Friday, October 29, 2004

What to expect when you're expecting after infertility

"Now that you've been pregnant once, you'll be able to get pregnant again easily."
Truth is, PCOS, male factor, etc is not fixed by pregnancy. The problem wasn't that our cervix needed to dilate to 10 so the sperm could swim past. Next time we're just older which is not good when you're talking fertility. I'm a prime example as second time took more to get me pregnant than the first time (IVF vs. IUI). Obviously, getting lucky once doesn't mean you will ever again.

"What type of birth control do you want to use after the birth?"
This one always made me laugh. It is usually asked in earnest by your doctors towards the end of pregnancy or at the post partum visit. When I'd answer none, I'd get lectures on how I could get pregnant again right away. Really? That would be fabulous. Pregnant for free and without intervention. Can you imagine?

"Do you want a boy or a girl?"
It doesn't matter. Either one. No really. They always think I'm lying when I'd say that. Now that I'm having a boy, they all seem relieved. Why? I would have been just as happy to have a girl. To an infertile woman, the sex of the baby doesn't matter. All we want is a healthy baby. Really.

"You asked for it."
This is usually said if you dare complain about any symptoms or lack of sleep after the baby is born. Yes, I did ask for a baby and I'm willing to go through fire if that's what it takes. However, I do reserve the right to whine as much as any other woman as I do. It doesn't mean I regret it or I'd change it for anything in the world. Going through infertility doesn't take away my right to bitch. Even Brooke Shields, who went through I think 7 IVFs before getting pregnant went through post partum depression. It happens to all of us. Infertility doesn't make us immune.

Thursday, October 28, 2004

Armand

My daughter turned 4 years old. 4! She now knows that she knows everything. Her pink princess party is on Saturday.

She has a boy friend (not boyfriend) at school named Armand (name not made up, it's his real name). Everyday she tells me new things about Armand...
.. Armand likes chocolate cupcakes the best, but he still ate one of the pink ones I brought.
.. I shared my Sleeping Beauty stickers with Armand. Since he's a boy I gave him the one of her in a blue dress.
.. My favorite princess is Sleeping Beauty but Armand's favorite is Belle.
.. Armand and I play Sleeping Beauty. He's the prince and kisses me to wake me up.

Janie is a funny kid. I brought her to school this morning and hung out for a little bit working on her letters. Armand kept coming up to her "Hi Janie. Janie. Hi. Hi Janie. Janie. Janie. Hi." and so on. My daughter is not social in the morning, I like to joke it's because she hasn't had her coffee yet but really she's just not a morning person, just like me. So she ignores Armand as he's desperately trying to get her attention. She just looks down trying to keep working and pretending she doesn't hear anything. Then he says, "Janie, do you have teeth? Do you have any teeth? Janie? Janie? Do you have teeth?" And so on until she gives a little smile while still looking down. When he sees the smile, he smiles and says, "Yep" then runs back to his chair, happy. He must love a girl that plays hard to get.

Oh Armand.

Wednesday, October 27, 2004

Healing

I'm kind of in a blue place after reading Cecily's blog today. She lost one twin and will be losing the other to save her life. (I would link, but I'm a technical idiot. I got there through Chez Miscarriage's blog.) I read her blog often and should have it on my list. It's actually the only blog that's restricted by my work probably due to language at some time or another. It's hard to find pregnant women to relate to. I'm such a case that only those who have suffered loss or infertility (or both) make sense to me. They understand. We are one great big bottle of uncertainty since all we had taken for granted (our fertility) had been a grand lie so we have no trust of the current truth (our pregnancy). Our fears are multiplied... and sadly they do happen.

What amazes me is the ability to heal after these events. Today, reading what Cecily is going through, it feels like I just witnessed someone fall off the highest cliff. I know they are lying in a twisted mess at the bottom, barely able to breathe. Part of me thinks that this is it. There are things you just can't recover from. I thought the same thing when my friend's baby was stillborn. What do you do then? I'm helpless, just a stupid bystander, trying not to say something accidentally hurtful. I can't do anything to relieve this pain although I would if I could, and I can't even go to the bottom of the ocean where they are (and it's even scary to imagine).

Yet, they somehow do survive the fall. They start by just lying there breathing, then crawling, until eventually they can pass among us, their scars hidden. I don't know how they do it. I can't imagine that kind of pain, I have only witnessed it and heard about it but never lived it (knocking on my wood desk). It seems like it would be a betrayal for your heart to keep beating and for the rest of the world to continue like it's a normal day. What must Cecily be going through right now? To have achieved so much with getting pregnant and getting past the first trimester, only to lose her sons now. Too early to save them. What a horrible decision to have to make to put your own life before your child's except I would have done the same. And if she would have died, it would mean they both would have. There was no possible happy ending at this point.

What a horrible dark place she's going to have to go through. I'm so so sorry. I wish there was more I could say or do. Today I only feel sad and wonder how life continues on and why bad things happen to someone who has paid their dues.

.....

And on a side note, today there was the following news story on Julia Roberts...


Pregnant Julia Roberts Reportedly in L.A. Hospital

LOS ANGELES (Reuters) - Actress Julia Roberts, who is due to deliver twins in January, has been admitted to a Los Angeles hospital after experiencing early contractions, People magazine reported on Tuesday. Roberts' condition was not serious, People said, adding that her doctors plan to keep her under observation in hospital for the near future and have advised that she stay in bed until she gives birth. Roberts, 36, accompanied by husband Danny Moder, was admitted to the undisclosed hospital on Saturday, and hooked up to a fetal monitor, People said. The contractions eventually stopped, and she hosted an impromptu bedside baby shower the next day, the magazine said. Roberts, perhaps the most sought-after actress in Hollywood, has two movies scheduled for release in December: the romantic comedy/drama "Closer" and the crime caper "Ocean's Twelve."
10/27/04

....

At first I was saddened to hear she was in the hospital. Although she has not discussed it, the rumor is that she underwent fertility treatments to get pregnant. She knew at 9 weeks that they were boy/girl twins. Anyway, I was thinking how scared she must have been to be in the hospital this early and to have to remain. But then I came to the part how she threw an impromptu bedside baby shower and I was dumbstruck. Huh? Okay, who goes through that kind of scare and then throws a party? I'm hoping her publicist is just trying to put a spin on it and not that she's really that cavalier. Although I guess cavalier is better than fearful? I just don't get it.

