Saturday, July 30, 2016

It's Just The Hormones

My lining check on Friday was "not where [they'd] like it to be". In fact, it actually seemed slightly thinner then when measured on Tuesday. Regardless, they are increasing the Estrodial dose to four pills (three oral and one transvaginal) and having me return on Monday. My tentative transfer date was cancelled and I am thankful I didn't actual move around any patients yet. Depending the Monday results, we will discuss a new transfer date.

Objectively, I am okay with this. It is just [hopefully], a small delay. No biggie. Emotionally, I am frustrated with my body and this process. I am also concerned with prolonging the estrogen supplementation. The side effects on this round have not been enjoyable. Let's review:

1. The first few days there was the urinary urgency, but this only rarely occurs lately.

2. The bloating is upsetting and not just in my head. I've gained nearly 7 pounds since starting this medication. Last week, one of the employees at the hospital cafeteria asked if I just had a baby (a whole new twist on the "Are you pregnant?" question). I don't have a superb memory, but I can tell you the exact times that people have commented on my body in relation to pregnancy:

  • A random time in high school or college while checking out at a craft store by the cashier. 
  • Three times during my last pregnancy attempts: My not-boss, a lady at church, and a patient's mother. 
  • Numerous times when actually pregnancy. (However, I pride myself in that I gave off a sufficient vibe that my belly was only ever manhandled once, by a cousin who is known for not always being socially appropriate.)
  • A hospital cafeteria employee, one week into the estrogen supplementation. 
Remembering these comments all bring back the raw emotions of getting punched in the gut. I'm know my stomach is where my body first holds it weight, but looking pregnant before you are pregnant, when you're trying desperately to become pregnant and it's not an easy feat, adds an extra level of bite that is hard to put into words. 

3. The moodiness. I joked about this the other day, but it is no longer a joke. I no longer feel like myself. My body has been taken over by an irrational, highly sensitive person who tends towards depression and despair. I still can't cry, but I want to often. I've lost motivation at work. I snap at C easily and have little patience with anyone else. I am not pleasant to be around. I don't want to be around me!

I feel like this is different than last time. C and I have spent a lot of time talking about this and he very gently reminds me that I was also very moody and irritable last time, and I do have some evidence in writing to back this up. But this time it's different. If not an actual different flavor of moodiness, which I'm still not counting-out, I know it's different because this time I feel more self-aware. I think last time I may have felt these same emotions but the sense was that the emotions were a part of me. I felt connected to them. 

This time, I know that it's the hormones. Objectively I still feel hopeful, despite my body's uncooperative nature. Objectively I know that I do not have major reasons to feel the way I do. But that doesn't stop the feelings. The emotions have railroaded any rational thoughts and are actively working to suffocate the person that I was two weeks ago. My mind is trying to hold on to that old person, but I am worried it is losing the battle. I don't want to slip back into depression. Depression and I go way back: there are two time periods in my life I only remember shrouded in darkness. I feel like I'm actively fight against this and it's exhausting and I'm not sure how much longer I can do it. It's concerning that this change has happened so quickly and I get overwhelmed thinking that I may have many, many more weeks of this. I believe that if I can hold on to the rational person fighting for a voice that I still have a chance, and so I have been separating out the irrational hormonal person that has possessed my body as much as possible. My current mantra: It's just the hormones, it's just the hormones, it's just the hormones... 

Wednesday, July 27, 2016

Uncooperative

I woke Monday morning to blood on the toilet paper. Bright red blood, that continued in small doses throughout the day.

Bleeding is not supposed to be a part of taking estrogen. I called the clinic and they asked me to come in Tuesday morning for an extra ultrasound. The one nurse I cannot stand called me back to relay the news that my cycle may or may not be cancelled based on the results. She then added that even though the estrogen is supposed to block the ovaries from creating mature eggs and ovulating, sometimes the body just wants to ovulate anyways.

I couldn't help but laugh at the ridiculousness of this theory. To the best of my knowledge, I have NEVER ovulated on my own without copious amounts of medication. My ovaries have no intention of ever growing any eggs, let alone attempting to ovulate them. It enjoys collecting many tiny little possibility of eggs and then hoarding them like an overcrowded bedroom on TLC (seriously, have you ever seen a PCOS ovary? There's no room to breath in there, let alone grow!).

Then again, the irony of this would also fit with how I conceptualize my reproductive body parts: obstinate and uncooperative. If my uterus and ovaries were people, they would be the disgruntled adolescents who spitefully do the opposite of what they think their parents may want.

On Tuesday I arrived for my bonus ultrasound. My lining looked okay and so did my estrogen level. Okay. As a perfectionist, I can't say I'm thrilled with this result. We are moving forward. As if this never happened and without a clear explanation. My real baseline ultrasound will be on Friday and then a likely transfer date. Assuming that my body can follow directions without any more ruckus.

