Thursday, March 27, 2014

Seven Weeks and Exhausted

I am working too much. I'm exhausted. It feels like a carnival ride that I can't off of. Everywhere I turn there are more kids, more teens, that are distressed and need help. Kids that aren't attending school because of their debilitating condition or are actively losing weight because they're not eating. It's hard to say no and to cut back, but I'm hemorrhaging. As in 50 hours per week, over 85%ile of national productivity hemorrhaging. I keep thinking about what my action plan will be to wean out of practice and ultimately take 2-3 months off. It's anxiety provoking and I don't have an answer.

This is a good problem to have. I am officially entering pregnancy week seven. This estimation is a little to silly to me, because they start counting two weeks before your retrieval day, but that's the way it works.

Sunday, March 23, 2014

One vs Two, Revisited

Tomorrow I have my first ultrasound. We will find out if there is one sack or two. One heartbeat or two heartbeats or no heartbeats. One sack and one heartbeat, two sacks and two heartbeats, or two sacks and one heartbeat. Or one or two sacs with one strong heartbeat and one weak heartbeat. Or just one weak heartbeat. Oh, the combinations. This sounds like a math problem. Or a Dr. Seuss book if I could make it rhyme.

Tuesday, March 18, 2014

In This Together... Not So Much

I confided in our fertility issues with a co-worker back in the fall. She was supportive and about a month later revealed that she was having a "difficult time" trying for her second child. While we're not typically very open with one another, it seemed that there was this moment of mutual understanding and oneness. As if we were now brothers in arms.

She knew when I had my IVF procedure because it interfered with some work stuff that we were working on together. A week later she asked how we were doing and I told her, that we were waiting to see at that point. I asked how she was doing and she said that she was also waiting to see, being relatively vague.

Saturday, March 15, 2014


Thursday night I went to bed with a wierd tugging pain in my groin area. I ended up dreaming about having a miscarriage. It was aweful.

I woke up the next day to find out that my cousin had passed away overnight. She was in her early forties and has a three-year-old little girl.

She had a retinoblastoma, a rare cancer originating in your eye that is hereditary. She originally was treated for this when she was a young child, resulting in her parents splitting up over the stress of it all and one eye being removed with a glass eye being put in its place.

I think that the glass eye was the cause of a lot of self-consciousness, and I know that it took her a while to find someone that she felt comfortable enough with to love and then marry. Her wedding was a few years before C and I were married.

Because she was older, they pretty quickly began trying to have a child. It took a while. Part of this was because they were both older. Part was because they were attempting to genetically screen the embryos for the genes that result in the retinoblastoma. Every embyro that was tested carried the genes and had to be discarded.

Eventually they just gave up on ART and decided to try naturally. Miraculously, she became pregnant with a beautiful daughter who did not carry the genes contributing to this cancer. She was so thrilled, so fulfilled. They were finally getting their healthy child who wouldn't be subjected to the horrific childhood that my cousin went through.

When their daughter was 6 months old, they sold their condo and bought a beautiful house in an area with a great school district. Within a month of closing on the house, my cousin began having severe stabbing headaches. The cancer had returned.

For the past two years, my cousin has been in the hospital more than she's been at home. She's had numerous surgeries, radiation, and chemotherapy. She ended up losing her second eye, rendering her completely blind for the past year. She traveled to different hospitals from Cleveland to Philadelphia to California in search of any treatment that would give her hope of regaining her life.

Her ailing mother had moved into their house to help take care of her daughter while her husband missed countless hours of work to travel with her to all of the appointments. Her father, my blood uncle, remained estranged from her despite the knowledge that this was occurring. We stopped talking with him as a result of being forced, by him, to "choose sides."

On the eve of one of these surgeries, thousands of miles from her daughter and the rest of her family, she bled out and passed away.

Her entire story is tragic. To overcome so much and finally have a taste of a wonderful fulfilling life, and then have it ripped from you overnight. To have missed out on the majority of your child's early life because you were hospitalized and traveling. To be three and never really knowing your mother, your life being complete changed forever. To go through all this effort to ensure that your child never has to share in your fate, and then she has a fate altogether different but equally deplorable. My heart aches for them all.

Friday, March 14, 2014

The Big Reveal: Another milestone scarred by infertility

I have been thinking a lot about Brianna's comment to my past post about holding out on telling people. That fact that the lab mistakenly tested a week before we were expecting, and before we told everyone else we were expecting, really did give us a small opportunity to feel like a fertile person who is able to keep pregnancy a secret. For a week.