Monday, October 25, 2004

It's a ....

What a stressful night that was when I last posted. I was so mad that I couldn't sleep, although it was also because I was nervous about the amnio. Basically I had to sign-over that I would pay for it myself if they couldn't collect from my insurance pals. I will make sure they pay for all they put me through during an already stressful time.

First we met with a genetic counselor. She wrote out our basic family trees asking about everyone's health. Everyone is good, except for an incident of Hutchinson's disease on my side of the family. Although it can be detected in an amnio, they don't test for it because it's a very specific test. They would only do the test if I was tested and proved to be a carrier. Considering that there is only 1 out of my 40+ cousins who have this, it may be that she got it from her father's side of the family.

The genetic counselor was interested in the fact that we went through ICSI to conceive. ICSI babies have a higher chance of Klinefelter's syndrome which means the baby has 3 sex chromosomes XXY, which can cause learning difficulties and infertility. She also explained that my age gave me a 1/300 chance of down's syndrome which gave me no comfort considering my friend's age gave her a 1/700 chance and she got the one.

The ultrasound was incredible. I hadn't seen little Flicker since 8 weeks. First the tech asked if we wanted to know the sex and as soon as I said yes, the baby's legs opened and out wagged the goods. Yep, it's a boy, and he's proud of it. This was a complete and total shock to both of us. I started crying and even Matt had tears. We both couldn't believe it. For the rest of the ultrasound, as she was showing us all the important parts of our baby, we couldn't get over that he's a boy. He's a boy. That still sounds strange.

We had both assumed the baby was a girl, and I have to admit that this came from me. Everything I read said that men with male factor issues sired girls because the female sperm is heartier. Even female embryos are heartier so it's impressive that out of our 12 fertilized embryos, the only one who survived was a boy. A boy. I can't believe it. I never thought I would have one. Never. I had given up on that and moved on to imagining my life with just a daughter or maybe two. Matt did as well. I think he'll still want to coach Janie in softball one day, but now he'll also get to coach little league like his Dad did and he's ecstatic.

Back to the ultrasound. Little flicker likes to put his hands up to his face and I swear he waved. He also had his ankles crossed when his legs were outstretched. He was very fidgety, constantly moving around which makes him just like his Dad. I couldn't be prouder.

Then fun time was over and it was time for the amnio. The physician came in and first did a quick ultrasound to get familiar with the baby. He said there were no soft makers for Down's. He told me that my odds of Downs is 1/300 and with no soft markers in an amnio such as this it makes it 1/700, but the risk of miscarriage from amnio is 1/300. Did I still want to continue? I almost said no. I understand the math as he explained it to me. I had seen my son and I loved him and I couldn't imagine anything being wrong with him. But, I knew that this was what I wanted and had discussed ad naseum with Matt for weeks and if I didn't get it done I would worry and stress and beat myself up over it. I said yes.

They tilted the table so that my feet were higher than my head. (I suppose this is to gather the most fluid in one pocket. I can't help but wonder if the baby floats?) Using the ultrasound, the doctor made a mark on my belly somewhat below my belly button. He then took the needle and you would think he would gently guide it in but it's nothing like that. I swear I'm not lying. It is a stab and I had no idea it would be like that. It didn't hurt, but it was traumatic. As he was taking out the fluid I couldn't look but Matt says he was worried that there wouldn't be much left for the baby. It was probably only 30 seconds or maybe a minute and it was over. He showed me the fluid to check my name and pointed out it was yellow like pee. (I never thought it would be yellow. I don't want him swimming in urine! Can we clean the tank?)

So Matt and I went to lunch in a strange stupor. We were excited that the baby was a boy and looked okay. We were off balance from the amnio. I finally think I got Matt to agree that 2 kids would be perfect so I can get my tubes tied. Before this, he liked to talk about trying naturally which got me nervous since I knew it would continue the emotional roller coaster for me. I'm done with it. I'm tired of not getting pregnant. Let's quit while we're ahead.

After not getting any sleep the night before, I nearly fell asleep in the car ride home and would have fallen asleep on the couch if my phone wasn't ringing nonstop. All our family and friends wanted to know the sex and they were as shocked as we were, but all were happy. We'll have one boy and one girl. I had bought a book on baby names and had read the girl section front to back, but couldn't find one I liked. Now I get to read the boy section. That's just weird.

That night Matt and I went to Ruths Chris steak house for a fabulous dinner. We celebrated a good ultrasound showing a healthy child as well as our 12th wedding anniversary. It was a beautiful night.

This weekend, I've been trying to entertain myself while I waited for the FISH results which is a quick response on some of the amnio. They just called and all is good. No trisomy 18, 21 or the other one that I forget. And there's only 2 sex chromosomes which she confirmed is XY for a boy. I still can't believe it. And you couldn't wipe the smile off my face if you tried.

Thursday, October 21, 2004

UnitedBastards

I hate insurance companies. Not just because I work for a hospital and I see all the money they are pocketing between the non-profit hospital and the patients. No. I also hate them for all the hoops they make patients jump through. Tonight I am living proof.

Around Sept 7th, I set up my appointment for my amnio tomorrow. The perinatologist's office stated I needed authorization in writing or I wouldn't be able to have it. I called my insurance who told me it was a covered benefit and that I wouldn't need paper authorization. I explained that I did and they said that they needed a written request from my doctor at least 30 days in advance. No problem. I called my OB/GYN and they made the request. United says they received it on 9/13, so they should be able to provide it for me on 10/13, well in advance of the 10/22 appointment. Right?

So I decided to call today and to see how everything was going. My OB/GYN's office said they never received anything. The perinatologists office says they never recieved anything. I never received anything. I ask my OB/GYN to follow-up and urgently because this appointment is tomorrow. After many promises that they would, they didn't and they closed without calling me back. Gee, thanks.

