are you to be asked again. Waiting for the arms of someone other than your husband to wrap around you and be willing to stand beside you on this journey. Waiting to not be the pink elephant. Waiting for two lines to appear on the very next test. Waiting for a life to grow inside you.

Waiting...

For normalcy.

It's been three times now, but who's counting...

A long time ago now, I started a journey toward motherhood. Ok, it's really only been since January that we found out that JF had no sperm, but now we're approaching nine months in, and three failed IUI's. Fourth one is just around the corner...

Clomid regime has been increased to 100mg x 5 days, followed by a three shots of Follistim, and then the trigger HCG. Third time around, even though I was heavily hormoned up, my follicles never got above 20mm, which means, we're not sure if I ever had a fully mature egg. My body started to ovulate on it's own, so we had to go with the IUI - and for the third time, it didn't work.

We have decided to do the fourth and final IUI for the donor we originally went with. Tomorrow is the third day of my cycle. It's the first IUI that I'll have had that is a back to back procedure - hard to believe we've been on this road for 9 months, and we're only on the 4th cycle of IUI, thanks to my hellacious travel schedule this year. We will have one vial of donor sperm left from the original donor. It will be time to find another for any further procedures.

We have decided that if the 4th cycle doesn't work that we will stop until January. In January, we will likely begin IVF. Health insurance doesn't cover IVF, so it will be an out of pocket expense, a costly one, so we need to wait until we can max out our FSA's, health spending accounts, and whatever else we can think of to buy us one or two rounds of IVF. We anticipate they are $16-20K a pop.

We will only do 2 rounds of IVF, and then we will pursue adoption.

That's what the plan is right now, anyway.

For now, I continue to delicately balance hope, faith, and a black pit of despair somewhere in a far place deep in my soul. My soul, which has become a very lonely place to be.

IUI 2: Results Are In...

And despite feeling quite different this time around (super tired, boobs hurt)...I am in fact, NOT pregnant.

So, again thanks to my agressive travel schedule and factors I can't wriggle out of, we will wait until August to try the third time. I wish I could have gone another round back to back, but there is a good chance I'll be in Atlanta for the timing of the IUI. So rather than go through the Clomid and poking and prodding for the first 11 days, I'm going to just wait until my next cycle.

This continues to be a struggle, although it's really only 2 tries, and it's just got a 20% chance of working, it's still really hard to reconcile against my feelings.

More to come soon.

IUI 2: Day 15 - IUI#1 - Epiphany

In all my life, or as least for as long as I can remember, I never felt like I would get pregnant by accident, or that I would know what it was like to carry a child. I don't know why, really. Maybe it's because I'm 34, and it seems weird that I haven't ever concieved despite a lot of odds that I would have already. Maybe I've always known that we'd have this problem, and God helped soften the blow by instilling that feeling in me.

Because of that, I have come to understand one thing: For at least the last 10 years, I believe I've been creating my own self fulfilling prophecy by reiterating to myself and others that thought. I believe I have been doing so in order not be disappointed when it didn't happen on it's own. I've spent 10 years, in some way shape or form desperately hoping that it would just happen, so that I would be surprised, so that I would be wrong. I believe that I always hoped for that surprise reaction of "oh my God, I'm pregnant" so that that the next course of life would just systematically figure itself out on its own, and I would be swept away, without having to think about actually making the conscious effort of doing it myself. Maybe that's because I didn't want the disappointment, or I didn't want it to be this hard. I don't really deal well with having to arrive at another of these life changing crossroads on my own accord.

But, like any true self-fulfilling prophecy, I arrived at the beginning of this journey exactly where I didn't want to: having to go through the hard part, having to work through something I didn't want to have to work through, in order to get to the good.

What you don't realize when you make a decision to pursue this whole process is what is really involved. You can't realize at the time how it feels to be thrown into the middle of a tornado that is whipping around you while you try nothing more than to attach yourself to anything that is remotely standing still. Nevermind the endless testing, prodding, stirrups, time off of work, hormones, and scheduling that has to go into it. How could you have actually stopped for a minute to realize that you were supposed to go through a grieving process, or that it was ok to be sad for a little bit. You just start mindlessly going through the motions, doing what you're supposed to do. You forget that for a few years the only thing you really knew about ovulation was based on what you read about mucus and basal temperature, not nearly what you know now, like that your uterine lining looks perfect, and that you have two mature eggs measuring 17 and 19 mm, respectively. It's a wave of sadness that flashes over you when suddenly you realize that there is never going to be that accidental surprise you always hoped to find. The understanding that your period will never just not come that month, or the acceptance that you will never again have to buy a pregnancy test or wonder if you'll get a positive result without the help of a team of doctors and a man you'll never meet manipulating your chances of actually becoming pregnant.

