Saturday, November 24, 2012
Heather and I agreed in August to wait a year. It was time to take a break from charting and appointments-and from squabbling about them. The other night, it took just a few minutes of conversation before I choked up. I don't know if I was thinking of the stress, or of the cluster of cells that weren't ready to become a baby, but I felt this profound grief that I couldn't and can't navigate.
Sunday, September 30, 2012
The obvious argument, of course, is that I miss having hope, blah blah blah, but the other argument is that it was nice to be good at something. I liked the routine of laying out a paper towel and spreading supplies across it: two wipes, a syringe, the second needle for the syringe, all while the vial warmed. The last became a matter of habit rather than benefit, since, late in the process, Heather's muscles were so tight from the nightly injections that even warmed oil didn't absorb.
And maybe part of what I miss is the team spirit-collaborating with Heather on a mutual goal. Everything else was total fucking chaos, but the shots we could do. Occasionally Heather was pissed if she bled; next to nurse phone tag, that meant nothing.
What has surprised me, though, is that we've felt so connected since finding out about her miscarriage. That first week was such a haze of grief, with no way to talk to friends or family about the hopelessness and loss we felt, that we clung together. I don't know that I have ever felt closer to her.
Yesterday we celebrated our four-year anniversary. The flower-delivery guy brought arrangements to both of us at work, and in a couple weeks we're going on our third-annual trip to a cabin in Mississippi-a place known to welcome committed lesbian couples. I don't know if it's the kitten or what (FYI, she is so fucking cute, it's ridiculous) but we're very content. It isn't as if the baby thing has disappeared, or that the miscarriage doesn't back up on us sometimes, but neither hope nor grief is at the center of our life together.
Tuesday, September 11, 2012
As eagerly as we soak up little Cleo's affection and admire her boldness, there's a real anticlimax to "Heather, look! We have a kitten." I say it sometimes, just to remind myself that something real has happened. We have an object for our affections. She has toys and doctor's visits and requires a lot of supervision, and we worry about how she'll fit in. We tell the other cat and dog that Cleo is their little sister: she just wants to play with them and that they're still very loved.
Saturday, September 1, 2012
Wednesday, August 22, 2012
No comments, please.
Wednesday, August 15, 2012
Last Friday, Heather had the third blood test of the week, displeasing the fertility powers-that-be with the results. That Monday, she'd been at 163; Wednesday, 349; Friday, 529. That was not good. Heather and I spent our lunch break home in bed, weeping over what we felt was an imminent miscarriage, and mourned off and on through the weekend. Heather felt certain we were done, while I felt ashamed that I was holding out just a little hope. We both planned out Monday afternoon, anticipating the blood test results around 12 with a swift exit from work to go home and grieve without distraction.
If, the Nashville crew told us, the hCG levels on Monday morning hadn't advanced significantly, we probably weren't looking at a viable pregnancy. If the numbers improved, Heather would need an ultrasound to see where the embryo had implanted. So we spent the day sitting around, vibrating with anxiety. Lunch was the most painful experience possible, with neither of us able to do anything but stare at each other like caged animals. Well, caged animals who occasionally cry and compulsively check their phones.
Thursday, August 9, 2012
After yet another voicemail marathon yesterday-- "Debbie, I'm sorry, I know we just spoke, but it's 4:10 and I'm worried you guys are going to close before we get today's results"-during which I was camped out in my boss's office because I was terrified to answer incoming work calls lest I miss incoming Nashville calls, I finally spoke to Jennifer (Jordan and Martha apparently out of pocket), who said that Heather's hCG level had more than doubled, from 163 on Monday to 349 on Wednesday. Super, right? "We're still concerned that's a little low." Motherfucker. The numbers doubled like you wanted; isn't that the important part?
Jennifer elaborated that the doctor was concerned about the possibility of ectopic pregnancy because of the combination of those levels and her cramping incident on Monday. Per Jennifer's question, I explained that Heather's cramps had gone away shortly thereafter and not reoccurred, but she didn't seem to feel any better about it. Motherfucker. I don't even...