So I call Unitedbastards. They tell me that my request is in medical review and they have no idea how much longer that will take. Is it a covered benefit? Yes. Then why the medical review? Because I asked for paper authorization. Why is it taking so much longer than the 30 days they promised? They don't know. What can you fax me or my doctor tonight so that I can still have my appointment tomorrow? Nothing. Nothing at all.

Bastards.

So, next I filed a complaint with the California Department of Insurance. Then I called the California Department of Managed Health Care and filed a complaint with them. They said they would file it as urgent, but still, it's late. There's nothing they can do for me tonight. They promised to have their agents look into it and call me tomorrow.

That leaves me exactly nowhere. Yes, I took out some of my anger by filing these complaints, but I'm still left with an appointment tomorrow and no all important piece of paper for a benefit that is COVERED. It is covered no matter what. What are they going to do in a medical review, deny my claim? No, but by not providing me with this paper in time, that's exactly what they are doing and they know it. Don't be naive, these insurance companies care only about one thing and that's profits. Their tactic is to delay, delay, delay and then deny, deny, deny. Set up many obstacles to avoid paying for, or in this case even receiving services.

I did everything I was supposed to do with plenty of extra time just for cushion. They are playing games big time. They are so unapologetic and so smug. "We're not denying you services, the perinatologist is by not giving it to you without this paper. It is covered." "Yes, you are denying me services since you knew that I needed this paper to receive the service. Bastards." Actually, I didn't call them that on the phone, but I think it could be implied by my tone. Or at least I hope it was.

So I don't know what's going to happen tomorrow, but more than likely nothing. All this stress, all this worry, all this planning and preparation for nothing. Like as if getting an amnio is the easiest thing in the world. As if I should just say, "Oh I understand, you lied about how long it would take you and now I'm screwed. That's okay, no need to apologize. At least I'll know that the amnio I'm unable to get is covered, right?"

Oh, and by the way, the reason I set the appointment so far in advance is because it is impossible to get an appointment for an amnio there without at least 30 days notice. Which leaves me with the option of.... nothing. Exactly nothing.

Bastards

Wednesday, October 20, 2004

Bad Juju

I found the most beautiful crib for sale on Craig's list. The price is right. The style is beautiful. the color is perfect. I can't buy it. At least not until after Friday's ultrasound. And maybe longer after that. That would be bad juju.

This is not easy, not at all. I'm on shaky ground. What am I supposed to do? I don't feel pregnant. I look chubby, not particularly pregnant. I've gained weight, that's for sure. I've felt no kicks. Shouldn't I have felt something by now considering this is my second? Flicker has a great heartbeat, strong and steady. I have no reasons to fear anything bad will happen, but I do.

I heard a song on the radio that I remember listening to after one of the good but failed IUIs before I got pregnant with Jamie. I was thinking I was pregnant, had to be. The IUI had gone well, why wouldn't I be? I heard this song and turned up the radio so that the 'baby' could hear it. My imaginary embryo. I thought I'd play it for the baby throughout my pregnancy and tell him (just knew it was a boy) later when he was older how this song was my favorite when I was pregnant with him. Of course I wasn't pregnant, and the song kind of reminds me of how innocent and naive I was then. And it reminds me of how it was supposed to be easier but never was. Now I hear the song and it's ... 5? 5 years later and I'm pregnant with our second. I turned the channel. It was haunting and I felt like this song would somehow hurt this baby.

So I'm not buying the crib. I'm crazy. I'll miss that crib later and I'm certain I'll never find one nearly as well priced and perfect as this one. Isn't that how it always is?

Or maybe it will still be for sale this weekend, after the ultrasound, when I'm feeling more stable.

Tuesday, October 19, 2004

Updates and Love at First Sight

Abby update -
She's doing okay. She's off the ventilator but she's having a hard time coming off the morphine and other meds they used to sedate her for so many days. She couldn't sleep and was very sick from withdrawl. They ended up giving her some methadone to help the adjustment. Otherwise her heart is doing well. Valerie is still battling the hospital administration. After only sleeping for 4 hours for two nights in a row, she was tired of standing while feeding Abby. She sat in an office chair while she fed her, which is generally used by the nurse except now Abby doesn't have a nurse constantly in the room so it wasn't being used. Amazingly enough, it's against some ridiculous hospital rule for the parent to sit in the office chair. Nice, huh? Valerie did let the night nurse who made the mistake come back and be Abby's nurse again the next night. She knew he would take extra special care of her and I'm sure he did.

My update -
I have an amnio this Friday. It's a difficult thing. My mind is constantly arguing for and against it. On one side, I'll be 34 1/2 when I give birth, which is not the same as 35 but c'mon there's not that much of a difference. Since my own friend 4 years younger just had a Down's baby with heart defect after normal AFP test and normal ultrasound measurements, I have no faith in those tests nor in the odds. Her odds were much less than mine, and yet she's the one. Also, I'm still concerned about the bad quality of the embryos we transferred and whether that could mean anything bad. It's not supposed to, but you can't help but wonder. Finally, there's a family history of Hutchinson's disease which is genetic, and usually causes problems and early death in the 40's.

On the other side, I am only 34, not 35. I could take the AFP and ultrasound then decide to do an amnio only if the results are bad. Amnio can cause miscarriage and you know how serious any sort of additional risk is of that. Very scary. If I should miscarry because I had an amnio, I don't know what I'd do.

Yet, I want to know if there's something wrong. I'm not sure what if anything I'd do about it. I'll cross that bridge if I have to come to it. Watching a baby go through heart surgery is not easy. Raising a Down's syndrome child is not easy. With Abby, I feel like I'm already committed to one. But I don't want to be surprised in the recovery room like Valerie was. I would want to think about it, research it, talk about it, and so on. If I decided to continue the pregnancy, I would be prepared. I would also have the option of not continuing, and let's not go there right now.

