Take Two

We're two days into the semester, which is to say not very far at all.

On the one hand, I'm starting this semester without a child home with pneumonia or a snowday, so yay!  I like my class (I think; we've only spent two hours together).  I have something resembling a plan for the semester, in regards to my own writing.  I'm doing a collaborative project I love.  I'm making headway on other stuff.  I have moments, like this afternoon, sitting on my couch writing a list of discussion questions for tomorrow, that I'm just excited to be able to do what I do.

But.

Too much going on.  Too many projects.  Too many obligations to other people.  Just too much all around.  (Case in point, I will spend about 13 hrs on COMMITTEE WORK alone this week.) Opening my inbox fills me with anxiety and dread.  Feeling like I need to go back to therapy and/or crack out the xanax, which, of course, is not really a legitimate plan.

Ah!!!!!

In Lieu of Therapy

Interwebs, forgive me this rant.  I'm feeling overwhelmed, if we need to put a label on it.  I'm tired of being asked by everyone who knows anything about what's going on with my family how I am, how my mom is, how my nephew is, blah blah blah.  Everyone is well intentioned.  But right now I can't really TALK, I just need to put one foot in front of the other, one word after another, and get shit done.  If I wanted to talk I'd go back to therapy--and I have seriously thought about it--but she would just give me the face and I would cry and that would probably be good but probably not worth paying out of pocket when I could if I wanted just cry at home.

My to do list keeps getting longer, as they are wont to do, and while I am generally pretty good about the putting one word after another and just doing what needs doing, one thing at a time, it's HARD. Sitting still is hard.  I'd rather be walking (it has occurred to me that I wrote the bulk of my PhD diss between long walks so this is not exactly new, but back then I did not have a house or two children to take care of).  Things to do include scheduling lots of home repair things, which I am notoriously slow about, and many doctors appointments, and addressing all the stuff for fall (syllabi, event planning) I have been studiously ignoring.  The ignoring got harder when I received an email from my chair re: our first department meeting before classes even begin.

I'm also dealing with the need-to-put-the-book-in-the-mail anxiety so I keep putzing and finding more things to fix instead of just calling it DONE and sending out the damn proposal.  I'm giving myself a couple days more for each chapter.

I also need to come up with a list of places/people to send galleys of the poetry collection (if you are in a position to write a review, even an amazon/goodreads type, please let me know and I'll see what I can do about sending it your way) and that makes that book real and anxiety producing, even though it's done and blurbed by people I admire and all that shit.

The point of these last two is that I like books better on my computer than out in the world.  Although the publishing is sort of necessary for career advancement.

Okay, I think I've talked myself down.  Thank you.

Treading the Same Ground

Maybe two years ago the main street that runs through town was repaved.  And since then it seems almost monthly the same small strip of road is ripped up again, with electrical and sewer work.  It's patched up more or less better (for a while there was a huge dip) until the process is repeated again.

It seems an apt metaphor for my mental processes lately.

I'm stuck, treading the same ground over and over.  All the conversations with Dr. Gorgeous 2008-2011 spinning my wheels.  Pregnancy loss and everything that could have happened, but didn't.  The horrible situation with my junior colleague last spring and what it means for going back to work.

Don't get me wrong:  I'm not sad.  I'm "happy" and productive and all those things.  And mostly that spinning is translating into creative work--and maybe that's just HOW I work--so that's something.  But in my more conscious life, I'd also like to let things go.

Blogotherapy

Oh, where to begin?

Usual disclaimer about life, big picture, being good, and I keep telling myself that.

Publishing books, it turns out, is stressful business.  Deadlines, crazy editors, family drama.

And it's the end of the semester, with all that entails.

I could probably handle that but unbloggable things at school--I mean absolutely batshit crazy things--have my anxiety level at RED ALERT CALL THE THERAPIST which is probably compounded by, or causing, hard to tell exactly, resurgence of insomnia.  (Have figured out there's a hormonal component, and a teething Tiny Boy component, as well.)

On a really basic physiological level I can't calm down.  I've been here before and the time that comes to mind is sitting on Dr. Gorgeous' exam table before the ultrasound that would tell me whether or not there was going to be a Tiny Boy.

So it's 10:00 and I'm exhausted and weepy and trying to figure out which of the drugs in my arsenal might possibly get me more than 4 hrs of sleep so I can get up tomorrow and grade...and call my therapist, you know, on the off-chance she has a cancellation for Thursday.

Baby Lust

I'm having baby lust again, people.

It's not the sort of thing I would act on.  I mean, I'm not completely out of my mind.

My life is GOOD.  I'm happy.  I'm not crying on a daily (or even weekly and probably not monthly) basis.  I have my shit together.  I have two books coming out and another one in very good shape and I have tenure and two kids and it's EXACTLY WHAT I ALWAYS WANTED.

But we were out at a kid event today and it was crawling with pregnant women and new babies and I was jealous in a very familiar way (circa 2008-2011).  Which makes no sense because I HAVE THE BABY.