Monday, July 25, 2016

Dual Relationships

My REs office meets over lunch with all of the doctors and nurses on staff for the day to discuss the morning testing results and medication plans for the day for each of the patients seen. Then the nurses call the patients in the afternoon with the plan.

My last name is not very common. In fact, my husband has a rather large Catholic family and whenever anyone has asked if so-and-so is related to me, I've always just assumed that they are and so far I haven't been wrong.

One of the REs in the practice happens to also specialize in adolescent gynecology and we have shared a few patients. Plus, I completed a learning evaluation on her son in the last year.

When I was waiting for a different doctor to come in to perform my hysteroscopy, while undressed from the waist-down and under a blanket, the nurses were talking and it happened to come up that I work at the hospital as a psychologist. One commented that she knew she recognized my last name and had heard it before from one of the doctors whose child was evaluated by me. She explained that the doctor was talking about me professionally and how helpful I was to her son. She didn't say who the doctor was, but I assumed it was this RE who I've also shared patients with.

This morning I stepped into the packed elevator with this physician. She and I briefly made eye contact and smiled at one another. I rode up to the 11th floor and she got out a few floors ahead of me, quietly saying "take care" on her way out.

This is a challenge of being employed by the hospital that is trying to make me pregnant. My husband likes to joke that my employer has some of his frozen sperm, although I'm not completely sure why he finds this so amusing.

Not one of these interactions was inappropriate or in violation of privacy rights, yet I have mixed feelings on the whole thing. She said "take care" with a specific gentleness that I can only assume means she knows who I am as a fertility patient and not just the psychologist who diagnosed her son. This was nice of her. It also kind of creeped me out.

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Friday, July 22, 2016

The Many Faces of Estrogen

Five days of estrogen and I've turned looney. It started with one random symptom of "urinary urgency," which I didn't even realize was a real thing until, holy cow it's real! Then mid-way through this week came the emotional roller coaster.

1. Sentimentality. Listening to an old CD track that C made a decade ago when we were first dating. My heart swooned as if I was an early-20-something in new love all over again.

2.  Irritability. The burning desire to shake and scream at the technician who reports to me with her never-ending incompetence. It used to get to me on an irregular basis for the really egregious errors, but this week I can't even look at her face.  I know that she objectively hasn't been any worse then normal, but I do not have the time or patience to micro-manage your every action and hold your hand through every G-D decision!

3. Rage. Don't mess with me. Period. Don't blow me off when you say you're going to do something. Don't promise something and then pretend it didn't happen or feign amnesia. Don't expect me to take on more and more responsibility but fail to give any support, emotional or concrete. You may be my boss, but I am ->this<- close to calling you out on all of this B.S. and that may not be my best career move so please stop tempting me.

4. Random Sadness. I have no precipitating causes for this one. Just the random urge to cry. But I am not the kind of person who cries. Ever. So instead I am left with the tingling feeling behind my eyes with no actual release which is even more upsetting.

Which leads to how my husband is the best man ever. This evening I return from work on my second straight day of the emotional coaster, generally stuck in Phase 4 and disappointed that I couldn't even release the sadness. He listens patiently. Then, when I come downstairs with my pajamas on, I find him sitting in front of the TV with Lion King, cued to the gut-wrenching moment in the gorge.

It was perfect and just what I needed. Something to help me release the sadness. Unfortunately, it didn't work. My eyes welled up but that was all. We look at each other disappointed and then he gets excited and says he has another idea.

He has me close my eyes while he prepares... My Girl, beginning with the scene where they share their first kiss under the willow tree and immediately before the boy returns to the woods to find her mood ring. This movie is guaranteed to shed a tear and it came through: one solid tear. Not fully the release I was hoping for, but enough to move on with my evening. I wonder what tomorrow's estrogen adventure has in store for me.




Monday, July 18, 2016

Microblog Mondays: On Being Adaptable

When evaluating a child for intellectual disabilities, one of the developmental milestones I ask about is the child developing a sense of privacy and personal decency. Whenever I ask this question, memories of babysitting preschoolers make me smile: Little kids streaking through the house with only a towel around their neck as a cap, standing at the top of the stairs naked and calling out my name, or barging in when I am in the bathroom.

Then this developmental milestone all goes out the window when a you undress from the pants down, spread your legs, and allow someone to stick a wand up your vagina and stare at your insides from a computer screen.

I had my baseline ultrasound this week to make sure everything looked okay and my lining wasn't too thick. My clinic doesn't always do this for individuals taking the pill, but I was an exception because even while on the pill I hadn't actually bled for the past four months. Yes, ladies and gentleman, it's true that pregnancy and childbirth doesn't always solve PCOS and menstrual irregularity. Not surprisingly, my lining was "in the gray area" with it being thicker then they would ideally like but not thick enough to actually induce a period. We will proceed as planned.