Random memory -
I remember the first time I decided that I was ready to have babies. I had always loved babies, but I wasn't in love with the idea of raising children. I found many kids to be annoying. Anyways, I was auditing this hospital in Northern Arizona and it was snowing outside. Snow is so unusual for me growing up in California and then moving to Arizona that I get distracted by the snow falling outside my window. I was walking through the hospital to get some papers or meet someone or something I don't remember. In the surgical waiting room was a little boy, probably 8 years old. He looked a lot like my youngest brother when he was little and how I imagined my little boy would look like. He had brown hair and freckles. His face was flush and he appeared lethargic so I immediately thought that he had a fever. Yet, he wasn't a patient, but waiting for someone else who was having surgery and no one seemed to be paying attention to the fact that he seemed sick and needed love. I wondered if it was his mother who was having surgery for surely she would be caring for him if she wasn't sedated. As I was walking, our eyes met and he gave me such a tired, sad look, I just knew he was sick. I felt immediate concern and love for him and wanted to put my hand on his forehead and see if he was alright. But he was not my child. And I couldn't. Touching other people's children is forbidden, even out of love or concern. I must have gave him a look that said 'I'm sorry' and then he gave me this tired smile. Like he knew that I cared but I couldn't and he understood or maybe he was signalling to me that he was fine. Anyways, I smiled back, withheld all urges to put my hands in his hair, and kept walking. It was love at first sight. I'm sure he forgot about me in seconds, but I've never forgotten about him. I felt like I was seeing my future child and finding out how deeply I could love them. I knew then that I wanted to start having babies with my man at home. I had no more fears.

My friend's mother woud tell me that he was probably an angel which is why no one else was paying attention to him. Sent only for me. To prepare me, to calm my fears, to make me fall in love with him. That's why he stood out so much from any other child I'd ever seen. That's why I still remember him.

I think he was just a little boy and I could sense he needed love. I discovered my motherly instincts weren't reserved only for cute little babies.

Back to the mundane, but not so mundane. I'm contemplating buying tickets to the San Francisco Ballet for the Nutcracker. I think it would be very special to bring Janie. I'm probably going to spend way too much on them, but I want good seats so she can see. I'd like Matt to go too, but I'm not holding my breath on that one. I'll probably be buying just two and making it a special mother/daughter night. I'll buy her a special dress and shoes and all that stuff so we can be dolled up together. I never had such an outing with my mother or father, but the thought of doing it with her is making me smile uncontrollably.

Yep, never has there been a more spoiled child than the only child of an infertile couple. And oh what fun it is to spoil her.

Monday, October 18, 2004

A Mistake

I'm home again. As much as I complain about this house, walking in the front door feels like wrapping up in a warm blanket. Mmmm, home.

When I left Abby was doing much better and about to come off the ventilator. She was having some difficulties after her night nurse mixed up her lines for proteins and lipids and didn't discover the mistake until 5 hours later. It meant she had far too many fats which messed up her glucose levels and kidney function tests. They say there's no permanent damage, but you can't help but wonder. Valerie was furious, of course, and from then on all changes had to have two nurses so that one could observe while the other made the change. If it had been different lines the baby would have been killed. We don't need that kind of drama.

Valerie was also doing better. She had talked administration into letting her have a cot in the room after they vetoed her twin air mattress. It's hard to believe, but they didn't have accomodations in this room for a parent to stay with their sick child or baby. The other PICU rooms had 6 foot long built in window seats for the parents to sleep on, but Abby's room had one that was only about 4 feet long. Not even wide enough for curling up on. It took a lot of hassle for her to be able to get to sleep there. They kept telling her to go home and sleep and trust the staff to take care of her daughter. She wouldn't leave her side. When the mix-up happened, the staff that told her to trust them had a hard time looking her in the face.

She actually asked to speak to the nurse who made the mix-up and told him this,
"I'm going to give you a gift. She's going to be okay and I wanted to be the one who told you. You made a mistake and I know that you're very sorry. I want you to go home and get some rest. You'll be working again tomorrow night and you're not going to be able to unless you get some sleep. If you let this bother you and play it over and over again in your mind, you will be tired again tomorrow night. I haven't decided yet if you'll be in here with Abby, but you'll be with some sick child and they will need you just as much. I think you'll be especially careful next time you work, but only if you can get some rest. Of course I'm upset and that's to be expected but Abby will be okay and that's what is most important."

She says he was crying the whole time because he felt so horrible. He had been talking to her during his shift about how much he loves down's kids and enjoys working with them the most. It was a careless mistake, but it wasn't lethal. He's a good nurse, but considering he just flew back from the Dominican after a humanitarian mission, he's just tired and should have taken more time to rest before working this night shift with such a sick child. I'm sure he'll never make that mistake again.

As for me, I'm back to the mundane. My voicemail box is full again. It is always full. I hate my voicemail. Patients call and ask to speak to Finance and get transferred to my phone (alphabetically first in Finance) when what they need is Patient Financial Services. I get all sorts of hang-ups and angry messages when I don't handle billing at all. My attempts at educating the call center have all been in vain.

Oh what an exciting work life I have.

Thursday, October 14, 2004

Abby

After driving 4 hours and flying for 2, I eventually arrived at the hospital last night. Baby Abby was in the PICU which means Pediatric ICU. Her surgery had started at 8 in the morning and ended about 6 hours later.

The PICU starts off with giant hallway decorated by children's paintings and primary colors. Each child has a private room with glass doors. Abby, 4 months old and only 12 lbs, was laying in the clear bassinet hooked up to more tubes than I can describe. She was still intubated so the machine was breathing for her. She is heavily sedated so she could rest and also not try to pull out any tubes. She has tiny restraints on her wrists in case she does wake up. She's wearing only a diaper and some little socks, so you can see the long cut down her tiny chest. She's laying on a cooling blanket which is similar to a think water bed with cold water in it designed to bring down her body temperature. They want her to be only 97 degrees for her heart. Surrounding her is many many machines keeping track of every vital statistic. She has a nurse who is in the room with her constantly, adding new meds, adjusting the machines, tracking everything. If the nurse needs anything she calls and someone brings it so that she never leaves the room. There's a team of doctors, intensivists, pediatric cardiologists, etc who come and go one by one, checking, changing, and asking questions.

My friend Valerie had deep red eyes from not sleeping and I know she had been crying. She smiled when she saw me because of my belly and laughed when I told her I wasn't showing, just getting the beer belly I deserved. Everytime some monitor would beep she would stop and see what was wrong. She would question all changes in Abby's meds or anything they were doing to her. Her husband was a lot more at ease, but always by Abby's side, watching over her. I had been there after their first daughter was stillborn. They're a strong couple, but you could tell they were waiting for bad news. They were waiting for something to go wrong. I think anyone who has been through infertility, miscarriage or loss knows what that is like.