But he's not a baby anymore.  He's like an actual person.  A person less than 3 feet tall, sure, but who has opinions and talks in complete sentences and will be going to PRESCHOOL in June.  What the fuck?

So that's probably what this is about, right?  Nostalgia for babyness I will never experience again.

Except there's those embryos in the cryotank...

oy.

Blogotherapy (New School Year Edition)

School starts tomorrow.  And I went back to my old therapist today, mostly because it's a safe space to cry.  And she saw me through 2010-2011 so, you know, there's that.

So I'm in a space that I really need to--want to--strategize.  I was going to write this all out longhand and decided if I did it here (well, not the work specifics, but the other stuff) you might have some thoughts.  You people are good for that stuff.

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Some observations and big thoughts:

1) Mostly I need to accept the fact that I am still not functioning 100% and really won't until, at minimum, I get more sleep.  I am working on that, steadily, but everything with Tiny Boy is slow going. 

2) So I need to be kind to myself and recognize I'm going to have good days and not good days and use the good ones and muddle through the bad ones (like today, today is BAD, because a kid woke me at 11:30 and I didn't go back to sleep until almost 1:00 [I think, it's hard to remember] and then at 4:30 and then the other one woke up at 5:30 and both of them were in my bed being generally annoying by 6:30).

3) Although it is hard to remember sometimes, work should not be about things like my ego (and the perfectionism that goes along with it).  Work should be a tool by which I earn money so I can actually live in my house and pay my bills.  That's it.

4) Money is also useful for cutting down on stress.  I need to remember to USE IT.

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Some things I can do (or need to do):

1. Suck it up and outsource.  (a) I hired a landscaper to do a general cleanup of my yard.  I feel much better, and that's HOURS of unpleasant work I don't need to do now.  I don't have the tools to do it well, and since I'm allergic to all of nature, it is not a pleasant experience, even though I like the IDEA of working in my yard. (b) I'm having a student (who works at a daycare) come by for a couple hours on weekends (maybe twice a month?) so I can regroup for the week.  I can grade or I can do other stuff or just go grocery shopping without chasing my son. (c) I should probably have someone come in to clean the house once a month...but I'll wait on that for a bit.

2. Be better about meal-planning.  Cloud has a post up about her family's method that I really enjoyed.  Her particular plan won't work with my family's issues, but I very much like the idea, which is basically repetition with a difference.  I need to think this through a bit more but something like:  Sunday:  big piece of meat in crockpot; Monday: beans and rice; Tuesday: taco/quesadilla (can involve the crockpot meat or leftover beans) ; Wednesday: pasta for kids, leftovers for me; Thursday: stew/soup; Friday:  sandwiches; Saturday:  open

3. Do the important things before the seemingly urgent as much as possible.  Now I don't mean the REALLY urgent things.  But there's a way that things that pop up over email seem like they need to be done now, when they really don't.  I expect that will be happening even more now that I'm an administrator.  I think I probably need to have a set time of day I check email and just stick with it.

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And now, given that I am fucking EXHAUSTED and I have not technically gone back to work yet, I am going to watch a DVD while ironing something to wear tomorrow.

Blogotherapy (Crazy Sibling Edition)

Oh, internets, talk me DOWN.

I will say now that I will probably erase this post, as this is really one of those un-postable things in which I reveal WAY too much about myself (yeah, ironic, I know given how much you know about my ovaries).

So long story somewhat shorter:  I think I am not going to the conference this weekend, for reasons that really have nothing to do with me and Tiny Boy.  My mom was supposed to be my childcare and she can't because my sister is being my sister.*

That is, she's currently hospitalized for psychiatric reasons.

And I'm angry.  Like, seething fucking angry, which I realize is NOT the way one is supposed to act when one has a sister in the hospital, and I sort of hate myself for that.  But there's a huge pattern here that goes back, well, my entire life.

And having two children now I understand completely the impossible, absolutely impossible, position that my mother is in.  And I suppose in her situation I'd probably make the same choice.  And I know, I know, I know, that my mother has helped me in countless ways, including helping me out last week.  But the bottom line is, it is ALWAYS about my sister.  Even when it's about me, it's about my sister.  (i.e. My mother comes to visit because I'm having a fucking miscarriage and she gets a call about my sister.)

So my mom has proposed an absolutely STUPID plan, in which she watches the kids at her house (which is, like, five hours the wrong direction, which would add basically TWO DAYS of travel time for me to get to the conference and back) just so she doesn't have to make this choice.  And I get it.  I totally get it.  But I will not do that to her, myself, or my kids.  My sister wins.  The End.

It is probably worth paying $100 out of pocket for me to go see my old therapist.


*When I stop seething, I'll think about other ways I might be able to swing going.  But, of course, if I'd thought of any of those options, well, I wouldn't have asked my mother to watch the kids in the first place.