She asked if we were still using the progesterone. I said yes, that we'd just gotten a new vial that morning ($150 + $15 overnight shipping). Good, she said; keep it up-unless it's hurting much, in which case we can discontinue. Per Jennifer, there's no need for it at this point, but that, if there's a miscarriage, we can't help wondering if that's a cause, "just psychologically." What? What? But anyhow we have it, so we're going to use it.
The conversation ended on what, for me, was kind of a sour note with the whole "numbers too low"/"ectopic pregnancy" business. It's an interesting comment on the situation that Heather, given just raw numbers, was completely delighted, while I had already taken the kinda/sorta
Wednesday, August 8, 2012
An important distinction, however (other than the fact that I was happier than Jesus looks in those pictures), is that she said she didn't regularly read trashy romance novels, while I have spent the last twenty-four hours incessantly reading the final book of the Fifty Shades of Grey trilogy. I've been afforded the opportunity because Heather has been incessantly sleeping. Every now and again, she wakes up to turn on a movie or the Olympics, then fall back asleep while it plays, so at least my sleazy reading has had a patriotic soundtrack.
Monday, August 6, 2012
That's kind of an unfair way of putting it. Heather wasn't being hysterical (an apt word, under the circumstances), and whatever she was, I was right there with her. She came home from work late, slumped on the couch, and said her legs and lower back were hurting terribly. At around 2:30, I'd spoken to a nurse in Nashville who said that Heather's hCG had nearly tripled-- from 55 to 163-- so we should continue to be cautiously optimistic. I asked when we could be fully optimistic; she said it would have to wait for the ultrasound, which will be around the 17th.
Yesterday, Heather told me her mouth had this metal taste to it and nothing made it go away. Pregnancy symptom. She's been drinking orange juice like a... like a citrus fish, I guess. Yesterday she ate only the lemon-flavored sour-star candy she bought at Garden Ridge (where they wisely pack the long, long check-out line with candy of all types and where I was also called upon to carry a 15-pound ottoman because Heather is in a delicate state or maybe just lazy). I mean, the sour stars were quite mild, but Heather isn't a fan of strong lemon flavors, so that was a pretty good sign. She's also sleeping funny-crashing out at 9:30 or so, then waking up around 2AM, totally unable to sleep for another couple hours. From what I can tell, she mostly spends those hours taking pregnancy tests and waking me to tell me the results. Her mood is a little inconsistent, too, which I guess I should appreciate as a sign that she'll soon bear my child. I don't appreciate it just yet.
I'm enjoying the fantasy very much. My mom is, too, having so far not just hinted of Friday's results to my sister, but also a work friend and my aunt. (I saw that my aunt asked my mom if she was "ready for grandma-hood, but didn't see the reply.) My dad has said nary a word to me on the topic, which could be an indication that he still hasn't accepted the situation, worries that he'll inadvertently offend me, or simply doesn't know how to talk to me in general. I continue to approach that the same way I did with getting a cat: yes, it's unauthorized, but once it's in his arms he'll mellow out. If only Heather's hormones would allow her to do the same.
Sunday, August 5, 2012
Heather has shared bathrooms with her own siblings, so she was duly surprised this afternoon to get an encouraging text from my sister. She called my desk breathlessly.
"Your sister sent this really nice text. I guess your mom said something. Your mom might have as big a mouth as you do."
Saturday, August 4, 2012
Heather says I need to stop with my doomsday attitude and focus on the fact that she is actually pregnant, which she is, instead of getting caught up in the hCG numbers that Nurse Jordan says are "a little low." Heather scored a 55 when the goal was 100 (apparently measured in something like milli-international-units per milliliter, or some such shit), and now the hope is for her number to triple by Monday.
Thursday, August 2, 2012
Yesterday was painful. I ached with anticipation the way Heather's body ached with hormones. She continued, and continues, to tell me about all her symptoms and what percentage of certain she is, while I marshaled my own forces to fight off that confidence. It seems like setting myself up for disappointment, or maybe it's the Christmas-morning thing: I don't want to think about my presents until I'm opening them. The one time my sister encouraged me otherwise--"Okay, what did you ask for? What did you say you really wanted? Now, what size might that box be?"-- I found the unwrapping of my Barbie motor home anticlimactic. A Barbie motor home should never be anticlimactic. Those fuckers are miraculous.