When they did the surgery, they put her on a bypass and stopped her heart. They then worked to repair the valves and think they fixed all except one hole in her heart that they couldn't close. She will have a little murmur but she should be okay. The good news was when they told everyone in the waiting room that they had restarted her heart and that she was doing well.

Last night her heart rate was too fast and her blood pressure too low. Because they had stopped and then restarted her heart, the chambers weren't beating in time yet. They were out of sync. The doctors were trying different medications and a pace maker to try to get them to beat together. I was told this is normal for these babies after open heart surgery so this was to be expected.

I got to talk to her, touch her legs and puff of hair, and just watch as she dreamed. She felt so cold because of the cooling blanket. Every instinct tells you to get her a warm blanket and to pick her up and hold her. She's used to being held every day. I told Valerie that she was probably dreaming of her face and her ducky swing.

I'm going back tonight after work and I'm hoping that my friend has gotten some sleep since then, but I doubt it. I'm so sorry for such a brief and factual post, but if I got into all my feelings I would show up at the hospital with puffy red eyes and that wouldn't do any good for anyone.

Thankfully Valerie has not asked me to pray with her or even for her while I was there but was just glad to see me and know that I cared. For those of you who answered me yesterday that you were praying, thank you. For those of you who answered me yesterday that you were keeping her in your thoughts and that I should do and say the same, thank you too. I couldn't find a better bunch of women for support.

Tuesday, October 12, 2004

Faith

Being an atheist doesn't make me a bad or immoral person. I believe that I live a decent life, married to my husband nearly 12 years, no infidelities, no abuse of person nor narcotics (except occasional use of pot, which is now off limits), no murder, etc.

I like religious people of all kinds. I find their faith incredible and have immense respect for it. It's interesting to hear of their beliefs. My youngest brother and his wife are devout Christians. They love their church and through it they've found happiness. As long as they don't try to convert me or pressure me, we can enjoy each other's company and be very at ease.

I just don't have any faith. I don't. I was raised Catholic as a child. I believed there was a God. Well, I believed until hell hit our home in the form of an abusive stepfather. I prayed for help and peace and it didn't come. I had to take matters into my own hands. Some would say that my actions were the result of my prayers. I believe that my actions were the result of my choices. I no longer believed that someone was looking out for me. That would include not only God but my parents as well. I could find strength only in myself.

It is a little scary. When you don't believe there is a net to catch you. When you feel alone when you are alone, and that death is the end of life. Life seems a little more precarious.

When times are good, I do not give credit to God. When times are bad, I do not blame God or ask him to fix it. To pray only when times are bad seems hypocritical to me.

So today my best friend Valerie asked me to pray her baby. Her 5 month old is having open heart surgery tomorrow to repair her broken valve. It's common with Downs babies. Valerie knows I don't believe so I know she feels funny asking me, yet she still thinks that my prayers could make a difference.

So I struggle. I could easily go through the motions. Say some prayers or tell her that I did. Yet I don't believe. They would not be sincere. It's not that I don't love her baby or want her to do well tomorrow. I love her with a hugely strong intensity that I can't describe. It's more than just a love for a best friend's baby. It's fiercely protective. I fear for future pains and want to make sure she has what she needs even when she becomes an adult. It's not about love for the baby.

It is about love for my friend. If saying these words will comfort her, I will probably say them. I don't understand how that can give her comfort, but then I don't understand much about faith. Am I being untrue to myself by saying prayers for her comfort? Or is it the humane thing to do under the circumstances? If it were not heart surgery for a child, I would not agree to pray for someone else. I would tell them instead that I love them and I will keep them in my thoughts.

Valier also sent me a poem which tells the story of God picking out special mothers to send disabled children too. Again, this is something that I think gives her comfort, but I read it and it upsets me. Of course the story is meant to be an homage to these mothers, but it bothers me. If God is hand selecting mothers, then why aren't some infertile women pregnant? They include all the qualities described. Why did I have such problems conceiving? Am I not good enough? I know, I know, I'm taking this poem all wrong. I know that, okay? It also makes me sad because not all disabled kids get the mothers described in the poem. It's not made special for them or any other baby. It's science and not someone deciding who is worthy enough to become a parent. Damn drug abusers get pregnant all the time.

Instead, I tend to see that it's the woman and her actions that make her a good mother to a special needs or any child. With my friend, when her daughter was born with Downs, she went through tremendous grief and shock. Neither the triple screen nor the ultrasound had predicted this, and they didn't test for it in her late amnio. Valerie had just suffered through the still birth of her first daughter only two years earlier. Her husband had brain surgery just 5 years earlier.

It took time, but the shock and grief did dissolve. She's now deeply bonded with her baby and considering becoming an advocate for Downs children. She'd be a great one. She has a master's in psychology and was working as a social worker for children before her daughter was born. She's extremely strong willed, open and direct. She's afraid of noone and actually enjoys confrontation for a good cause.

I think she's a good mother to a disabled child because she's a good and strong person. She didn't choose this road, but now that she's there she's going to go beyond what is usual to do more simply because of who she is. I admire her greatly, although I try not to act star struck in her presence.

So was she chosen to be a good mother to a child with special needs? Or did she become one? Again, I have to give full credit to her.

So when she sent me the poem I told her it was beautiful because she does embody all the characteristics that are described. And if she asks me to pray, I will go through the motions for her comfort. It feels sort of dishonest, but at times like these, when she's facing what she's facing, I'll do what I can to make it easier for her. She knows how I feel and what I believe and so will know that I'm doing this for her.

And as for my genuine authentic self, her daughter will be in my thoughts and hopes. I am flying out there tomorrow even though I can't be by her side (only parents allowed in the PICU), I can stand vigil in the hospital. They do these surgeries all the time. The surgeon is the best in the state. My rational mind tells me that she'll be fine. My emotions are uneven as I fear for her and my friend. I'd do anything to make it easier for them and if this is what it is, then that is what I will do.