Welcome to the Healing Salon

Welcome to The Healing Salon.  Academic readers might want to skip over this one (or you might want to stick around, for the same reasons folks turn their heads to look at car crashes, or if you like community politics and drama).  If you’re a member of the ALI community, well, you probably know what this is about.  Before we start chatting, let me introduce myself, for those of you who are just visiting for the first time.

I’m gwinne (no, that’s not my real name).  I’m a single mother by choice.  I’ve got two kids (finally!), referred to as Little Gwinne (LG) and Tiny Boy on this blog.  LG is the product of magical fluky unmedicated IUI #10 (after clomid, repronex, a miscarriage, and an IVF consult) and Tiny Boy is my DE/DS baby (after 21 (?) IUIs, a couple IVF attempts, recurrent miscarriage, and more drama than I ever thought possible).  I started blogging when I started trying to conceive kid #2.  After the rigmarole involved in trying to conceive kid #1, I already considered myself “infertile,” although I (stupidly) assumed secondary infertility wouldn’t be an issue.  Ahem.

*

That is, Something Remarkable has always been a mishmash.  Posts about academic life.  Posts about single-parenting.  And, increasingly, posts about infertility and pregnancy loss.  And then high-risk pregnancy.  There is no parenting after infertility for me.  It’s parenting while infertile.  Still is, even after the birth of my son.

I’m pretty sure it was Mel who talked about the difference between childlessness and infertility.  And as I have experienced, having the baby doesn’t necessarily mean that you’ve dealt with your infertility.  I used an egg donor; I had a baby, but I’m still infertile.  And really truly scarred by that experience, still working it out almost daily (has to do with my relationship with my body, not my relationship with my son).  And that’s why, personally, I won’t be joining PAIL, though I think it’s a perfectly respectable and obviously, for some folks, needed space.  Although I don’t read her blog, now called “Alice in Diaperland,” I do want to quote Elphaba, because I think her words, rather than other folks’ speculation, are important:

“I’ll just reiterate what I said initially about the idea of a parenting after infertility and loss blogroll–namely, what I wanted was an active community where the focus was more on being a mother and not about loss and infertility. Of course, those experiences as a parent are coloured by the difficult journey to get there, but the main point was that I didn’t want to keep talking about infertility all the time.”

Me?  I’m just not there.  Or rather, I’m still here, with a daily reading habit of infertility/loss blogs.  Although I blog here about motherhood, I don’t feel like this is a “mommy blog,” and frankly sometimes I want to smack myself for yet another post about Tiny Boy’s lack of naps.  But I also don’t censor myself.  As far as I know, my readers are predominantly academic moms, single moms, infertile women still in the trenches, women who are finally parents-or-pregnant-after-infertility.  (I think that covers everyone.  If it doesn’t, please introduce yourself!)  While I wouldn’t say I write for those readers—I write primarily for myself, to work out issues—I am generally aware of my audience.  I assume I’ve lost some readers after becoming pregnant and now giving birth, but I also know that I’ve gained many along the way.  My blog reading habits have also gone in waves, and I am increasingly reading blogs by academic women.  Confession:  back in the dark days, the only pregnant-or-parenting blogs I would read were by those who had dealt with recurrent pregnancy loss.  (No, as folks keep saying, “there’s no pain Olympics,” but I am willing to say that the experience of someone who has had RPL is qualitatively different than someone who got knocked up after one clomid IUI.  I’m just being honest here.  It is perhaps one of my best qualitites.  Or one of my worst.  You decide.)

All this preamble brings me to my duties as host of this Salon.  Some questions to bat around in the comments:

1.      For those of you who are pregnant or parenting following infertility treatment, what is your relationship to the ALI community?  What are your blog reading/writing habits?  To what extent has infertility colored your pregnancy/parenting experience?

2.      For those of you still in the trenches, how do you feel about pregnancy/parenting blogs? Are they merely the next stage on a journey that begins with infertility, or are they something completely different?  Do you read them or avoid them?

3.      Here, I’m borrowing from Mel:  “Are people being asked not to write about parenting, or is that just their perception?”

4.      And because I’m invested in the “meta” question:  Why do you read/write blogs?  What do you want from the experience?  For you, how is blogging different from journaling or participating in a listserv?

Those are my big questions.  If I’ve overlooked something you want to talk about, talk about it.  Keep it as respectful as you always do. 

Blogotherapy (DE edition)

Well, weird HPT result aside, I figured out yesterday I was definitely not pregnant. I don't know about the rest of you, but I've observed that I always feel follicular activity a couple days before my cycle is set to start. It happens around the same time that the progesterone fog wears off and the insomnia sets in. This doesn't happen on cycles when I've used luteal estrace (that's sort of the point of that protocol).

Yesterday, when LG was out with her grandmother, I let loose with the sobbing and histrionics. Today? I'm frankly nonplussed with the actual negative result. But I need to figure out what to do. Do I do an unmedicated cycle in January? Do I go ahead with this DE in March/April plan, or do I put it off while I play around with my own eggs for a while longer? Or do I have another sit-down with Dr. Gorgeous and work out a more interesting plan?