Wednesday, August 1, 2012
Everything will turn out fine
I have confidence the world can all be mine
They'll have to agree I have confidence in me!
I like to talk shit about how Heather is impatient, prone to cheating on home pregnancy tests, and unable to savor the anticipation, but I'm on board now. This is excruciating. To hell with the savoring.
Yesterday over dinner at the Olive Garden, I realized I was grumpy and negative and had hit my wall. Heather is getting more positive every moment-- 80%, she says-- just a week since she and I wept together about what it would mean to get another "no." And that's the game, kids: you careen from moments of hope to total despair, day in and day out. I texted Heather's usual Wednesday-night dinner group to ask them to please not cancel because I needed her out of the house. The only way I can get the baby stuff out of my head is to be away from her, and I need it out of my head for at least a few hours a day. I'm grateful that she understands.
Maybe she understands because she believes she's pregnant, so my anxiety seems adorable. She's been walking around today with this beatific expression, as though she was getting a wonderful foot massage, but telling me that her body is aching and swollen. The two aren't unrelated: the pain and discomfort might be symptoms of pregnancy, and swollen breasts are a small price to pay for fueling that fire.
Believing Heather is pregnant, silently, is bad enough, but I'm terrified of saying it aloud, so I don't think about it if I can help it, and I try to avoid talking about it, too-- not (obviously) the situation, but whether I believe it's legit. There's maybe some iffy evidence that could support that theory, and maybe Heather's confidence should encourage me. "At this stage," she said, "I would be surprised if I wasn't pregnant." That scares the bejesus out of me. I like that she's happy, but seeing her so joyful is such a treat that I don't want to watch her face drop.
FYI, guys, the blog is going to go dark starting Friday for probably a few months. If we get a negative, I won't want to talk about it for a long time, and, if we get a positive, I don't want to jinx it by saying it publicly. I probably will, though.
Tuesday, July 31, 2012
If you've read the blog through previous generations of potential pregnancies, you'll know that Heather has no wherewithal when it comes to observing the official timeline. Nine days is too early to test. Wait for your period or two full weeks. Patience is not my beloved's strong suit, and I don't believe she has ever made it two weeks for a pregnancy test.
This has been an ongoing back-and-forth between us, as I beg for two weeks of hope before facing results-which, so far, have only been negative. I don't want to hear bad news any sooner than I have to, especially when the bad news doesn't even count. After a week, you're definitely going to get a negative, so why do you want to do that to yourself?
But this is the same woman who would like to open her Christmas gifts a week early, forgoing the ritual I treasure. And it's in the same spirit of ceremony that I want to sit down in her office with the door shut to listen to our voicemail Friday afternoon, instead of squinting at (imagined) pink lines on a pee strip for days beforehand.
The most ridiculous element of the whole thing is that we were warned specifically at our IVF class not to bother with home pregnancy tests because they could be influenced by the remaining traces of hcg from the Ovidrel trigger shots we administered just before egg retrieval. As of today, that was 13 days ago exactly. Sunday night, Heather, overcome by desire to both learn the secrets of her uterus and, I suspect, make some use of the dozens of pregnancy tests living in our bathroom closet, snatched up her iPad to dispute my warnings.
"Listen! This lady did her test only ten days after the trigger shot. They say it only stays in your system ten to fourteen days."
"Well," I said, "it's not fourteen days till tomorrow, and there's no point having a half-answer-or a bad answer-when we'll get an official result on Friday."
This did not register at all.
"Okay, this lady says that she did her test after ten days, though, and she got a pale pink line. You just have to watch and see if it gets darker."
"Heather, the nurse in the IVF class said that you'd just be kidding yourself to test in advance."
"Yeah, but this lady says that it's about a week if you get a 250iu shot, ten days with 500, and fourteen with 1000. What did we do?"
"Hell if I know, babe. They were pre-filled syringes and I just put 'em in like they said. There were two, though, so it must have been at least 500iu."
"Why don't you know? How do you find out?"
Overcome with the adrenaline of baby-making research and rebellion against my ideas, Heather hopped out of bed. I began to drift off. I think at some point she came back and tried to tell me something else, eventually giving up when all my responses were "Dude, you're supposed to wait. Stop it." And I'm pretty sure she tried to fall asleep, then left again. I can tell you that, when I got up Monday morning, records from MetroDrugs were strewn across the countertops.