Monday, October 11, 2004

Making Hay While the Sun Shines

After such a productive weekend, today kind of sucks. My husband came home and he took off Friday so he could spend it with us. Against all odds, I didn't catch Janie's flu. Instead, I got caught up in some serious nesting. I reorganized several cupboards in the kitchen as well as my office. Sadly, today Matt has the flu. I don't know how he caught it and I didn't when he arrived after she was better and I'm the one who cared for her. My poor sweetie.

So what caused me to start cleaning and organizing? The glorious second trimester. In the short time since I started this second trimester, I've finished several big projects around the house that have been hanging around for months. I was more exhausted than sick in my first trimester. Now, not only has my energy returned, but it's my attitude. I'm starting to feel confident. Is that the right word? Maybe it's that I'm not depressed or consumed by infertility and the necessary drugs and their side effects and setting new appointments and checking for symptoms and so on.

Here's my 8 months medically...

December - gall bladder surgery & bad mammogram
January - breast surgery
February - appointments and tests
March, April, May - failed IUI, failed IUI, failed IUI
June - birth control pills
July - IVF
August, September - first trimester

All this and work and school and family and Pazel's a weak and tired girl. Finally, I'm regaining my strength. I'm rebuilding my fire. I'm not so sad, but I'm actually happy. Not just for the moment, but when I'm alone. It's a little scary, but it's much better than the alternative. I think I'll take it and not complain. Not today anyways.

Except for my husband being sick. Poor guy.

Thursday, October 07, 2004

Sickness and Ghosts

I'm in limbo as I wait to get sick. My daughter was sick all day yesterday and the night before. Last night was throw-up free which is wonderful. Today she's home just to finish recovering, and she felt jipped that her hookie day was spent sick on the couch. (Speaking of which, I have to call that company with the fabric protection and have them come out and clean that area where she was sick and it didn't come out with my attempts.)

So I know I've been exposed and I know I will get sick. I've read that pregnant women have a 9 times higher rate of death from the flu than regular women. Of course the rate is so low that 9 times is still not that significant. Pregnant women have lower immune systems so the flu can be worse and last longer. Oh yay! My biggest concern is who will take care of Janie if I get sick.

The good news is that Matt is coming home tonight, two weeks early because they finished their work in Florida. I just have to hold out getting sick until tonight. What a lovely homecoming.

Taking care of Janie while pregnant did prove to me that I must be in the 2nd trimester. Despite all the disgusting things I cleaned up in the last 36 hours, I gagged a few times (when she wasn't around) but I didn't throw up. Actually, I survived the whole 1st trimester without throwing up once, but I did have many episodes of feeling sick and that I could be at any moment. I think if I was still at that morning sickness stage I would have been too weak and sick to take care of her.

All hail the 2nd trimester. A weekend ago I even painted her playhouse, finally! I'm actually feeling more energetic like my old self, pre-IVF. That's a long time of feeling sick or sore or extremely tired.

I guess I should feel like I'm going to make it, but I'm still not there yet. There should be a name for this condition because it's very strange. To want to be pregnant so badly, trying for years, extraordinary methods, then finally getting pregnant and not believing it. Like post traumatic stress. Crushed so many times that it's hard to reprogram and believe I'm in a safe place.

I run into ghosts of the past when I go to familiar places. When I went to the OB's office, I had a few tears in the exam room. Sitting in there reminded me of the other times I had been there, a mess by the time I reached the exam room after waiting with all the pregnant women. I seemed to be the only one who wasn't.

There was my appointment after being two weeks late, first time my cycle was longer than 31 days in 2 1/2 years. I had taken many negative HPTs and one negative blood test before my period finally showed up. I had allowed myself to get hopeful and the fall back to earth hurt like hell. My OB/GYN had set up an appointment to talk about it and I think because she was worried about my emotional health. At that appointment she told me to get back to the RE's office, that at least then I would be trying and have a chance. And at that appointment she found my breast lump. I remember sitting in my car in the parking lot, holding my order for the mammogram and wondering what would happen to Janie if I died. When I drive in the parking lot, I see the space I sat in that day. As I walk past, it's like walking past a ghost and I step quicker. She's still there, stunned into silence. Soon she will have her first mammo, and soon after surgery. She doesn't know that it will be okay. She is still sitting in her car, unable to drive home and with no one to call to pick her up.

I've held the surgeon's order for a repeat mammo since early August without calling to schedule it. I could say I'm a procrastinator but there's much more to it. It's not the pain of the mammo, because through infertility I've been through much worse. Squishing my breasts is better than poking something past my cervix. For one, I'm concerned about doing a mammo while pregnant. Sure they'll shield me, but what if it's not enough? What if I put this much wanted baby into unnecessary risk? Mainly, I'm worried about a bad result. What happens if they didn't get it all from the left during surgery? What about the right one which was uncertain and left to be reviewed in 6 months (now 3 months overdue)? I know the odds are greatly in my favor, but a bad result would be a very bad result. It's enough to make me put it off another day...and another day...

I don't want to go back to that mess again. I remember laying on the bed and finding that lump time and time again. I hadn't found it in my shower self-exams before the appointment. Now, I would lay and find it like I was studying it. I wanted to learn what it felt like so I could find the next one. How long had it been there and I didn't know? Like Glenda the Good Witch asks Dorothy in Wizard of Oz, "Are you a good lump or a baaad lump?" It was small and very hard like a piece of gravel. Other good lumps were soft and moved around but this one didn't. It was different. It was foreign and it didn't belong.

Unfortunately I couldn't have an FNA, fine needle aspiration where they poke a needle in to see what's inside. It had to be surgically removed. Now I've got a scar on Lefty Lucy, one seen only by me, my husband, my surgeon, my OB/GYN, and my daughter. It's almost 2 inches long. I don't mind the scar. I wasn't planning on being a topless dancer or centerfold anyway. It did make my left breast a little more perkier than my right. I make a slight adjustment in my bra so that if it gets cold I'm not pointed in different directions.

I guess that's too much information, but considering I've posted on when CD 1 was, it's all open for discussion now. What's a little nipple among friends?

If I'm out for a few days, it's only because I'm sick and in bed. Nothing exciting, not even with my hubby coming home. Did I tell you it's tonight? I'm so excited. I'd better get the house cleaned up while I still can.