Here's what I know:

1. I am fucking DONE. My next cycle needs to work. The end. The best way to go about that would seem to be DE, combined with a lovely Lovenox/steroid cocktail.
2. I am having a really hard time grasping the fact that I will never have another chance at pregnancy on my own. I said I just did my "last" cycle, but, really, I can't let it go. I find it particularly hard to fathom making myself deliberately NOT ovulate in order to do a DE cycle.
3. These would seem to be mutually incompatible. Thus the "dithering" that my actual therapist talked about.

Here's the possibly crazy plan that I seem to be cooking up, the thing that actually allowed me to sleep last night, the first thing that's actually felt right: talking to Dr. G about doing some kind of co-cycle with a donor. Like, would it be possible to do a stimulated IUI (or possibly IVF) at the same time as doing a DE cycle. I know it's medically possible from a friend who's done something like that. I also know it will present logistical, not to mention psychological and ethical, complexities both long and short term. But, damn, it solves the problem that I'm having. I don't know that Dr. Gorgeous will go for it. And if she says no and I'm completely distraught, well, that probably means I'm not quite ready to do DE and I need to do something (IVF again?) with my own eggs. But she's always been willing to think outside the box and just maybe she'll go for it...

You know, this is the one time I've actually really wanted to talk to my therapist like now, but my appointment isn't for another two weeks. In the meantime, I think I need a phone consult with Dr. G to work out some of this before I meet with the DE coordinator.

Blogotherapy (meta-therapy edition)

So I met with that infertility counselor today. And I liked her. And I think if I choose to have a therapist, she'd be a good one. But that's the thing...I don't know if I want to be in therapy. For IF issues or anything else.

When I asked Dr. Gorgeous for a referral, I was in the bad place. You know the one: it's when I get all angsty and go back-and-forth about what to do and can't figure anything out. I cry and fret and spew words here and more on the phone (usually to A, sometimes to M and L). Of course today I wasn't in the bad place. Frankly I haven't been in the bad place in more than a month, despite negative pregnancy tests and donor egg consults and all that stuff. I'm in a decision-making place, to be sure, but emotionally I've been okay.

That was not the version of me that came out in therapy. I was a weepy, gooey mess, with very little prodding. Now, I get that that probably means I should be in therapy, that it will help me deal with all this emotional stuff. But I don't like the fact that I went into the session calm, focused, on top of things, and came out stressed, weepy, and headachey. I do not want to schedule appointments to feel like that. When I feel like that already, then I'd want to talk. But clearly therapy doesn't work on an on-call only basis. I'm sure I know enough pop psychology to label this way of dealing with things repression, but let's be honest, that method has kept me a functioning human through all of this. I don't need angst where there isn't any. And I don't like losing work time--when I'm functional--because I'm talking and making myself less functional. Left to my own devices, I'm more likely than not to get angsty at night. So maybe what I need to do is figure out a strategy to deal with it in the moment and not save it up for some arbitrarily scheduled appointment.

I'm not angsty anymore. And I'm not crying. And I'm not even remotely thinking about peeing on a stick (even after looking at Mo's new photo!). But the Headache? Urgh.

Blogotherapy (more thoughts from Dr. Slideshow)

Well, I will definitely NOT be pregnant before my 38th birthday. OPK I took about half an hour ago was positive, or will be by the end of the day. That means no IUI this month (though I might ask Dr. G to run a P4 level on Tuesday to check). I'm too stunned to even start registering disappoinment. The only time I've ever surged on cd 8, I've been hopped up on Clomid/Femara. And given that my lining was 12+ yesterday...clearly my body is ready to go. Not only does this rule out an IUI this month, it really fucks up the whole schedule I have going. And unless I do something (put myself on the pill? do the estrace/prometrium combo?) my next IUI would likely fall Thanksgiving weekend.

Do I take this as a sign that I need to give up on my body and run to donor egg? Do I take this as a sign that I need to give up the "natural" approach, because clearly it's not doing a damn bit of good? I'll admit there's a part of me that thinks this would be the perfect time to take estrace and do a femara/follistim combo.

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So as I said yesterday, Dr. Slideshow did not provide me with the sense of clarity I was hoping I'd have. I'll admit that the numbers he gave me for IVF were not pretty (17% live birth rate, though he admitted that's arguably dependent on ovarian reserve which is still in question [he wants to redo AMH level and day 3 labs]). But while he was very professional, he did indicate that he thought Dr. Gorgeous's MDL/Ganirelix protocol is very odd and suggested I do a straight antagonist cycle (no EPP) if I choose to do IVF. He also suggested that the fact that I had an E2 level of 2100+ and had only 2 mature eggs at retrieval indicates a problem with how the eggs were retrieved (though it sounded like his method is the same one that Dr. Gorgeous uses).