Maybe, she told me later, she could take the tests every day and see if they got darker. I expressed disapproval, but I'm not sure she heard me.
Today we're supposed to get our toes done between naps. Wednesday night Heather has dinner out with friends. Thursday night, we're going to see a movie. By my estimates, that will kill about six hours of the seventy between now and the voicemail. Thank god for the Olympics.
Saturday, July 28, 2012
Thursday, July 26, 2012
Tuesday, July 24, 2012
What she would do, however, is tolerate my snuggling against her (albeit with tender accommodation of her everlastingly-sore breasts) with a hand placed over what I imagine to be her uterus. She's reported to me that embryos are something like 1/100th of an inch in size, and I'm guessing they aren't receptive to my baby-talk, either, but I feel like we have to put those encouraging vibes out there. Hence the inspirational movie that Heather most assuredly did not cry over.
Sunday, July 22, 2012
Saturday, July 21, 2012
I was subsequently told by a nurse that there's no way to know whether little #5 can catch up, but a cursory web search suggested that the really slow-developing embryos were probably a little fucked-up anyhow, so perhaps that's not meant to be the object of our life's work after all.
With four-- the two "approaching" maturity, the embryologist, would probably catch up-- Heather and I are back at the question of PGD. She is leaning heavily, I believe, towards canceling the test and just getting all the embryos we can, but I'm listing in the opposite direction. Diseases aside, abnormal embryos are much more likely to miscarry or just not implant at all, so, yeah, maybe skipping PGD would mean we had two embryos left for a second cycle if we needed it, skipping PGD might also mean we will need it.
The lab is scheduled to do the biopsy on day four, tomorrow. They were left instructions to call us before they did anything. Heather and I have to decide before then.
Friday, July 20, 2012
Of course, the good luck was tempered by Heather's day-long sojourn at the toilet, vomiting up her morning doxycycline, Wendy's chili, and a variety of other items. Nurse Jordan dispatched me on an evening Walgreens run to get nausea medications, saying that, if Heather couldn't hold anything down, she would have to go to the ER. "I don't want to go to the hospital!" said Heather. She didn't, but she's an exhausting sick person, so I'm optimistic that she has food in her belly again.
Waiting today for more news about how the embryos are developing.
Wednesday, July 18, 2012
The thing that has belatedly occurred to me as I contemplate a late-night snack is that I will have to be the first to listen to the embryologist's message. Heather knows the message will be in our mailbox at noon, and she knows how to access it, but I feel pretty confident that I'll be the one dialing. Should we put it on speakerphone and listen together? That would have to be better than telling her. Still, I'll have to watch her face when she hears the numbers.
We spent a lot of the afternoon talking about the next steps-- how many eggs we thought would fertilize, etc. "You know," I said, "If you'll remember, there were a couple weeks when we thought we'd gotten pregnant after the first ICI. We said it had to happen to somebody and maybe we're the lucky ones who'll beat the odds. That didn't happen, but what if it happens now? We haven't caught a break yet, so maybe this is it. Maybe all the eggs will fertilize perfectly, and then four of the embryos will pass PGD. It has to happen to somebody."
So we're going with that.
Heather is still in bed and not excited about getting up. "You can go right back to sleep," I told her, but she muttered that she needed thirty more minutes. Listen, lady: I am more than happy to let you sleep while I watch unending re-runs of Big Bang Theory, but let's knock out these new meds first. (That, anyway, is how it goes in my head; I'm not sure how to approach someone as drugged and sleepy as she is.)
They only got six eggs. It's not great. According to the handout they sent with us, they'll go forward with implantation if there's at least one embryo of four cells or more. If they only have a few good ones, PGD will be canceled (and, hopefully, refunded) and they'll just put whatever they've got into Heather's uterus.
They plan to fertilize the six eggs via ICSI, and by tomorrow at noon we'll find out how many developed. Meanwhile, Heather is drugged to the hilt and has collapsed with her decorated butt cheeks into bed for what I assume will be another eighteen hours.