On Tuesday, I was 14 days post transfer. This was the day I was originally scheduled to test, and the day that everyone else expected it. C and I agree that if it was still good news that we would tell people then. It is, and we did. My results came back at 1055, which was a 34 hour doubling time. Very solid. Possibly in the twin range, but trying to figure this out with Dr. Google is just maddening.

C told his parents and one sister the day before because he was seeing them for lunch. I agreed because he doesn't see them all too often and it would be nice to tell them in person. I told my parents Tuesday night. I called my sisters and my best friend after work the next day.

Essentially, everyone was expecting it. They were all excited, but it felt a little anti-climactic to me. There was no real surprise. Yes, there was questions of "yes" or "no", but everyone was expecting some sort of answer. They all knew when we had the procedure. They all knew when I was hospitalized. They all can do math and it doesn't take a genius to know that a few weeks is enough to know.

I may have liked to make a big reveal. To do something creative. To really surprise people. C mentioned that we could still surprise people on if it's one versus two or still surprise them with a gender reveal. Those are good ideas.

In the meanwhile, the close and important people know. This is real thing. And I am still reminded of the differences in becoming pregnant naturally versus having infertility.

Tuesday, March 11, 2014

Symptom Spotting

I had every intention of writing a post about symptom spotting, but never got around to it before the symptoms were confirmed. Oh well. Basically, the only "symptom" I have experienced is some initial heartburn, which happened right after my last [negative] cycle as well, and I have attributed it to the progesterone, and breast tenderness. This is also attributed to the progesterone, as they were tender last time as well. Unlike last time, C has actually noticed that they already seem to be engorged. I told him that it was likely just due to the progesterone and then he joked that he wanted to give me shots for the rest of my life. Oh, brother! In general, I actually feel just fine and my supposed symptoms are much less extreme then they seemed to be the last cycle that I wasn't pregnant.

I was a little nervous about the expanding bra size, given that I don't actually have larger bras, because my sister (AE) was in town this weekend and I didn't want her to notice. I got the feeling she was on high alert for symptoms, so I made sure to bring up my fertility in very uncertain terms throughout the weekend. She asked what I was doing for my birthday, in early April, and I told her I didn't know yet. I said I will likely be either a) depressed or b) unable to drink, which would both have a big influence on how I would like to spend the day. This partially true. I also used the word "if" a lot when she would bring up baby stuff.

At one point, my mom and sister joked about how horrible a liar I am. This is usually true. C responded that I'm actually getting better at this skill, and then my mom asked for an example. Luckily he was able to come up with a different example, because obviously this little rouse was the first thing to pop into my head.

Saturday, March 8, 2014

Second Best Day Ever

Yesterday, 10 days post-transfer, I am still pregnant. My HCG rose to 146, "progressing well."

C also passed his nursing final. He was in major jeopardy of failing this class, which would mean that he would be removed from nursing school. This is not his reality. He now has 1.5 semesters before he graduates. The remaining classes are known to be easier. It's downhill from here.

I was fairly nervous at the beginning of the day. What are the odds that we both get good news? That things could go so perfectly right for both of us at the exact same time?

We still haven't told anyone, enjoying our secret, but I am working on making it feel more real. On Thursday, I went into a baby superstore. It's relatively new in town and I drive by it on my way home from work every day. I've always wanted to check it out, but didn't want to jinx myself or get upset over what I could not have. So this was my first move. The effect was not what I was going for.

Holy crap is that place overwhelming! It was pure baby overload. I found myself thinking over an over, "how ridiculous!" Special jugs of "purified baby water." Infant bath robes. A baby towel warmer. Special cups to pour water over your baby's head to wash their head, because regular cups will not do. Specialized tupperware to store homemade baby food, again because regular Tupperware is not sufficient without a baby themed name and imprint. Floor to ceiling bibs, towels, and diapers. Over a sixteen feet tall wall of childproofing equipment. Rows and rows of what-felt-like over a hundred strollers, all of which looked nearly identical.

I think I need to ease into this a little more. It will be a while before I venture back into that store.

In the meanwhile, I have change my thinking from "having a positive Beta" to "being pregnant." I began looking at some websites. I began getting twinges of excitement.