Do I want to do IVF? No. But I'm not ready to dive into DE either. If I do decide to do IVF, do I do it with him, for something new? For his lab? For his success rates? I'm honestly not sure.

He also told me that he thought IUIs were a complete waste of time/money, that if it hasn't worked by 12-15 cycles, it won't work (but, I think, even at age 29-30, I needed to do 10 IUIs to conceive LG). And, to be sure, I'd rather spend that $600-700 on something else, or save it, but in the whole scheme of how much this baby project has cost me, really, what's the expense of a few more IUIs? Because, really, that's all I plan to do.

Still don't know what to do folks. As always, observations are welcome!

Blogotherapy

I thought I'd be okay. Hearing the word negative yet again. I knew to expect it. But, really, I'm not okay.

I'm defeated. I'm angry. I can't get my head around the fact that I've done--I don't even remember the exact number anymore--something in the realm of 19 actual cycles, plus a couple cancelled ones.

The message on the phone, while gentle, said something like I'm not really sure what your plans are, IF you plan to do another cycle with us, give us a call. I'm not going to read much into that, as the last page in my chart includes reference to me getting a consult at another clinic (I do have my medical records, as you'll recall), and Dr. Gorgeous, anyway, knows very well what my plans are.

But the fact of the matter is I don't want to do another fucking cycle. Ever in my life. I want this last one to have worked.

I have one more shot at getting pregnant before I turn 38. I spent my 36th birthday completely pissed off about a cancelled cycle. I spent my 37th birthday hopeful that I might actually be pregnant, only to experience what was likely a chemical pregnancy a few days later. And here I am again.

I don't know what to do. I have plans. But I don't know that I want to act on them. I'm sure I will, because as much as I don't want to do it, not cycling, which is equivalent to completely bailing on the possibility of another child, is unthinkable. But really what I want to say is fuck acupuncture and Chinese medicine and IVF and put LG to bed and get really drunk or maybe take that valium I have from the IVF-that-wasn't. (I miss living by a recycling center. I miss smashing glass.)

I want someone to tell me what to do. I mean, what would you do, if you were me, and you'd spent way too much money on failed IUIs and donor specimens and two years of your life driving an hour away for treatment while your daughter asks almost daily for a baby sister and even your doctor doesn't know what to do with you anymore (it literally says in my chart "whatever tx she wants for dIUI") but you have an acupuncturist who is fucking certain that if you just change your diet and stop eating pretty much everything you'll get knocked up? What would you do?

Here's the nonhysterical reaction: I think I'm going back to acupuncturist #2, even though she's too dogmatic and this diet might kill me. I think I'm going to have E2/FSH/DHEA-s/testosterone checked on cd3 and make a decision about DHEA supplementation. I think I'm doing several months of unmedicated IUIs (w/Ovidrel, Prometrium, and Lovenox, that is). And then. Then, depending on what I hear at Big Clinic (which, for now, I'll name: AFC of Chicago), possibly one last big push with femara/follistim (IVF?), and then, if it comes to that, donor egg late spring/early summer. I also wonder if I need a consult with an even bigger clinic, like CCRM. Because I'm not convinced that using someone else's eggs will actually help me, if indeed there's some autoimmune wackiness going on (and the fact that I've been diagnosed, variously, with APA and MTHFR, and allergy/autoimmune problems do run in my family, suggests that there is likely autoimmune wackiness going on). Dr. G doesn't want to put me on steroids; I'm not sure I want to be on steroids, but part of me wonders if I should be on steroids, at least for a short while, like during an IVF attempt.

I just don't know. I don't want to waste eggs not cycling. I feel like doing unmedicated cycles is pretty much tantamount to wasting time/money. But at least it gives me a possibility, however remote, of getting pregnant. Part of me wonders if I should just dive in to DE right now, but I don't feel quite ready to give up on my body. And, really, I can't fathom spending that kind of money with tenure still up in the air. I just don't know. I'm tired. And I want this so much. And I don't understand why it's not happening. But hey, at least my diagnosis is officially not male-factor anymore.

Blogotherapy (Cycle 18 Edition)

I think I've cracked.

I came out of my class Monday night with this list of realizations:
1. What I'm going through sucks beyond words.
2. I can either bemoan the fact that it sucks beyond words or I can do something to make it better.
3. Doing something to make it better (obviously) is going to donor egg.
4. Just because I go to donor egg doesn't mean I won't have to grieve. I will. A lot.

And yet by last night I had cried myself into a migraine. Again.

A. actually asked me last night if I should consider going on an anti-depressant. And given how anti-drug A. is, well, that seems to be an indication that I am in a bad way, people.

Is this Femara? Is this like when the acupuncturist said I was essentially going through postpartum depression (minus the baby) due to the crazy high hormones followed by a hormonal crash?

I know I'm depressed. That is, I know I have major symptoms of depression. Which is really not me. I'm having a hard time focusing on work. I'm being surly with LG. If I could stay home and watch TV and cry all day that would be ideal. Instead I keep piling up more and more responsibilities at work because I think maybe doing things will get me out of my head long enough to be okay.