Tuesday, July 17, 2012
Monday morning, she had yet another visit to the Memphis clinic for an ultrasound and estrogen test. She had several follicles over 20mm, as well as some stragglers—about nine "measurable" ones in total. You can tell things are getting serious since they're now recording the follicles in centimeters rather than millimeters. All afternoon we waited for news from Nashville about the results: Was it time for the trigger shot? When was the egg retrieval?
In past, it took till the afternoon for the test results to arrive in Nashville, so I occupied my morning with an e-mail to Nurse Jordan. It wasn't so much that I expected her to e-mail back—their office is disappointingly phone-centric—but Heather started spouting out questions and I was afraid I'd forget. Anyway, otherwise it was just empty waiting.
Later I gave in and called. I left a message. (Dude, that would be the best drinking game: sit down with a bottle of Grey Goose and the last six months of this blog, then take a shot every time messages or voicemail are invoked. It's awesome.) Debbie, the receptionist, asked if she could tell Jordan why I was calling; I endeavored not to say The same baby-making bullshit we always talk about. Does it really need to be more specific than that? The options are test results, medications, and treatment plans. There isn't much more to it. The time I asked that the office not specifically refer to Heather as a lesbian when dealing with the Memphis office, the other receptionist got all antsy and said she'd just give the nurse our number.
When I heard back from Jordan, she confirmed that we should go ahead with the trigger shot that night, then come to Nashville for egg retrieval Wednesday. We went over the questions from my e-mail, including:
Q: Do larger follicles mean higher-quality eggs?
A: Nope. A larger follicle might mean the egg is more mature, but it has nothing to do with quality. Quality decreases with age and fattening up the follicles won't change that.
Q: Will you take out all the eggs, or just harvest from the bigger follicles?
A: We will take everything we can get.
The part that caused Heather to be traumatized is something we already knew, but she had either forgotten or blocked out.
Sunday, July 15, 2012
Thursday, July 12, 2012
Tuesday, July 10, 2012
Friday, July 6, 2012
Yesterday afternoon we got back from Nashville with enough time to float in the pool before late-day naps. The suppression check was pretty mellow: a blood test, pelvic ultrasound, and medical history. Despite a family history chock-full of cancer, Heather came out rosy with the regular medical history, having had no surgery or other disorders in her past. The worst revelation was that penicillin made her itchy.
Saturday, June 30, 2012
It's June 30th. The first pregnancy test is scheduled for August 1st. That gives us a month to make a mockery of nature by manipulating Heather's body with pharmaceutical substances, tiny catheters, and aspirated cells before finding out if we're getting a baby or tickets to St. Croix.
Sunday, June 24, 2012
Wednesday, June 20, 2012
Now that it's getting close, I keep going back to my notes from the IVF class last month to see what's coming. AND I found out, in doing so, that I was totally wrong about what all this stuff is. So I'm going to review. (Teaching is the best way to learn, right?)
Lupron is central to the ovarian-suppression phase and is designed to drain your reproductive hormones. According to my notes, the Lupron will come in a little bottle and will look dangerously empty. It won't look like there's enough for the whole cycle, but allegedly there is. So says Nurse Jennifer. You inject 10 units every morning with an orange-capped insulin needle. It can be injected anywhere you can pinch the skin, but the stomach is often least painful (so long as-- and I was vague about this before-- you don't insert it along the longitudinal line of the navel). You poke it in at a 90-degree angle; my notes say that 45 is too shallow. Not sure why.
Side effects are due to low estrogen levels. The most common are headaches and, just before you begin FSH, nighttime hot flashes.
FSH (Follical Stimulating Hormone)
FSH is the beginning of the ovarian-stimulation phase. Right around Day 27 of the cycle, you have a "suppression check"-- something that the Nashville people take very seriously. It's a super-long appointment, we're told. They check estrogen (technically estradiol or E2) levels, do a pelvic ultrasound, and do a test run of embryo transfer where they use the catheter to "map the cervix" and figure out which things twist which way. I guess so they don't poke your innards too hard during the real thing. Once they see how all that plays out (the E2 level should be below 50), they kick off the FSH. What's ridiculous is that the Lupron has been suppressing your FSH all this time, so after the suppression check they wean you off the Lupron while jacking you back up with the FSH.