Thursday, March 6, 2014


It still doesn't feel real. Instead, I just have this bizarre sense of not knowing what to write about. I had all of these thoughtful post ideas to write about during my wait and this was stripped of me in half the time I was anticipating. Not that I'm complaining. 

The biggest benefit of this early testing business is that it wasn't expected by anyone. Many people knew about our IVF procedure. Many of those people knew about the specific day that my blood test was scheduled for. This makes is hard to keep it between C and I for more than a moment without avoiding people. And some of those people, as in my parents, we live with. 

So we decided to keep it to ourselves and to enjoy in this secret. At least until Friday. We'll see after that. I might try to hold out until Tuesday for my family since my sister AE is coming into town over the weekend and I already "promised" her I wouldn't know anything at that time. 

Wednesday, March 5, 2014

Best. Day. Ever.

Yesterday started off rocky. It was the day of my Grand Rounds presentation. I was speaking to a full auditorium comprised of the entire staff of the Children's hospital. It was also being live-broadcasted across the satellite campuses. I was a little nervous, to say the least.

If you were to ask me immediately following how I'd done, I'd say that I was just glad it was over. I could also have pointed out each of three or four times that I stumbled over my words and said the wrong thing. But my boss, the one who is usually pretty formal and dry, had a huge grin on his face and told me in several different ways how great the talk was. His boss, the head of the entire  Children's hospital came up and congratulated me, shaking my hand. I returned to my office to find an email from the department head of Pediatric Infectious Diseases, cc'd to my boss and the head of the pediatric GI department, praising the talk as the "best grand rounds she's ever attended" and how lucky each of them were to have me working on their team. Each of them then responded, that they were indeed lucky, and that I am asset to the entire hospital. Yeah, I was on cloud nine.

When I got home from work, I received a letter from my health insurance company, explaining that they reviewed my appeal form and have agreed that I am a) not diabetic (Metformin can, in fact, be used for other purposes) and b) and not overweight. This means that I can now get lower healthcare premiums next year, just for wearing a pedometer and maintaining my activity! Totally doable, whether pregnant or not. If they didn't accept the appeal, I would have had to lose weight in order to keep my low premiums, which is just slightly in opposition of my more important goal for the year ;)

In between these two awesome occurrence something else happened. I went to the lab to get my blood drawn. I was one week post-transfer, and they wanted to check my estrogen and progesterone levels. My beta wasn't scheduled until next Tuesday, a full 14 days after the transfer; which I had accepted as a positive, despite the longer wait than I've heard is typical, because it would decrease the changes of finding out about and then being let down by a chemical pregnancy.

Well, the lab made a mistake. It's wasn't the fertility lab, but the general hospital lab in my building. It turns out that the order for the HCG was already in the system. I recognized the error almost immediately. When the lab technician was drawing three vials, instead of two, I briefly considered asking what they were for and clarifying the error. But I kept my mouth shut.

Over lunch, I decided that I couldn't wait any longer and I didn't want to be completely thrown off during the afternoon full of patients. I logged into my medical chart and confirmed. The HCG serum blood test was drawn. The result was 45.5. It was a little challenging to make sense of this because Dr. Google didn't have a ton of information on levels this early in the game, but it seemed pretty legit.

I waited until the nurse call to be sure. She confirmed it. She then said that it's still very early and that my estrogen levels are too low so they're increasing my dose. They want me to come back on Friday for more blood work to recheck all the labs; confirming the HCG results and hopefully an improved estrogen level.

I think I'm still in shock. When my presentation went stellar, I was elated. I could clearly feel the emotion, and it felt awesome. A few minutes after sharing the blood results with C, I opened the letter from the health insurance company and I literally squealed with delight. With this news, there was no squealing, no tears of joy, no 100 lb weight lifted, no elation. It's as though my mantra through this whole thing of being cool, calm, and collected has become a permanent sense of my being. As I type this now, I feel nothing. Not nervous, terrified, elated, or relieved. Not anything. But apparently I am something. I am a healthy kick-ass psychologist...who is pregnant.

Monday, March 3, 2014

I Am More Than Infertility

Dear Everyone,

I have recently discovered that some of you have been avoiding me because of my infertility. Because you “don’t know what to say” or what to ask about. Because you’re not sure how to ask how I’m doing without feeling like you pestering me for information. Perhaps even because I make you feel uncomfortable. I would like to offer up some suggestions.