Whatever joy couples who concieve naturally have as part of the process of becoming a parent feels like it's been stripped away, down to a place where all you can wonder is how the hell did I get here? That's what yesterday was like for me.

It was both an incredibly hard moment of realization and a step forward in this journey I'm on.

As for the IUI. Today, I dropped off my swimmers at 1:00 p.m., at MY doctors office, in MY city. Sigh...I felt relief. I went and had lunch at Moby Dick's (chicken and kubideh kabob, shirazi salad, water) and played Solitare on my iPhone while I ate. I then went back to the office to wait for about 20-minutes before my IUI. This time we had 8.3 million sperm after the thaw, with 59% mobility. The doctor (MY doctor), told me it was a great specemin. Comparatively, last time the post thaw was roughly 5M and 6M sperm. The swimmers that launched their greatest competition today, came from a vial that was collected on 3.24.10...my nephews birthday.

Tomorrow is round two, and the dreaded two-week wait. This is the time when you wished that all those medical advances, all that equipment that has been hooked up to your hoo-ha all this time could actually tell you right away if that 20% chance will turn into the rest of your life.

IUI 2: Day 14 - Trigger, Day 15 - IUI #1 of 2

June 6, 2011

It's a little funny to me that this time I've had a stronger dose of Clomid, and stuck to the normal day 3-7 dosing schedule, but apparently my body doesn't want to co-operate just yet. I got checked on Friday, Sunday, and again this morning, and I think I'm finally ready to go tonight. Good news is I have two follicles that look like they are mature, bad news is, I have to drive to Rockville for both IUI's this time...it's about 1 hour + each way, so it's not real conveinent either. I was feeling pretty good about going through the process again, I think until standing at the receptionist desk at the clinic this morning trying to schedule those two IUIs. It was just like nothing was possible as far as scheduling, and I half expected them to tell me "sorry, you'll just have to wait another month." The waiting room was packed again this morning, and I think that also freaks me out. So many people have a problem getting pregnant on their own. It just continues to amaze me. It also gives me such sadness. I stood there at the receptionist desk with tears in my eyes, trying to hold them back to mask my disappointment that I wouldn't be able to have MY doctor, MY nurse there with ME...again. I think a combination of hormones and tiredness of course isn't the best mix for me, but, I just really kind of lost it and spent a good hour of the morning in tears.

My friend, The Belgian, and his girlfriend/wife and kids were visiting for the past almost week and it was nice to have someone to listen to me talk it out and reassure me that I'm not crazy (although, I think I really am) and that what I've been dealing with is kind of normal. I want really want to believe that, but sometimes I wonder because I feel so stuck inside my head sometimes...

June 7, 2011

As I was typing this (now yesterday), my very awesome nurse called to tell me that she told the scheduling person that I HAD to come to the regular office for the IUI's -- so they got me in, for both rounds. I can't tell you how grateful I am for her, and for that. For whatever reason, knowing that I was going to have to go to another doctor, in a far away place was such a small thing that suddenly completely overwhelmed me. For me, I guess in part its sitting around in an office filled with so many sad people, knowing you're another number in this great big machine, and every personal element (your nurse, your doctor, the familiarity of at least that office) gets stripped away, it just reminds you of why you're there in the first place, and it reminds you that you are only one thing to them: 760122.

My nurse, is the silver lining...and by just making an extra effort for me to get into my office today and tomorrow, really, really, helped give me back some perspective. It just really hit me again:

I continue to feel overwhelmed and struggle to make sense of all of this.

I've also come to a realization....

Let's Try It Again

IUI Round Two is officially underway. The doctor increased my Clomid to 100 mg, and this time I did not act like a total psycho beotch, and in fact felt pretty darn good. I go back on the 3rd to see how many little follicles I have produced, and looks like we'll be sperminating me on June 4 & 5.