Prior this lining check, I hadn't dropped trou since giving birth to our daughter 20 months ago. I was struck by how it felt just as awkward as the first time I had a vaginal ultrasound. I didn't expect this because the last time someone was up in my business I had absolutely no sense of decency. Childbirth will do that to you. Especially childbirth that follows over two years of people regularly invading your sense of privacy with ultrasounds, inseminations, retrievals, transfers, more ultrasounds, and then eventually cervical checks.

So it turns out that our sense of privacy and personal decency is a developmental milestone that, once developed, can be foregone for goals that are more important (i.e. pregnancy and healthy childbirth) but then returns back to baseline when the competing goals are gone. We are taught to protect our personal privacy, then forced to learn to tolerate having this repeatedly violated, then return to the deeply entrenched privacy sense that we developed as children. So here I am now, back to the need to desensitize myself to this. I anticipate this won't take long. It fascinates me how quickly we humans adapt to our surrounding and what is required of us.

Sunday, July 17, 2016

Why I Am Here


In the past 18 months, I had considered writing on multiple occasions. Multiple barriers stopped me. I primarily used the excuse of lack of time from parenting an infant, working full-time, and then owning a new home. It was difficult to be reflective. But it was more than that. I was conflicted. I had forgotten, or more likely never fully understood, why I started blogging about infertility. So therefore it was difficult to know the future of an infertility blog once motherhood was achieved.

I couldn't put my finger on exactly what was so conflicting until just the other day. Something about Mel's 500th/600th Friday Roundup sparked an epiphany. I'm not sure what it was exactly, but I loved her explanation of how certain blogs stick with her and how she fishes for new gems each week. 

I have found myself returning to read others' blogs more frequently within the past several months. Wanting to catch up on people's lives, people that I have begun to consider distant friends or pen-pals of sorts. Although admittedly I am doing this all without commenting or acknowledging my presence. I'm lurking and I apologize for that. This is what I used to do before I had a blog of my own. Because it feels awkward to comment on someone's post without having a link where they can return to learn more about me if they so choose. Because, to me, lurking seems like the better of two evils then a complete or even semi-stranger making it aware that they know about you. Part of why I started blogging in the first place was to "come out" and join the conversation. 

I realized that other day that I was no longer scouring blogs just to catch-up. I was searching. I am still searching. I am searching for people who understand what I am going through. People who have been there before. People who have survived this. I am searching for answers to unanswered questions about what to do next and what the future might have in store for me. This feels like a direct parallel to how I felt in years past, in the beginning of my journey to motherhood, but surprising because I hadn't expected to be back to this place. 

I have also taken to re-reading my old posts. Over and over. I find comfort in them, even the ones with raw emotion of uncertainty and despair. I have found myself looking back to clarify specific dates, or numbers, or stats that have faded from my memory with time. These numbers were once so important, and then no longer important at all, and now may again be important references. I also find myself wanting to empathize with the person shedding her soul. I have largely forgotten those emotions and reconnecting at this point seems helpful for some reason. As though some of the answers I am searching for are found in my own history. 

***

This blog serves as documentation of my infertility journey. I am not a particularly outspoken person, but this blog serves to share my story, in all of it's raw and unflattering details. I do this for myself, so that I return to remember how far that I have come and never forget the toll of an infertility diagnosis even after the largely overcoming it. I do this for others, so that they might find answers and understanding in my words as I have also searched. I do this to be a part of a conversation that needs to become more vocal, less hidden and shameful. 

***

This is not a parenting blog. A huge source of conflict was how to address my daughter now that she was alive and a very real person. Her anonymity and respect for her privacy is important to me. One day I will teach her about social media and all of its benefits and potential problems. But this if for her to learn and figure out how she is portrayed and what she wants to share. As much as I would love sharing about my joys and challenges of parenting, and I am sure that some of that will inevitably filter in from time to time, I could never figure out a way to do this in its entirety while protecting her privacy without turning the blog to private status. While having a private status blog works for many, this didn't feel right and I couldn't grasp why until just now accepting the purpose of my blog. 

This is not a personal journal. Yes, I will write about non-infertility related topics at times because this can also be cathartic and can put the infertility journey in context, but that is is not the purpose. In general, my life is fairly mundane and primarily positive. I have stressors and daily trials like most, but I don't believe that these stories serve much of a greater purpose. Plus, journaling is always too difficult for me to maintain. 

This is not an infertility advocacy or infertility education blog. I hope that it can serve a small advocacy or educational purpose to some, but that is not the primary reason I write. Honestly, I would love to have to the time to serve in more of an advocate or education role for the infertility community. Maybe someday this will be possible. For now, my time and emotional energy in spent on my family and my work/my patients.