Next time we talk, you could ask me about the video-recorded presentation I am giving to the entire Children’s Hospital tomorrow or the paper that I am submitting for publication. I could tell you about my yearly performance review coming up and how I’m struggling to identify career goals for the upcoming year. You could ask about my upcoming trip to Philadelphia and give me suggestions on what not to miss. We could talk about C and how stressful his academic course load is this semester. I always have cute and funny stories about our dog and his new feline friend. If all else fails, we could talk about TV shows; I’m really into the Walking Dead, Downton Abbey, Parks and Rec, Daily Show, and Modern Family and I just started watching Orange is the New Black.

The point is, with rare exceptions, I have so much more going on in my life then my struggles with infertility. Yes, it is big and yes, it is stressful. But it does not consume me. Sure, last week when I was hospitalized and then bedridden that was pretty much the only thing going on. But when I’m mobile, I’m my life is full. I am a relatively well-rounded person. Infertility is a part of me, and I wouldn’t mind talking about that as well. It would be nice if you asked how our fertility treatments were going, but if you simply ask, “how are you?” don’t expect to jump right to that part of my life.  

If you want to ask how I am doing with this specific aspect of my life, I won’t get offended or be put-off. If you have questions, I would love to answer them for you. If you’re ignorant, be prepared for me to correct you (no, it is not my intention to carry 8 babies!). If I make you feel uncomfortable because I let it casually slip into conversation (I’m not drinking wine because I’m in treatment), well then this is something I cannot help. If you’re uncomfortable because you know that I am sub-fertile and you know that I doing treatments, this is about you and not me. It doesn’t have to be awkward. It doesn’t have to be uncomfortable. I won’t make it this way if you don’t.

I would love to talk (about anything).

Saturday, March 1, 2014

A Word About My Husband

I am pretty good at picking up on subtle social/emotional changes in people based on the words they choose; their facial expressions; the prosody, speed, and volume in their voice. In fairness, this is a fairly important part of being a psychologist. What I've noticed over the past few months is a distinct change in C's mentality.

In the beginning, we were both excited. He would joke after intercourse that we just made a baby. We would talk a lot about our future child.

I figured out really early on that I wasn't ovulating (thank you OPKs) and began Clomid far before we would have ever been considered infertile by the standard definition of 12 months. Technically, I had only been off birth control for about 6 months and we were only seriously "trying" for 1-2 months.

Six months in, as I was inconstantly responding to the Clomid, and more often not responding, my frustration level was increasing. C, on the other hand, was calm and collected. He told me that, "I assumed it would take several months and we really haven't been trying for that long," ignoring the obvious fact that I wasn't ovulation and wasn't responding to medications.

After nine months of continued frustration, continue lack of response to any oral medication they threw at me, C stopped being overly reassuring. He turned into "the rock," a role so many husband's assume. He would attend appointments and would provide words of encouragement. He was very supportive. But I could tell that he was supporting me, not us. He wasn't allowing the discouragement to affect him, to become emotionally involved himself, likely feeling that he needed to hold it together for me. He was on the outside looking in, and feeling helpless that there was nothing he could to truly comfort me. He was feeling bad for me, not with me.

This continued even through our injectable cycle, when I did respond (beautifully, I might add) and we did have a very real shot at pregnancy. Maybe he still felt the need to be guarded, to not get swept away in the possibilities.

Then things changed. If was after I melted down, we began talking IVF, and ultimately decided to cash in our life savings.

It was gradual at first. A random comment about our future child. Jokes about "creating a baby" during our nightly injection routine. Talking about specific treatment details with some of his friends and family. He would still come to my monitoring appointments, but this time he would take a picture to capture the moment, as if he knew that these moments were ones we would like to look back and remember someday. The talk of our hypothetical child(ren) increased and I could tell that his wall was slowly crumbling. It was solidified the other night that he informed me he wanted to scan in our embryo pictures, "just in case something would happen to the originals."

He was hooked, invested, in this. He's not just excited because I'm excited. He's excited for himself. He's hopeful all on his own. This is no longer about him being a wonderful support for me. This is about us finally being in this together. Together sharing in the joys and excitement. Together sharing in the possible disappointment and let down.

A large part of me is so happy to see this shift, to know that we're in this together and that he's emotionally invested. A smaller part is nervous. If things don't go well, he will suffer double. I know he'll still be very upset for me, but he'll also be very upset for himself. But I suppose this is the potential cost of caring: twice the reward or twice the let-down.