But I'm not okay. And I'm really not in the mood to be told that I should see a therapist, or go on an antidepressant, or go to acupuncture, or take a walk, or break glass (although I haven't tried that one recently), or anything else. Because while any of those things might deal with the current symptoms, they will not deal with my actual problem. So please don't.

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But if I snap out of it. And if I have time later. I might tell you a funny about male factor infertility as told by LG. That girl is way too fucking precocious.

Blogo-therapy

The sad hit yesterday. I pushed the sad back because, really, it doesn't help anything and I really need to get work done. Then today my yoga teacher double checked to make sure I wasn't pregnant (I told her about the IVF). I almost lost it right there.

My life is so busy that it's easy to forget about all this, to get caught up in the immediate and the urgent needs of teaching and going to committees and taking care of LG. But when I slow down, when I spend two hours in the car driving to and from Dr. Gorgeous's office again, it's undeniably there. It: the great emptiness that is two years of infertility treatment.

I'd have to check my calendar for the exact date, but this month marks my offical two year "anniversary" of beginning ttc attempts for kid #2. Last year I still had some small amount of hope that IVF would work. Then I thought surely my post-IVF Follistim plan would work (and we think it did, sort of). Then I tried hybrid cycles. I was treated for micropolyposis. I started DHEA. I tried IVF (again). One of these plans had to work.

Of course none of them did. Then I actually listened to that growing-louder inner voice that says the more I mess with my cycles, the more complicated this gets, the worse I seem to respond. Even Dr. Gorgeous got on the natural cycles bandwagon. And then yesterday I had an IUI without any evidence of mature follicle on ultrasound. I'm going here on nothing more than faith that when my doctor says two mid-sized collapsed follicles means you-just ovulated-let's-do-this-now that there's actually a possibility that she's right.

But, really, I've written off the cycle. Another $700 dollars and another month wasted. When do I stop this? When do I decide that having a baby, any baby, is more important than having a child genetically related to me and LG? When will the universe cut me a break?

Blogo-therapy (session 7?)

So I'm not sleeping. Again. I think I'm so past the point of tired that I just can't sleep. And believe me I've contemplated the single, unused, pre-transfer valium that is currently with my IVF drug stash in the basement. In lieu of that, I'll give writing a try.

I had an unbelievably good conversation with Dr. Gorgeous today. We were really talking about all this stuff. One of her greatest assets as a doctor is that she really considers the whole patient. She entertains finances, emotional considerations, logistical work considerations, as they intersect with reproductive concerns. That is, she fully supports my decision to take this down about fifteen notches back to unstimulated cycles (saying natural seems weird, given how much stuff I'll still be doing), and if/when I decide to bring out the Follistim again, she's also willing to have me monitor locally.

While she clearly hasn't given up on me, she's also said that medically there's not a reason for me to do one kind of cycle or another at this point, as I've tried it all. I'm not sure that's exactly true, but it's also pretty clear that there's not a huge difference in my cycles no matter what I do. And she said of all her patients, I'm in the very very top in terms of my education about all this. You're smart, she said, you make good decisions. (If only she knew the stupidity I've been up to this week!)

Donor egg, we both agree, is my best shot and the logical next big step. But I'm not ready to do it, and I'm not sure I ever will be (she did suggest seeing a reproductive counselor, and I might do that at some point). At 37, with a decent FSH level and decent AFC [it's my AMH level that sucks beyond words] I have a hard time making the mental leap to my eggs are crap let's use someone else's. She said today she thinks I've got about a 40% chance of conceiving with my own eggs. Let's just say that's better odds than getting a tenure track job in my field. Which I've done. Twice. From where I sit, that sounds pretty good. Not fabulous. But worth trying. She suggested 6-8 months of this unstimulated-or-whatever plan. I'm giving it Sept-Nov and then back to Follistim or something. Maybe try IVF in December, with an EPP protocol? Maybe do that out of state?

So the plan: no stims [believe me, it's going to take some self-restraint NOT to use my leftover drugs], one ultrasound on cd 11, trigger with Ovidrel [she was pretty adamant about that, not for timing but for luteal support], then Prometrium, Lovenox and all the rest. That's how I got pregnant with LG, more or less, after a year of clomid and repronex. Maybe I'll be so lucky again...

Blogo-therapy (what number are we on?)

Just taking stock of my mental state and putting a few things out there...

It was a year ago (to the day?) that Dr. Gorgeous told me I needed to be a little more zen. I was coming off a miscarriage and failed cycle and gearing up for an IVF attempt that I/we had no reason to believe wouldn't work. How wrong we both were.

It's a year later, and I feel like I've been broken so many times by this process that I can't be damaged any further. My negative last week? Just threw the sucker in the trash and went on with my life. The thing is, much as I want it, much as Dr. Gorgeous says that she thinks my persistence will pay off, I don't see myself getting pregnant. Ever. Maybe I'm not so much zen as hardened and completely resigned to failure.