***

Some day, I anticipate that my infertility story will come to an end. At some point we will be finished with our family and I will be content with the outcome. The remaining embryos will no longer be in frozen limbo. At some point, I do believe that this blog will be concluded, but not deleted. It will always serve as a document of one person's journey through this [often silent] diagnosis affecting 1 of 8. It will remain, in the archives on the internet, for myself and my child(ren) and, hopefully, for others to happen on and find solace, comfort, and answers to their own questions. 

I am reminded of the moment of when I suddenly and unequivocally realized and accepted that I was a mother, not when she was first placed in my arms, but a quiet moment of breastfeeding when she was three weeks old. My first post in this blog was nearly 3 years ago, albeit with a 1.5 year hiatus. It is with a great sense of satisfaction and slight amusement that I can finally understand and articulate its purpose. 





Monday, July 11, 2016

I'm Back (Microblog*)

Hello, world. Like Episode VII, I have returned after an unknown lull for a new generation. Only I anticipate that my return will have slightly less hype. In fact, it may be more akin to Land Before Time XIV**.

I digress. An entire post is deserved about why I have returned, which I am still sorting out, but the short answer is that I have redefined the purpose of this blog. And by redefined, I mean that I remembered the purpose of creating this blog in the first place. This is the place where I tell my infertility story. As much as I would have liked my story to be ended, wrapped up in a nice little bow with a beautiful daughter, it continues on.

Please allow me to catch you up over the past year-and-a-half of my life. Since December, 2014:

C was hired as an RN in a bone-marrow transplant unit on the oncology building of the main hospital that competes with my employer. He began almost at the same time as I returned to work full-time from maternity leave, which made for a very chaotic time in retrospect. He loves his job but it can be very stressful.

I have returned and continued to be employed as a psychologist, full-time, after a wonderful 12-week maternity leave that I managed from all of my saved-up vacation. My work life has not gotten any less busy, probably the opposite in fact, but I have successfully gotten much better at maintaining my own work-life balance. I almost always leave the office by 5:30 or 6pm at the latest. I have only gone into the office to work on weekends once or twice since returning. I am more efficient at work. I love my job, but have started to consider if reducing my hours would be financially and professionally viable.

We bought a home last summer that I am absolutely in love with, but is requiring more work then I anticipated. This is probably me having been a naive first-time home buyer, telling myself the house was "move-in ready". Which it was, until it required a new septic system that resulted in the lawn being torn up (luckily, this was discovered before closing and thus largely funded by the previous home-owner). However, I think the biggest issue is that I didn't fully anticipate the amount of work it would take to make this house our home and the amount of time it would require to maintain this amount of square-footage and property. As we approach the one-year anniversary of our closing date, I still feel like we are moving in and getting settled.

We got a puppy. Another Cavalier King Charles Spaniel, although different coloring from Marv. This happened over this past winter, with what seemed like enough time to formally mourn our first puppy. As he was so perfect for us, we were torn for a very long time about getting another just dog just like him but not wanting the constant reminder and comparison. We settled on another Cavalier with different coloring. Fortunately, or unfortunately, Ivan has a very different personality. He is much more brave, more energetic, and not as well behaved. He is wonderful with our daughter and watching the two grow up together has been fantastic, although having a crawling baby and a puppy at the same time has not always been easy.

Our daughter is generally doing wonderful and brings us so much joy. She is not without her own challenges though. She was diagnosed with the same congenital heart condition that my husband has, the condition that was diagnosed after one of his cousins died suddenly from cardiac arrest, and is now followed closely by a cardiologist. She takes medication three times per day and otherwise has no restrictions or limitations. She was also diagnosed with Torticollis and was in physical therapy for about 9 months until this was successfully resolved. At her 18-month check-up she was not yet walking and this was discussed at length, but has since taken her first steps and is slowly becoming more brave with leaving the furniture. Her speech was also a concern with no words at 18 months, but she has great receptive language, social skills, and has picked up sign language very easily. I try, and am mostly successful, at focusing on her forward progress and daily feats instead of wondering and researching about what this may or may not mean for her future development.

We have begun talking about a second child. More then talking, actually, we met with the RE last week and have started scheduling pre-testing and nursing visits. We have 8 embryos frozen, all 5-day blastocysts frozen in pairs of two. There is still a lot of discussion and uncertainty about the future of my fertility and our family. How big do we ultimately want our family to be? How many embryos to thaw and implant this time around? What do we do with the remaining embryos? These are all questions that we have not settled on.

This brings us back to the return of blogging: My continued infertility story.

*After completing this entire post, I realized it's not as micro as I was anticipating. However, considering it's a summary of 1.5 years, I'm satisfied with the brevity. 

** Yes, believe it or not, this series returned in 2016 for a 14th film after a hiatus since 2007. Who knew?! Personally, I think I stopped following after the second film.