Wednesday, October 06, 2004

One Flu Over The Cuckoo's Nest

I woke to the sound no mother likes to hear. The sound of her child throwing up in her bed. I won't go into detail, but it was a long night. Today she's still sick, laying on the couch and watching videos. She's drinking but not eating and sick again minutes ago. I've been reassuring her, bringing her 7-up, and washing all the laundry from last night. Damn whomever sent their child to school sick so they could work and therefore infected probably her whole class. How hard is it to take a day off for your sick baby?

I know I'm going to get sick too, it's just a matter of when. Did you know that pregnant women have a 9 times higher rate of death from flu? Of course the rate of death is so small, it's still no worry. What does concern me is the slightly higher rate of miscarriage, and that the flu lasts longer and is harder to get over when you're pregnant. Actually, no, my number one concern is who will take care of Janie when I'm sick. Anyone I call will mean exposing them to this virus and I don't wish that on anyone. I can't wait for Matt to get back from Florida.

Speaking of which, they've finished their work and will be coming back tomorrow night. Two weeks early! All I have to do is hold out falling sick until then. Please let it be a long incubation period. So much for a homecoming filled with great sex and good food. Sorry sweetie.


Tuesday, October 05, 2004

Some Things Never Change

There's nothing like years of infertility to change a person. I suppose my infertility is different because we have eventually achieved success. I can't imagine what it would be like otherwise, and to assume would be insulting to those who are at that point. Instead all that I know is from my own experience so I'll speak from there.

We started trying to have a child in 1998. For our anniversary, we both exchanged cards that said we'd like to have a baby. I had escaped from Arthur Andersen and the 70 hour weeks. Matt was only a year away from graduating college. We had bought our first house, had a good dog, and my sister had moved back to my mother's. I had also stopped taking the pill a few months earlier. That Halloween we went out with our friends (who now have 2 kids) and I was joking how without the pill it was like skeet shooting, "Release the Egg" and then the rifle shot. It was fun. I bought What to Expect and Girlfriend's Guide and read the first several chapters of both. I joined an online bulletin board and gained some new cycle buddies. Our cycle group had some goofy name like Summer Sweetpeas. My mother had 6 kids and my father had 9, so how could I not be super fertile. And Matt, well check him out, he's all man, super masculine, very strong, fantastic in bed, has to be super fertile as well. This won't take long at all.

Not long after starting the ttc (trying to conceive) bulletin board, I learned about charting. I bought the book Taking Charge of Your Fertility and started taking my temperature everyday. We timed our sex and I put pillows under my hips. It was all so cute and still very hopeful. I'm the perfect student. I followed everything I was supposed to do and knew it would soon lead to success. By following these tips I felt I was going to get us there sooner rather than later, and all under our control.

But it didn't work. Cycle buddies graduated month after month and I was still there. I studied my charts and changed our sex to every other day and started on the Robitussin. There's nothing I can't accomplish as long as I just try harder.

Eventually I lost some of that innocense as we started doing tests and it was quickly determined that I have PCOS and Matt's male factor was such that we were told to go directly to IVF. How do you switch gears that fast from trying at home to IVF? I could tell you that I was really depressed, but I was really in complete denial. I still believed that we could do this without all that. Besides, we didn't have the money for IVF anyway. I shoved the thought away and refused to acknowledge it.

After that comes the months of testing, some physically painful like the HSG and some just things that you have to do. A little clomid renewed my optimism, but a few months of negative HPT's shot it back down. I got tired of reading about the successes of the other women online. There were those that got pregnant right after joining the group. There were also those who gave all credit to praying, being positive, or one well timed night of passion. They weren't trying nearly as hard as I was. They didn't know about reproduction nearly as much as I did. I was a good student. I did everything I was supposed to and more, yet it wasn't working.

Eventually we went on to IUI's. Hope resurfaced. Surely our time was here. The first IUI, Negative. The second IUI, Cancelled. The new second IUI, Negative. We took a month off. I was losing hope. If it didn't work with 6 eggs, how could it ever work? My mind calculated the new possibility of failure and it was very high. Yet, what were my options? We couldn't afford IVF and we knew natural cycles or those with drugs alone didn't work. We did a third IUI, and the doctor told us that there was no chance it would work because of the male factor and that we needed to go straight to IVF. His exact words were "wasting our time." Minutes later the IUI was performed and I had 20 minutes to lay on that table and think about it. Under that exam table was a big black sea, with wave after cold wave crashing over me. I couldn't shiver and couldn't leave. Although there was no hope, I was the good student. I did everything right. I would lay there my 20 minutes so I could go home to cry on my couch.

I don't remember much about the next two weeks. I don't know how I got through work. I don't know what else I did besides cry. I remember laying on my best friend's couch watching the Super Bowl trying to just be normal. Her stupid friend Keller found out we were having trouble and told me to use a turkey baster. Normally such comments are so easily ignored. I smile at their blissful ignorance and think how wonderful it must be to go through life never having a clue. But when you're sitting in the pit of despair, such a comment can hit right on target. My shield wasn't up, it was forgotten in some corner. I was an easy mark.

Two days after releasing my rage on our RE, I got a positive pregnancy test. The first one in my life. I could say that I broke down crying, but I didn't. Actually, I stopped crying. I didn't believe it. Obviously the test was broken. I finished packing for our Valentine's weekend and soon we were in our friend's car on the way to an inn. I spent the next few hours quietly thinking about it. How could it be? Was it really there? It was really faint.

At the inn, when we were supposed to be dressing for dinner, I took another test. Secretively. In case it didn't work. Besides, who was I to have hope when I knew there wasn't any? It was positive. I left it on the sink and left the bathroom to see my lover sitting on the bed. He asked what I was smiling about as I straddled him. "I think I might be pregnant." He stopped smiling. "I took at test, and there's a faint line." He still looked at me seriously like I was about to hurt him. I got up and retrieved the test from the bathroom and showed it to him. "Look." I smiled. He looked. He looked at me. Then he smiled and we laughed and laughed until tears came down our faces.