And I think that's my resistance to donor eggs. I would be devastated if I tried donor egg and it didn't work. And I don't think it will. I've always been convinced that at least part of my problem is implantation related, not egg quality related. Hysteroscopy confirmed that. I've always been okay moving to the next step so long as there was a backup plan. And after donor egg? I've got nothing.

*

I watched A's kids the other day. One is 4 and gets along pretty well with LG. The other is six months, the age my would-be baby would be if I hadn't miscarried. It was really hard holding him when he was a newborn (and I'm not really fond of newborns in general). But now? Wow. He's at my favorite baby age, and I just sat him on the floor and spoon fed him some squash and watched the big girls have a picnic at the coffee table. It just felt right. (Well, until I tried to put LG to bed while holding an inconsolable baby and trying to appease a restless 4-year-old with toys. But if this works out, I won't have 3 kids, and I'd be able to give my own inconsolable baby the breast to get him to shut up!) When I started this process I had some pretty serious doubts about whether I would be able to handle the stress of parenting two. I know babysitting for 3.5 hrs isn't close to the same thing, but I have to say I was pretty zen about it all.

I just don't know what else to do so I can have that. I've never felt sad about not having a partner through this process. I absolutely never wanted a husband. But right now I am so fucking jealous of every woman who stands a chance to get pregnant while she takes a cycle off from treatment. Because I really need time off. But I'm not willing to give up even a month, if there's a glimmer of hope that there's a good egg somewhere in there.

I think I'll schedule an appointment with Dr. Gorgeous for the end of August to hammer out my low-tech plan. Because I have a strong feeling I'm going to need it.

Blogo-therapy (Session 5)

Things got bad last night. It was sobbing on the screened porch in the midst of cancelled IVF #1 bad. I think I might need to rename it The Porch of Hysteria. Or maybe just The Porch of Tears. Or the Porch of No Baby. Needless to say, I couldn't sleep after that. What I needed was to talk to Dr. Gorgeous. Or maybe vodka. Or valium.

I had to settle for my nightly Zyrtec. And emailing my doctor. (Hey, at least I didn't have her paged!)

Oh, I didn't say anything I'd regret. It wasn't angry. It was gently put, but the gist of it was I'm crushed; help me figure out what to do. Of course, I knew even as I was writing it she'd already given me her advice (and I didn't want to hear it). What I really wanted, of course, was for her to hear me. Not just respond to an ultrasound and an E2 level.

The nurse who is always the bearer of bad news called me today to say that Dr. G would get back to me in the next day or so, but I should call with anything urgent before then. Of course, what I'm going through feels urgent, or I wouldn't have sent her that note. But not urgent in any kind of medical way. If I really wanted an answer to the protocol question I posed in the email, all I needed to do was ask the nurse to ask her. I started thinking about her availability and then I started thinking about the availability of RE's more generally.

I left Dr. Evil as quickly as I could because he wasn't available. It was hard to schedule appointments. He wouldn't do email or do phone consults either. And when I did see him, he just didn't listen. Dr. Gorgeous, by contrast, is both physically and emotionally available. She's getting busier (it's a pretty new practice) so it's getting harder to schedule spur-of-the-moment appointments. But questions (asked through nurses) are always attended to the same day. She's called me at home when we really need to talk and she didn't have appointments for weeks. She came in to do my IUI on a Sunday, in the midst of the cancelled IVF debacle. She's been there for me, above and beyond just doing her job. She listens and is clearly concerned with her patients' emotional, not just physical, health. There are limits to what she can--or is willing--to do. And I bumped up against that boundary today. I knew email wasn't the best way to communicate with her if I actually wanted a quick response. But it was the only way to communicate without translation from the nurses and right now that's more important.

I know I need a lot of hand-holding from my RE. Perhaps I grew to expect it with Wonderful Former RE, with whom it was incredibly difficult to schedule appointments (I made them months in advance) but who was always willing to give me a call. She called me a lot during the miscarriage--she even joked after my D&C that I'd better stay in bed and she'd know if I didn't because she would check up on me--and during early pregnancy with LG. We talked about my professional life while she was doing my annual exam. She knew me as a whole person. But, as caring as she was, she didn't get me emotionally. Her response to my freaking out about spotting was to tell me to take it easy, hang out on the couch and watch some funny movies. Dr. Gorgeous would say to take it easy, hang out on the couch, and be zen.

They aren't therapists, these REs. But I suspect that I'm not the only patient who needs that hand-holding--or a big hug--along the way. I'm feeling better today, but I'm a long way from whole.

Blogo-therapy (Session 4)

So I really truly was pretty zen on Sunday. And even yesterday after the negative, which was, if disappointing, not surprising (despite the, shall we say, equivocal result I got Sunday night), I took it pretty much in stride. I had one of those crazy busy days at work--I met with students for about 4 hours straight--and that kept me on task mentally. Then LG went to bed and I cried myself into a migraine. Bye bye zen.