FSH is definitely supposed to be injected into the belly. The average dose is 300IU. There are a few different ways of administering it. We picked Follistim because Nurse Jennifer said that was what PGD manager Amy would want-- and we were grateful because the four options they gave us were confusing as fuck.
This one scared me most. It's a powder that you mix with sodium chloride, and there's a whole long thing about the "q-cap," which goes on top of the syringe... All of which is to say that my eyes began to glaze over at, say, step three out of what the Bravelle website describes in eighteen. (You can take a look at their website for the FIVE videos it takes to explain this, along with the PDF instruction sheet.) Per my notes, Bravelle is a pain in the ass, but cheaper than the pens at about $50 for 74IU.
2) Menopur: Also a powder; uses the exact same process as above. It's not clear to me what's different about the two, as they're made by the same company. According to the Menopur folks, it is "the most widely used and extensively studied reproductive hormone, proven to be both safe and effective." Not claimed about Bravelle. Both Menopur and Bravelle contain a combination of FSH and LH (luteinizing hormone), but in different concentrations-- Menopur has a higher level of LH. Our doctors didn't give us any sign that one is better than the other, and from a casual Googling it looks like a lot of doctors put women on a combination of the two, or switch depending on what's effective.
Progesterone in Oil
Saturday, June 16, 2012
Thursday, June 14, 2012
Monday, June 11, 2012
Saturday, June 9, 2012
For now, though, there are prenatal vitamins in the morning and folic acid at night, and I can't begin to say how thrilled I am that we're only a few days away from the pharmaceutical marvels that lead to a baby. This time next year, we should have one.
Wednesday, June 6, 2012
I'm going to try this out for a little while, maybe a month or two, see if I'm rich, and either keep going or discontinue it. Part of me wants to find it's a waste of time so I can take it all down, and the other part says that, if there's cash involved, fuck it: I can betray my principles.
So, anyhow, don't hate me for being a capitalist, but Mama needs to pay her phone bill.
Tuesday, June 5, 2012
WebMD says Prenaissance Plus is comparable to CitraNatal 90 DHA*, described on its website as "a comprehensive prenatal vitamin with increased amounts of iron. It has now been reformulated with a patented dual iron combination of ferrous gluconate and carbonyl iron. The formulation contains calcium citrate and ascorbic acid, which enhance iron absorption." Moreover, the site says, "CitraNatal® 90 DHA also provides docusate sodium, a gentle and effective stool softener that protects against the discomfort of constipation."
Today I have also been embarrassed talking to Marsha in Nashville because she totally knows, as does Therapist Michele, that it's me (again, if you want to say something about "it's I," you are probably ridiculous) and not Heather who's calling. We have two phone numbers, and I have lied to both of them by saying that we trade phones around to be sure there's always someone to get these calls. What really happens is that I babysit the phones and the calls, and Heather makes the physical appearances when blood or a uterus is needed. "Oh, no, you're totally talking to Heather."
Monday, June 4, 2012
One, I looked up assisted hatching and found via Google some guy's explanation:
Assisted hatching is the oldest and most commonly added procedure aimed at improving an embryo’s ability to implant. Embryos must break out or hatch from their shell that has enclosed them since fertilization prior to implanting into the uterine lining. This can be performed mechanically, chemically and most recently by utilizing a laser microscopically aimed at the zona pellucidum, the shell surrounding the embryo. Assisted hatching appears to benefit patients who are older than 38 years of age and those with thick zonae.
Sunday, June 3, 2012
Thursday, May 31, 2012
So when I see a grown woman, unironically, refer... Okay, what she wrote was, "All embies made it to blasts and frosties!" I don't know how to provide adequate commentary. EMBIES, for chrissake.
That's why I don't like to read fertility forums.
Wednesday, May 30, 2012
Monday, May 28, 2012
Sunday, May 27, 2012
Friday, May 25, 2012
Thursday, May 24, 2012
Wednesday, May 23, 2012
It took me about twenty minutes to read the thing, and I realized belatedly that I had given our consent to donate any unused or unusable eggs or embryos to the lab to improve their "quality control" procedures. I like to believe they're going to use the eggs to practice with lasers and needles and whatnot, but shouldn't they already know how to do that? Fuck, I hope they do.