I call it success except it's not the right term. It doesn't really feel like our victory. We didn't conquer infertility. It didn't come from anything that we had done because we did everything the same as before when it had failed. It was just luck. Just a mystery. Something that happened and may never happen again sort of thing. Still out of our control and no advice for next time around. Still very infertile.

This time, I don't believe that a positive test means baby. I held my best friend's stillborn daughter in my arms only 3 years ago. She was perfect except that she was dead. The same friend is now getting her 5 month old daughter with Down's ready for open heart surgery. I've had friends with miscarriages without any explanation. I don't believe in fairy tales. I have a hard time with happy endings. Maybe Cinderella married the prince after just one date to escape her horrible home life. Maybe the prince has a foot fetish in that he wanted to marry only the girl who fit into that shoe. What's wrong with us big footed gals? What's wrong with dating for a few years or even living together first? Did Cinderella and the prince ever have kids? You never hear about them. Maybe happily ever after is a lie. A way to end the story and get us to sleep before the rest of the real story gives us nightmares.

Being a pregnant infertile is better than the alternative, a not pregnant infertile. Yet, for me, this time it doesn't bring on with it the showers of happiness. Sure, I have happy times, lots of them. But I haven't bought anything for this baby. I haven't started cleaning out my office for the nursery. I only bought maternity clothes because I absolutely had to. I'm still scared that I'll have to go back to all those I told I was pregnant to and say that I'm not pregnant anymore. I'm keeping a mental list. The thought of telling my boss that I need maternity leave seems impossible.

I don't need anyone to feel sorry for me because I know things could be much much worse. I don't write out my heart for pity nor even understanding. It's more of a chronicle of my truths. The ultimate truth I've learned is that a pregnant infertile is still infertile. My heart is scarred and my journey has changed me. I can't take anything for granted and guard my hope in self preservation. Even now.

Still.

Monday, October 04, 2004

Dear Friend

My mother is still visiting so this has to be quick.

Yesterday we went shopping and I bought a bunch of maternity clothes. I have been rotating my last few remaining clothes that fit and it was getting ridiculous. The sales woman told me that all sales items sold are final, and I immediately thought that if something happens I will give them to my sister-in-law. Bringing home such a huge pile of maternity clothes felt like I was jinxing it rather than a victory. I had to listen to the baby's heartbeat last night because I felt for sure that buying that much would surely stop its heart.

Matt has been calling me every night from Florida. Last night was his second night in Orlando. They had left Fort Lauderdale after they finished their project down there. They're actually working about 90 minutes outside Orlando. He complains that they aren't being given enough work to do that they spend too much time waiting. Yesterday, the managers (who do not actually do any field work, have never dealt with a work force this large, and aren't good at estimating times) again assigned them too little work. They were specifically told not to go out on their own. Rather than sitting around waiting for bus back to the hotel, they took off in their truck in search of work. They came upon 6 houses without power and fixed it. Some people came out to thank them and they asked for where another neighborhood would be without power. They then drove there and restored their power. Then did it for another neighborhood, and another.

He said that it felt great to finally feel like they did all that they could do in a day, and the people were so nice and grateful that it made it even more worthwhile. I have a feeling that as long as the managers continue to assign them too little work, they will continue going out on their own and hooking up the little guys. Who knows when these people were finally going to get their power on.

I understand having priorities as to getting the power turned on, and have made my guess as to how they probably are listed. First would be hospitals and other life saving entities. Second maybe government (although should be last), schools and businesses. Third would be residents who are well connected, know the right people, live in an exclusive zip code. Fourth would be the rest of us. Ideally, the managers should be assigning them more work than they can do in a day. These guys are happy to work, wanting to get as much done everyday so that they can get back to their families sooner. They are used to long hours and hustling the whole time. They don't do well standing around. So they're skipping ahead to the small neighborhoods in their spare time. And they love it.

Of course he misses home and I miss him. Hopefully by the time he gets back I will have a more substantial tummy, not one that just looks chubby. I have this feeling like people at school are wondering if I've let myself go. Yep, but hopefully I've got a pregnancy to blame it on.

My doctor's visit went great. Nothing was said about my weight. My OB said congratulations and gave me a big hug because she has known all these years we've been trying and all we did to get here. She made me cry that she cared. I love her and can't think of a better doctor for this pregnancy. She signed my note to get me out of the TB test at work, which isn't bad for a pregnancy but I don't want to do it. Besides, I'm only at the hospital a few days a month and that's in the finance and administrative offices. She also said that I should stop flying at 24 weeks. That's only 10 weeks from now! My last trip could be in December, then not again until... June? Next time I go to Phoenix I'm going to have to talk to my boss about that, maternity leave, and my desire to work part time after the baby is born. It's either part time or not at all. With school and another child, I don't think I could manage working full time from home with a baby again. I'm not looking forward to this conversation as I love my boss and she's been especially generous and understanding with me.

This feels more like a letter to a friend than a deep introspection of the soul. It's all I can manage with my mother in the other room. I'd better get back to work before she steps in here and sees that I've got a blog. Scary!

Friday, October 01, 2004

Grandma's Coming

Matt called last night and said that although they're staying in Fort Lauderdale, they're working about an hour and a half south of there. Their trucks still haven't gotten there yet so they're using borrowed trucks. Yesterday they got power turned on for a bunch of people. I'm hoping Dee was included, otherwise he didn't get my message.

My mother is coming tonight or today, I'm not sure when. Janie is so excited she can barely contain herself. My mother was not a great mother, but she's the most fantastic grandmother. It's all the day-to-day stuff she couldn't handle. As a grandmother, she can play for a few hours or days and then go back home. I'm providing the meals, rules, safety and security so all she has to do is be fun, which she is. My daughter cries when she leaves because she's so much fun. Unfortunately she wasn't like that when I was a kid. There's no time for one-on-one when she's wrapped up in men, and 6 children meant no time for singular play time.

I have class all day tomorrow, so I feel like my work week is being extended. This will be my last Saturday class for the semester. I hate Saturday classes. Saturday is for catching up on housework and playing and errands and fun.

Sorry such a quick update. Work is a bear and I've got to get some housework done before she shows up. Also, I have my second OB appointment today. It should be pretty boring since there will be no ultrasound, but it's good to be at this point anyway. I hope I don't get in trouble for my weight. (eek!)