I think I'm done crying and moving on to planning. I'd like to drink myself silly tonight, but there's too much work to do. Help me, friends, figure out the plans?*


*

So it would appear that I'm doing Dr. Gorgeous's "hybrid" protocol. Ordinarily, that's Femara cd 3-7, injectables cd 7-9 (and possibly beyond). She says pregnancy rates are nearly equivalent to a straight injectable cycle, but it invovles less $$ and less monitoring. She's actually not saving me any money (my copay for Follistim is the same whether I start on cd 3 or 7), but the time/stress difference is substantial (and, to be fair, the blood work is less intensive so that is a cost saving as well). But...let's travel back in time to April 2009, when I almost did the hybrid cycle, but ended up having a single mature follicle on day 6. That was when she put pre-cycle Luteal Estrace into my protocol. And this time? Per her request, I'm only doing ~4 days of Estrace (I started last night; bad Gwinne) instead of the usual 9 or so. Let's just say I'm a bit concerned about how this is going to go. I think I'm going to ask if I can start Femara on cd 2, use OPKs beginning cd 7, and see if I can come in for monitoring on cd 9 (instead of 10). I'm hoping that this length of Estrace is just enough to slow things down without having them come to a grinding halt (which is what Estrace, at a twice-daily dose for 9 days, does to me). I think she'll agree; she's had me start on cd 2 before, and monitored as early as cd 8.

I think I'm playing this by ear, in terms of how many hybrid cycles I'm willing to do. I think if I get 3 follicles, I'll keep playing. If it's only 2, I'll ask to do a REAL injectable cycle, shooting for 3-4 follicles. A year ago, the statistical threat of twins seemed significant. Right now the reality of twins is significant, but I'm willing to take the statistical risk and deal with what happens later. And then...I don't know. Then I need to figure out if I (a) get a second opinion and go out of state for IVF, (b) keep going with IUIs for the forseeable future (she's told me that IVF really doesn't hold much/any advantage for me), or (c) move on to donor egg/donor embryo. My tentative plan is that I'm willing to do IUI until I turn 38 (that's 6-7 more cycles). As much as I'd like a baby now, I'm just not ready to move on to donor egg. And the more I think about donor embryo, the more wrong the whole thing just feels, at least for me and my family.

That leads me to a question you might be able to help me with. Maybe in February, Dr. G mentioned hysteroscopy as a possibility. What I don't know--I need to ask her--is what a diagnostic hysteroscopy might reveal that both sonohysterogram and HSG (both of which I've done) do not. This cycle or next--assuming I don't bleed until cd 10--would be a good time for me to do it. Anyone have comparative experiences?

So I guess that's where I'm at. Ordering drugs. Ordering gametes. Making plans. Not dwelling on the baby I won't have in December 2010. (This year is turning out to be just as shitty as the last one, anyway.) 2011, here we come.


* You'll note that I am not considering the possibility that my beta actually comes back positive because, honestly, another chemical pregnancy would put me over the edge. [Anyway, thankfully (?), the official word is negative.]

Blogo-therapy (Session 3)

On one level, LG and I had a perfectly enjoyable day, the kind of day that one imagines when one imagines being a mother. You know, taking the kid to ballet lessons and watching her twirl around, checking out books from the public library, playing at the neighborhood park with another mom and kid. The kind of day when you realize how good your life is.

So why is it that it's also the kind of day that leaves me swallowed up by the gaping hole that is the not baby? Sure, I watched LG play on the park, but I was also looking at all the newborns in slings and all the pregnant women. I did the math: if I hadn't had the miscarriage, I'd have an almost three month old. Or, if the IVF had worked, I'd be about that far along.

I'm so fucking envious, even as I know that for some of you who read this, I already have what you want. I know I'm lucky. And there's not a day that goes by that I don't think about what would have happened if I'd waited even another year to try to get pregnant (even my RE was stunned to find a 29-year-old in her office looking to do donor IUIs). I certainly wouldn't have LG. And I might not have had a baby at all. But...that doesn't change the fact that I want a new baby. That everyone around me is getting pregnant. That even within the IF blogosphere, there seem to be fewer and fewer of us still not pregnant.

I don't know how much more I can take. But I also know that giving up means that I will not have another child. As a single, not-currently-sexually-active person, there is *no* chance for me to have that miraculous spontaneous pregnancy that so many fertility patients seem to have. I started this process fairly certain that it was just a matter of when and now it truly seems to be a question of if. I have big questions for Dr. Gorgeous this week. I know, ultimately, I'm the only one who can make the decision. But I need to know what she thinks about a reasonable time to give up. If I'd set an arbitrary stopping point when I started trying for a second, I would have said no more than two years and twenty thousand dollars. And here I am...

I want to stop living in this world of IF and enjoy the life I have. But I want so much more.